Background: Community-based medical education (CBME) is an essential component of medical education, where primary healthcare physicians (PHPs) play a crucial role. This study explores PHPs' awareness and engagement in CBME and investigates the factors influencing their participation. Methods: This mixed study was conducted in two phases. In the first phase, a qual-itative study was conducted using semi-structured interviews with PHPs, and thematic analysis related to their awareness and engagement in CBME. In the second phase, a quantitative survey was conducted among 72 PHPs pre- and post-training programs. Results: Primary healthcare physicians had a positive attitude toward community-based medical education. The participants have an acceptable level of awareness and engagement, which increased substantially (p-value = 0.03) and (p-value = 0.003), respectively. Logistic analysis indicated that non-Saudi physicians were likelier to participate in the CBME (p-value=0.001). Professions and academic experiences influence their willingness and engagement to participate in CBME (OR= 7.5, p-value=0.001) and (OR=0.21, p-value=0.001), respectively. Conclusion: The study findings highlighted the importance of increased awareness and the factors that enhance PHPs' engagement in CBME. This positive perspective of the PHPs helps build effective partnerships and facilitates the extension of the curriculum to apply CBME.

In this paper, carbon nanotubes modified screen-printed electrode (CNTs/SPE) was prepared and the CNTs/SPE was employed for the electrochemical determination of antioxidant substance Chlorogenic acids (CGAs). A pair of well-defined redox peak of CGA was observed at the CNTs/SPE in 0.10 mol∙L^-1 acetic acid-sodium acetate buffer (pH 6.2) and electrode process is adsorption-controlled. Cyclic voltammetry (CV) and differential pulse voltammetry (DPV) method for the determination of CGA were proposed based on the CNTs/SPE. Under the optimal conditions, the proposed method exhibited linear ranges from 4.73×10^-7 to 4.45×10^-5 mol∙L^-1, the linear regression equation was Ipa(µA) = 4.1993 C (mol∙L^-1)+1.1039 (r = 0.9976) and the detection limit for CGA could reach 3.25×10^-6 mol∙L^-1. The recovery of matrine was 94.74~106.65% (RSD = 2.92%) in coffe beans. The proposed method is quick, sensitive, reliable, and can be used for the determination of CGA.

Background and Objectives: Cancer as the second leading cause of death in the United States poses a huge healthcare burden. Barriers to access to advanced therapies influence the outcome of cancer treatment. In this study, we examined whether insurance types affect the quality of cancer clinical care regarding access to an important monoclonal antibody, ramucirumab. Materials and Methods: Data for 13,340 cancer patients with Purchased or Medicaid insurance from the All of Us Database were collected for this study. The Chi-square test of proportions was employed to determine the significance of patient cohort characteristics and ramucirumab usage between Purchased and Medicaid insurance groups. The independent t-test was utilized to assess the influences of other determinants on insurance types. Results: Cancer patients who are African American, with lower socioeconomic status, or with lower educational attainment are more likely to be insured by Medicaid. Analysis of survey questions demonstrated the relationship between income and education level with insurance type as Medicaid cancer patients were less likely to receive primary care and specialist physician access and more likely to request lower cost medications. In addition, those with Medicaid insurance were identified to have poorer access to expensive therapeutics like ramucirumab compared to those with Purchased insurance.  Conclusions: The inequities of the US healthcare system are observed for cancer patient care; access to physicians and therapeutics are highly varied and dependent on insurance types. Socioeconomic status determines insurance type, which unfortunately generates a significant impact on cancer treatment and disease outcome.

3D-printed models with high anatomic fidelity are an increasingly viable tool in simulation-based medical education. One advantage of 3D models is they provide enhanced tactile and spatial understanding of complex anatomy to develop technical skills used in minimally invasive procedures. We propose that 3D anatomical models can improve the development of Interventional Radiology vascular access skills – first described in the 1950s as the Seldinger Technique – for pre-clerkship medical students. Early adoption of 3D-printed technology in pre-clinical medical education can lead to improved student engagement and satisfaction when learning procedural techniques. This study involved creating a 3D model of the upper extremity vasculature from an anonymized CT angiogram, using it as a medical education tool for 31 pre-clinical medical students practicing the Seldinger Technique on a prefabricated venipuncture arm, and assessing student satisfaction with this form of learning. Overall, attendees responded positively to the incorporation of the 3D model in medical education to improve their anatomic understanding and application to the Seldinger Technique. These results indicate that the use of 3D models in simulation-based medical education can provide benefits to acquiring technical skills and the potential to decrease training costs without harming a patient.

Introduction: Left ventricular dysfunction in an independent predictor of mortality in Chagas disease. Global longitudinal strain (GLS) is an emerging echocardiographic modality with possible incremental value in early detection of cardiac involvement. Objective: Compare left ventricular function with multiple echocardiographic parameters between patients with the indeterminate and chronic forms of Chagas and perform a literature review. Methods: In this observational study, 11 patients with a confirmed diagnosis of Chagas disease were evaluated. Individuals were distributed as follows: 5 with the indeterminate and 6 with the chronic forms. Conventional echocardiographic evaluation was followed by GLS measurement. Results: The mean left ventricle ejection fraction LVEF was 33 ± 2.88 and the mean GLS of the left ventricle was - 10.76 ± 2.20 in the chronic form as compared to 57.80 ± 6.49 and - 17.34 ± 3.82, respectively in the indeterminate group. Contractility was reduced in segments of the inferior, inferoseptal and anteroseptal walls in both groups. Conclusion: Analysis of longitudinal strain in the indeterminate form has potential incremental value to the conventional analysis of ejection fraction when compared to patients with chronic Chagas cardiomyopathy, especially with individual segmental analysis but the impact and clinical significance of these techniques is still unknown.

Introduction: The disease caused by Coronavirus-2019 (COVID-19) was initially described in December 2019. Severe acute respiratory syndrome type 2 (Sars-Cov-2) is responsible for an important multisystem inflammatory spectrum. Cardiovascular conditions have been reported with an estimated frequency of 8-28%. In this context, transthoracic echocardiography associated with the analysis of the two-dimensional Global Longitudinal Strain (GLS) of the left ventricle derived from Speckle Tracking emerges as a promising modality. Objective: This study aims to evaluate the applicability of GLS and segmental deformity assessment in detecting subclinical myocardial dysfunction in patients that recovered from COVID-19 infection. Methods: The observational study involved 18 patients (mean age 52 years) with recent evidence of COVID-19 infection that underwent detailed echocardiographic evaluation with GLS, and cardiac magnetic resonance (CMR) according to segmental assessment results. The degree of correlation between the methods was analyzed and a systematic literature review was also conducted. Results: The mean left ventricular ejection fraction (LVEF) was 57.50 ± 9.98%. Only 16.6% of patients had reduced LVEF. The average GLS was – 18.70 ± 3.54% and in 44% of cases only one myocardial segment was affected, particularly the inferolateral basal. CMR revealed inflammatory cardiomyopathy. Discussion: Subclinical myocardial involvement is associated with major adverse cardiac events. Literature review supports the use of GLS for detecting early cardiac involvement. Conclusion: Speckle-tracking echocardiography has been shown to have clinical utility in a variety of settings and to offer superior prognostic value with a potential to enhance subclinical detection of myocardial changes in patients after COVID-19 infection.

Poverty has long been associated intricately with neurological disorders. Majority of the previous studies designed to describe the effects of poverty on neurological ailments have mostly linked the association of hypoxic ischemic encephalopathy and nutritional deficiency disorders with poverty. Authors herein try to delve deeper into this issue. The association of begging with neuropsychiatric disorders is robust. The burden of probable autosomal dominant neurological ailments is very common among beggars; followed by neurological disorders with social stigma like abnormal movements, facial dysmorphism and gait unsteadiness. Dearth of support from family members in autosomal dominant neurological disorders (as family members are likely to be suffering from similar neurodegenerative disorder ) and poor perception about neurological diseases, misconceptions, myths and low educational attainment at large in the society can be implicated as the often overlooked but important factors underneath this association of begging and neurological disorders.

Improving the capabilities of faculty members, including competencies of emotional intelligence in professors, can play a major role in various education levels of success and achievement, adjustment, and mental health in students, and is a fundamental solution to the promotion of higher education quality. For accurate examination of the issue, the present study aimed to determine the association between basic science professors' emotional intelligence and the ability to teach at the School of Medicine of Iran University of Medical Sciences. The present descriptive-analytical study was conducted at the School of Medicine of Iran University of Medical Sciences by census sampling of faculty members of the basic sciences. We included 98 faculty members in the study. The research tools included Dr. Haghani's "Emotional Intelligence in Teaching" questionnaire and Dr. Akbari's "Teaching Ability" questionnaire. We analyzed data through descriptive statistics and analytical tests, including Spearman's correlation test, Pearson test, t-test, and two-way analysis of variance. The mean score of faculty members' emotional intelligence was 111.51±9.3 equal to 89.93±7.5 percent, and the median score of total teaching ability of the questionnaire was 101.89±8.59 equal to 87.84±7.4 percent. There was a positive correlation between faculty members' emotional intelligence and teaching ability. (p= 0.0001, r= 0.71). The faculty members' emotional intelligence can be a determinant in their teaching ability. Their emotional intelligence was evaluated as good and there was a positive relationship between emotional intelligence and teaching ability.

This study delves into the dynamic field of medical education research, emphasizing the integration of research training within medical curricula. It seeks to understand the impact of such integration on the competencies of future medical professionals. The primary aim is to systematically categorize and analyze the current trends and future directions in medical education research. This involves assessing the influence of research training on medical students' skills and the methodologies used in such research. Methods: The research employs an extensive bibliographic literature review across multiple databases. It classifies studies into categories like experiential or case studies, editorials, and original research articles. This classification is based on criteria such as geographical location, research objectives, theoretical frameworks, and methodologies. Results: Findings reveal a diverse landscape in medical education research, with a significant emphasis on research training. The research showcases varying methodologies and approaches used globally, highlighting the thematic focus and geographical distribution of these studies. Conclusion: Medical education research is a globally expansive and evolving field. It underscores the importance of continuous investigation, particularly focusing on integrating research elements at curricular levels and exploring innovative educational strategies. The study also points out potential gaps in research, especially in underrepresented regions, indicating directions for future research efforts.

Depression is the commonest mental disorder worldwide. Both antidepressants and psychotherapy are effective in treating depression, but response to these treatments is often incomplete. Yoga-based interventions (YBIs) have emerged as a promising adjunctive treatment for depression. Recent research has attempted to identify the biological mechanisms associated with the antidepressant actions of YBIs. In this scoping review, conducted according to the PRISMA-ScR guidelines, the PubMed and Scopus databases were searched to retrieve research on biomarkers of response to YBIs in patients with depression. Eleven studies were included in the review. Based on these studies, YBIs may improve depression through beneficial effects on systemic inflammation, stress axis regulation, cardiac autonomic functioning, and possibly reductions in oxidative stress-related cellular damage. Increases in brain-derived neurotrophic factor (BDNF) may represent a final common pathway upon which these processes converge. Though these results are theoretically plausible, they should be interpreted with caution due to certain methodological limitations in the existing research. Replication of these results and improvements in study methodology, and the evaluation of other biomarkers relevant to the pathophysiology of depression, could further elucidate the mechanism of action of YBIs in this disorder, and identify which patients would benefit most from this treatment approach.

Artificial intelligence-powered generative language models (GLMs), such as ChatGPT and Google Bard, have the potential to provide personalized learning, unlimited practice opportunities, and interactive engagement 24/7, with immediate feedback. However, to fully utilize GLMs, properly formulated instructions are essential. Prompt engineering is a systematic approach to effectively communicating with GLMs to achieve the desired results. Well-crafted prompts yield good responses from the GLM, while poorly constructed prompts will lead to unsatisfactory responses. Besides the challenges of prompt engineering, significant concerns are associated with using GLMs in medical education, including ensuring accuracy, mitigating bias, maintaining privacy, and avoiding excessive reliance on technology. Future directions involve developing more sophisticated prompt engineering techniques, integrating GLMs with other technologies, creating personalized learning pathways, and researching the effectiveness of GLMs in medical education.

As a member of smart materials, electrorheological elastomers (EREs) formed by pre-treating active electrorheological particles are attracting more and more attention. In this work, four Mg-doped strontium titanate particles with spherical, dendritic, flake-like and pinecone-like morphorlogies were obtained by hydrothermal and low-temperature co-precipitation. XRD, SEM, Raman and FT-IR were used to characterize the obtained products. The results showed that the sizes of Mg-doped strontium titanates are about 1.5‒2.0 μm, and the phase structure are dominated by cubic crystal. These Mg-doped strontium titanates were dispersed in a hydrogel composite elastic medium. Then, Mg-doped strontium titanate/glycerol/gelatin electrorheological composite hydrophilic elastomers were obtained with or without electric field. The electric field response properties of Mg-doped strontium titanate composite elastomers were investigated. It concluded that dendritic Mg-doped strontium titanate composite elastomers is high-performance EREs. And the maximum value of energy storage modulus of Mg-doped strontium titanate composite elastomers has achieved 8.70 MPa. This high electrorheological performance of the products is helpful for their applications in vibration control, force transducers, smart structures, dampers, and other fields.

Gestational trophoblastic diseases (GTDs) encompass a spectrum of conditions characterized by abnormal trophoblastic cell growth, ranging from benign molar pregnancies to malignant trophoblastic neoplasms. This systematic review explores the molecular underpinnings of GTDs, focusing on genetic and epigenetic factors that influence disease progression and clinical outcomes. Based on 65 studies identified through systematic search and selection criteria, key findings include dysregulations in tumor suppressor genes such as p53, aberrant apoptotic pathways involving BCL-2, and altered expression of growth factor receptors and microRNAs. These molecular alterations not only differentiate molar pregnancies from normal placental development but also contribute to their clinical behavior, from benign moles to potentially malignant forms. The review synthesizes insights from immunohistochemical studies and molecular analyses to provide a comprehensive understanding of GTD pathogenesis and implications for personalized care strategies.

The United States is plagued with the highest rates of preventable metabolic diseases it has ever seen, and while poor nutrition is increasingly recognized as a critical contributing factor, good nutrition has been shown to be a potent factor in prevention and management of these illnesses. Notably, nutrition is inextricably intertwined with farming practices and the stewardship of our environment – particularly its soil. In this proposal, we propose a method to expose medical students to basic agricultural and environmental knowledge regarding the production of food, as well as educate them in practical nutrition education within the interactive, case-based, and longitudinal preclinical curriculum at Case Western Reserve University School of Medicine (CWRU SOM). We propose a two-part approach; first: integrating relevant topics in nutrition, culinary medicine, and farming practices into the preclinical blocks through Official Learning Objectives, and second: an optional 8-week, zero credit elective for students interested in pursuing a deeper understanding of these topics. Through these interventions, we believe courses like this will support a generation of physicians able to understand health from soil to plate with a consideration for the environment in addition to exemplifying healthful lifestyles themselves. We believe these kinds of future physicians will be the most effective in treating (and ideally reversing) the chronic disease epidemic.

Asymmetric lithium salts, such as Lithium (difluoromethanesulfonyl)(trifluoromethanesulfonyl)imide (LiDFTFSI), have been demonstrated to surpass traditional symmetric lithium salts with improved Li+ conductivity and the capacity to generate stable solid electrolyte interphase (SEI) while maintaining compatibility with aluminum (Al0) current collector. However, the intrinsic reductive mechanism through which LiDFTFSI influences battery performance remains unclear and under debate. Herein, the detailed SEI reactions of LiDFTFSI-based electrolytes were investigated by combining density functional theory and molecular dynamics, aiming to clarify the formation process and atomic structure of SEI. Our results show that asymmetric DFTFSI– weakens the interaction between carbonate solvents and Li+, and substantially alter the solvation structure, exhibiting a well-balanced coordination capacity to bis(trifluoromethanesulfonyl)imide (TFSI–). Nanoseconds hybrid molecular dynamics simulation further reveals that the preferential decomposition of LiDFTFSI produces sufficient LiF and Li2O to facilitate a robust SEI. Moreover, the abundant F– generated from LiDFTFSI decomposition accumulates on the Al surface and subsequently combines with Al3+ from the current collector to form AlF3, potentially inhibiting corrosion of the current collector. Overall, these findings elucidate how LiDFTFSI regulates the solvation sheath and SEI structure, advancing the development of high-performance electrolytes compatible with current collector.

This investigation explores the potential of enhancing aqueous zinc-ion batteries (AZIBs) through the introduction of a novel cathode material, NH4V4O10 (NVO), combined with reduced graphene oxide (rGO). Utilizing Density Functional Theory (DFT), it was hypothesized that the incorpora-tion of rGO would increase the interlayer spacing of NVO and diminish the charge transfer in-teractions, thus promoting enhanced diffusion of Zn2+ ions. These theoretical predictions were substantiated by experimental data acquired from hydrothermal synthesis, which indicated a marked increase in interlayer spacing. Significantly, the NVO-rGO composite exhibits remarkable cyclic durability, maintaining 95% of its initial specific capacity of 507 mAh g−1 after 600 cycles at a current density of 5 A g−1. The electrochemical performance of NVO-rGO not only surpasses that of pristine NVO but also outperforms the majority of existing vanadium oxide cathode materials reported in the literature. This study underscores the effective integration of theoretical insights and experimental validation, contributing to the advancement of high-performance energy storage technologies.

This study explores the enhancement of aqueous zinc-ion batteries (AZIBs) using ammonium-enhanced vanadium oxide cathodes. Density Functional Theory (DFT) calculations reveal that NH₄⁺ incorporation into V₆O₁₆ lattices significantly facilitates Zn²⁺ ion diffusion by reducing electrostatic interactions, acting as a structural lubricant. Subsequent experimental validation using (NH₄)₂V₆O₁₆ cathodes synthesized via a hydrothermal method corroborates the DFT findings, demonstrating remarkable electrochemical stability with a capacity retention of 90% after 2000 cycles at 5 A g⁻¹. These results underscore the potential of NH₄⁺ in improving the performance and longevity of AZIBs, providing a pathway for sustainable energy storage solutions.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

Off-grid electrification planning increasingly recognizes the importance of productive use of electricity (PUE) to promote community value creation and (financial) project sustainability. To ensure a sustainable and efficient integration in the community and energy system, PUE assets must carefully be evaluated to match both the community needs and the residential electricity demand patterns. We propose a novel methodology interlinking qualitative interviews, statistical analysis, and energy system modelling to optimize decision-making for PUE integration in off-grid energy systems in rural Madagascar by aligning relevant PUE effectively with anticipated residential electricity demand patterns based on socio-economic determinants of the community. We find that a possible contribution of the PUE to reducing the electricity costs depends signifi-cantly on three factors: 1. the residential electricity consumption patterns that are influenced by the socio-economic composition of the community, 2. the degree of flexibility of i) PUE assets and ii) operational preferences of the PUE user, and 3. the capacity of community members to finance and operate PUE assets. Our study demonstrates that significant cost reductions for PUE-integrated off-grid energy systems can be achieved by applying our proposed methodology. When matching PUE and residential consumption patterns, the integration of PUE assets in residential community energy system can reduce the financial risk of operators, provided the PUE enterprise operates reliably and sustainably. We highlight that the consideration of local value chains and co-creation approaches are essential to ensure the energy system is addressing the community’s needs, creates value for the community, enhances the project´s financial sustainability, and is achieving the overall objectives of decentralized energy system planning.

Background and objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome ME/CFS is a common complex multi-system disease with a significant impact on the quality of life of patients and their families, yet the majority of ME/CFS patients go unrecognised or undiagnosed. For two decades the medical education establishment in the UK has been challenged to remedy these failings, but little has changed. This study was designed to ascertain the current UK medical school education on ME/CFS and to identify challenges and opportunities to inform the future of medical education. Materials and methods: A questionnaire, developed under the guidance of the Medical Schools Council, was sent to all 34 UK Medical Schools to collect data for the academic year 2018-2019. Results: Responses were provided by 22 out of a total of 34 medical schools (65%). 59% of respondents taught ME/CFS, led by specialists drawn from 6 medical disciplines. Teaching delivery was usually by lecture; however, discussion case studies and e-learning were used. 7 schools included questions on ME/CFS in their examinations and 3 schools reported likely clinical exposure to ME/CFS patients. 64% of respondents were interested in receiving further teaching aids in ME/CFS. None of the schools shared details of their teaching syllabus so it was not possible to ascertain what students were being taught. Conclusions: UK medical school teaching in ME/CFS is shown to be inadequate. Several medical disciplines, with known differences about the disease, need to set these aside to give greater clarity in teaching undergraduates so they can more easily recognise and diagnose ME/CFS. Improvements are proposed in ME/CFS medical education consistent with the international paradigm shift in biomedical understanding of this disease. Many medical schools (64% of respondents) acknowledge this need by expressing a strong appetite for the development of further teaching aids and materials. The GMC and MSC are called upon to use their considerable influence to bring about the appropriate changes to medical school curricula so future doctors can recognise, diagnose and treat ME/CFS. The GMC should also consider creating a registered speciality encompassing ME/CFS, post viral fatigue and Long Covid.

This study presents the synthesis and electrochemical evaluation of nitrogen-doped vanadium oxide (N-V2O3/C) as a cathode material for aqueous zinc-ion batteries (AZIBs), using a hydrothermal method. Compared to undoped V2O3/C, N-V2O3/C exhibits enhanced electrical conductivity, capacity, and electrochemical kinetics, attributed to the incorporation of pyridinic and pyrrolic nitrogen. Initial charge-discharge cycles indicate phase transitions to amorphous vanadium oxides, enhancing conductivity. N-V2O3/C shows a high specific capacity of 168.4 mAh g−1 at 10 A g−1 and remarkable reversibility, highlighted by the transient existence of intermediate species during cycling. Optimal electrochemical performance is achieved with a vanadium to nitrogen molar ratio of 2:3, indicating the significant impact of nitrogen doping concentration on the material’s efficiency. This work underscores the potential of N-V2O3/C as a superior cathode material for AZIBs.

Using density functional theory (DFT), the density of states of NH4V3O8 (NVO) was analyzed pre and post-oxygen defects (Od) formation. The findings revealed a reduced bandgap in NVO after Od introduction, emphasizing the role of Od in enhancing conductivity of the material, thus improving its electrochemical attributes. Through the water bath method, both NVO and its oxygen-deficient counterpart, (NH4)2V10O25⸱8H2O (NVOd), were synthesized as potential cathode materials for aqueous zinc-ion batteries (AZIBs). Experimental outcomes resonated with DFT predictions, highlighting the beneficial role of oxygen defects in boosting electrical conductivity. Notably, the refined material displayed a remarkable capacity of 479.3 mAh g-1 at 0.1 A g-1, underscoring its promise for advanced energy storage solutions.

Carotid atherosclerotic lesions are a major cause of cerebrovascular disease (CVD). Identification and quantification of carotid plaques are important for categorizing the vulnerability of plaques for rupture and assessing the impact of treatments. The irregularity of plaque surface is associated with previous plaque rupture and plays an important role in the risk of stroke. Thus, the aim of this study is to develop and validate novel vulnerability biomarkers from three-dimensional ultrasound (3DUS) images by analyzing the surface morphological characterization of carotid plaque using fractal geometry features. 3D box-counting and 3D blanket are the two types of 3D fractal dimension that were employed to describe the smoothness of plaques. This fractal dimension analysis tool was used to evaluate the effect of atorvastatin using 3DUS carotid images, which were acquired from 6 patients treated with atorvastatin with 80 mg daily and 5 patients with placebo. The Student's T Test results showed that those two fractal features were effective for detecting the statin-related changes in carotid atherosclerosis with p<0.0068 and p<0.015 respectively, suggesting that 3D fractal dimension measurements can be used effectively to analyze the surface characteristics of carotid plaques, especially for evaluating the impact of the treatment.

M-polynomial of different molecular structures helps to calculate many topological indices. A topological index of graph G is a numerical parameter related to G which characterizes its molecular topology and is usually graph invariant. In the field of quantitative structure-activity (QSAR) quantitative structure-activity structure-property (QSPR) research, theoretical properties of the chemical compounds and their molecular topological indices such as the Zagreb indices, Randic index, Symmetric division index, Harmonic index, Inverse sum index, Augmented Zagreb index, multiple Zagreb indices etc. are correlated. In this report, we compute closed forms of M-polynomial, first Zagreb polynomial and second Zagreb polynomial of Octagonal network. From the M-polynomial we recover some degree-based topological indices for Octagonal network. Moreover, we give a graphical representation of our results.

Recent discovery of triangular boron Nanotubes makes it a competitor of carbon in many respects. Closed forms of M-polynomial of nanotubes produce closed forms of many degree-based topological indices which are numerical parameters of the structure and, in combination, determine properties of the concerned nanotubes. In this report, we give M-polynomials of triangular boron nanotubes and recover many important topological degree-based indices of these nanotubes. We also plot surfaces associated to these nanotubes.

The aim of this review was to summarize the available literature regarding resident and medical student education utilizing the spaced repetition program Anki. This review enables current residents and medical students to recognize and utilize evidence-proven study techniques to increase learning efficacy. A systemic review of papers across all medical journals available on Pubmed was conducted to identify studies published without time constraints. The search was for (Anki) and (spaced repetition residency). Available outcome data was collected and discussed independently for students and residents. Many studies showed a statistically significant increase in exam performance associated with Anki use and high levels of satisfaction among residents and medical students. Further research is warranted to provide high-quality evidence of Anki’s applications and there is a need for exploration in additional residency specialties. Anki use has steadily increased with both medical students and residents. The application demonstrated consistent improvement on exam-based performance and was regarded highly by users. As burnout and time constrictions threaten educational workflow, Anki may serve as a powerful tool to improve the quality of learning. Further data needs to be collected and analyzed in specialties where Anki use may already exist.

Background: Although National Licensing Examinations (NLEs) may be a costly process, they can predict better performance for many following years. The current licensing requirements will not entail and new requirements will be requested. Therefore, this study suggests a framework for the development of the Medical Licensing Exam by exploring the opinions of Egyptian medical practitioners and educators regarding the exam format and criteria. Objective and methods: to describe the needed steps to develop the EMLE through a two-phase exploratory mixed-method study that had been conducted among the Egyptian medical sectors: medical practitioners and educators. Results: There were 50 clinical and academic educators shared in the online discussion about EMLE development. Then, a survey was carried out on 266 participants with various working places in which 198 of the participants were staff in the Higher Education Ministry and 68 physicians in the Ministry of Health. The input from both had contributed to the development of the following framework that is divided into two main sections; the Exam Logistics and the Exam Set up. The exam Logistics included the exam committee, prerequisites for the exam, the admission criteria and fees, and the validity of the license. While the Exam Set up included exam setting, structure, standard-setting, pass marks and reset policy. Conclusion: A Multidisciplinary team resources for the exam setting. Fairness and objectivity were highlighted through several factors; development of the exam blueprint, types of assessment methods, post-exam analysis, and standard-setting. Finally, the reset policy, fees, and validity of the license were recommended with a student-centered perspective that was suggested for the exam committee.

Multiple myeloma (MM) accounts for about 10 to 15% of all diagnosed hematologic malignancies and about 1-2% of all cancer cases. Approximately 80-90% of MM patients develop bone disease and the changes rarely regress. It is only possible to stop or slow their progression. A major role in bone destruction in MM is attributed to the Wnt signaling pathway, and its action can be modified by various types of interventions including training and diet. Therefore, the aim of this project was to evaluate the effects of a Nordic Walking (NW) training cycle and intermittent fasting (IF) on the levels of selected bone turnover markers associated with the Wnt pathway in patients with MM. Results from 35 patients divided into training (NW and IF NW) and non-training (IF and control) groups were included in the analysis. A 6-week training cycle involving 60-minute workouts 3 times a week was conducted. Body mass and composition and the levels of: vitamin D, calcium and phosphorus, beta2-microglobulin and albumin were examined before and after completion of training cycle. Markers of bone turnover were also determined: sclerostin (SOST), Dickkopf-related protein 1 (DKK-1), osteoprotegrin (OPG), osteopontin (OPN) and Tartrate-resistant acid phos-phatase 5b (TRACP 5b). There was no negative effect of IF or combined training and fasting on the nutritional status of the patients (the level of albumines was unchanged). Both training groups showed an increase in serum concentrations of the active metabolite of vitamin D (IF NW and NW: p=0.001 and p=0.022, re-spectively). The change in the concentration of this vitamin negatively correlated with the con-centration of TRACP 5b (r=-0.413, p=0.014). Evaluating the concentrations of markers related to bone turnover, a reduction in the concentrations of SOST (time: p=0.026, time vs. group: p=0.033) and TRACP 5b (time: p

Plant activators have emerged as promising alternatives to conventional pesticides for crop disease manage-ment due to their unique mode of action. By priming the plant's innate immune system, these compounds can induce systemic acquired resistance against a broad spectrum of pathogens without directly inhibiting their proliferation. Key advantages of plant activators include prolonged defense activity, lower effective dosages, and negligible risk of developing pathogen resistance. Among the various defensive pathways tar-geted, the salicylic acid (SA) signaling cascade has been extensively explored, leading to the successful devel-opment of commercial activators like benzothiadiazole for widespread application in crop protection. While the action sites of many SA-targeting activators have been preliminarily mapped to different steps along the pathway, a comprehensive understanding of their precise mechanisms remains elusive. This review provides a historical perspective on plant activator development and outlines diverse screening strategies employed across multiple levels, from whole-plant bioassays to molecular and transgenic approaches. We expound on the intricate components, biological relevance, and regulatory circuits governing the SA pathway, while criti-cally examining the structural features, bioactivities, and proposed modes of action of classical activators such as benzothiadiazole derivatives, salicylic acid analogs, and other small molecules. Insights from field trials as-sessing their practical applicability are also discussed. Furthermore, we highlight the current status, challenges, and future prospects in the realm of SA-targeting activator development globally, with a focus on recent en-deavors in China. Collectively, this comprehensive review aims to synthesize existing knowledge and provide a roadmap for future research toward developing more potent and mechanistically understood plant activa-tors that fortify crop immunity against disease.

Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

While the role of safe riding behavior as a safety contributor for cyclists has been increasingly studied in recent years, there have been few studies analysing cycling behavior in relation to crash-related outcomes in Baltic countries. Indeed, to the best of our knowledge, this is the first time this issue has been addressed in the case of Latvia. Aim: The objective of this study was to assess the relationships among self-repotted cyclists’ behavior, traffic safety literacy, and their cycling crash involvement rates. Method: A total of 299 cyclists aged M=32.8 from across Latvia (42% females) participated in an online survey, which comprised questions regarding respondents’ demographics, frequency of riding, and the number of crashes in the past five years. The Cycling Behavior Questionnaire (CBQ) and the Cyclist Risk Perception and Regulation Scale (RPRS) were applied to assess cyclists' behavior patterns and traffic safety literacy. Results: According to the findings, it can be inferred that cyclists frequently engage in riding errors and traffic violations while cycling. Those who exhibit more antisocial behavior patterns are also more likely to be involved in road crashes. Conversely, cyclists with greater positive behavior rates more often also tend to possess better knowledge of traffic rules and exhibit a heightened risk perception, indicating a greater awareness of road traffic safety. Conclusion: All in sum, this study underscores key age differences, with older individuals significantly less involved in riding crashes, exhibiting fewer driving errors and a higher level of risk perception, which serves as a crucial factor in road safety. At the practical level, these results stress the need to address both traffic safety literacy and protective cycling factors of cyclists, in a manner to improve overall road safety and promote active transport modes in Latvia.

There are complex ethical dilemmas inherent in medicine teaching, particularly in clinical prac-tice involving actual patients. Questions must be raised on fulfilling medical students' training needs while still respecting patients' fundamental rights to autonomy and privacy. We aimed to assess patients' perspectives regarding medical students' involvement in their medical care. An observational, cross-sectional study was developed, and an interview-like questionnaire was ap-plied randomly to patients waiting for a consult/admitted to three distinct departments: General Surgery, Obstetrics/Gynaecology, and Infectious Diseases. Of the 77% interviewed patients who reported previous experiences with medical students, only 59% stated that they were asked for consent for their participation and 28% that students had adequately introduced themselves. Pa-tients from Gynaecology/Obstetrics were the ones who reported lower rates of these practices and were also the ones who were most bothered by students' presence, stating that they would refuse students' participation in the future. Male patients received more explanations than female pa-tients regarding the same matters. 35% of patients stated they would feel more comfortable without the medical students' presence. The study shows a need to pay closer attention to ful-filling patients' fundamental rights.

Understanding vaccine hesitancy in organ transplant recipients (OTR) is critical, given clear, alt-hough attenuated, benefits from vaccination. Adult OTR were surveyed regarding vaccine-related values and a novel outcome variable called Vaccine Acceptance Composite Score (VACS) was built as the average Likert score of 7 domains of vaccination confidence. Of 46 OTR included (93.5% kidney transplant recipients), 32.6% were female, 13.3% Black, 6.77% Hispan-ic/Latino/a/x; median age was 58 years. Patients were most concerned about COVID-19 vac-cine-associated risks (46.3%), its potential effect on allograft (47.6%) and motives of government officials involved with vaccine policy (55.6%). Politically conservative patients were likely to have a significantly lower VACS, while those who lived with someone ≥65 had a higher VACS. The VACS was not significantly associated with race, income, religious beliefs, comorbidities, COVID-19 history, or influenza vaccination status. Higher VACS was significantly associated with ≥3 and ≥4 COVID-19 immunizations. This study highlighted political beliefs and elderly household members as correlates of vaccine acceptance among OTR. The VACS may be a useful tool to help standardize multifaceted analyses in vaccination-focused behavioral research, as well as identify individuals and groups at risk for vaccine hesitancy, who may benefit from tai-lored outreach and educational interventions.

Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the cavity left in the tooth, most commonly with amalgam or composite resin. The consequences of filling failure include repeating the filling, or performing another treatment, such as a root canal, or extraction. Dental amalgam contains mercury, and there is a global effort to reduce its use. However, no consensus has been reached using randomized clinical trials, regarding whether amalgam or composite resin materials are more durable, and which is the best restorative material. To determine which material is superior, we performed a retrospective cohort study using a large database where members of the 58 dental clinics with 440 dental units were treated. The number of failures of the amalgam compared to composite resin restorations between 2014 and 2021 were compared. Our data included information from over 650,000 patients. Between 2014 - 2021, 260,905 patients were treated. 19,692 out of 113,281 first amalgam restorations failed (17.49%), whereas significantly fewer composite restorations failed (11.98%) 65,943 out of 555,671. This study indicates that composite is superior to amalgam and therefore it is reasonable to cease using mercury containing amalgam.

Human milk (HM) feedings are associated with reduced risks of neurodevelopmental and neurocognitive delays and systemic inflammatory diseases in infants born prematurely and/or at a low birth weight. Utilizing a neonatal piglet model, HM feedings were compared to bovine milk-derived infant formula (IF)-feedings with the aim of understanding the underlying mechanisms involved in reducing these risks. Six male piglets at postnatal-day (PD)2 were randomized into two feeding groups: HM-fed (n = 3) or IF-fed (n = 3) for 28 days. At 3- and 4-weeks-old, piglet memory and learning performance were assessed using novel object recognition (NOR). At PD30 piglets were euthanized, and whole brains were excised, weighed, and preserved for further analyses, and brain microglial morphology, and systemic inflammatory cytokines were quantified. During NOR, HM-fed piglets had significantly more non-novel revisits at both 3- and 4-weeks-old compared to IF-fed piglets. Microglia of HM-fed piglets had longer processes, more branch points, more endpoints, and a larger territorial volume compared to IF-fed piglets at PD30. In a neonatal piglet model, HM-feedings may improve cognition and reduce brain inflammatory response compared to IF-feedings.

This study reports on the development of bio-based hydrophobic coatings for packaging papers through deposition of polyhydroxybutyrate (PHB) particles in combination with nanofibrillated cellulose (NFC) and plant wax. In a first approach, PHB particles in micrometer range (PHB-MP) were prepared through a phase-separation technique providing internally nanosized structures. The particles were transferred as a coating by dip-coating filter papers in the particle suspension, followed by sizing with a carnauba wax solution. This approach allowed partial to almost full surface coverage of PHB-MP over the paper surface resulting in static water contact angles of 105° to 122° and 129° to 144° after additional wax coating. In a second approach, PHB particles with submicron sizes (PHB-SP) were synthesized by an oil-in-emulsion (o/w) solvent evaporation method, and mixed in aqueous suspensions with 0 to 7 wt% NFC. After dip-coating filter papers in PHB-SP/NFC suspensions and sizing with a carnauba wax solution, static water contact angles of 112° to 152° were obtained. The intrinsic properties of the particles were analyzed by scanning electron microscopy, thermal analysis and infrared spectroscopy, indicating higher crystallinity for PHB-SP than PHB-MP. The chemical interactions between the more amorphous PHB-MP particles and paper fibers were identified as an esterification reaction, while the morphology of the NFC fibrillar network was playing a key role as binding agent in the retention of more crystalline PHB-SP at the paper surface, hence contributing to higher hydrophobicity.

Introduction The prevalence of adolescent electronic cigarette (e-cigarette) use has increased in most countries. This study determines the relation between the frequency of e-cigarette use and the frequency and intensity of cigarette smoking. Furthermore, it evaluates the association between the reasons for e-cigarette use and the frequency of its use. Materials and Methods Participants were 68,043 middle and high school students aged 13–18 years from the 2015 Korean Youth Risk Behavior Web-Based Survey. Of the 68,043 participants, we analyzed 6,655 adolescents with an experience of e-cigarette use. Results The prevalence of ever using and current (past 30 days) use of e-cigarettes was 10.1% and 3.9%, respectively. Of the ever e-cigarette users, approximately 40% used e-cigarettes for ≥1/month and 8.1% used e-cigarettes daily. Daily e-cigarettes users were 10 times greater among daily cigarette smokers than among cigarette users for <1/month (18.1% vs. 1.8%) and 16 times more prevalent among those smoking ≥20 cigarettes/day than among those smoking <1 cigarette/month (38.9% vs. 2.4%). The most common reason for e-cigarette use was curiosity (22.9%), followed by less harmful than conventional cigarettes (18.9%), smoking cessation (13.1%), and indoor use (10.7%). Curiosity was the most common reason among less frequent e-cigarette users; however, smoking cessation and indoor use were the most common reasons among more frequent users. Conclusions Results showed a positive relation between frequency or intensity of conventional cigarette smoking and frequency of e-cigarette use among Korean adolescents, and frequency of e-cigarette use differed according to the reason for the use of e-cigarettes.

MicroRNAs (miRNAs), particularly miR-16 and miR-21, play a crucial role in mul-tiple myeloma (MM) pathogenesis by regulating gene expression. This study evalu-ated the prognostic significance of circulating miR-16 and miR-21 expression levels in 48 patients with MM at diagnosis treated with lenalidomide/dexamethasone (LD) compared with 15 healthy individuals (HI). All patients were treated with LD, 13 at first line and 35 at relapse, of whom 21 were tested twice at diagnosis and before LD initiation. The results revealed significantly lower levels of miR-16 and miR-21 in patients than in HIs, both at diagnosis and relapse, with decreased miR-16 levels at diagnosis, indicating improved overall survival (OS) (p value 0.024). Furthermore, miR-16 and miR-21 levels were associated with disease markers, while both corre-lated with the depth of response and mir-16 with sustained response to LD treatment. The ratios of both miR-16 and miR-21 expression levels (prior to LD treat-ment/diagnosis) below 2 predicted a shorter time to response (P = 0.027) and a longer time to next treatment (P = 0.042), respectively. These findings suggested a prognostic value for serum miR-16 and miR-21 levels in MM, as their expression levels corre-lated with disease variables and treatment outcomes.

This study explores the complexities of sport manager selection, investigating the impact of affirmative action, recruitment strategies, organizational culture, diversity initiatives in board selection, and career advancement insights from coaches' perspectives. To conduct this investigation, a purposive sampling technique was employed, selecting 65 prominent sports managers and coaches from Romania. Participants, aged between 35 to 58 years old, boasted an average of 10 to 20 years of sports experience and were chosen based on specific criteria, including academic qualifications. Data collection occurred over an extended period, spanning from fall 2022 to spring 2024, through semi-structured interviews with sport managers and coaches. The findings unveiled persistent challenges in effectively implementing affirmative action measures, as sport managers grapple with balancing the promotion of deserving candidates while maintaining continuity in board culture. Achieving meaningful diversity necessitates nuanced approaches that consider both candidate quality and cultural compatibility. Moreover, the study sheds light on coaches' perspectives when considering executive council positions, highlighting various pathways to career advancement. Recruitment practices prioritized informal methods, emphasizing board cohesion. Despite the recognized importance of diversity, challenges persist in selecting candidates solely based on demographic representation. The study provides valuable insights into promoting diversity and inclusivity within sports organizations' executive councils. Future research directions may include exploring longitudinal trends and delving into the qualitative experiences of underrepresented groups, with the aim of advancing understanding and promoting equity within sports organizations.

Coronavirus (COVID19) appears to be an inflection point that is forcing a disruption in medical education. However, it is not clear what the responses of the institutions are to this pandemic and how the adaptation of new methods may impact medical education in the post COVID-19 era. Objective: The study aims to explore how medical schools in Egypt responded to COVID-19 pandemic regarding the teaching and learning/assessment for undergraduate students. Design: A mixed method exploratory two-phase study was conducted. A survey was prepared and disseminated to a convenient non-probability sample of the medical school faculty through various social platforms. Then, a focus group guide was conducted to explore in more depth the findings. Results: The staff level of preparedness for that unexpected shift was evaluated by 55.1% of the survey participants as optimum to high and a good leadership support was reported by 70 % of them. They reported conflicting views about the proper role of medical education units but reinforced the idea of Egyptian Knowledge Bank’s crucial role in this transition. Additionally, there is a communication problem with the students that leads to their detachment. Subsequently, 84.6 % of the participants reported that their schools used alternative teaching methods for small groups, large groups, pre-clinical and clinical clerkships. However, 64.1 % of the participants identified a clinical skills teaching challenge. Although, 68.4% reported that alternative methods were used for formative assessment but absence of alternative methods for summative assessment was declared by 76.3%. Conclusions: Individuals moved faster than bodies and relied on support existing outside the universities when catastrophe happened. However, institutes which have experience in adapting modern engaging learning methods should organize a better response for crisis. Online learning should be integrated in the curriculum with a fair percentage especially in the early years of medical study.

Background/Objectives: High-intensity anaerobic physical training frequently results in muscle damage among boxers and kickboxers, which can impede performance and recovery. Vibrational therapy (VT) and passive rest (PR) have been employed as methods to enhance muscular recovery and performance. This study evaluates the effectiveness of these two recovery methods on upper limb muscle strength and lactate levels in plasma after high-intensity exertion. Methods: Eighteen elite boxers and kickboxers, aged 19-32 years, underwent tests employing VT and PR as recovery methods in a controlled, crossover study. Muscle performance was assessed via isokinetic dynamometry, and lactate levels were measured pre-exercise, post-exercise, and post-recovery. The study adhered to the Declaration of Helsinki guidelines and was approved by the relevant bioethics committee. Results: The results showed that VT led to a faster recruitment of muscle fibers and improved muscle endurance as indicated by decreased fatigue work indices compared to PR. However, no significant differences were observed in peak torque or lactate levels between the two recovery methods. The VT group exhibited quicker recovery times in torque generation and better performance in fatigue resistance. Conclusions: VT appears to provide superior muscular recovery compared to PR following intense anaerobic effort, particularly in terms of muscle strength endurance and activation speed. These findings support the potential of VT in sports recovery protocols, although similar lactate response suggests that metabolic recovery rates are not significantly affected.

The aim of the study was to assess the impact of two lengths of Nordic walking (NW) training interventions combined with time restricted eating (TRE) on improving body composition parameters, lipid profile, and levels of selected adipokines in women with disrupted body mass. Overweight and obese women (n=55, age: 21-85) were recruited. Four groups were selected: 6 weeks (SG6, n=13) and 12 weeks intervention (SG12, n=13); and two control groups: CON6 (n=13); and CON12 (n=13). The training sessions took place 3 times a week (60 minutes each) and were conducted outdoor under the supervision of professional coach. The training intensity was determined individually. The extended NW program combined with TRE induced a significant weight reduction in SG12 by 1.96 kg (p=0.010) and fat tissue by 1.64 kg (p=0.05). The proposed interventions did not affect LBM, TBW [kg], VFA and lipid profile. The LDL/HDL ratio changed with small size effect. Leptin concentration differed between groups (p=0.006), but not over time. For resistin, the differentiating factor was time (p=0.019, with lower results observed after the intervention). The change in leptin concentration was negatively correlated with its baseline concentration. Extended to 12 weeks, this intervention allows for an improvement in body composition. Neither 6 nor 12 weeks of training and fasting affected the lipoprotein profile.

By this contribution we would like to briefly highlight the problems in conceiving the “Hydrogen Bond” (HB) as a real short-range, directional, electrostatic, attractive interaction and to reframe its nature through the non-approximated view of condensed matter offered by a Quantum Electro-Dynamic (QED) perspective. We focus our attention on water, as the paramount case to show the effectiveness of this 40-years’ old theoretical background, which depicts water as a two-fluid system (where one of the two phases is coherent). The HB emerge to be the result of the electromagnetic field gradient in the coherent phase of water, whose vacuum level is lower than the non-coherent (gas-like) fraction. Thus, the HB can be properly looked at, i.e. no more as a “dipolar force” among molecules, but as the phenomenological effect of their collective thermodynamic tendency to occupy a lower ground-state, compatibly with temperature and pressure. This perspective allows to account for many “anomalous” behaviours of water and to understand why the calculated energy associated to HB should change when considering two molecules (water-dimer), or the liquid state, or the several kinds of ice. The emergence of a condensed, liquid, phase at room temperature is indeed the consequence of the boson condensation as described in the framework of spontaneous symmetry breakings (SSB). The switch from a still semi-classical Quantum Mechanical (QM) in the 1st quantization to a Quantum Field Theory (QFT) view embedded in the 2nd quantization is advocated for a more realistic and authentic description of water, condensed matter and living systems.

Gestational Diabetes Mellitus (GDM) is related with adverse outcomes for both the mother and the offspring. Immune and senescence play a crucial role in GDM progression. This study aims to explore the diagnostic significance of immune-related senescence (IRS) genes in GDM. We used weighted gene co-expression network analysis (WGCNA) and single sample gene set enrichment analysis (ssGSEA) to compute the immune score and aging score in control and GDM samples. Machine learning identified core IRS genes. Then we performed unsupervised cluster analysis in GDM patients to explore immune infiltration. Finally, we validated the core genes in clinical samples. We used the intersection of MEblack module from WGCNA and differentially expressed genes (DEGs) to obtain the potential genes. Next, a univariate logistic regression model including 23 potential genes were constructed, and these genes were filtered by least absolute shrinkage and selection operator (LASSO) algorithm. There were 5 potential genes (COX17, RRAS2, RRAGC, CECR1, and TACC2), which defined as biomarkers, remained eventually, and the efficacy of these biomarkers was evaluated by nomogram. Finally, the results from both qRT-PCR and western blot analyses demonstrated CECR1 was down-regulated, while TACC2 was up-regulated in GDM placental tissue. Our study identified CECR1 and TACC2 as diagnostic biomarkers for GDM associating with immune and senescence, providing a new perspective on GDM progression.

Nutritional status problems in school-age children are a crucial public health problem worldwide. This research explored the relationships between family factors, food consumption behaviors, and the nutritional status of Muslim school-age children in Thasala District, Nakhon Si Thammarat Province, Thailand. This descriptive research was conducted among 228 children aged 9-12 years. Data were collected using demographic data, nutritional status, and food consumption behaviors assessment. Data were analyzed using descriptive, chi-square, and binary logistic regression statistics. The results revealed that most samples reported having moderately healthy food consumption behaviors (M = 2.01, SD = 0.56). The samples had a normal weight (72.4%), while 15.8% were classified as overweight and obese. The number of siblings and food consumption behaviors had a significant relationship with nutritional status (p &lt; 0.05). Confirmation with binary logistic regression results also revealed that the likelihood of normal nutritional status was 2.40 times higher in children who had 3 or 4 siblings compared to those with 1 or 2 siblings (AOR = 2.40; 95% CI: 1.299-4.459). Additionally, children with healthy food consumption behaviors were 2.34 times more likely to have normal nutritional status compared to those with unhealthy dietary consumption (AOR = 2.34; 95% CI: 1.183-4.631). Conclusion: Since the number of siblings and healthy food consumption behaviors were associated with nutritional status, healthcare providers must consider these 2 factors when establishing health education and behavior modification care plans to promote healthy food consumption and nutritional status among this group.

Mangrove ecosystems are one of the most productive on our planet but have declined globally by 30-50%. Many species rely on mangrove habitat and thus their conversion to aquaculture farms has led to a noticeable loss in commodities such as wild fish stocks. This study aimed to assess 1) the influence of the presence of aquaculture and 2) restoration projects on the ecosystems ability to provide resources. We collected data on mangrove vegetation (i.e., biomass, richness and abundance), soil nutrients (i.e. organic carbon, aluminium and nitrogen), crab abundance and fishing pressure in six sites. We set up 15 plots in each site and collected data between May and July 2023. Via generalised linear mixed models we found that the abundance and richness of crabs was significantly higher in aquaculture plots than in no aquaculture plots. Aquaculture plots had higher topsoil aluminium, topsoil and subsoil Nitrogen, and had lower topsoil Carbon than non-aquaculture sites. Restored sites had less Nitrogen in the topsoil than unmanaged sites. Biomass did not change between aquaculture, restored and unmanaged plots. We found a negative correlation between crab abundance and richness and mangrove DBH, suggesting that the species of crabs present preferred areas with propagules for feeding (e.g., Grapsidae crabs). The content of nitrogen in the subsoil was positively correlated with mangrove richness, diversity and height, suggesting the importance of nitrogen availability for mangrove growth. The content of aluminium in the subsoil was negatively correlated with the content of organic carbon both in topsoil and subsoil, suggesting the detrimental effect of aluminium on the carbon cycle. Fishing practices were observed in all sites during the data collection period. Even if most of the vegetation parameters were not significantly affected by presence of aquaculture or management for restoration, it is clear that important variables such as aluminium carbon, and nitrogen content in the soil and crab assemblages were highly variable.

Given the long-standing debate about the nature of the concept of disease, the objective of this study was to understand how doctors categorize a condition as a disease or not and what kind of information they use. A survey with a set of clinical vignettes was designed, and a group of physicians were asked to interpret those situations as a disease or not and to motivate their choice with a short written text. Thematic analysis of the answers resulted in four themes: the temporal dimension of a disease, reification of disease, disease as an existential condition, and disease as a motivation to action. The respondents’ interpretations were very heterogeneous, supporting the idea that physicians do not share a common prototypical concept of disease. An interpretation of these results according to a critical realist and systemic approach suggested that the doctor-patient relationship is the context able to influence the interpretation of a condition as a disease or not as the final outcome of a process in which both objective, subjective, and socially mediated elements are taken into consideration.

Objective: To explore the hot spots and development trends of community public health research. Methods: The literature related to this topic was searched in CNKI and PubMed databases, and the trend map of the number of articles was drawn according to the obtained data. The included literature were analyzed with Vosviewer software for keyword and author co-occurrence, and CiteSpace 6.3.R1 Basic software was used for mechanism co-occurrence, key emergence and clustering analysis, and timeline distribution map drawing. Results: 189 Chinese literature and 77 English literature were selected. The Chinese literature focused on “community public health service, emergency management, and community governance”, and the research trend was “community public health emergency management and community governance”; English literature focuses on “nursing education, health education, human qualitative research”. Conclusion: Although the Chinese and English literature shows that scholars in this field have different emphases, the primary community health is the key and difficult point to realize the national public health service project, and improving the basic public health service in the primary community is related to the health of all the people, so it is very important.

Background: Serious games are conceptualized as a broad topic and overlap segments of more modern forms of education: e-learning, edutainment, game-based learning, and digital game-based learning. Serious Games aligns with digitalization and the modern era and creates novel opportunities for learning and assessment in medical education. Escape rooms, a type of serious games, merge mental and physical aspects to reinforce critical skills useful in daily life. It challenges logic and reasoning and demands careful analysis of situations to correlate and solve different stages of the escape room under pressurized, timed conditions. Furthermore, it serves as an adequate environment to build problem-solving skills, communication skills, and leadership skills through the collaboration of people to achieve a common goal. The aim of this study was to investigate the applications of escape rooms in Medical Education. Method: This study investigated the applications of escape rooms in medical education. Serious games are expanding in education and have attained great relevance due to their intriguing and intrinsically motivating attributes. Within serious games, we focused on escape rooms in which participants are locked in a room, faced with puzzles that must be solved to ‘escape the room’. Compiling the data from the first 100 hits of medical application of escape rooms, we found 72 cases and categorized them by year, specialty, participants structure, simulation experience, and design. Results: We reported on escape rooms in medical education by the year in which they were reported, the medical specialty, the participant structure, grouped or individual, the experience design; real, hybrid, or digital, and the modality of the delivery. 72% of the escape rooms focused on four main areas: nursing education (25.0%), emergency medicine (22.2%), pharmacy (12.5%), and interprofessional education (12.5%). Most of the escape rooms had a group-based physical design and little attention was given to provide a detailed description of the design considerations, such as the pathway type (linear, semi-linear, open). Conclusion: Escape rooms are applied in a wide range of medical education areas. In Medical Education, group-based on-site escape rooms with a focus on nursing, emergency medicine, pharmacy and interprofessional education dominates the implementation landscape. To further advance the field, stronger emphasis on making explicit the design considerations will advance the research and inform implementations.

Students have historically fared poorly on the West African Examinations Council’s (WAEC) mathematics exam. This study investigated senior high school students’ difficulties with studying Geometry in the Cape Coast Metropolis, Central Region, Ghana. Using the descriptive survey design, data were collected from 300 Senior High School Two (SHS 2) students using simple random sampling. Students responded to the questionnaire and a 30-item multiple-choice achievement test on geometry. Four geometry concepts students perceived difficult to study are Circle theorems, Perpendicularity of Tangent and radius of a circle, Angle between Tangent and a chord and Tangents from an external point. The reasons for the difficulty in studying geometry topics are the unavailability of instructional materials, the geometry topics being complex, and teachers not teaching geometry concepts to the students’ understanding. Students’ gender did not influence the learning of concepts in geometry at a 0.05 level of significance. There was an insignificantly weak positive correlation between the students’ performance and their perceived difficult geometry concepts. It was concluded that the Ministry of Education does not provide relevant instructional materials to the various schools to teach geometry concepts. Schools do not organise workshops and seminars for teachers on effectively teaching geometry concepts in mathematics.

(1) Background: The aim of the research was to present and emphasize the importance of magnetic resonance imaging (MRI) in diagnosing Achilles tendon (AT) ruptures by presenting case reports. (2) Materials and Methods: The sample of respondents included 7 patients (4 males and 3 females, 2 athletes and 5 non-athletes), aged 25 to 58 years, with AT injuries, who were examined and treated at the Institute for Treatment and Rehabilitation "Niška Banja", Niš, Serbia. Ankle examinations with MRI were conducted using the Esaote O-scan 0.3 T machine. The examinations were performed without the application of a paramagnetic contrast agent and without the use of anesthesia. Results: The MRI method's sensitivity and overall diagnostic accuracy were excellent, with 100% true positives. In our study, the method accurately detected the presence, location, and severity of AT injuries in all cases. MRI is an important and reliable method for detecting AT injuries, classifying them, monitoring the course of recovery, and assessing the effects of therapy. Conclusions: An unrecognized or delayed diagnosis of an AT injury can lead to chronic changes. Timely diagnosis (clinical examination, ultrasonography, magnetic resonance imaging) and appropriate treatment (conservative or operative) enable patients to return to normal activities, including sports. Unfortunately, the use of MRI is limited by restricted access and the cost of the examination.

Diastolic dysfunction, a prevalent condition characterized by impaired relaxation and filling of the left ventricle, significantly contributes to heart failure with preserved ejection fraction (HFpEF). Galectin-3, a β-galactoside-binding lectin, has garnered attention as a potential biomarker and mediator of fibrosis and inflammation in cardiovascular diseases. This comprehensive review investigates the impact of galectin-3 on diastolic dysfunction. We explore its molecular mechanisms, including its involvement in cellular signaling pathways and interaction with components of the extracellular matrix. Evidence from both animal models and clinical studies elucidates galectin-3's role in cardiac remodeling, inflammation, and fibrosis, shedding light on the underlying pathophysiology of diastolic dysfunction. Additionally, we examine the diagnostic and therapeutic implications of galectin-3 in diastolic dysfunction, emphasizing its potential as both a biomarker and a therapeutic target. This review underscores the significance of comprehending galectin-3's role in diastolic dysfunction and its promise in enhancing diagnosis and treatment approaches for HFpEF patients.

The extent of access to energy of displaced populations in settlements and camps in Africa is largely 14 unknown. A multitude of contextual factors, such as the location and the characteristics of housing, 15 the legal status, the socio-cultural background, and the availability of humanitarian and public ser- 16 vices impact the living conditions and the needed energy services. Limitations in accessing energy 17 services have direct, multilayered, and far-reaching implications, including impacts on health, nu- 18 trition, education, protection, and livelihood. The objective of this article is to contribute to a more 19 comprehensive overview of the current state of energy access in displacement contexts on the Afri- 20 can continent by identifying and utilizing existing data. After a screening of the vast and various 21 available information, setting up of a database, consolidating the gathered data as well as assessing 22 the quality through a quality assessment method, the currently available information is visualized 23 and discussed. Considerable differences in the access to electricity for displaced persons across the 24 countries are found. For both electricity and clean cooking, the availability for displaced persons 25 ranges from nearly no access at all up to an access rate of 100%. More strikingly, the results also 26 show that besides South Africa and countries in the Maghreb region, the access to both clean cook- 27 ing and electricity for displaced persons is very low. At the same time, the fragmented data availa- 28 bility, the poor data quality, and the questionable expediency of available data allows neither solid 29 theoretical conclusions nor planning of effective practical implementation measures. Novel inter- 30 disciplinary research, conceptual frameworks and indicators are needed for the purpose of compa- 31 rability and consistency. Future research has the potential to more comprehensively capture the 32 current state of access to energy in displacements contexts and in a next step to examine how energy 33 is interwoven in the lives of displaced people to derive a set of more detailed context-sensitive en- 34 ergy indicators. It is essential that the concerned persons, the displaced persons themselves are in- 35 cluded in the research in a meaningful way.

Preventive Maintenance (PM) is a periodic maintenance strategy, which has great results for devices in extending their life, increasing productivity, and most importantly, help avoid unexpected breakdowns and their costly consequence. A preventive maintenance scheduling (PMS) is determining the time for carrying out PM, and it represents a sensitive issue in terms of impact on production if the time for the PM process is not optimally distributed. In this study, hybrid heuristic methods were used to solve the PMS problem, as genetic algorithm and Tabu research were adopted. The optimal solution was reached in a short time compared to previous studies in which optimal methods were used, integer programming and nonlinear integer programming. Also, sensitivity analysis was applied to measure the robustness and strength of the method used, where an optimal solution was obtained for all experiments and in record time. This method can be used for power plants in privet or public sectors, to generate an optimal PMS, to save money, and to avoid water or electricity cuts.

In this follow-up study, we aimed to assess the effectiveness of the “I do not smoke, I exercise”, anti-smoking preventive health education program. The program was based on the Theory of Planned Behavior supplemented with life-skills teaching and targeted at high school students. The intervention comprised ten one-hour online sessions, administered by physical education instructors. The study cohort comprised 222 students (109 boys, 113 girls) from 11 secondary schools, with an average age of 16.42 ± 1.36 years. Data collection involved pre- and post-intervention self-assessment questionnaires. The examined variables included attitudes towards smoking, intention to smoke, subjective norm, perceived behavioral control (PBC), knowledge about smoking, smoking behavior, exercise behavior, attitudes toward the program's implementation, and satisfaction with the program. Separate paired samples t-test revealed a significant improvement in students' knowledge about smoking, perceived behavioral control, and overall program satisfaction following the intervention. However, no significant changes were observed in the remaining variables. These findings suggest that the health education smoking prevention intervention incorporates techniques and strategies that influence the Perceived Behavioral Control variable, emphasizing students' strong interest in educationally theorized programs integrating technology into their design. Future studies should consider further examination of tobacco control strategies within the high school context.

This work presents a novel approach for the study of the movement of droplets on inclined surfaces under the influence of gravity and chemical heterogeneities. The developed numerical methodology uses data-driven modeling to extend the applicability limits of an analytically derived reduced-order model for the contact line velocity. More specifically, while the reduced-order model is able to capture the effects of the chemical heterogeneities to a satisfactory degree, it does not account for gravity. To alleviate this shortcoming, datasets generated from direct numerical simulations are used to train a data-driven model for the contact line velocity, which is based on the Fourier neural operator and corrects the reduced-order model predictions to match the reference solutions. This hybrid surrogate model, which comprises of both analytical and data-driven components, is then integrated in time to simulate the droplet movement, offering a speedup of five orders of magnitude compared to direct numerical simulations. The performance of this hybrid model is quantified and assessed in different wetting scenarios, by considering various inclination angles and values for the Bond number, demonstrating the accuracy of the predictions as long as the adopted parameters lie within the ranges considered in the training dataset.

The BL Lacertae (BL Lac) object OJ 287 underwent an intense X-ray activity phase, exhibiting its brightest recorded X-ray flare in 2016-2017, characterized by much softer X-ray spectra and, concurrently, its first-ever recorded very-high-energy (VHE) emission (100--560 GeV), reported by the VERITAS observatory. Broadband spectral energy distribution reveals a new jet emission component similar to high-synchrotron-peaked BL Lac objects, thereby implying the soft X-ray spectrum for the synchrotron emission. Using the advantage of simultaneous X-ray and VHE spectral information, as well as the source being a low-synchrotron-peaked BL Lac object, we systematically explored the extragalactic background light (EBL) spectrum by demanding that the VHE spectrum cannot be harder than the X-ray spectrum. We used three different phenomenological forms of the EBL spectral shape (power-law, parabola, and polynomial) motivated by current constraints on the EBL with the Bayesian Monte Carlo approach to infer the credible EBL range. Our study favors an almost flat power-law spectral shape and is consistent with previous studies. The other spectral forms capable of capturing curvature though result in a better statistics value; the improvement is statistically insignificant given the additional parameters.

Taiwan's bed and breakfast (B&B) development has been more than 25 years ago, from the first generation of retirement to the B&B industry, serving tourists from all over the world accom-modation, providing breakfast and accommodation mode to the present, after the change of employees from the second generation, more and more attention is paid to the cultivation and cultivation of business ability. With the advent of the era of AI technology networking, the ca-pabilities required for B&B operation are more focused on all aspects of service, and the good marketing ability of B&B can promote a green chimney-free tourism economy, which is also a favorite industry of various governments and the public. This study explores the basic vocational competency indicators required for running a B&B, with (1)EQ emotion management skills, (2)Financial management ability, (3)(SK) technical skills, and (4)Marketing and promotion management capabilities. Through the study method, the K-S Z test was determined by the con-sensus conclusion of expert reliability and validity p value

Adult neurogenesis involves generation of functional neurons from neural progenitor cells, which have the potential to complement and restore damaged neurons and neural circuits. Therefore, the development of drugs that stimulate neurogenesis represents a promising strategy in stem cell therapy and neural regeneration, greatly facilitating the reconstruction of neural circuits in cases of neurodegeneration and brain injury. Our study reveals that compound A5, previously designed and synthesized by our team, exhibits remarkable neuritogenic activities, effectively inducing neurogenesis in neural stem/progenitor cells (NSPCs). Subsequently, transcriptome analysis using high-throughput Illumina RNA-seq technology was performed to further elucidate the underlying molecular mechanisms by which compound A5 promotes neurogenesis. Notably, comparative transcriptome analysis showed that the up-regulated genes were mainly associated with neurogenesis and the down-regulated genes were mainly concerned with cell cycle progression. Furthermore, we confirmed that compound A5 significantly affected the expression of transcription factors related to neurogenesis and cell cycle regulatory proteins. Collectively, these findings identify a new compound with neurogenic activity and may provide insights into drug discovery for neural repair and regeneration.

In order to solve the problem of large eddy current loss and high temperature rise caused by large amount of permanent magnet, a new type of combined magnetic pole permanent magnet motor is proposed in this paper. The sinusoidal distribution subdomain model of non-uniform air gap rotor is established by using Laplace equation, and the analytical expression of eddy current loss of rotor in uniform air-gap and non-uniform air-gap is derived. The effect of rotor eccentricity on eddy current loss is obtained. According to the characteristics of distributed winding of non-uniform air gap combined pole permanent magnet motor, equivalent treatment is performed to obtain the equivalent thermal conductivity, so as to establish equivalent thermal network model of motor, calculate the temperature value of each component of the motor, and verify the correctness of the thermal network model through the method of magnetothermal bidirectional coupling. Finally, an experimental platform is set up to carry out temperature rise experiments on the two prototypes respectively. Experimental results show that the non-uniform air-gap rotor structure can effectively reduce the rotor eddy current loss and motor temperature rise, and also verify the accuracy of the analytical model calculation results.

Titanium alloys belong to the metal biomaterials that are one of the most widely used in medicine. In recent years, in order to reduce the use of vanadium, Ti6Al4V alloy is increasingly replaced by Ti6Al7Nb alloy. In addition, to ensure the best possible biocompatibility, its surface is subjected to appropriate modifications, for example, anodic oxidation. Despite the extensive use of anodic oxidation of titanium implants in orthopedics, there are few works focused on a detailed analysis of the chemical composition of the surface layers. In addition, the effect of treatments before anodic oxidation on the properties of the produced layer has not been analyzed. Thus, the purpose of this study was to analyze in detail the chemical composition of the passive layer of Ti6Al7Nb alloy obtained by anodic oxidation preceded by sandblasting. Moreover, the physicochemical properties of the analyzed surface affecting biocompatibility were determined. For this purpose, surface observation, wettability and roughness tests, microhardness tests, electrochemical tests and phase composition analysis were carried out. In addition, the preclinical suitability, of the surface modified in this way, was evaluated by cytotoxicity tests.

Aging causes various degenerative diseases in the older adult population. Senescence, a state of permanent cell-cycle arrest accompanied by the production of various pro-inflammatory factors known as senescence-associated secretory phenotype (SASP), is considered a significant contributor to the aging process and its chronic diseases. Ample evidence showed that various stressors could induce senescence, including DNA damage, telomere shortening and damage, activation of oncogenes, and mitochondrial dysfunction. Numerous credible findings indicate that environmental agents can induce senescence, including UV radiation, a high-fat diet, heavy metal exposure, and cigarette smoke. These findings posed the possibility that many more environmental agents may induce senescence and accelerate aging but remain unidentified. Senescence also becomes more intriguing due to its promising future as a pharmacological target to blunt the detrimental effects of aging and prevent aging-related diseases, either by eliminating the senescent cells or by controlling the SASP. On the other hand, investigating senescence has become more intricate due to the need for a multi-marker approach and translation in vivo analysis. This review will discuss senescence and its biomarkers, how to identify gerontogens in vivo, and also the development of senotherapy that targets senescent cells.

The purpose of this study is to examine the match-related performance (scores and penalties) of the athletes in the Junior EJC (European Judo Championship) and U23 EJC categories before and immediately after the Covid-19 quarantine, according to gender and weight category groups. Our sample was based on the junior and U23, male and females, 2019-2020 Junior European Judo Championships and 2019-2020 U23 European Judo Championships. A total of 1431 matches in these tournaments were analyzed: male (n=812) and female (n=619). The main findings of this study showed that most matches in both the male and female categories resulted in ippon (2019-2020 average: 64,35% for Junior male, 70,55% for U23 male and 69,3% for Junior female, 64,4% for U23 female). No significant differences (p &gt; 0.05) were observed between gender and age groups concerning the match scores. In the formation phase of the technique, considerations of high- and low-intensity actions, and analysis of the speed of athletes during matches in official competitions can help to better understand the dynamics of the variability of movements in judo matches. In addition, suggestions are presented to be applied to athletes in different age categories who are on the way to become Olympic athletes.

Objectives: Female genital mutilation (FGM) is a significant public health problem. It is estimated around 14,700 women affected by FGM live in Switzerland, primarily among women with a history of migration. Our qualitative research investigated the sexual health of immigrant women living with FGM in Switzerland, describing their own perception of health, reproductive life and sexuality. Methods: We conducted semi-structured, in-depth interviews with a group of eight immigrant women of African origin living in Switzerland with Type III FGM (infibulation). Results: Seven of the women were from Somalia and one from Ivory Coast. All of the Somali women were mothers and married (two separated), and the Ivorian woman was a single mother. The women in our study reported a low level of sexual satisfaction and reproductive health. They affirmed their desire to improve, or at least change, their condition. Although they rarely talk with their husbands about sexual subject matter, they would like to include them more and improve dialogue. Conclusions: Specific socio-sexual management is recommended when caring for immigrant women living with FGM in order to respond to their specific health care needs. Multidisciplinary approaches may be able to offer more comprehensive health care, including facilitated communication to improve dialogue between women and health care professionals, and eventually between women and their husbands in discussing sexual matter.

Developing sustainability competences is an important endeavor for education, as competence development can be complex and requires appropriate approaches. In the case of preparing future educators, this becomes even more important, because of their multiplier role. The current study presents how a project, based on living-lab methodology, helped preservice preschool teachers, attending a course on sustainability issues, develop sustainability-specific professional action competence. Students collaborated with an organization and a school and were trained to deliver to 6-year-old pupils, activities concerning the protection of sea turtles. The process included reflection, based on a given template. After the intervention, the preservice preschool teachers reflected upon their role and professional performance and discussed how they, benefited from this project. They further analyzed through a group interview, how the Living Lab methodology raised their professional confidence and self-efficacy, and helped them develop content knowledge, pedagogical content knowledge, and a sense of purpose and motivation for teaching about sustainability. Outcomes indicate that participants felt confident and efficacious to teach about sustainability, and developed their content knowledge, pedagogy content knowledge, motivation, and volition due to a strong sense of purpose and responsibility. The overall process facilitated the development of critical thinking, systemic thinking, reflection, and collaboration..

Aim: This study aimed to evaluate the effectiveness of a plyometric training program designed to enhance agility, speed, and social interaction among boys with mild intellectual disability (ID) aged 10-12, within the Special Olympics framework. Participants: Thirty-two boys (mean age = 10.69 ± 0.8 years; mean IQ = 61 ± 7) from three inclusive education centers participated in the study. Methods: The intervention consisted of a 10-week plyometric training program, conducted twice a week. Pre- and post-intervention assessments included the Reaction Time Test, 4-Corner Agility Test, 10-Meter Speed Run, 4x5 Meter Relay Test, and the Friendship Activity Scale (FAS). Results: The study found significant improvements across all measures. Reaction time decreased by 0.83 seconds (t = 7.44, p < 0.001), 4-corner agility improved by 0.77 seconds (t = 11.93, p < 0.001), 4x5 meter speed improved by 0.61 m/s (t = 17.37, p < 0.001), and 10-meter run speed improved by 1.55 m/s (t = -12.76, p < 0.001). Additionally, the FAS score increased by 0.81 points (t = 9.59, p < 0.001), indicating enhanced social interactions. Conclusion: The plyometric training program significantly improved agility, speed, and social interaction in children with mild ID, demonstrating the effectiveness of inclusive, adaptive physical education strategies within the Special Olympics framework.

Photovoltaic (PV) systems, which are renewable energy sources, are increasingly being utilized in distributed generation. To maintain a stable energy balance, energy storage systems such as batteries (BAT) play a vital role. Electric vehicles (EVs) offer a promising solution with rechargeable battery systems for operation. The BATs must maintain their state of charge within design boundaries, despite intermittent PV and load power fluctuations, and advanced power control and management techniques are essential for their effective operation. The article evaluates an intelligent controller that uses a Sliding Mode Control adaptive deep learning algorithm Convolutional Neural Networks (SMC-CNN) and a unique Strategy for managing supervisory power. (SPMS) for photovoltaic systems with battery energy storage for better regulation of DC bus voltage. SMC-CNN offers exceptional resilience and seamless functionality, minimizing fluctuations in DC bus voltage in the control strategy design requirements. The primary goals are maintaining a consistent power supply and ensuring continuous service by preventing system components from exceeding capacity. This study aims to enhance the control of DC bus voltage in the PV and battery system, with the primary significance focusing on the following aspects. The advanced SPMS has been created, incorporating control system constraints to enhance SOC balancing speed and reduce fluctuations in DC bus voltage. Power flow management involves optimizing energy flow between the PV system, battery system, and load while minimizing battery capacity requirements. The proposed SMC-CNN and SPMS are demonstrated through real-time simulation using Matlab/Simulink, as demonstrated in comprehensive case studies.

Excessive oxidative stress and exercise-induced fatigue reduce physical performance and can lead to dysfunction in antioxidant systems within muscular and hepatic tissues. Integrating natural substances with exercise may mitigate fatigue via anti-oxidant effects. This study aims to compare and evaluate the effects of exercise and supplementation with Sundarbans honey vs energy drinks on the strength, anxiety physiological profiles, and hepatic antioxidant capacity in mice undergoing extraneous exercise and fatigue. Forty-eight four-week-old Swiss albino mice were randomly assigned to one of eight groups: (1) Control, (2) Speed™ (Sp), (3) Royal Tiger™ (RT), (4) Sundarbans Honey (SH), (5) Exercise (Ex), (6) Exercise + Sundarbans Honey (Ex+SH), (7) Exercise + Speed™ (Ex+Sp), and (8) Exercise + Royal Tiger™ (Ex+RT). Supplements were administered via oral gavage: Sp (2.5 ml/kg BW), RT (2.5 ml/kg BW), and SH (1 g/kg BW), four times a week for 60 days. Mice in the Ex, Ex+SH, Ex+Sp, and Ex+RT groups underwent daily swimming and running. The strength, fatigue, anxiety levels, lipid profiles, and antioxidant biomarkers were evaluated post-treatment. The SH, Ex, and Ex+SH groups exhibited significantly enhanced physical performance (p

This study aimed to evaluate the effects of Blazepod technology when incorporated with various training regimens on the essential elements of physical fitness in volleyball, such as agility, speed, visual response time, and vertical leap. Thirty-six participants (age :17.33±0.48 y, height: 183.78±6.34 cm, weight: 77.14±5.16 kg) were in-volved in this study. In randomized design, three equal groups with two experimental groups and one control group were involved in the study over a period of six weeks: (GE1) used Blazepod technology to workout at a low level; (GE2) used Blazepod technology to workout at a higher intensity; (CG) did not employ Blazepod technology, but it adhered to the same fundamental training curriculum. We conducted agility, speed, reaction time, and vertical jump tests before, midway and after the study to determine optimal training volume, intensity, and frequency. A significant main effect of time (P0.01), and time×group interaction (P>0.001) were found for all tests. Post hoc test showed that the two experimental groups gadget significantly improved in all performance variables (P

The increasing adoption of student-centred learning environs by the institutions of higher education in business, has led to new mechanisms and methodologies such as the Simulation-Based Learning (SBL), Problem-Based Learning (PBL) and Challenge-Based Learning (CBL). Literature has shown evidence of raising interest in these methodologies towards a more experiential paradigm with regard to upcoming events from the surrounding real-world context. This paper presents a Systematic Bibliographic Literature Review (SBLR) with respect to the integration and application of these innovative and collaborative methodologies in higher education. It aimed to identify its relevant advantages, challenges, and consequences for the future of business education. Bibliographic databases were searched for documents published up to May 2024 to categorize key topics discussed in the literature on SBL, PBL and CBL. The review process identified 89 empirical and non-empirical papers on SBL, PBL and CBL, business related paperwork, which resulted from the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method. PRISMA is a framework with evidence-based data designed to help authors perform a systematic literature review. Data analysis revealed diverse subthemes for those methodologies uses in business higher education institutions. The research questions “What are the advantages, challenges and implications of SBL, PBL and CBL altogether, in the training of business students?” guided the study. The central output of the research is the discovery of the varying uses of SBL, PBL and CBL overall, to cope with diverse demands arising within environmental context. Future research directions are suggested.

High resolution information on nucleotide arrangement in the genome of any or-ganism is critical to understand its genetic makeup, function, and evolutionary his-tory. For years, DNA sequencing has provided crucial breakthroughs in the field of genomics and molecular biology. With the advent of technology, Next Generation Sequencing has now transformed the whole genome sequencing prospects, thus unveiling the novel and interesting features of an organism genome that can behold. Next generation sequencing platforms offer realistic approach to identify and anal-yses whole genome with high throughput, accuracy, scalability in a very short time span. Information obtained can be further used in improving our existing healthcare systems, designing novel and personalized therapeutic modules, making the envi-ronment sustainable and proactively preparing ourselves for future pandemics and outbreaks. This article discusses the various NGS technologies and approaches, their advantages, drawbacks, and futuristic usage in different fields. Though still in nascent stages and marred with flaws, with ongoing advancement, NGS will indeed have promising impacts in the future.

Lean body mass (LBM) is correlated with powerlifting performance in athletes competing in different bodyweight classes. However, it remains unknown whether changes in LBM are correlated with performance changes in powerlifters preparing for a competition. Aim of the study was to investigate the changes in LBM and performance in powerlifters preparing for a competition. Eight male powerlifters (age 31.7±9.8years, height 1.77±0.06m, weight 99.2±14.6kg) and three female powerlifters (age 32.7±16.3years, height 1.54±0.06m, weight 66.6±20.9kg), participated in the study. Athletes followed individualized periodized training programs for 12 weeks aiming to maximize their performance for the national championship. Maximum strength (1-RM) in squat, bench press, and deadlift, body composition, grip strength, anaerobic power, quadriceps’ cross sectional area and vastus lateralis muscle architecture were measured before and after the training period. Significant increases were found after the training period in squat (5.8±7.0%, P

This paper numerically investigates a 3D mesh independency study of a straight blade horizontal axis tidal turbine modelled using Computational Fluid Dynamics (CFD). The solution was produced by employing two turbulence models, the standard k-ε model and Shear Stress Transport (SST) in ANSYS CFX. Three parameters were investigated: mesh resolution, turbulence model, and power coefficient in the initial CFD, analysis. It was found that the mesh resolution and the turbulence model affect the power coefficient results. The power coefficients obtained from the standard k-ε model are 15% to 20% lower than the accuracy of the SST model. It can also be demonstrated that the torque coefficient increases with the increasing Tip Speed Ratio (TSR), but drops drastically after TSR = 5 and k-ε model failing to capture the non-linearity in the torque coefficient with the increasing TSR.

Conflicts in Indonesia today indicate intolerance towards other religions and cultures. Several places such as Ambon, Papua, Kalimantan and Posso have experienced the increasing effects of intolerance. Conflicts caused by intolerance between groups in societies seem inevitable in various regions. This study tests the effectiveness of tolerance education model, based on local wisdom in the community of Tomohon City in North Sulawesi, Indonesia. The Research and Development (R&D), specifically ADDIE design, was used to test the effectiveness of tolerance education. Data was validated and analyzed using the triangulation of sources, techniques and theories and Miles Huberman model respectively. The results showed that tolerance education was portrayed through elements of mutual help, empathy andcooperation. Therefore, the developed education model increases tolerance significantly. This model is appropriate for people living outside Tomohon City due to different cultural and emotional settings. Tolerance education model can be more effective when using local values from the region to optimize potential and local social capital in society. The teaching material contains a combination of tolerance traits and local wisdom. Tolerance content is obtained from local wisdom values in the communities living in Tomohon City, North Sulawesi, si tou timou tumou tou, Mapalus and Torang Samua Basudara. Efforts to instill a tolerant attitude include education and practice to equip the community with understanding that background differences can trigger empathy.

This study presents a comprehensive investigation into the spectrum and determinants of child abuse and neglect in Nkpor-Uno, a community in Anambra State, Nigeria. Through a descriptive surveys design, the study explores various forms of abuse and neglect experienced by children, as well as the underlying factors contributing to these phenomena. The population for the study consisted of 1000 parents/ caregivers who are residents of Nkpor-uno. The sample for the study consisted of 100 respondents, purposive sampling techniques was used for the study. The questionnaire was a self-designed structured questionnaire. Data collected were analyzed using frequency, mean and standard deviation. Findings reveal alarming prevalence rates of child maltreatment, including physical, emotional, sexual abuse, and neglect. Socioeconomic factors such as poverty, parental substance abuse, family dynamics, and inadequate sex education emerged as significant contributors to child maltreatment. The study underscores the urgent need for targeted interventions and support systems to address the root causes of abuse and neglect and safeguard the well-being and development of children in Nkpor-Uno. By raising awareness, enhancing access to resources, and promoting positive parenting practices, we can strive towards building a safer and healthier environment for children, ensuring they are protected from harm and given the opportunity to thrive.

The aim was to identify if surface electromyography (sEMG) parameters are indicative of post-activation potentiation (PAP)/post-activation performance enhancement (PAPE), in terms of twitch potentiation and voluntary performance. Three databases were used in March 2024, with the following inclusion criteria: (a) original research, assessed in healthy human adults, (b) sEMG parameters were measured. The exclusion criteria were: (a) studies with no PAP/PAPE-protocol, (b) non-randomized control trials. The following data were extracted: study characteristics/demographics, PAP/PAPE-protocols, sEMG parameters, twitch/performance outcomes, and study findings. A modified physiotherapy evidence database (PEDro) scale was used for quality assessment. Fifteen randomized controlled trials (RCTs), with a total of 199 subjects were included. The M-wave amplitude (combined with a twitch torque outcome) was shown to generally be indicative of PAP. The sEMG amplitude (in some muscles) were found to be indicative of PAPE during ballistic movements, while a small decrease in the MdF (in certain muscles) were shown to reflect PAPE. Changes in the Hmax/Mmax ratio were found to contribute (temporally) to PAP, while the H-reflex amplitude was shown to be neither indicative of PAP nor PAPE. This review provides preliminarily findings suggesting that certain sEMG parameters could be indicative of PAP/PAPE. However, future research is warranted.

The concept of a Social License to Operate (SLO) has become increasingly important in the sustainability literature in recent years. Having its origins in the business discourse of the mining industry with respect to limiting opposition to mining projects, the notion of a social contract above and beyond legal requirements has since become applied across a number of different industries. Despite the concepts adoption confusion exists over the practices and outcomes of SLO, and particularly the nature of engagement. Given this situation it is surprising that not more attention to the role of marketing, and social marketing in particular, in operationalizing the concept. The paper discusses the potential of social marketing to contribute to SLO. Economic, political and social relations are complex in SLO and exchange is intricate in such relational environments. A community-based social marketing orientation is proposed as a means to improve exchange relations and enhance engagement. Seven models of SLO related social marketing models are discussed with community-based social marketing and adaptive co-marketing models being regarded as the most positive for the achievement of an SLO. Potential barriers to adoption of these approaches are noted.

This review explores the integration of Virtual and Mixed Reality in medical training. The advent of immersive technologies has revolutionized traditional methodologies, offering immersive, interactive, and flexible learning environments. This study aims to assess the impact, efficacy, and potential of Extended Reality (XR) in medical education. Methods included a comprehensive analysis of current Metaverse’s applications in various medical fields, including surgery, diagnostics, and patient care. Results indicate a significant enhancement in learning outcomes, practical skills, and student engagement. Conclusions suggest that Virtual Reality is a valuable tool for medical training, providing realistic simulations and improving both theoretical knowledge and practical skills. The intersection of virtual reality and cognitive neuroscience presents an exciting frontier for understanding the human brain's response to immersive environments. This review explores how VR impacts learning, with a particular focus on the activation and engagement of the prefrontal cortex during immersive experiences. It delves into various studies that highlight the transformative potential of VR in educational settings and therapeutic applications, demonstrating how VR can facilitate deeper and more effective learning experiences. The review will present a dedicated section on the current methodologies used to analyze the brain's response while immersed in a virtual environment.

In this article we compute many topological indices for the family of Möbius ladder. At first we give general closed form of M-polynomial of this family and recover many degree based topological indices out of it. We also compute Zagreb indices and Zagreb polynomials of this family.

Despite the recognized influence of body mass on combat techniques, the relationship between body segment mass (BSM) and combat moves remains unexplored. This study aimed to examine the relationship between striking arm mass (SAM), kicking leg mass (KLM), and body mass (BM) with the dynamic forces of the direct punches (DP), palm strikes (PS), elbow strikes (ES), front kicks (FK), and countermovement jumps (CMJ) performance. Sixteen male military cadets (22.3 ± 1.8 years, 181.4 ± 7.0 cm, 82.1 ± 8.5 kg) performed combat techniques, with performance measured by using a force plate and body segment mass assessed by Dual-energy X-ray absorptiometry. Spearman's correlation analysis, the Wilcoxon test, and Cohen's d were applied. Results indicated the relationship between KLM or BM and FK impulse (r = 0.64, p = 0.01; r = 0.52, p = 0.04, respectively) and CMJ impact force (r = 0.80, p ≤ 0.01; r = 0.70, p ≤ 0.01, respectively). Moreover, FK peak and impact forces were moderately correlated with CMJ jump height (r = 0.74, p ≤ 0.01; r = 0.77, p ≤ 0.01). The highest relationship was found between KLM and FK impulse; however, the difference in variability explained by KLM versus body mass is only 12%. This suggests that knowledge of BSM did not provide a significantly better estimate of the dynamic forces of the punches and FK than BM.

Background We investigated to determine the effectiveness of verbal feedback in learning the round-off back somersault on the balance beam with stable landing. Methods: The research material consisted of female gymnasts (n = 16). They were randomly assigned to one of two groups: FKE group (n = 8) with feedback on key elements, or FAE group (n = 8) with 100% feedback on all errors made in the phase structure of the task. Results: Based on research, it was established that key elements could be identified in the preparatory, main and final phases. Mixed ANOVA showed that significant differences (p &lt; 0.05) were noted due to the teaching method used (Group x Time factor) when performing the gymnastic routine of round-off back somersault with stable landing on the balance beam. Based on the Welch t test for independent data it was revealed that the group with feedback on the key elements obtained significantly higher mean scores from judges at the end of the experiment. Conclusions: The findings of the present study point to a possibility of offering coaches teaching methods that increase the effectiveness of learning complex motor skills and indicate a possibility of applying such solutions in groups of female gymnasts both in training and during competitions.

The landscape of medical education has witnessed significant transformations over the past decades, particularly with the advent of active teaching methodologies. However, despite these advancements, the traditional theoretical assessment methods have remained largely unchanged. This lack of evolution in assessment systems poses a challenge, as it is crucial for assessment methods to evolve in tandem with teaching approaches to ensure a comprehensive and effective learning process in medical education. This paper reviews the integration and effectiveness of open-book examinations (OBEs) in medical education, reflecting their growing significance. An integrative review of the literature was conducted, drawing from a range of relevant publications over the last decade, sourced from databases such as PubMed, Web of Science, Scopus, and ERIC. The inclusion criteria focused on full-text articles in English, with search terms including "medicine," "assessment," "open book examination," "open book exam," and "open book assessment," combined using Boolean operators. Thirteen publications were selected and critically appraised using The Critical Appraisal Skills Program checklist. The analysis identified three primary thematic categories: ' Teaching Strategy for Pandemic and Challenging Conditions,” Tool of Learning & Educational Impact” and “Operational Challenges & Future Directions”. These themes were explored to understand the role and impact of OBEs in medical education. The findings indicate that open-book examinations are a crucial component in the evolving landscape of medical education. While certain reservations remain, OBEs have shown significant potential in fostering critical thinking, argumentation skills, and lifelong learning among medical students. They reflect the ongoing evolution of knowledge in the medical field and contribute to the development of professionals’ adept at navigating and applying complex information. Further research is recommended to solidify these findings and to expand the understanding of OBEs in medical education.

Higher education equips youth with the requisite knowledge and skills for navigating environmental education and sustainability. The current study aims to test a comprehensive model for integrating environmental education and sustainability principles within the higher education ecosystem. The model emphasizes problem-based and service-learning approaches, technological integration, and behaviour change models to foster environmental education, and community engagement and enhance overall well-being. In this study, researchers examined the impact of curriculum, extracurricular activities, and community engagement as independent variables on dependent variables namely environmental education, sustainability, and well-being while also considering the mediating role of the undergraduates' awareness level. Data was collected from a higher education academic Institute in Riyadh, Saudi Arabia. The variance-based structural equation modeling (SEM) technique using Smart-Partial Least Squares (PLS) software was used to test these hypothesized relationships empirically. The study findings revealed a significant positive impact of curriculum development, extracurricular activities, and community engagement efforts on elevating undergraduates' awareness levels. Awareness levels mediated the effect of environmental education, sustainability, and well-being, highlighting the need to integrate environment-related topics into academic and extracurricular activities. This underscores higher education's potential to shape eco-conscious leaders by infusing environmental education into academic life. These findings have implications for higher education institutions, policymakers, and community organizers, emphasizing the importance of a holistic approach to environmental education for a sustainable society. By fostering environmental awareness among youth and integrating it into broader societal initiatives, educational institutions can play a crucial role in shaping a generation committed to sustainability and well-being.

Ulleung County, one of the most medically vulnerable areas in South Korea, requires public attention because of the high incidence of liver cancer. This study was conducted as a part of the Ulleung Liver Cancer Prevention and Management Project. The purpose of this study was to estimate the community prevalence of hepatitis B and C viruses and to identify the associated risk factors. The Project’s interagency workgroup established a procedure for conducting blood sampling and health behavior surveys at the Ulleung Public Community Health Center. A total of 1,792 residents aged 40 years and older voluntarily participated in the study between 2019 and 2022. The hepatitis B surface antigen (HBs Ag) and hepatitis C virus antibody (anti-HCV) positive rates in Ulleung were 7.19% and 1.37%, respectively. Low education level and lifetime smoking were associated with HBsAg positivity, whereas cupping therapy at non-medical institutions was associated with anti-HCV positivity. The odds of HBs Ag positivity were lower among those with tattoos than among those without. There was a difference in the risk factors associated with hepatitis B and C viral infection. While a high HBs Ag positivity rate alone may not fully explain the high incidence of liver cancer in Ulleung, it may be a contributing factor.

In recent years, bioengineered and biotechnological products have gained tremendous attention to identify unique biologic features associated with oncology. To overwhelm the complexity of tumor personalized medicines (PM) or vaccines could be a promising way-out to be considered. Cancer is a heterogeneous disease. This characteristic variability of cancer provides itself to the emergent era of PM i.e., precision oncology. The prime objective of PM is merely to deliver the right treatment to the right patient at the right time. For instance, imatinib was effectively targeted chronic myeloid leukemia. To date, attainment in using PM approaches to cancer treatment have been mixed. The next-generation sequencing (NGS), and the use of several biomarkers (e.g., HER2, BRAF, ALK, etc.), to drive precise cancer treatment through a timely and cost-effective manner. In current review, author summarizes the advancement in the field of PM such as CRISPR-Cas9, NGS, pharmacogenomics, and the benefits of machine learning techniques. The precise communication between healthcare professionals, regulatory bodies, and patients is essential to translate advances in PM into immense benefits for patients with cancer globally.

Cardiovascular diseases are one of the most common causes of death in the United States of America and the sudden rise of patients having cancer are suffering from cardiovascular side effects of Chemotherapeutics drugs. Trastuzumab is a potent targeted agent for HER2-positive cancers though despite its excellent efficacy, the cardiotoxic effects of Trastuzumab restrict its usage globally. The most severe adverse effect is cardiotoxicity presents as contractile dysfunction that is reduction in left ventricular systolic function but the electrophysiological side effects are still not known. Due to these severe life-threatening side effects, it routinely results in the cessation of Trastuzumab. This review aims to provide a comprehensive overview of Trastuzumab-induced cardiomyopathy, offering insights into the mechanisms through which Trastuzumab exerts its cardiotoxic effects, clinical manifestations, diagnostic strategies, and potential cardioprotective interventions. By shedding light on the multifaceted aspects of this condition, we hope to emphasize the importance of early detection and effective management, while highlighting the urgent need for continued research to optimize the balance between oncological success and cardiovascular well-being. Cardiologists, oncologists, and researchers stand at the forefront of this critical intersection between oncology and cardiology, collectively striving to improve patient outcomes in the era of Trastuzumab therapy.

To address the problems of insufficient semantic fusion between text and questions and the lack of consideration of global semantic information encountered in machine reading comprehension models, we proposed a machine reading comprehension model called BERT_hybrid based on BERT and hybrid attention mechanism. In this model, BERT is utilized to separately map the text and questions into the feature space. Through the integration of Bi-LSTM, attention mechanism, and self-attention mechanism, the proposed model achieves comprehensive semantic fusion between text and questions. The probabilities distribution of answers is computed using Softmax. Experimental results on the public dataset DuReader demonstrate that the proposed model achieves improvements in BLEU-4 and ROUGE-L scores compared to existing models. Furthermore, to validate the effectiveness of the proposed model design, we analyze the factors influencing the model’s performance.

Tuberculosis (TB) remains a global health threat, necessitating innovative strategies for control and prevention. This comprehensive review explores the Mycobacterium tuberculosis Lysine Exporter (LysE) gene, unveiling its multifaceted roles and potential uses in controlling and preventing tuberculosis (TB). As a pivotal player in eliminating excess L-lysine and L-arginine, LysE contributes to the survival and virulence of M. tuberculosis. This review synthesizes findings from different electronic databases and includes 13 studies focused on the LysE of M. tuberculosis. The research unveils that LysE can be a potential drug target, a diagnostic marker for TB, and a promising candidate for vaccine development. The absence of LysE in the widely used BCG vaccine underscores its uniqueness and positions it as a novel area for TB prevention. In conclusion, this review underscores the significance of LysE in TB pathogenesis and its potential as a drug target, diagnostic marker, and vaccine candidate. The multifaceted nature of LysE positions it at the forefront of innovative approaches to combat TB, calling for sustained research efforts to harness its full potential in the global fight against this infectious disease.

Introduction: Cleft lip with or without cleft palate (CL/P) is the most common congenital face anomaly in the world of multifactorial etiology. Objective: To determine the prevalence and characteristics of cleft palate. To identify associated risk factors to guide prevention and/or prenatal detection for early intervention and better health outcomes. To assess the rehabilitation protocols after operations in cleft palate. Design: Retrospective descriptive and clinical study. Patients: One hundred and three children with cleft palate treated in the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury, were included in the study. Methods: Records evaluation was conducted regarding sex, cleft type, mother occupation, parents education, histories of cleft in any of parents. The data were analyzed using R (R core team 2021) and the ordinal logistic regression analyses. Results: Children of stressed mothers during pregnancy had 9.4 times higher odds of having bilateral cleft. While there was no evidence that children sex, order of birth, and body mass as well as risk of maternal toxicity at work or reporting infections or drugs toxicity had a significant effect on the dependent variable. Conclusions: Children of parents with cleft history and having low educated mothers had higher probability of bilateral cleft palate. Children of stressed mothers during pregnancy had higher odds of having bilateral cleft. In literature, there is a lack of reports about rehabilitation in different operations methods in children with cleft palates.

Medical data flows in streams as the data related to clinical tests and administered drugs by the doctors flows continuously. The doctors must be immediately alerted if negative associations are found among the drugs they prescribe. Data streams are to be processed in single scans as it is not possible to re-scan the data for any iterative processing. To detect negative drug connections, regular and frequent drug patterns must be processed. Negative correlations between disease-curing medications might create adverse responses that kill patients. This paper proposes an algorithm that finds the negative associations among regular and frequent patterns mined from medical data streams. The negative associations mined are the most effective and reduce the negative associations, which are more critical by 50%.

Intrahepatic cholangiocarcinoma (ICCA) is a malignant epithelial neoplasm characterized by biliary differentiation within the liver. ICCA is molecularly heterogeneous and exhibits a broad spectrum of histopathological features. It is a highly aggressive carcinoma with high mortality and poor survival rates. ICCAs are classified into two main subtypes: small duct type and large duct types. These two tumor types have different cell origins and clinicopathological features. ICCAs are characterized by numerous molecular alterations, including mutations in KRAS, TP53, IDH1/2, ARID1A, BAP1, BRAF, SAMD4, and EGFR, and FGFR2 fusion. Two main molecular subtypes–inflammation and proliferation–have been proposed. Recent advances in high-throughput assays using next-generation sequencing have improved our understanding of ICCA pathogenesis and molecular genetics. The diagnosis of ICCA poses a significant challenge for pathologists because of its varied morphologies and phenotypes. Accurate diagnosis of ICCA is essential for effective patient management and prognostic determination. This article provides an updated overview of ICCA pathology, focusing particularly on molecular features, histological subtypes, and diagnostic approaches.

We developed an ovarian cancer-targeted drug delivery system based on a follicle-stimulating hormone receptor (FSHR) peptide. The lipophilic chemotherapeutic drug SN38 and the photosensitizer IR820 were loaded into the phospholipid bilayer of liposomes. Near-infrared laser irradiation stimulated the generation of reactive oxygen species, causing short-term reactive molecular species and spatial-temporal restricted photodamage to the biological targets. The reactive molecular species and spatial-temporal restricted photodamage enhanced the release and uptake of chemotherapy drugs and increased the sensitivity to chemotherapy drugs in ovarian cancer cells. FSH liposomes loaded with SN38 and IR820 (SN38/IR820-Lipo@FSH) were prepared using thin-film hydration-sonication. FSH peptide binding was analyzed using 1H NMR spectrum and Maldi-Tof. The average size and zeta potential of SN38/IR820-Lipo@FSH were 105.1 ± 1.15 nm (PDI: 0.204 ± 0.03) and −27.8 ± 0.42 mV, respectively. SN38/IR820-Lipo@FSH exhibited good drug-loading properties and the in vitro release was slow. FSH significantly increased the uptake of liposomes, inhibited cell proliferation, and induced apoptosis in A2780 cells. Moreover, SN38/IR820-Lipo@FSH exhibited good tumor-targeting ability and anti-ovarian cancer activity in vivo. The SN38/IR820-Lipo@FSH exhibited specific targeting to A2780 ovarian cancer cells. The combination of chemotherapy and photodynamic treatment based on an FSH peptide-targeted delivery system may be an effective approach to treating ovarian cancer.

Background: Bioelectrical impedance (BIA) and ultrasound (US) have become popular for estimating body fat percentage (BF%) due to their low cost and clinical convenience. However, agreement of these devices with gold standard method still require investigation. The aim was to analyze the agreement between a gold standard %BF assessment method with BIA and US devices. Methods: Twenty-three men (age 30.1 ± 7.7 years, 82.5 ± 14.9 kg, 1.77 ± 0.05 m) underwent Dual Energy X-Ray Absorptiometry (DXA), BIA (tetrapolar) and US (three-site method) %BF assessment. Pearson and concordance correlations were analyzed. T-test compared means between methods, and Bland Altman plots analyzed agreement and proportional bias. Alpha was set at &lt; .05. Results: Pearson coefficients between BIA and US with DXA were high (BIA = 0.94; US = 0.89; both p &lt; .001). Concordance coefficient was high for BIA (0.80) and moderate for US (0.49). BF% measured by BIA (24.5 ± 7.5) and US (19.4 ± 7.0) were on average 4.4% and 9.6% lower than DXA (29.0 + 8.5%), respectively (p &lt; .001). Lower and upper agreement limits between DXA and BIA were -1.45 and 10.31, while between DXA and US were 2.01 and 17.14, respectively. There was a tendency of both BIA (p = .09) and US (p = .057) to present proportional bias and underestimate BF%. Conclusions: Despite the correlation, the mean difference between the methods were significant, and the agreement limits are very wide. This indicate that BIA and US, as measured in this study, have limited potential to accurately measure %BF compared to DXA, especially in individuals with higher body fat.

The marketing industry is rapidly evolving, necessitating educational programs to adapt and equip graduates with relevant skills and knowledge. This systematic literature review with bibliometric analysis (SLRBA) explores the integration of Problem-Based Learning (PBL) in marketing education. PBL is an instructional strategy that empowers students to solve real-life problems by integrating theory and practice, thus fostering critical thinking and decision-making skills. Our review synthesizes data from 71 sources, highlighting the definition of PBL, strategies to promote its implementation in marketing education, and the benefits and challenges associated with this approach. The findings indicate that PBL enhances student engagement, provides hands-on experience, and prepares students for real-world marketing challenges. Strategies such as using social media, serious games, e-learning, and feedback mechanisms are discussed for their effectiveness in promoting active learning and student participation. Despite its advantages, PBL faces challenges such as resource intensiveness, student resistance, and information integrity issues. This review underscores the importance of PBL in bridging the gap between theoretical knowledge and practical application, ultimately preparing marketing students to meet the demands of the industry. The paper concludes with recommendations for future research and best practices for implementing PBL in marketing education.

IntroductionThe use of protective masks, especially medical masks, increased dramatically during the COVID-19 crisis. Medical masks are made of synthetic materials, mainly polypropylene, and a majority of them are produced in China and imported to the European market. The urgency of the need has so far prevailed over environmental considerations.ObjectiveAssess the environmental impact of different strategies for the use of facemaskMethod Different strategies for the use of medical and community masks are being investigated for their environmental impact in this study. 8 scenarios, differentiating the typologies of masks and the modes of reuse are compared using several environmental impact indicators, mainly the Global Warming Potential (GWP100), and the plastic leakage (PL). This study attempts to provide clear recommendations that consider both the environmental impact and the protective effectiveness of face masks used in the community.Results The environmental impact of single-use masks is the most unfavorable, with a GWP of 0.4 -1.3 kgCO₂ eq., depending on the transport scenario, and a PL of 1.8 g, for a one month protection against COVID-19. The use of home-made cotton masks and prolonged use of medical masks through wait-and-reuse are the scenarios with the lowest impact.ConclusionThe use of medical masks with a wait and reuse strategy seems to be the most appropriate when considering both environmental impact and effectiveness. Our results also highlight the need to develop procedures and the legal/operational framework to extend the use of protective equipment during a pandemic.

During the last years, significant initiatives have been launched for the dissemination of Open Access as part of the Open Science movement. Nevertheless, the other major pillars of Open Science such as Open Research Data (ORD) and Open Peer Review (OPR) are still in an early stage of development among the communities of researchers and stakeholders. The present study sought to unveil the perceptions of a medical and health sciences community about these issues. Through the investigation of researchers’ attitude, valuable conclusions can be drawn, especially in the field of medicine and health sciences, where an explosive growth of scientific publishing exists. A quantitative survey was conducted based on a structured questionnaire, with 51.8% response rate (215 responses out of 415 electronic invitations). The participants in the survey agreed with the ORD principles However they ignored basic terms like FAIR (Findable, Accessible, Interoperable and Reusable) and appeared incentive to permit the exploitation of their data. Regarding OPR, participants expressed their agreement, implying their interest for a trustworthy evaluation system. Conclusively, researchers urge to receive proper training for both ORD principles and OPR processes which combined with a reformed evaluation system will enable them to take full advantage of the opportunities that arise from the new scholar publishing and communication landscape.

As companies increasingly undergo digital transformation, the role of talent management pro-cesses becomes pivotal in enhancing overall organizational performance. The research addresses the significance of talent management in corporate digital transformation, examining whether variations in the digitalization of these processes can be attributed to company size. A qualitative approach was employed, utilizing a questionnaire, collecting responses from 202 organizations across diverse sectors. Findings reveal disparities in digitalization throughout the talent man-agement process, with pronounced presence in the attracting, selecting, and rewarding phases, but diminishing in deployment and development, further declining in planning. A positive cor-relation between company size and adoption of specific digital platforms was observed. Larger enterprises exhibit greater utilization of digital platforms in talent deployment and development. Moreover, corporate communication tools are consistently utilized in the rewarding phase, irre-spective of company size. These findings offer practical insights for organizations to optimize their digitalization strategies based on their scale, thereby contributing to more effective and tailored digitalization endeavors. The uniqueness of this research lies in its exploration of the in-fluence of company size on the digitalization of talent management processes and its potential to explain variations across different stages of these processes.

Machine learning (ML) offers potential opportunities to enhance the learning, teaching and assessments within veterinary medical education including but not limited to assisting with admissions processes as well as student progress evaluations. The purpose of this primer is to assist veterinary educators in appraising and potentially adopting these rapid upcoming advances in data science and technology. In the first section, we introduce ML concepts and highlight similarities/differences between ML and classical statistics. In the second section, we provide a step-by-step worked example using simulated veterinary student data to answer a hypothesis driven question. Python syntax with explanations is provided within the text to create a random forest ML prediction model and within each step, specific considerations such as how to manage incomplete student records are highlighted when applying ML algorithms within the veterinary education field. The results from the simulated data demonstrate how decisions by the veterinary educator during ML model creation may impact the most important features contributing to the model. These results highlight the need for the veterinary educator to be fully transparent during the creation of ML models and future research is needed to establish guidelines for handling data not missing at random in medical education, and preferred methods for model evaluation.

Background: Physiotherapy and chronic low back pain (CLBP) form a broad and fast developing research area. The aim of the article was to holistically, thematically and chronologically analyze and synthesise literature production and identify most prolific research entities and research themes. Methods: The article quantitatively and quantitatively analyzed research literature production harvested from the Scopus bibliometric database. using a triangulation of bibliometric and thematic analysis. For this, Excell and VOSwiever software were used. Results: In the Scopus database, 2843 data sources were found, which were published between 1974 and February 26, 2024. The growth trend has been linearly positive since the beginning of publication, and after 2018, exponential growth began. A review of the most prolific entities showed that the most literature was published in America, Europe and Australasia. The thematic analysis of the information sources identified six main themes, while the chronological analysis revealed three main areas of developments: assessment tools, CLBP processing and study methodology. Conclusions: The results of the bibliometric study presents a good starting point for further research providing Taxonomy and research landscapes as a holistic framework offering multidisciplinary knowledge about CLBP, while chronological analysis provides a basis for identifying prospective research trends.

Beta thalassemia is an inherited blood disorder that results in inefficient erythropoiesis due to genetic mutation that leads to reduction or absence of the hemoglobin beta-globulin protein. Approximately 8.5% of UAE residents suffer from β-thalassemia, a significant health and financial problem. The treatment options available for β-Thalassemia major are limited and associated with a wide range of complications. β-thalassemia gene therapy is emerging as a potential novel treatment option that eliminates the complications caused by the current long-term treatment modalities and the associated economic burden. This paper reviews the scientific literature related to emerging gene-therapy for β-Thalassemia by analyzing all the articles published from January 2010 to December 2023 in the English language on Databases like PubMed, Scopus, ProQuest, and CINAHL. The use of gene therapy has demonstrated promising outcomes for a permanent cure of β-Thalassemia. ZYNTEGLO (Betibeglogene autotemcel) is the only cell-based gene therapy which was approved by the FDA on 19th August, 2018. To conclude, Gene therapy is an innovative solution. It demonstrates a promising future, but does come with its own set-backs and is something that must be tackled in-order to revolutionize it in the medical world. FDA approved ZYNTEGLO is a potentially one-time curative treatment for β-Thalassemia. Although cutting-edge, its use is limited because of the high cost; a price of $2.8million per patient.