Data4HumanRights training materials have been developed as open-source and tailored to limited resource settings where community data collectors often live and work. An overview of how the training material was developed together with community data collectors in Nigeria and Kenya is provided. The paper gives insights into the fundamental principles (i.e., inclusiveness, adaptive, limited resources, gender- and incentive-sensitive) and the structure of the open-access training materials. This resulted in 28 modules designed to be delivered in a face-to-face format in less than one day by a local trainer. To maximize adaptivity, the training modules can be mixed and matched (e.g., as individual modules or a learning path of several modules around a specific training need). The individual modules cover a range of methods and tools that are useful to human rights work, for example, documenting evictions, performing rapid needs assessments after acute crises, community profiling, and monitoring community development indicators. The training materials contain instructions for the facilitator(s) of the training and all necessary training materials to conduct the training. To maximize inclusivity, the training covers basic to advanced topics. Most training modules address basic training topics that can be optimally followed with a mobile phone (to avoid using a computer and printing handouts). The training was developed and implemented with local community groups in Nigeria and Kenya. The material is free to use, adapt, and translate into different contexts and languages.

Intensive care unit discharge is an important transition which impacts on patient wellbeing. Nurses can play an essential role in this scenario, potentiating patient empowerment. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. Embase, PubMed/MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were evaluated in May 2021. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. Quality of the studies included was assessed using the Cochrane risk-of-bias tool. Of the 273 articles initially identified, eight randomized controlled trials reported nursing interventions mainly focused on patients’ ICU discharge preparation through information and education. The creation of ICU Nurse-Led and nurses’ involvement in critical care multidisciplinary teams also aimed to support patients during ICU discharge. This systematic review provides an update on clinical practice aimed at improving the patient experience during ICU discharge. The main nursing interventions were based on information and education, as well as the development of new nursing roles. Understanding transitional needs and patient empowerment are key to making the transition easier.

Background: The Second Victim Phenomenon (SVP) significantly impacts the well-being of healthcare professionals and patient safety. While SVP has been explored in various healthcare settings, there is limited data on its prevalence and associated factors among nurses in Austria. This study investigates the prevalence, symptomatology, and preferred support measures for SVP among Austrian nurses. Methods: A nationwide, cross-sectional, anonymous online survey was conducted using the SeViD questionnaire (Second Victims in German-speaking Countries), which includes the Big Five Inventory-10 (BFI-10). Statistical analyses included binary logistic regression and multiple linear regression using the bootstrapping, bias-corrected and accelerated (BCa) method based on 5000 bootstrap samples. Results: 928 participants responded to the questionnaire. Among the respondents, 81.58% (744/912) identified as Second Victims (SVs). The primary cause of becoming a SV was aggressive behavior from patients or relatives. Females reported a higher symptom load than males, and higher agreeableness was linked to increased symptom severity. Notably, 92.47% of SVs who sought help preferred support from colleagues, and the most pronounced desire among participants was to process the event for better understanding. Conclusions: The prevalence of SVP among Austrian nurses is alarmingly high, with aggressive behavior identified as a significant trigger. The findings emphasize the necessity for tailored support strategies, including peer support and systematic organizational interventions to mitigate the impact of SVP on nurses and to improve overall patient care. Further research should focus on developing and implementing effective prevention and intervention programs for healthcare professionals in similar settings.

Monitoring of clients living with HIV encompasses a specific array of activities that routinely check on various aspects of ART following its initiation depending on the availability of resources in that particular state, among other factors as per guidelines from the World Health Organisation. This is a significant practice as it promotes positive health outcomes for patients and efficient utilisation of ART regimens to reduce resistance to the medication – hence it is a measure to guard avoidable costs. It also forms a basis on which decisions are made from. It can be done clinically by assessing for signs e.g., skin rash and symptoms e.g., nausea and vomiting, checking vital organ function and measuring weights across all populations, or can be also be done by assessing specimens for their respective viral loads, white blood cell count, pregnancy status or other infections such as hepatitis B. There have not been any special indications required for one to be eligible for monitoring during ART in developing countries; all qualify for routine monitoring even though some may be more frequent than others in cases of comorbidities such as renal failure where medications can be attributed to exacerbating the condition.

We were tasked by Canada’s COVID-19 Immunity Task Force to describe severe adverse events (SAE) associated with emergency department (ED) visits and/or hospitalizations in immune-mediated inflammatory diseases (IMID). At 8 Canadian centres, data were collected from adults with rheumatoid arthritis (RA), axial spondyloarthritis (AxS), systemic lupus (SLE), psoriatic arthritis (PsA) and inflammatory bowel disease (IBD). We administered questionnaires, analyzing SAEs experienced within 31 days following SARS-CoV-2 vaccination. About two-thirds (63%) of 1556 participants were female; mean age was 52.5 years. BNT162b2 (Pfizer) vaccine was the most common, with mRNA-1273 (Moderna) being second. Forty-nine percent of participants had IBD, 27.4% RA, 14.3% PsA, 5.3% SpA, and 4% SLE. Twelve SAEs leading to ED visit or hospitalization were self-reported, occurring in 11 participants. SAEs included 6 ED visits (including one Bell’s Palsy 31 days after first vaccination) and 6 hospitalizations (including one Guillain-Barré syndrome 15 days after the first vaccination). Two SAEs involved pericarditis, one in SLE (considered a serious disease flare) and one in RA. Thus, in the 31 days after SARS-CoV-2 vaccination in IMID, though several serious AEs occurred, these were relatively few. As SARS-CoV2 continues to be a common cause of death, our findings may help optimize vaccination acceptance.

Undernutrition and micronutrient deficiencies such as anemia are considered significant public health challenges in Bangladesh, which enhancing fish consumption is a well-established food-based intervention to address these. This paper documents the establishment of community-based fish chutney production and reports the impact of its consumption on mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels among targeted 150 pregnant and lactating women (PLW) in rural Bangladesh. A fish chutney was developed using locally available ingredients followed by a series of laboratory tests, including nutrient composition, shelf-life and food safety. A community-based fish chutney production process was designed to: 1) supply locally available ingredients for processing; 2) establish two fish drying sites; 3) initiate a community-based production site, and 4) distribute fish chutney to PLW by six women nutrition field facilitators for one year. Then a pre- and post-intervention study was designed for a selected 150 PLW to receive 30g of fish chutney daily for 12 months. Differences in mean mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels pre- and post-consumption were analyzed using one-way analysis of variance. Consumption of 30g of fish-chutney resulted in significant increases of the mean values of Hb levels and MUAC among the targeted PLW.

Management of sarcomas in specialist centers delivers significant benefits. In much of the world specialists are not available and development of expertise is identified as a major need. However the terms ‘specialist’ or ‘expert’ center are rarely defined. Our objective is to offer a definition for patient advocates and a tool for healthcare providers to underpin improving the care of people with sarcoma. SPAGN developed a discussion paper for a workshop at the SPAGN 2023 Conference, attended by 75 delegates. A presentation to the Connective Tissue Oncology Society (CTOS) and further discussion led to this paper. Core Principles were identified that underlie specialist sarcoma care. The primary principle is the multi-disciplinary team discussing every patient, at first diagnosis and during treatment. Principles for optimal sarcoma management include accurate diagnosis followed by safe, high-quality treatment, with curative intent. These Principles are supplemented by Features describing areas of healthcare, professional involvement, and service provision and identifying further research and development needs. These allow for variations because of national or local policies and budgets. We propose the term ‘Sarcoma Intelligent Specialist Network’ to recognize expertise wherever it is found in the world. This provides a base for further discussion and local refinement.

(1) Background: Second Victims are health care workers negatively affected by adverse events and are prone to developing dysfunctional coping strategies compromising not only their own, but also patient safety. An effective way to address this issue is the implementation of peer support programs. This paper reports on the effectiveness of a peer support program at the Austrian Hietzing Clinic (KHI). (2) Methods: Telephone interviews were carried out after peer support sessions using a questionnaire. Descriptive analysis was carried out reporting frequencies and proportions for nominal variables, means with standard deviations for ordinal and interval-scaled variables. (3) Results: So far, 45 peer supporters have completed telephone interviews after a peer support session. The main reasons for the session were bad news from the private sphere and death of a patient. The peer supporters rated the helpfulness of the sessions for their colleagues as very high while not feeling very burdened themselves afterwards. (4) Conclusions: Underutilization of the program is probable. However, the high rating of helpfulness of the carried-out sessions by the peer supporters in combination with them not feeling very burdened, shows that the program is safe for the peer supporters and an upscaling is warranted.

This paper has two objectives: the first, to analyze the mediating effect of teacher empowerment between innovation culture and innovation capacity, and between inclusive leadership and innovation capacity; the second, to analyze the moderating effects of the school context on the innovation capacity. Data were collected in a representative sample of secondary schools in Valencia, Spain. The research model adopted is structural equation modeling, using the partial least squares (PLS) technique. The model has confirmed that teacher empowerment mediates between innovation culture and innovation capacity and between inclusive leadership and the innovation capacity. It is found that the educational context does not moderate the relationships in the proposed analysis model. This paper emphasizes the role of teacher empowerment in educational innovation and extends the knowledge of culture and leadership in the school organization.

Introduction. Intra-abdominal cystic formations represent heterogeneous pathologies with varied localization and clinical manifestation. The first challenge of a giant intra-abdominal cystic lesion is identifying the organ of origin. The clinical presentation of intra-abdominal cystic lesions varies from acute manifestations to non-specific symptoms or accidental discovery. Case presentation: A 2-year-old girl presents to the emergency unit with a fever of 38.5 Celsius, loss of appetite, and apathy. The investigations showed a gigantic intra-abdominal mass whose organ belonging could not be specified. Postoperatively, a giant mesenteric lymphangioma was evident, which was completely excised. Discussions Giant cystic formations modify the anatomical reports and become space-replacing formations, and the starting point is even more challenging to assess preoperatively. Nevertheless, the careful evaluation of the characteristics of the formation, the effect on the adjacent organs, the age of the patient, and the clinical picture can provide elements of differential diagnosis.

This study examines the differential impact of proactive and reactive job crafting behaviors on job well-being, drawing from the perspective of boundary theory. The increasing popularity of work connectivity behavior after-hours (WCBA) after work has attracted widespread attention from scholars on the relationship between WCBA and employee well-being. One view suggests that the impact of WCBA is negative, while another view suggests it is positive. Obviously, the impact of (WCBA) on well-being at work is still contradictory. To clarify the complexity of the impact of WCBA on well-being at work, based on boundary theory, we divided WCBA into proactive WCBA (PC) and reactive WCBA (RC), and examined the double-edged sword effect of WCBA on well-being at work, as well as the mediating mechanisms of job control and work-to-home conflict, and the moderated effects of boundary segmentation preferences. This study uses empirical sampling method to collect data from 125 employees for a period of five days for quantitative research. The results show that, first, PC has an inverted U-shaped effect on job control, and job control is negatively related to well-being at work. Thus the mediating effect of job control is significant. Second, RC has a negative impact on job control, and there is also a negative relationship between job control and well-being at work. Therefore, the mediating effect of job control is significant. Third, PC and RC are positively correlated with work-to-home conflict, and work-to-home conflict has a significant positive impact on well-being at work. Therefore, the mediating effect of work-family conflict is significant. Fourth, the study also found that integration preference moderates the relationship between work-to-home conflict and PC on well-being at work, that is, the mediating effect of work-to-home conflict is stronger for employees with low integration preference. This study enriches our understanding of WCBA, PC and RC from the perspective of proactive and passive employee behaviors. The study also provides a new interpretation of the impact of WCBA on well-being at work and offers valuable insights for the sustainable development in digital social transformation and the application of boundary theory and the theory of empowerment-subjugation in achieving the United Nations Sustainable Development Goals. In addition, the study deepens our understanding of the heterogeneous regulatory role played by work-family integration preferences in influencing well-being at work under different types of WCBA.

Aim: The aim of the study is to analyze quantitatively the scientific literature covering nursing studies on patient safety. Method: The Web of Science database is queried in this retrospective bibliometric analysis to identify relevant publications. The study themes, contributing journals, countries, institutions, and authors were evaluated quantitatively. Thus, a total of 5470 publications concerning patient safety in nursing were included and analyzed. Findings: The number of studies conducted increased every year from 1992 to 2023. While the country whose articles receive the most citations (31072) is the United States of America (USA), Turkey is ranked as last with the lowest number of citations (581). Journal of Clinical Nursing, with 338 articles, appeared to have the highest number of publications, Chaboyer W. appeared to have the highest number of citations with a total of 1426 and 45 publications. The countries that have the strongest international cooperation for research in this field are the USA, England, Australia and China. Results: After examining the literature in the field of patient safety in nursing through bibliometric analysis, it is seen that themes such as patient safety, medication errors, nursing care, nursing, education, systematic review, quality care and leadership were emphasized as important considerations.

Lichen Amyloidosis (LA) is a type of cutaneous amyloidosis characterized by brownish hyperkeratotic and itchy papules on the lower leg, back, forearm or thigh. It is associated with itching and Atopic Dermatitis (AD) according to an etiopathogenetic mechanism that has not yet been fully elucidated. Currently, available therapies for this condition include oral antihistamines, laser, cyclosporine, topical corticosteroids and phototherapy, but in light of the overlap with AD, Dupilumab may also be indicated. We report the case of a female, 52 years old, suffering from AD and LA for about 27 years. She had lesions attributable to both diseases on the trunk and lower limbs associated with severe itching and had proved resistant to cyclosporine therapy. It was decided to opt for Dupilumab with induction of 2 fl of 300 mg and maintenance with 1 fl every other week. The therapy proved effective, returning a total resolution of both diseases one year after the beginning of the treatment. Dupilumab demonstrated efficacy and safety in LA related to AD and led to clinical and quality of life improvement in this patient. Therefore, Dupilumab should be considered when treating LA. Further studies should be conducted focusing on the efficacy of the drug on LA (whether or not related to AD), changes in skin lesions after discontinuation, and the safety of long-term application.

Despite concepts of human flourishing, a term connected to empowerment that acts as an archi-tectural structure within the development and sustainability discourse, tensions remain between exponential economic growth, planetary health and community empowerment. Scholars argue that the development agenda is maldevelopment due to the unrequested interventions delivered to communities, mainly in the Global South (Shiva, 1999). A current state of disorientation grips the modern world, and despite sophisticated global frameworks like the Sustainable Development Goals (SDGs), internal approaches are side-lined. This research article repositions empowerment and compassion at the centre of the sustainable development discourse by drawing on the Inner Development Framework, particularly goal one – Being – ‘Relationship to Self’ and goal three – Relating – ‘Caring for others and the World’ as a guiding theoretical underpinning. Accordingly, this research article presents a qualitative interpretative study that examines the lived experience of women and their journeys to empowerment. The key findings indicate an intricate relationship between wellbeing and empowerment and the realisation of inner development as a tool to re-imagine alternative futures. The Machiavellian tendency to the sustainability agenda is deeply embedded in the profiteering of the misery of affected communities.

Entrepreneurship education in South Africa holds significant promise in empowering the youth and fostering economic growth. This article explores the impact of entrepreneurship education on youth empowerment, focusing on case studies of successful young entrepreneurs, evaluation of entrepreneurial skills development, and analysis of employment and economic outcomes. While effective models of entrepreneurship education emphasize experiential learning and collaboration with local businesses, resource constraints and infrastructure gaps pose challenges. Moreover, socio-cultural perceptions and gender disparities influence youth's willingness to engage in entrepreneurship, hindering inclusivity. Evaluating the long-term impact remains challenging, requiring robust monitoring and evaluation mechanisms. The article concludes with recommendations to enhance the impact of entrepreneurship education, including increasing funding, challenging stereotypes, fostering collaboration, and developing evaluation mechanisms to support South Africa's youth in realizing their entrepreneurial potential.

This research provides an in-depth analysis of drought impacts in West Pokot, Kenya, utilizing both remote sensing surveys and focus group discussions. The study commenced by assessing the impact of drought on vegetation health via spatial sensors. It then utilized surveys and focus group discussions (FGDs) to engage farmers from the most drought-affected areas in Kacheliba and Sigor sub-counties. The analysis of remote sensing data from 1990 to 2022 highlighted that Sigor and Kacheliba experienced significant drought events during the years 1995, 2000, 2002, 2005, and 2009, and 1991, 1995, 2000, 2005, and 2019, respectively. This study delves into both the meteorological and socio-economic effects on local communities. Using the Multinomial Logistic Regression (MLR) model with the glm function, the research uncovered the impacts of so-cio-economic factors and agricultural practices on household livestock production. Additionally, the study employed Multiple Correspondence Analysis (MCA) to explore the dynamics between livestock production, community resilience, and crop production. The findings underscore the urgent need for tailored interventions to enhance community resilience in the face of increasing climatic extremes, serving as a blueprint for similar arid and semi-arid regions worldwide.

Transdisciplinary research approach requires that different scientists with their discipline-specific theories, concepts and methods find ways to work together with other societal players to solve a real-life problem. In order to put this into practice, Trans-disciplinary Action Research (TDR) approach was applied in this study using Push pull technology (PPT) as a boundary object. The study was conducted in Bako Tibe, Jimma arjo and Yayu Woredas (Districts) in the Oromia region of Ethiopia from August 2014 to April 2015. PPT is a biological based mechanism developed by researchers for stemborer pest control in maize. It involves inter-cropping maize with a stemborer moth-repellent silverleaf or Greenleaf Desmodium (push), and planting an attractive trap crop, Napier or Brachiaria grass (pull), around the maize crop. On farm PPT implementation was used to provide an opportunity for collaboration, interaction and learning among heterogeneous set of stakeholders comprising of researchers from Ethiopian Institute of Agricultural research and the practitioners from the ministry of agriculture and smallholder farmers/traders. The data was collected using mixed methods approach comprising of key informant interviews, Focus Group discussions, workshops, on-farm practical demonstrations and participant observations. The findings shows that; collaborative leadership provides a chance for the stakeholders to participate in the technology learning and decision making by enabling them to jointly contribute skills towards development, refinement and adaptation of PPT. In situations where there are conflicts, they are embraced and become opportunities for in-depth learning, finding solutions and adaptation rather than being sources of contradictions or misunderstandings. Leadership roles taken by farmers play a key role in terms of ability to reflect on their own practices and drawing on scientific explanations from researchers. It also enables them take lead in new technology implementation and information sharing in free and easy manner with fellow farmers and other stakeholders. Although PPT perennial nature of cropping provides opportunities for continuous stakeholder interaction and learning, it requires a personally committed leadership and formal institutional engagements for the sustainability of its activities spanning over several cropping seasons. Market forces and the involvement of private sector players also has a role to achieve this as shown from the involvement of individual farmers and traders in Desmodium and Brachiaria seed production, collection and distribution.

(1) Background: As part of the Scottish Governments five-year recovery plan to address the backlog in NHS care following the COVID-19 pandemic, community pharmacies in Scotland are planned to provide a Hospital Discharge Medicines Supply and Medicines Reconciliation Service. We aimed to qualitatively explore patients’ experience of this new service; (2) Method: Adult patients (≥18yrs age) who consented to participate in the Community Pharmacy Hospital Dis-charge and Medicines Reconciliation Service were invited for interview within 21 days of dis-charge from hospital. Qualitative, one-to-one, semi-structured, patient interviews were conducted by telephone and audio-recorded using Microsoft Teams®. The interview audio recordings were transcribed verbatim and underwent thematic analysis; (3) Results: 12 patients were inter-viewed, evenly split by sex and with a median age of 62 years (range; 36 to 88 years). Analysis generated main five themes; Patient Engagement, Stakeholder Communication, Practical Factors, Human Factors, and Comparative Experiences. Many of these were interdependent; (4) Con-clusions: Patients appreciated that the service ensured a quicker discharge from hospital. Good stakeholder communication, practical factors (including choice, location, and the realities of ob-taining their medication from the community pharmacy), and a pre-existing and trusted rela-tionship in their usual community pharmacy were the key factors that regulated the patient ex-perience. In the main, patients were positive about the introduction of this new service. However, a lack of previous relationship or trust with a community pharmacy, and previous experiences with medication supply problems were factors which had the potential to negatively impact on patient experiences.

(1) Background: The study of microbiome is being crucial for his role in major systemic diseases, in particular the oral and gut microbiota. In the last years the study of microorganism correlated for example with neurodegenerative disease is increasing the prospective of a possible link between gut microbiota and brain. Here we report a new case report about a patient evaluated genetically firstly for dementia and late-onset dyskinesia, and then tested with 16S metagenomics sequencing. (2) Methods: Starting from buccal swab, we extracted bacterial DNA and then we performed a NGS metagenomics sequencing based on the amplification of hypervariable regions of the 16S in bacteria. (3) Results: The sequencing revealed the presence of Spirochaetes Phylum, a pathogenic bacterium generally known to be able to migrate to the Central Nervous System and not only. (4) Conclusions: Oral infections as our results shows could be possible contributing factors to various neurodegenerative conditions.

In 2018, the state of Himachal Pradesh in north India launched an initiative to convert all its farmers to natural farming (NF), an agroecological approach. The aim was to address multiple challenges related to rural livelihoods, high input costs, biodiversity loss, and environmental degradation. This paper is based on a qualitative case study of the state programme to transition farmers to NF. It seeks to understand how its mechanisms support and empower small and marginal women farmers. In addition to identifying mechanisms that facilitate the effective uptake of NF, the case study sought women's views on whether these increased spaces for decision-making and developed capabilities and autonomy. Framed within the vision of reclaiming food sovereignty, various mechanisms such as training in villages, participating in NF groups and networks, visits to model farms and adopting leadership roles offered new pathways for women farmers to gain confidence and capabilities. Women began to participate in spaces that had been culturally and structurally denied to them. This case study illustrates how agroecology efforts with a specific focus on gender have the potential to provide women with creative outlets and a variety of decision-making and income-generating roles, spaces for community learning and knowledge needed for sustainable ecosystems.

ChatGPT, a freely-accessible AI language model designed to generate human-like text responses to users, has been utilized in several areas, such as healthcare industry, to facilitate interactive dissemination of information. Academic advising has been an important factor in promoting success among university students, particularly those from disadvantaged backgrounds. Unfortunately, however, student advising has been marred with problems, with the availability and accessibility of advisors being among the hurdles. The current study explores how ChatGPT might serve to make academic advising more accessible, efficient, and even effective. Researchers compiled a list of questions frequently asked by current and prospective students in a teacher education Bachelor’s degree program in the United States. Then, the questions were typed into the free version of ChatGPT and the answers generated were evaluated for their content and delivery. ChatGPT generated surprisingly high-quality answers, written in an authoritative yet supportive tone, and it was particularly adept at addressing general career-related questions comprehensively, such as career outlook. We argue that ChatGPT may complement, but not replace, human academic advisors and it may very well promote educational equity through empowering students from a wide range of backgrounds with the means to access effective advising.

As a potential motivation, psychological empowerment stimulates employees' work behaviors, and it determines the degree of effort and duration of employees' work. Only when employees are psychologically empowered, will they have an impact on their behavior when they believe that they are trusted. This paper chose to set the independent variable as the employee's perceived trust and the dependent variable as the company's work performance, and explored the mediating role of psychological empowerment in the two. The psychological empowerment of employees had a positive impact on work performance. Employees with high psychological empowerment tended to be proactive in their work, and had more input in the work, which in turn encouraged employees to have higher work performance. The four dimensions of psychological empowerment can positively affect employee task performance, and the ability and influence of psychological empowerment had a positive impact on relationship performance. Psychological empowerment as a whole perception played a part of the mediating role between the perception of superior dependency and task performance, and it played a part of the mediating role between perception of superior dependency and relationship performance. As a whole perception, psychological empowerment played a part of mediating role between perceived information disclosure and task performance, and part of mediating role between perceived information disclosure and relationship performance. In the study of perceived trust and work performance, this article focused on the mediating role of psychological empowerment, and further understood the internal mechanism of perceived trust.

In 2013, thirty-eight treadle pumps (TPs) were installed as low-cost technology introduction for small-scale irrigation in eastern Ethiopia. This pilot project also trained six farmers on tube well excavation, installation and maintenance of pumps. In June 2015, researchers visited nine of the 38 TP villages, and found only two functional TPs. The rest were replaced with a new technology developed by the trained farmers. Adopters of the new technology stated that the limited water output and high labor demand of the conventional TP did not optimally fulfil their irrigation water requirements. The new technology had spread quickly to more than one hundred households due to three key factors. First, farmers’ innovative modifications of the initial excavation technique addressed the discharge limitations of the conventional TP by excavating boreholes with wider diameter. Second, local ownership of the new technology, including skills used in well drilling and manufacturing excavation implement, made the new irrigation technology affordable and accessible to the majority of households. Third, this innovation spread organically without any external support, confirming its sustainability. Farmers, empowered by training, gained more control in developing technology options tailored to local needs and conditions of their communities.

Empowering women and promoting gender equality is crucial for accelerating sustainable development in fragile countries, including the Democratic Republic of Congo (DRC). However, there is scarce existing knowledge or understanding of the factors determining women’s empowerment in these contexts. We aimed to assess women's empowerment and determine its associated factors in Kinshasa, DRC. We analyzed data from the 2021 Performance Monitoring Assessment (PMA) survey. A sample of 1,365 women of childbearing age was retained for this study. Twenty empowerment items related to household decision-making, contraception use, and husband/partner influence were considered. We calculated the average women’s empowerment index (aWEI), identified the women empowerment variables using principal component analysis (PCA), and determined the associated factors for the first three principal components through the performance of multivariate binary logistic regression. In Kinshasa, the overall aWEI was estimated at 0.65. It was low for household decision-making (0.34) and high for husband/partner influence domains (0.93), respectively. Three principal components were identified and named, including the absence of threats, control of sexuality, and participation in decision-making. The factors associated with these components were having internet access, being in free union with a partner, being aged 40-49 years, and residing in a non-slum area. Increasing access to information would enable women in Kinshasa to make strategic decisions about their lives, benefiting themselves and others.

Hemophagocytic lymphohistiocytosis (HLH) is a serious haematologic condition that can be re-lated to various diseases, including tuberculosis (TB). The patient is a previously healthy 26-years-old man, originally from Western Africa, admitted to hospital for fever and weight loss. Given the results of computed tomography (CT) scan, ocular examination and microbiologic tests, a miliary TB with pulmonary, lymph nodal and ocular involvement was diagnosed. Following introduction of antitubercular treatment (ATT) an increase in inflammation indexes and severe pancytopenia were observed; at this point the patient presented six of eight diagnostic criteria for HLH and the diagnosis of HLH secondary to TB was raised. Therefore, HLH treatment with high dose of dexamethasone was started with a good clinical response. We performed a literature re-view of TB-related HLH, which shows a high mortality rate; ATT is necessary to ensure patient survival to remove the antigenic driver. Our patients developed HLH after initiation of ATT as a paradoxical reaction, that may be linked to the release of antigens due to the bactericidal effect of ATT.

The process of developing therapies to treat rare diseases is fraught with financial, regulatory, and logistical challenges that have limited our ability to build effective treatments. Recently, a novel type of therapy called antisense therapy has shown immense potential for the treatment of rare diseases, particularly through single-patient N-of-1 trials. Several N-of-1 antisense therapies have been developed recently for rare diseases, including the landmark study of milasen. In response to the success of N-of-1 antisense therapy, the Food and Drug Administration (FDA) has developed unique guidelines specifically for the development of antisense therapy to treat N-of-1 rare diseases. This policy change establishes a strong foundation for future therapy development, and addresses some of the major limitations that previously hindered the development of therapies for rare diseases.

In an era driven by technology and connectivity, where the sphere of learning goes beyond conventional classrooms, e-Service-Learning (e-SL) merges the possibilities of technology with the principles of experiential education in a powerful blend [1]. Service-learning (SL) is an educational proposal that has been cited by UNESCO [2] as an innovative educational tool through which to address the complex challenges of our society. The Sustainable Development Goals [3] provide a framework around which to structure the SL projects and thus develop the skills needed to act on the full range of goals. Embedding digital means open a debate on the intricate relationship between technology, education, and societal impact [4]. By analyzing two focus groups involving faculty, students and community partners, this contribution aims to explore the potential of combining SL and digital empowerment (DE). The focus group participants discussed the opportunities for innovation, the expected impact on them and the society at large, their needs and the pre-conditions needed to make SL and DE successful, and limitations. The results are presented according to the six principles of sustainability education in the university environment, highlighting the transformative potential of combining these principles within SL and DE.

Background: Our previous study highlighted important healthcare access and utilization concerns among new immigrants. Hence, in this study, we aimed to explore the role of public and patient involvement (PPI) may have in enhancing the accessibility and their contribution to migration health studies. Method: An open and in-depth interactive consecutive virtual discussion was conducted among volunteer asylum seekers and refugees from Eritrea and Syria in Switzerland. The novel PPI establishment had three phases; inception, training phase, and contribution phase. Result: At the beginning, the concept of PPI was apprehensive to grasp, as it was a new approach. After training and consecutive discussions, volunteers were ardent to engage actively. Hence, among the prime findings were the PPI's role and effect in raising awareness, PPI's role in exploring and communicating the healthcare system accessibilities and utilization among their community, the impact of PPI in echoing the healthcare needs of their fellow migrants, and PPI's contribution in enhancing and strengthening migration health researches. Conclusion: The PPI volunteers in the study were keen to raise their community's awareness through their networks, and bridge the research gap between researchers and the public.

Background: With the rapid improvement of the healthcare technologies, security and privacy of the most sensitive data, health data is at risk. Protecting patient privacy has many components, even though the data are in electronic format. Although patient privacy is thoroughly discussed in the literature, there is no study presenting all components of patient privacy protection. Methods: In this study, a complete evaluation framework is presented, as an evaluation tool, an inventory is developed, reliability and validity of the inventory is examined. Study is conducted in three phases: Conceptual framework development, inventory development and an evaluation case study. In the evaluation, fuzzy conjoint analysis is employed to handle the subjectivity and am-biguity. As the result of the evaluation, the institution is given a patient privacy protection ma-turity grade, between 1 and 5, where 1 is the worst and 5 is the best grade. Results: In the case study, XXX’s biggest hospital, employing 800 nurses, is evaluated. Half of the nurses, 400, have partici-pated in the study. Literature tells healthcare institutions do not invest enough to protect patient privacy, and the study results support this finding. Institution’s maturity grade resulted as level 2, which is bad. Conclusion: The study measures he privacy maturity with many evaluation com-ponents. Result of the evaluation explains to the patients and the public if their data is safe or not. With this maturity grade, patients have an idea about which institution to choose, public can conclude the institutions’ reliability in terms of patient privacy.

Endometriosis is known to be a chronic, debilitating disease. The pathophysiological mechanisms of endometriosis development include local chronic inflammation and a certain degree of local immune deficit. We investigated the relationship between the endometriosis severity, IL-8, IL-10, BDNF, VEGF-A serum and tissue levels, patient-related pain, and physical activity in a cohort of 46 patients diagnosed with endometriosis who underwent surgery. The same panel of biomarkers was investigated in a control group of 44 reproductive-aged patients with non-endometriotic gynecological pathology who underwent surgical intervention. Our data show a high statistical significance between tissue expression of IL-8, IL-10, patient-related pain and the severity of endometriosis. No relationship was identified between serum or tissue levels of VEGF-A and BDNF and the severity of endometriosis. These results validate the presence of local chronic inflammation and immune deficit, thereby creating, alongside other studies in the field, an opportunity for the development of innovative and personalized treatment approaches in endometriosis.

The supply chain has incorporated products by putting them into hair scarfs. This study introduces the use of mini chips in health and beauty products and can reduce fatigue through enhanced sleep patterns. The mini chip could be placed in the scarf and used as a prototype. RFID technology provides the supply chain with specific information that is used to identify products and make communication easier. (Muhammad, et. al. 2013) This paper presents a new tool herein referred to as a scarf prototype which is developed to analyse EMG (electromyogram), ECG (electrocardiography), EEG (electroencephalogram), and EOG (electro-oculogram) signals that focuses in the area of sleep disorders. The mini chips used can be used to determine a solution for sleep disruption by using automated analytics. This could lead to improvement in our understanding of sleep disruption and overall sleep physiology. Automated technology allows repeated measurements, evaluation of sleep patterns, and provide suggestions to improve a person’s quality of sleep. This analysis compares the use of polysomnography and the scarf prototype. The analytics provide models and shows correlation between variables, such as EMG, ECG, EEG, and EOG. This study shows that the results from the scarf prototype is just as reliable as the original method, polysomnography.

Background/Objectives: Patient positioning during surgery can influence intra- and postoperative complications. Therefore, we assessed the impact of the sitting and park-bench positions on anesthetic parameters and complications in neurosurgical patients. Methods & Patients: For this retrospective study, 314 adults who underwent neurosurgical procedures for posterior fossa pathologies were divided into two groups: sitting (n=231) and park bench (n=83). The following data were collected, monitored, recorded and compared: age, sex, tumor type, surgical approach, cardiovascular and respiratory complications, and postoperative surgical complications. The association of hypotension with position was further investigated through multivariate logistic regression models by adjusting for CO2 decrease, desaturation and documented gas embolism. Results: The average age was significantly lower in the sitting group (55 years, interquartile range (IQR)=43-63; female proportion=59.74%) than in the park-bench group (62 years, IQR=45-74; female proportion=57.83%) (p<0.001). Cerebellopontine angle tumors were detected in 37.23% of the patients who underwent operation in the sitting position and in 7.26% who underwent operation on in the park-bench position (p<0.001). Patients in the sitting position had significantly greater anesthetic complication (91.77% vs. 71.08%, p<0.001), hypotension (61.9% vs. 16.87%),and >2-mmHg CO2 decrease (35.06% vs. 15.66%, p<0.001) incidences. Hypoxemia and death occurred more frequently in the park-bench group (8.43% vs. 1.73% and 6.03% vs. 1.3%, respectively). Conclusions: Compared with the park-bench position, the sitting position was associated with a greater specific anesthetic complication incidence and lower postoperative mortality rate, indicating a need for careful risk‒benefit assessment when selecting each individual patient’s surgical position.

Background. The Stanford Health Assessment Questionnaire-Disability Index (HAQ) is widely used to measure functional ability in persons with Rheumatoid Arthritis (RA). The instrument was developed with limited involvement from persons with RA, and their perception of the instrument has not been studied in depth. The aim of this study was to explore how persons with RA experience the use of the HAQ in care. Methods. Forty persons with RA were purposefully recruited to participate in semi-structured interviews. The interviews were then analyzed qualitatively using thematic analysis. Results. The participants questioned the relevance of the HAQ but nevertheless experienced that the instrument had a profound effect on their understanding of health and how care is delivered. The analysis resulted in three themes: Problems with individual items, meaning of the summative score, and effects on care and health perceptions. Conclusions. To make the HAQ relevant to persons with RA, it needs to be revised or to include an option to select items most meaningful to the respondent. To ensure relevance, the HAQ update should preferably be co-created by researchers, clinicians and persons with RA.

In the contemporary era, the movement for women empowerment is not merely a social cause but a transformative force reshaping societies across the globe. The article "Breaking Barriers: Women Empowerment Transforming Societies in Modern Times Building a Better Future" delves into the multifaceted impact of empowering women, highlighting how it transcends individual upliftment and fosters widespread societal progress. It also delves into the transformative impact of women’s empowerment on societies, highlighting successful initiatives, case studies, and personal narratives that illustrate the journey towards gender parity. It examines the challenges and opportunities in this ongoing struggle, emphasizing the need for continued advocacy, education, and policy reform. By fostering an environment where women can thrive, societies can unlock unprecedented potential and build a better, more prosperous future for all. By examining key areas such as education, economic participation, political representation, and social inclusion, the article elucidates how empowering women leads to more equitable, prosperous, and resilient communities. It underscores the importance of dismantling historical and cultural barriers that have long hindered women's potential, while celebrating the strides made towards gender equality. Furthermore, the narrative showcases inspiring stories of women leaders, entrepreneurs, and change-makers who are spearheading efforts to build a better future for all. This exploration not only emphasizes the moral imperative of gender equality but also its critical role in driving sustainable development and global advancement.

Pulmonary complications are frequently observed in patients with ulcerative colitis (UC), with large airway disease being the most prevalent manifestation. In this case study, we explore the potential for Immunosuppressant, a monoclonal antibody, to induce pulmonary hemorrhage—a side effect not previously documented with its use. The subject, a young male in his twenties with a six-year history of UC, tragically died suddenly. Found in a pool of blood without external injuries, extensive post-mortem examinations were required to determine the cause of death. The patient had been on biologic therapy, receiving Immunosuppressant intermittently over the past two years, including an infusion five days prior to death. External examination revealed bloody, pinkish foamy material expelling from his nose and mouth. An autopsy supported an atypical presentation of UC, while histopathology confirmed diffuse pulmonary hemorrhage, marked by edema and emphysematous changes. Additionally, there was a notable lymphomonocytic infiltration around the arterial walls, and signs of bronchiolitis and focal pleural fibrosis were evident. We concluded that the cause of death was Diffuse Alveolar Hemorrhage (DAH), directly associated with the recent administration of Immunosuppressant. This finding underscores the need for vigilant pulmonary monitoring in patients treated with monoclonal antibodies to promptly identify and manage potential fatal adverse reactions.

Aortic stenosis (AS) is a prevalent valvular disorder that often requires surgical aortic valve replacement (SAVR) to alleviate symptoms and improve survival. However, the selection of an appropriate prosthetic valve size is crucial to avoid patient-prosthesis mismatch (PPM), which can lead to suboptimal hemodynamic outcomes. Von Willebrand factor (VWF), a key component of hemostasis, has been shown to be altered in AS patients and may contribute to the hemostatic imbalance observed following valve replacement. This prospective study aimed to investigate the impact of PPM on postprocedural VWF levels in patients undergoing SAVR for severe AS. The study included 31 consecutive patients diagnosed with severe AS who underwent SAVR. By focusing on the relationship between PPM and VWF dynamics, this study sought to provide valuable insights into the potential role of VWF as a marker for hemostatic changes associated with PPM, ultimately informing strategies for optimal valve selection and perioperative management to minimize complications.

We present a case report of a 26-years-old female suffering from Coffin Siris Syndrome, who underwent orthodontic treatment and surgery to solve her malocclusion and improve her aes-thetics and functional occlusion. Methods: The presurgical phase involved multibracket self-ligating attachments, Damon prescription. The patient underwent maxillofacial surgery to correct the severe skeletal malocclusion and relocate the bone bases in the right relationship. The post-surgical orthodontic treatment was performed to complete the alignment. Results: The pa-tient improved her aesthetics and functional abilities. Conclusions: Syndromic patients can un-dergo orthodontictreatment if comorbidities and collaboration allow it. Support and collaboration of families and psychotherapists must be considered, but clinical cases of syndromic patients can be faced and solved. Obviously, each syndromic patient is considered unique, and the risk-benefit ratio must be correctly assessed for each one.

Background: Permanent tracheostomy because of total laryngectomy surgery entails great conse-quences for the patient regarding respiratory physiopathology such as the filtering, humidifying, and heating function of the air by the nose is lost. The use of special stomal filters can determine adequate protection of the trachea-broncho-pulmonary system with a reduction in respiratory pathologies. In fact, in most cases laryngectomee patients are first cigarette smokers who for this reason already have also respiratory diseases such as chronic obstructive pulmonary disease (COPD). Despite the availability of tracheal filters, multiple times, as reported in the literature, the patient tends to limit their use due to reported breathing difficulties, especially in conditions of intense breathing. Methods: The objective of this clinical study was to evaluate the most suitable stomal filter for the laryngectomee patient during physical activity. The filters studied were an INHEALTH device (Blom-Singer SpeakFree HME); two ATOS devices (Provox® Life™ Energy HME and Provox® Life™ Home HME); and an FAHL device (Laryvox HME Sport). Results: For this purpose, the performances of 31 laryngectomee patients, subjected to medi-um-high physical effort, were analyzed through a standardized pneumological test, the Six Minute Walking Test (6MWT) which involves a sustained walk lasting six minutes, with evaluation , every 60 seconds, heart rate, oxygen saturation and meters travelled; furthermore, it examines two sub-jective indices, namely, the basal and final dyspnea index and the initial and final muscular fatigue index.

We report the case of a 61-year-old woman who was referred to the Oral Surgery and Implantology Unit of the University Hospitals of Geneva to take care edentulous sites after dental avulsions of teeth 11 and 21 following traumatic shock due to endotracheal intubation under general anaesthesia. The dental history revealed that the patient had a history of generalized chronic periodontitis that had been treated several years earlier. Treatment consisted, for the first time to our knowledge, of immediate insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure and immediate restorations.

Goldenhar Syndrome (GS), also known as oculoauriculovertebral spectrum (OVAS), is a rare congenital condition characterized by impaired development of structures such as ears, eyes, nose, palate, lip, mandible, maxilla, and teeth. The etiopathogenesis is multifactorial and dependent on genetic and environmental factors, yet the syndrome has many unknowns. We report a case of a 31-year-old male diagnosed clinically with GS as an infant with an absent left ear, hearing loss, absent left lung lobe, reduced growth of left upper limb, decreased size of left face, absent left kidney, and a missing left thumb, who was seen in the genetic clinic for prenatal genetic counseling. A microarray comparative genome hybridization (aCGH) was performed for copy number abnormalities and targeted NGS panels were performed for hereditary hearing loss and limb/digital malformations. aCGH revealed a 471kb loss at 16p12.2 and a mosaic 7.3Mb gain at 19p12q12. Metaphase FISH confirmed the orientation of 19p12q12 gain as small supernumerary ring chromosome 19. NGS revealed multiple variants (MYH14 c.4001C&gt;T, PDE1C c.8C&gt;T, ADGRV1 c.15502A&gt;G, CDH23 c.8772C&gt;A, MYO3A c.484G&gt;A, ADAMTS10 c.506G&gt;A, CHUK c.1294C&gt;T, CSPP1 c.1972A&gt;G, and TCTN2 c.160G&gt;A). Due to the heterogeneous clinical manifestation and genetic heterogeneity of GS, a comprehensive genetic testing strategy is needed for timely diagnosis and better patient care.

Malawi has developed an excellent, nation-wide system for monitoring people infected with HIV and keeping track of key epidemic markers. Their success lies in two things: the focus on simplicity and the use of data collection not only to track the epidemic and identify problems but also to give regular feedback and support to every clinic in the country. This achievement is the more remarkable given that Malawi is one of the poorest countries in the world, ranking 190 out of 194 countries by GDP, but has one of the most severe epidemics of HIV in the world, ranking 9th out of 168 countries by HIV prevalence. We first discuss the current state and likely future epidemic trends in Malawi: unless we know where we are and where we are going we cannot decide what to do or how to do it to in order to achieve a better outcome. We then discuss the history and development of Malawi’s patient monitoring system, as reported in their Integrated HIV Program Reports,ix which have been published quarterly since the beginning of 2004. We consider the current state of patient monitoring and support as reflected in the most recent report for the third quarter (Q3) of 2016 and comment on some of the questions that this raises. Finally, we consider ways in which the current system could be improved by strengthening Malawi’s analytical capacity and making better use of this unique data set. The focus here is on HIV in adultsv because if ART is initiated early in all adults living with HIV this should include testing all pregnant women for HIV and starting them on treatment immediately. However, PMTCT is especially important and care must be given to reducing MTCT and identifying the long-term child survivors of mother-to-child transmission and this demands a complementary assessment. There is an ongoing debate about the relative merits of treatment and prevention in reducing transmission and it should be made clear that the primary reason for starting people on treatment early is that it is in the best interest of the individual patient to start treatment as soon as possible after becoming infected. Allowing a person’s immune system to deteriorate to any degree is not consistent with the clinician’s commitment to ‘first do no harm’ and even those with the highest CD4⁺ cell count are at a substantially increased risk of death. What matters, therefore, is to get as many people as possible onto ART, ensure that they remain virally suppressed, and consider prevention in this context.

The COVID-19 pandemic has highlighted the critical need for telehealth and remote patient monitoring in healthcare delivery. Despite the growing use of on-body wearable sensors for continuous monitoring and predicting adverse events, such as hospitalizations or falls, their widespread adoption within the healthcare ecosystem remains a significant challenge. While the pandemic has accelerated the acceptance of these technologies, achieving widespread integration requires their sustained incorporation into routine healthcare practices beyond emergency situations. In this study, we extend the application of our previously developed remote patient monitoring system, originally designed for the geriatric frail population, to COVID-19 patients. Our objective is to assess whether the metrics obtained from this system, which includes physical activity and indoor localization sensors, along with vital sign monitoring, can provide additional insights into the recovery trajectory of individuals affected by COVID-19.

Background: Over the past decades, efforts have been made to improve the nutritional well-being in people with cystic fibrosis (pwCF). Due to the correlation observed between nutritional indices and lung function, prevailing recommendations consistently advocate for BMI percentile goals at or above the 50th percentile in pwCF. Recent global trends show a notable increase in overweight and obese statuses among pwCF. This study aims to explore the nutritional status of Italian pwCF. Methods: Data from the Italian CF Patient’s Registry were analysed to assess the proportion of individuals categorized as underweight, target weight, overweight, and obese from 2010 to 2021. Patient-level comparison data from 2021 were also examined to identify potential determinants of overweight and obesity. Results: Analysis spanning 2010 to 2021 reveals a decrease of approximately 40% in underweight status among adults, while the proportion of malnourished patients 90, and lower prevalence of Pseudomonas aeruginosa colonization. Conclusions: Our study confirms the evolving nutritional status landscape among Italian adult pwCF, with a significant shift towards overweight and obesity over the past decade. These trends highlight the need for proactive measures within CF standards of care to adapt and address the changing needs of patients.

The nematode Caenorhabditis elegans, with its highly sensitive olfactory system, has emerged as a promising tool for testing chemotaxis. In the field of cancer diagnostics, there is a growing interest in the development of non-invasive screening methods for the detection of volatile organic compounds in a patient's urine. The objective of this study was to contribute to the existing body of knowledge by evaluating the ability of a Caenorhabditis elegans-based chemotaxis assay to discriminate between urine samples from healthy individuals and patients diagnosed with breast or colon cancer. Following synchronization of the developmental stages of C. elegans, nematodes were exposed to the urine of cancer patients and healthy individuals. Subsequently, chemotactic indices were calculated for each urine sample. Our results demonstrated a statistically significant difference in the chemotactic response of C. elegans to urine samples from cancer patients compared to healthy volunteers (p < 0.001). Moreover, the test exhibited promising diagnostic utility, with a sensitivity of 98%, a specificity of 62%, and a detection rate of 78%. Our findings expand on previous observations, confirming the remarkable sensitivity of C. elegans hermaphrodites to discriminating cancer-related volatile organic compounds in urine samples.

Dysmenorrhea symptoms are frequent and often self-treated using non-prescription medicines. To further characterize women with dysmenorrhea using a combination of hyoscine butylbromide and paracetamol (PLUS) for self-management of their complaints, we performed a secondary analysis of a published pharmacy-based patient survey. 314 women (mean age 32.3 years) with dysmenorrhea reported a pain and cramps intensity of 7.45 ± 2.13 on a 0-10 Likert scale, which was reduced to 2.86 ± 1.81 upon treatment. Associated impairments of work/daily chores, leisure activities, and sleep were improved by 64.6%, 62.2% and 70.4%, respectively. The onset of symptom relief was within 60 min in 84.7%. Tolerability was rated as very good or good by 97.2%. These findings confirm the efficacy and tolerability data on PLUS from randomized controlled trials in a larger group of women conducting self-management of their dysmenorrhea.

Relatives play an important role in mental health service users’ care. Interventions directed either at service users or their relatives may influence the other person as well. The project Activa’t per la salut mental (Get active for mental health) consisted of a series of four interventions addressed at people diagnosed with mental disorders and their relatives to help them in their recovery process, increasing their agency and quality of life. The objective of the present study is to evaluate the interaction of the participation of service users on their relatives’ outcomes and vice versa. The impact of the project was evaluated within an RCT. The treatment group had access to all the circuit interventions while the control group received treatment as usual and could only access one of the interventions. All participants were evaluated at baseline, six months, and twelve months after the end of the first intervention. Service users were evaluated with the Stages of recovery questionnaire, and relatives with the Family Burden Interview Schedule II and the Duke-UNC-11 questionnaires. The interaction between service users and their relatives was analysed by means of correlational analyses within the intervention group. Service users baseline characteristics influenced in the level of participation of relatives and vice versa. The results also indicated an interaction between service users’ recovery score changes on the change of care burden of relatives. Service users’ participation levels interacted with the decrease of relatives’ burden. These results can be extremely helpful in fostering interactive benefits in future projects addressing the wellbeing of mental health service users and their relatives. Future studies could use specific designs to explore the directionality of the causality of these effects.

Diabetic foot ulcers (DFUs) significantly affect the lives of patients and increase the risk of hospital stay and amputation. We suggest a remote-monitoring platform for better DFU care. This system uses digital health metrics (scaled from 0 to 10, where higher scores indicate a greater risk of slow healing) to provide a comprehensive overview through a visual interface. The platform features smart offloading devices that capture behavioral metrics such as offloading adherence, daily steps, and cadence. Coupled with remotely measurable frailty and phenotypic metrics, it offers an in-depth patient profile. Additional demographic data, wound characteristics, and clinical parameters, such as cognitive function, were integrated, contributing to a comprehensive risk factor profile. We evaluated the feasibility of this platform with 124 DFU patients over 12 weeks; 39% experienced unfavorable outcomes such as dropout, adverse events, or non-healing. Digital biomarkers were benchmarked (0-10), categorized into low, medium, and high risk for unfavorable outcomes, and visually represented using color-coded radar plots. The initial results of case reports illustrate the value of this holistic visualization to pinpoint the underlying risk factors for unfavorable outcomes, including a high number of steps, poor adherence, and cognitive impairment. Although future studies are needed to validate the effectiveness of this visualization in personalizing care and improving wound outcomes, early results in identifying risk factors for unfavorable outcomes are promising.

Introduction and Background: Bangladesh as a country could prove its development potential over the past several years with its thriving economic growth and also with a significant level of positive changes made possible in its significantly important health and social indicators including MMR, IMR, Child nutrition, fertility regulation, child survival and Infectious disease prevalence. ^1,2,3 The country could make a commendable contribution in achieving Global development goal (MDG) at a significant level and also aiming to continue its effort to sustain that status quo and also making progressive changes consistently to be contributory to SDG goals and indicators towards positive development.^2,3 Purpose: This lyrical critic is an attempt to uphold the facts and evidences embedded in social development reality where the implementations are in constant challenge with urgency, need and continuity. Methodology: A quick and intensive desk review and web search made to capture the insights from secondary data facts, stories, evidences, news features and the findings blended with personal insights and experiences. Finally, compilation of insights and views through a laid over narrative analytics and described in a descriptive lyrical format. Purposefully ignored the figure and quantity data reflection in the write up as this write up is considered more as a social development lyric rather than a scientific write up. Conclusion: Our diversified marginalized community people are of vital importance from a social inclusion and exclusion point of view, to look into this more deeply whether they are socially, epidemiologically, statistically, economic indicator wise fall into the embracing practice of our democracy and inclusion culture of addressing the marginalized. This posed our country in a very challenging situation, a dilemma in between morality vs reality, emotion vs equity, social response vs political standpoint and so on. With a long end history of community responsive and socially sensitive works within /among our generalized poor, poverty stricken and marginalized people group, where the sustainable and ethically driven, gender sensitive social empowerment is still a far cry! The diversity in nature always claims to add on beauty, tranquility and completeness towards the sense of Equity management, but it’s very true that this diversity word has a very opposite and different connotation while it is relevant to diversity in marginalization and appears in a more critical and complex dynamics to seek solution. Therefore, the ultimate empowerment of community specially the marginalized people remain entrapped into the social development process of enduring response in embracing urgency in community care where the right response may not get right weightage into the community development priority response and also the development actors priority agenda.

Thyroidectomy has been post-operatively managed by hormone replacement therapy in order to satisfy the reference ranges of thyroid stimulating hormone (TSH) and thyroxine (T4) levels. While medication and standardized reference ranges have proven to be effective, many patients continue to report unintentional weight gain despite adequate amounts of treatment and levels of TSH and T4. Physicians, over the years, have become complacent to these “normal” ranges, and have ignored the metabolic consequences that are affecting thyroidectomy patients. This paper aims to redefine the approach to post-thyroidectomy clinical care by: challenging the current standardized hormonal range values, exploring the gaps in thyroid hormone conversion, investigating the metabolic pathways of T3, considering the influence of inflammatory markers, and proposing the future for patient-centered management.

This study aimed to investigate the impact of specific single nucleotide polymorphisms (SNPs) on clinical and laboratory outcomes in COVID-19 patients receiving Paxlovid treatment. The primary focus was on genetic variants in IFNAR2, OAS1, OAS3, and ACE2. Laboratory parameters were assessed at admission and discharge, including oxygen saturation, white blood cell count, absolute neutrophil and lymphocyte counts, erythrocyte sedimentation rate, platelet count, hematocrit, and various liver and kidney function tests. The results demonstrated significant associations between certain SNPs and clinical outcomes. Patients with the IFNAR2 rs2236757 G allele exhibited improved oxygen saturation and lower eosinophil counts. The OAS3 rs10735079 and OAS1 rs10774671 G allele was associated with lower eosinophil and total bilirubin levels. Furthermore, patients with the ACE2 rs2074192 C allele showed increased segmented neutrophils and AST levels, while the T allele was associated with lower total bilirubin levels. These findings indicate that the efficacy of Paxlovid treatment may be influenced by genetic variations in IFNAR2, OAS1, OAS3, and ACE2. Further research is warranted to investigate the potential therapeutic implications of these genetic markers.

This study presents a strategic approach to developing applications focused on implementing Large Language Models using the Langchain framework in Python. Three language models are highlighted: GPT-3.5 (turbo mode), LLaMA 2, and Vicuna 7B, each with their distinctive features and capabilities. The methodology used is described in detail, including data extraction from medical reports using zero-shot prompting data extraction techniques, interaction with language models, and structured storage of results. The performance of the models in data extraction is evaluated, presenting metrics such as precision, recall, and F1 score. The results demonstrate high model capability in extracting information, although areas for improvement are identified, particularly in data extraction precision. In conclusion, the efficacy of the models in extracting information from medical histories is not considerably acknowledged, with an emphasis on the importance of improving precision and increasing the volume of trained data for future research in healthcare digitalization.

Background. Malignant pleural mesothelioma (MPM) is still a rather incurable disease. Many classes of compounds with various mechanisms of action have been tested in vivo and ex-vivo, with rather disappointing results. This is partly due to preclinical studies mostly performed in models that fail to recapitulate MPM complexity and do not retain the intra-tumor heterogeneity, a propelling force for tumor progression. Additionally, we and others have shown that, under stress-induced chemotherapy, profound rearrangements take place in MPM cultures to fuel the emergence of chemoresistant cell subpopulations. Thus, finding clinically actionable modulators of MPM resistance is still a very urgent need. Methods. Setup and propagation of patient-derived organoid cultures from MPM pleural effusions; flow cytometry-based validation of organoid cultures, isola-tion and propagation of mesothelioma-associated fibroblasts; co-cultures, Lu-minex-based Cytokine array, ELISA assay to quantitate IL-6 in the conditioned media, qRT-PCR to assess mRNA expression of cancer stem cell markers and fibroblast markers. Results. Organoid cultures were obtained from eight MPM patients by using specific growth media and conditions to propagate pleural effusion-derived cells. We proved that primary MPM specimens and serially passaged (mesothelio-ma-Patient-Derived-Organoids) mPDOs were cytologically similar, with the obtained mPDOs expressing mesothelial markers similarly to the originating specimen. As expected from a clinically relevant model, the size and number of mPDOs were altered, in a patient-specific way, when pharmacologically relevant doses of chemotherapy drugs were added. We derived Mesothelio-ma-Associated-Fibroblasts (MAFs) and the addition of MAFs, to various ratios, altered the response of the mPDOs to pemetrexed + cisplatin, toward a reduced sensitivity to the latter anticancer agents. Additionally, organoid formation and size were altered by MAF-conditioned media, and this correlated with increased expression of cancer stem cell markers. We showed increased levels of IL-6 in the media of the treated cocultures and showed that this latter was derived from the MAFs. Conclusions. Increased secretion of IL-6 by mesothelioma-associated fibroblasts (MAFs) contributes to the resistance of the MPM to therapy.

Alzheimer’s disease (AD) is an irreversible neurodegenerative disease characterized by progressive cognitive decline. The two cardinal neuropathological hallmarks of AD include buildup of cerebral β amyloid (Aβ) plaques and neurofibrillary tangles of hyperphosphorylated tau. The current disease-modifying treatments are still not effective enough to lower the rate of cognitive decline. The paucity of early detection and disease progression biomarkers also seems to present a major obstacle to AD drug development. The current established readouts based on expression levels of amyloid beta, tau and phospho tau have shown many discrepancies in patient samples when linked to disease progression. There is an urgent need to identify diagnostic and disease progression biomarkers from blood, CSF or other biofluids that can facilitate early detection of the disease and provide pharmacodynamic readouts for new drugs being tested in clinical trials. Advances in proteomic approaches using state-of-the-art mass spectrometry, are now being increasingly applied to study AD disease mechanisms, identify drug targets and novel disease biomarkers. In this report, we describe applications of the quantitative proteomic approaches for understanding AD pathophysiology, summarize the current knowledge gained from proteomic investigations of AD and discuss development and validation of new predictive and diagnostic disease biomarkers.

Sepsis is a serious disease that can lead to mortality. The etiology of the disease is connected to how the body as a host reacts toward microbes such as bacteria, viruses, and fungi invasion. Current research shows that during sepsis, the reaction toward microbe attacks takes two main phases. The first is known as a cytokine storm, while the second is a vicious cycle of pro-inflammatory responses followed by a strict anti-inflammatory response led by CD4+ Tregs. Various immunomodulatory therapies have been proposed to break the cycle of pro- and anti-inflammatory reactions to sepsis. However, clinical trials did not show promising results, indicating further research into the mechanism that Treg uses to inhibit proinflammatory reactions. We used next-generation sequencing (NGS) analysis of bulk RNA-seq and single-cell RNA-seq data to examine the exact molecular pathways used by Treg to inhibit the immune response in sepsis. Our approach identified ACOD1 (Aconitate Decarboxylase 1) as a primary mediator of Treg suppression of immune cells. We identified and validated CD36 as a downstream target of ACOD1. CD36 is a known metabolite regulator in Tregs. Taken together, our results indicate that targeting ACOD1 could prove valuable in regulating Treg function during sepsis.

High systolic blood pressure and increased blood pressure variability after the onset of ischemic stroke are associated with poor clinical outcomes. One of the key determinants of blood pressure is arteriolar size, determined by vascular smooth muscle tone and vasodilatory and vasoconstrictor substances that are released by the endothelium. The aim of this study is to outline alterations in vasomotor function in isolated peripheral arteries following ischemic stroke. The reactivity of thoracic aortic segments from male C57BL/6 mice to dilators and constrictors was quantified using wire myography. Acetylcholine induced endothelium-dependent vasodilation was impaired after ischemic stroke (LogIC50 Sham=-7.499, LogIC50 Stroke=-7.350, P=0.0132, n= 19, 31 respectively). Vasodilatory responses to SNP were identical in isolated aortas in sham and stroke groups. Phenylephrine induced vasoconstriction was impaired in aortas isolated from stroke animals in comparison to sham counterparts (Sham LogEC50= -6.652 vs Stroke LogEC50=-6.475, P< 0.001). Our study demonstrates that 24 hours post-ischemic stroke, peripheral vascular responses are impaired in remote arteries. Aortas from stroke animals exhibited reduced vasoconstrictor and endothelium-dependent vasodilator responses, while endothelium-independent vasodilatory responses were preserved. Since both vasodilatory and vasoconstrictor responses of peripheral arteries are impaired following ischemic stroke, our findings might explain increased blood pressure variability following ischemic stroke.

To identify factors associated with interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) and build an algorithm to better define this association, for a personalized application in clinical practice. Methods. 78 SSc patients underwent HRCT to assess ILD. Demographic, clinical and laboratory variables were collected, focusing on those associated either directly or indirectly with lung involvement. The discriminant value of each variable was determined using the operating characteristic curves (ROC) and included in a model to estimate the strength of ILD association in SSc. Results. Thirty-three (42.31%) patients showed ILD on HRCT. DLco, M-Borg, GERD-Q, and capillary density were significantly associated with the presence of ILD-SSc. A model including these variables had a coefficient of determination (R2) of 0.697. DLco had an AUC of 0.861 (p&lt;0.001) with a cut-off ≤72.3% (sensitivity 78.8%, specificity 91.1%, +LR 8.86). The m-Borg scale showed an AUC of 0.883 (p&lt;0.001) with a cut-off &gt;2 (sensitivity 84.8%, specificity 82.2%, +LR 4.77), GERD-Q had an AUC of 0.815 (p&lt;0.001) with a cut-off &gt;7 (sensitivity 72.7%, specificity 86.7%, +LR 5.45). The capillary density showed an AUC of 0.815 (p&lt;0.001) with a cut-off ≤4.78 (sensitivity 87.9%, specificity 68.9%, +LR 2.82). Based on the pre-test probability values, these four variables were applied to Fagan's nomogram to calculate the post-test probability of this association. Conclusions. Our study identified four associated clinical factors of ILD in SSc patients. Moreover, their inclusion in an algorithm for the post-test probability, tailored to the specific patients’ characteristics, significantly increases the ability to find out the presence of SSc-ILD.

Women's empowerment represents a process in which they are recognized as subjects of rights. Despite advances in women's rights, inequalities persist in various areas. This study aims to validate a psychometric scale of 31 items in seven factors: Participatory Empowerment, Temerity, External Influences, Independence, Social Satisfaction and Equality. The objective is to measure the empowerment of women in the university context. The research was carried out in a transversal and non-experimental manner, with the participants' voluntary collaboration, including the participation of 1,478 university students from four Higher Education Institutions in Zone 4 of Ecuador. The data was analyzed through inferential statistics, including exploratory and confirmatory factor analysis. The results indicated that the instrument for measuring empowerment can be made up of 24 items grouped into six factors, and this model showed a good fit.

This study aimed to investigate the knowledge of patients with hypertension about their condition, adherence to antihypertensive medication, and the factors influencing it. A cross-sectional study was conducted in two cardiology outpatient clinics of two tertiary hospitals, in Greece. The study included 188 patients diagnosed with hypertension. The patient’s knowledge about their disease and adherence to medication were assessed by using the HK-LS and A-14 scales, respectively. Patients had sufficient knowledge levels about their disease, but significantly low levels of adherence to medication. Patients with higher knowledge levels were more adherent to medications [r(188) = 0.885, p &lt; 0.001]. By using multivariate analysis, higher age (p = 0.018), residence in a more populous area (p = 0.041), more years with the disease (p = 0.012), and a lower number of medications (p = 0.03) were associated with higher levels of knowledge. Conversely, younger age (p = 0.036), lower educational levels (p = 0.048), fewer years with the disease (p = 0.001), and a higher number of medications (p = 0.003) were associated with lower adherence to medication. The Greek patients' hypertension knowledge was sufficient, however, adherence to medication was significantly low. Healthcare managers could utilize our findings to design targeted interventions for improving adherence to medication for these patients.

As previous study in many countries shown that stroke patient onsets are not distributed randomly, but associate with meteorological factors. However, the relationship between stroke occurence and meteorological factors remain unknown in mountain area in Guizhou China. This paper firstly introduces multi-source fusion data which is integrated by the mountain meteorological factor, geographic mapping elevation information data and stroke population monitoring of Guizhou province. Mainly elaborates from a few aspects, which concludes data collection, data sorting, data extraction, data cleaning and data production in detail. A completed and detailed meteorological stroke data set was successfully established and multi-source data fusion was realized by the use of Gbase and unified data service interface of Guizhou meteorological big data cloud platform. And we report the impact of meteorological variables in Guizhou mountain area climate on stroke. In this study, we performed a statistical fusion data between January 2017 and December 2020 about stroke incidence rate and meteorological factors respectively, for instance, concerning the mean (Mean), maximum (Max), minimum (Min), median (Median), standard deviation (Std) . We calculated stroke rates (date stroke occurence)/(year stroke occurence) and we investigated the distribution of days included in the label. Results: the distribution of the incidence rate basically conforms to the normal distribution with the label Max 0.007399, label Min 0.000204, label Mean 0.002738, label Median 0.002643, label Std 0.00076. We observed a positive significant correlation of stroke incidence rate directly proportional to the daily temperature difference (between 0 and 20 degrees Celsius), as the value of this factor exhibits variation larger, the incidence rate is gradually increasing. And we investigated from the Pearson correlation coefficients that stroke incidence increasing when meteorological factors at low humidity (less than 40% (RH 80%), temperature higher than 31℃); the 24-hour daily temperature difference varies between 6 and 10℃ (6

Obstructive sleep apnea (OSA) may be linked to various factors that narrow the upper airways, such as obesity, adenotonsillar hypertrophy and craniofacial abnormalities. Hypothyroidism has also been described as a risk factor for OSA. However, the implication of goiter independently of thyroid function in the occurrence of OSA remains unclear. We present the case of a 66-year-old patient, with a large compressive multinodular goiter for whom total thyroidectomy was indicated. During the preoperative assessment, the patient showed a body mass index (BMI) of 37.8 kg/m2 with symptoms of OSA. Respiratory polygraphy confirmed the diagnosis of severe OSA (apnea hypopnea index: AHI=32) and treatment with continuous positive airway pressure (CPAP) was initiated prior to thyroid surgery. Surprisingly, after total thyroidectomy, OSA symptoms disappeared and the patient abandoned CPAP therapy. Subsequent respiratory polygraphy after thyroidectomy showed a decrease in AHI to a normal value (AHI < 5). Interestingly, there was no change in BMI or other factors explaining the resolution of OSA, except for thyroidectomy. This case report suggests that goiter can be considered a risk factor for OSA. However, prospective studies are needed to accurately assess the effects of goiter on occurrence of OSA according to its dimensions and local extension.

The research objectives were (1) to examine the determinants of community empowerment towards the revegetation of Arjuna mount forests; (2) assessing the influence of geography and soil conditions on the revegetation of Arjuna mount forests; (3) reviewing the effect of Arjuna mount forest revegetation on the preservation of spring water sources and (4) formulate a model of community empowerment around the forest based on revegetation of Arjuna mount and preservation of the area around the springs. The method used was descriptive method. While based on the techniques and tools used to research, the author uses the survey method to obtain facts that occur in the research area, namely in the area around the spring of the Kedunglarangan and Gumandar Prigen watersheds, Pasuruan Regency. Data obtained in the field are then processed and analyzed using GIS, ArcView 3.3 and Google Earth programs. The study population covering the community around the forest and springs, who lived in three villages, namely Leduk, Jatiarjo and Dayurejo village, Pasuruan, East Java-Indonesia. Data obtained from respondents with questionnaires and analyzed using SEM (structural equation modeling), to find out a general description of respondents' responses about community participation in the preservation of Arjuna mount forest. The results showed that (1) human resources, economic, social, local institutional factors, facilities and infrastructure had a very significant effect on forest revegetation; (2) geography and land variables have a significant effect on forest revegetation; (3) forest revegetation variables have a significant effect on the preservation of springs; and (4) The development of human resources, economic, local institutional, facilities and infrastructure in the community around the forest was a relevant model for the success of forest revegetation and the preservation of springs in Arjuna mount.

1). As on-the-ground projects come into existence and continue to expand to adapt to climate change and empower women, it is important to understand their location within TANs. Using the Bhungroo technology as a case study, we aim to assess the potential of TANs to increase the scope and scale of local projects as well as the ability of similar and emerging projects to create social change at local levels. 2). We do so by analyzing interview and earned media hits data from the UNFCCC Momentum for Change. 3). We find that while TANs may help increase the scale and scope of projects, increasing their ability to effectively reach more people and areas is still up for debate 4). We conclude by considering how women’s political participation may be enhanced by similar projects.

Tumor to stroma ratio is a highly debated prognostic factor in the management of several solid tumors and there is no universal agreement on its practicality. In our study we proposed to confirm or dismiss the hypothesis that a simple measurement of stroma quantity is an easy-to-use and strong prognostic tool. We have included 74 consecutive patients with colorectal cancer who underwent primary curative abdominal surgery. The tumors have been grouped into stroma-poor (stroma &lt;10%), medium-stroma (between 10 and 50%) and stroma-rich (over 50%). The proportion of tumor stroma ranged from 5% to 70% with a median of 25%. Very few, only 6.8% of patients had stroma-rich tumors, 4% stroma-poor tumors and 89.2%tumors with a medium quantity of stroma. The proportion of stroma, at any cut-off, had no statistically significant influence on the disease specific survival. This can be explained by the low proportion of stroma-rich tumors in our patient group and the inverse correlation of stroma proportion with tumor grade. The real-life proportion of stroma-rich tumors and the complex nature of the stroma-tumor interaction has to be further elucidated.

Background: Positive person-centered attributes of inpatient rehabilitation need to be identified from the patient perspective to be further developed and sustained. Purpose: To identify which attributes patients openly evoke as being great care experiences, using an open appreciative inquiry during the inpatient rehabilitation stay. Methods: Qualitative secondary analysis of appreciative patient comments during a bedside patient experience rounding, facilitated by a neutral party. Two independent analysts employed an inductive, summative form of content analysis. Results: Among 150 patients rounded, 122 provided categorizable appreciative accounts. Over two thirds of the patients (67.2%) focused on “staff attributes” in their great-experience accounts. Those attributes were mostly interpersonal such as being “attentive & caring - beyond clinical duty” and being “encouraging (but not too hard) & reassuring”. These interpersonal staff attributes were reported with words showing deep levels of personal significance or patient appreciation. Beyond staff attributes, the perceived quality of the “patient care” (31.1%) and opportunities for “leisure and social activities” (9.0%) were also frequently evoked. Amenities like food or costumer service were the least evoked, rarely so as an exclusive attribute (0.8% for each). Conclusions: The human(e) factor, especially the interpersonal qualities of staff, emerged as greatly appreciated from the patient experience perspective during inpatient rehabilitation. These experiences help identify which person-centered attributes of care might be further developed and sustained.

Visual Patient technology is a situation awareness–oriented visualization technology that translates numerical and waveform patient monitoring data into a new user-centered visual language. Vital sign values are converted into colors, shapes, and rhythmic movements—a language humans can easily perceive and interpret—on a patient avatar model in real time. In this review, we summarize the current state of the research on the Visual Patient, including the technology, its history, and its scientific context. We also provide a summary of our primary research and a brief overview of research work on similar user-centered visualizations in medicine. In several computer-based studies under various experimental conditions, Visual Patient transferred more information per unit time, increased perceived diagnostic certainty, and lowered perceived workload. Eye tracking showed the technology worked because of the way it synthesizes and transforms vital sign information into new and logical forms corresponding to the real phenomena. The technology could be particularly useful for improving situation awareness in settings with high cognitive demand or when users must make quick decisions. This comprehensive review of Visual Patient research is the foundation for an evaluation of the technology in clinical applications, starting with a high-fidelity simulation study in early 2020.

There is little understanding of patients' experiences and perceptions with satisfaction by health professionals such as medical and dental clinicians. Furthermore, patient satisfaction is not well understood. The objective of this article is to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of the treatment influence participant satisfaction at different stages of the intervention's process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. The consumerist method may misrepresent the concept of satisfaction in health service.

This study investigates the relationship between authentic leadership and socially responsible behavior among employees in Saudi Arabia's service sector. Utilizing social cognitive theory as the theoretical framework, the research proposes that authentic leadership indirectly influences socially responsible behavior through psychological empowerment and psychological capital as parallel and serial mediators. Additionally, the study examines the moderating effect of CSR perceptions on these relationships. A cross-sectional survey was conducted with 349 professionals from the service sector. The results, analyzed using partial least squares structural equation modeling (PLS-SEM), revealed that authentic leadership does not directly impact SRB. Instead, the relationship is fully mediated by psychological empowerment and psychological capital. Moreover, CSR perceptions significantly moderate the relationship between authentic leadership and psychological empowerment, as well as the indirect effects of authentic leadership on SRB through psychological empowerment and psychological capital. The findings highlight the importance of fostering an authentic leadership style and how psychological resources of empowerment, and psychological capital carry forward this effect to promote SRB in the service sector. Additionally, the study underscores the role of CSR perceptions in strengthening the impact of authentic leadership on employee outcomes. The research contributes to the literature on leadership, CSR, and employee behavior, and offers practical implications for organizations aiming to enhance their social responsibility initiatives.

Background: Having a laboratory renal profile for medical imaging examinations requiring contrast media (CM) administration is strongly advised. Creatinine helps identify patients at risk of contrast-induced nephropathy (CIN). GEM® Premier™ ChemSTAT (Werfen) is a point-of-care (POC) analyzer with 12 emergency parameters including creatinine assay. The aim of this study consists to compare ChemSTAT with the central analytical solution of the University Hospital of Clermont-Ferrand and to evaluate the interest of the POC creatinine in the emergency department (ED) in optimizing the flow of patients, especially if CM used. Methods: More than 200 whole blood (WB) samples from the ED were evaluated on the ChemSTAT analyzer. As comparative methods, the plasma aliquots from the same samples were assayed on an Atellica® CH (Siemens Healthineers). The clinical concordance was assessed ac-cording the decision cut-offs of the French Society of Radiology for the risk of CIN. The availability times of biological results between ChemSTAT and the central laboratory were studied. Results: WB results from ChemSTAT correlated well with those from Atellica® CH, except for tCO2 (known bias between Siemens and Cobas Roche methods predicting ChemSTAT values). The results of creatinine assay allow to have identical medical decisions compared to the renal risk cut-offs. The availability of biological results is reduced by 50 min on average with ChemSTAT vs the central laboratory. Computed tomography was performed for 44.7% of patients including the injection of the CM in 68% of cases. For these patients, the availability of creatinine results relative to imaging time is faster with the ChemSTAT on average of 45.2 min. Conclusions: Great analytical and clinical correlations for creatinine assay allow safe iden-tification of patients at risk of CIN and improve patient flow in ED especially for those requiring computed tomography with use of CM.

Combined hepatocellular cholangiocarcinoma (cHCC-ICC) is a rare malignancy that involves a combination of features of hepatocellular carcinoma and intrahepatic cholangiocarcinoma (ICC). cHCC-ICC is generally considered to exhibit a more aggressive clinical course compared to ICC; however, its risk factors and outcomes remain largely undefined. A single-center retrospective study of 82 patients diagnosed with ICC or cHCC-ICC from June 2011 and January 2023, all of whom underwent surgical resection. Our analysis included 70 patients with resected ICC and 12 with resected cHCC-ICC. The overall survival (OS) for the entire cohort was 21.6 months, with a recurrence-free survival (RFS) of 11.8 months. The cHCC-ICC group had significantly higher levels of AST and ALT (AST median 206 vs. 46; ALT median 165.5 vs. 48; p=0.012 and p=0.013, respectively), whereas the ICC group had higher alkaline phosphatase (median 66 vs. 104; p=0.03). CA 19-9 values (p=0.02) were higher in the ICC group, while AFP values were higher in the cHCC-ICC group (p=0.0004). The cHCC-ICC group had a significantly higher rate of recurrence (83% vs. 47%, p=0.028) with a significantly decreased RFS (4.7 months vs. 12.4 months; log-rank p=0.007). cHCC-ICC is a rare entity that needs to be further studied to improve patient outcomes. Our study showed that RFS is lower in the cHCC-ICC group as compared to ICC patients alone. Further studies are warranted and possibly suggest the need for more aggressive initial treatment strategies in patients diagnosed with cHCC-ICC.

Background: There are limited evidence-based data to guide treatment recommendations for breast cancer (BC) patients ≥ 80 years (P80+). Identifying and addressing unmet needs are critical. Aims: Advocate-BREAST80+ compared the needs of P80+ vs. patients < 80 years (P80-). Methods: In 12/2021, a REDCap survey was circulated electronically to 6,918 persons enrolled in the Mayo Clinic Breast Disease Registry. The survey asked about concerns and satisfaction with multiple aspects of BC care. Results: 2,437 participants responded (35 % response rate); 202 (8.3%) were P80+. P80+ were less likely to undergo local regional and systemic therapies vs. P80- (p

Pheochromocytoma is a rare neuroendocrine tumor that affects people in the 4th and 5th decades of life. It can be benign or malignant, and present as isolated tumors or along with other neuroendocrine syndromes. We present a case of an elderly man who underwent laparoscopic adrenalectomy for pheochromocytoma when he was 58 years only to have a recurrence of metastatic malignant pheochromocytoma in his seventies. We also conducted a literature review to understand the epidemiology and presentation of the tumor and to emphasize that there should be a low threshold of suspicion for timely diagnosis and management of recurrent pheochromocytoma.

Children—Dependents in Social Construction Theory—are assessed within democracies regarding their ability to self-direct their behavior concerning their associated society. In this regard, childhood represents a lack of self-direction, a life period when people require the guidance and protection of adults. The assumed necessity of adults supervising children in democracies requires substantial social resources, reducing the self-direction of those charged with overseeing children. Given that self-direction defines the optimal experience of people within democratic society, finding ways to increase the self-direction of children is an individual and a social benefit. In this regard, smartphones have improved self-direction in children. How children have become empowered to self-direct their lives with smartphone use considering Social Construction Theory—as Advantaged, Contenders, or Deviants—is the focus of a scoping review conducted on “children, empowerment, smartphones” of the following databases: OVID, JSTOR, ProQuest, PubMed, Scopus, and Web of Science. The result is that children permitted to self-direct their activities aided by smartphone technology have comparable social behavior to adults positioned as Advantaged, Contenders, or Deviants and, as such they should be encouraged to utilize smartphone technology to improve their self-direction, as doing so will augment individual and caregiver self-direction, providing increased social benefit.

Diabetes is a chronic disease that often causes progressive complications in the elderly. Along with the decline in cognitive function in the elderly, it causes dependence on disciplined management of diabetes mellitus. This dependence causes a very important mentoring role to be given. The purpose of this study is to provide knowledge, attitudes, and family skills to care for the elderly with diabetes mellitus at home through the empowerment of elderly cadres in Lampung. This research method is a quasi-experimental research with a control group design with a total of 64 elderly respondents and 64 families selected by simple random sampling technique. The assessment used an instrument for assessing family abilities that the researcher developed included aspects of knowledge, attitudes, and skills. The results of the dependent t-test analysis showed a significant increase in the knowledge and skills variable in the intervention group (0.000) but decreased in the attitude variable with p 0.198. Meanwhile, the increase in value also occurred in the attitude and skill variables in the control group. So that the results of the independent t-test only showed a significant difference in the attitude score (0.000) with the highest score in the control group. So that there is no significant increase in the ability of the family after the implementation of elderly cadres empowerment.

The EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), EULAR Sjogren’s Syndrome Patient Reported Index (ESSPRI), and other patient-reported outcomes (PROs), such as the visual analog scale (VAS) for symptoms and EULAR sicca score (ESS), are used to assess the disease activity of primary Sjögren’s syndrome (pSS). Recently, Clinical ESSDAI (ClinESSDAI) and Clinical Trials ESSDAI (ClinTrialsESSDAI) were developed for objective clinical disease activity indexes. However, the relationship of ClinESSDAI and ClinTrialsESSDAI with PROs as well as that between ESSPRI and other PROs and the objective parameters of glandular function in pSS have not been established. Herein, we investigated the correlation of ESSPRI and other PROs with the objective parameters of glandular function and the relationship of PROs with ClinESSDAI and ClinTrialsESSDAI in 66 patients with pSS. Correlations were calculated with Spearman’s correlation coefficient. ClinTrialsESSDAI was correlated with ESSPRI, dryness (ESSPRI-Dryness), fatigue, and pain domains of ESSPRI, VAS for oral dryness (oral-VAS), and patient’s global assessment. Although ESSPRI did not correlate with the objective parameters of glandular function, ESSPRI-Dryness, ESS, and oral- and ocular-VAS did. These results suggest that ESSPRI-Dryness, ESS, and VAS for symptoms, but not ESSPRI, reflect the glandular dysfunction and that ClinTrialsESSDAI correlates with PROs for dryness in pSS.

The World Health Organization(WHO) in 2016 considered mHealth as: “the use of mobile wireless technologies including smart devices such as smartphones and smartwatches for public health” as an important resource for health services delivery and public health given their ease of use, broad reach and acceptance. WHO emphasizes the potential of this technology to increase access to health information, services and skills as well as promoting positive changes in health behaviors and management of diseases. In this regard, the capability of smartphones and smartwatches for m-health monitoring as well as verification of the patient the signal has become an important component of mHealth system. Most of the smartwatches could extract more than one bioelectrical signal therefore, therefore they provide suitable platform for extracting health data for e-monitoring. The existing approaches have not considered the integrity of data obtained from these smart devices. Therefore, it is important that the integrity of the collected data be verified continuously through user authentication. This could be done using any of the bioelectrical signals extracted and transmitted for e-monitoring. In this article, a smartwatch is used for extracting bioelectrical signal before decomposing the signal into sub-bands of Detail and Approximation Coefficient for user authentication. To select suitable features using biorthogonal wavelet decomposition of signal from a non-intrusive extraction, a detailed experiment is conducted extracting suitable statistical features from the bioelectrical signal from 30 subjects using different biorthogonal wavelet family. Ten features are extracted using Biorthogonal wavelet to decompose the signal into three levels of sub-band Detail and Approximation Coefficient and features extracted from each level the decomposed Detail and Approximation Coefficients. Comparison analysis is done after the classification of the extracted features based on the Equal Error Rate (EER). Using Neural Network (NN) classifier, Biorthogonal Wavelet Detail Coefficient Sub-band level 3 of bior1.1 achieved the best result of EER 13.80% with the fusion of the best sub-band three levels of bior1.1 achieving a better result of 12.42% EER.

South Africa is afflicted with the worst epidemic of HIV in the world a legacy of the system of oscillating migrant labour in the region and the consequent social disruption that was the legacy of Apartheid. The initial response from the national government was slow and ineffective but once the magnitude of the epidemic became apparent the government began to respond. The investment in HIV- and TB-related activities in 2013 was R22 Bn or (US$2.5; 2013 exchange rate) of which the South Africa government contributed 80% and the Presidents Emergency Plan for AIDS Relief (PEPFAR) 17%. South Africa now has the more people on anti-retroviral therapy than any other country and treatment is being started much sooner after infection. Much of the best biomedical, virological, immunological, mathematical and social science around the treatment and prevention of HIV and AIDS and the associated epidemic of TB has been done by South African’s and their international collaborators. If the efforts to control the epidemic are maintained South Africa is on track to meet the UNAIDS 90-90-90target by 2020 and to End AIDS by 2030 in spite of the magnitude of the problem. While individual, patient level data are increasingly available, especially in the Western Cape, much greater efforts need to be made to ensure that the information collected in this way is used to give feedback and support to clinic staff, to ensure that health clinics are providing the best possible service, and to individual patients and people living with HIV to ensure that they are receiving the best possible care and support. South Africa needs to make better use of the rich and detailed data that are being collected from individual clinics and their patients to identify problems or difficulties at the clinic level and to ensure that individual patients are retained on treatment, are virally suppressed and receive the best possible care and support.

INTRODUCTION Recently there has been a significant increase in age in the United States. It is necessary to better understand the physiological and surgical needs of these patients in order to optimize outcomes. The vast majority of procedures performed in adult patients are low-risk operations, such as laparoscopic cholecystectomy. Our aim is to investigate the outcomes, including length of stay, morbidity, mortality, re-admission and discharge disposition of the elderly population (>80) undergoing low-risk operations in our tertiary community hospital. METHODS A retrospective chart review was done at a tertiary community hospital. The time frame utilized was 2011-2015. Patients were excluded only on the basis of their age (< 80) at the time of operation. RESULTS There were a total of 30 patients who underwent laparoscopic cholecystectomy from 2011 to 2015. 21 patients (70%) were female and 9 (30%) were male. No patients were converted to an open procedure. The average age was 86.4 years and average ASA classification prior to surgery was 2.88. Higher ASA class, specifically those that were class III/IV were more likely to have an increased length of stay that was statistically significant. Overall age greater than 80 was an independent risk factor for transfer to a higher level of care upon discharge (SNF, LTAC, etc.), a surrogate marker for physical decompensation following surgery. CONCLUSIONS Routine surgery, such as the laparoscopic cholecystectomy, effects the elderly population in a more substantial way, and early recognition coupled with increased education for physicians regarding geriatric patients can help to reduce length of stay, morbidity, and overall physical and mental deconditioning.

In the era of Big Data and the Internet of Things (IoT), ensuring the security and privacy of patient data within distributed health systems is paramount. This research delves into the challenges posed by these advancements and explores viable solutions, focusing notably on blockchain technology, data encryption methods, and access control mechanisms. Employing a comprehensive literature review approach, the study synthesizes current research findings, complemented by analyses of existing frameworks and case studies from healthcare organizations, offering practical insights. Interviews with cybersecurity experts and healthcare IT professionals provide nuanced perspectives on current security issues and emerging trends. Through qualitative and quantitative data analyses, the study generates recommendations aimed at enhancing patient data security. These include the adoption of new frameworks and innovative technologies to fortify healthcare data systems. By addressing these critical aspects, this research aims to significantly contribute to the advancement of a more secure and efficient healthcare ecosystem in today's digital landscape.

After reviewing cancer theories, cancer treatment development histories, randomized clinical trial's performance, cancer treatment strategy, trial follow-up times, and conducting numerous simulations using existing data, the authors found: (1) medical treatments come with three to four lethal factors: treatment side-effects, emotional distress and chronic dress, lack of exercises or physical inactivity, and excessive nutrition in some cases; (2) clinical trial exaggerates the benefits of fast-acting treatments and underestimates the slow-delivering adverse side effects as a result of statistical averaging, interfering effects of personal lifestyle factors, and insufficient follow-up times; (3) the benefits of medical treatments are limited by chain comparison, where surgery sets up a negative standard relative to the best way for resolving cancer; (4) the strategy of destroying the tumor is unworkable; (5) medical treatments can turn natural cancer growth curve into approximately doubly exponential curve; (6) multiple factor non-medical measures are much more powerful than medical treatments in controlling cancer growth and metastasis rates; and (7) cancer early diagnosis and over treatments are bad strategies that have great adverse impacts on cancer patients. Based on huge increases in cancer growth rate constants, substantial of loss of organ functional capacity, and severe systemic aging-like cellular damages, the authors concluded that medical treatments promote cancer growth and metastasis rates and shorten patient lives in most cases, and the claimed benefits are caused by triple biases of clinical trials. The authors believe that the better strategy for ending the global cancer epidemic is abandoning clinical trails as the research model, changing caner treatment strategy from killing cancer cells to slowing down cancer growth rates by using multiple factors optimization approach in personalized medicine.

Glycogen storage disease type III (GSDIII) is a hereditary glycogenosis caused by deficiency of the glycogen debranching enzyme (GDE), an enzyme, encoded by Agl, enabling glycogen degradation by catalyzing alpha-1,4-oligosaccharide side chain transfer and alpha-1,6-glucose cleavage. GDE deficiency causes accumulation of phosphorylase-limited dextrin, leading to liver disorder followed by fatal myopathy. We tested here the capacity of the new autophagosomal activator GHF-201 to alleviate disease burden by clearing pathogenic glycogen surcharge in the GSDIII mouse model Agl-/-. We used open field, grip strength and rotarod tests for evaluating GHF-201’s effects on locomotion, biochemistry panel to quantify hematological biomarkers, indirect calorimetry to quantify in vivo metabolism, transmission electron microscopy to quantify glycogen in muscle, and fibroblast image analysis to determine cellular features affected by GHF-201. GHF-201 was able to improve all locomotion parameters and partially reversed hypoglycemia, hyperlipidemia and liver and muscle malfunction in Agl-/- mice. Treated mice burnt carbohydrates more efficiently and showed significant improvement of aberrant ultrastructural muscle features. In GSDIII patient fibroblasts, GHF-201 restored mitochondrial membrane polarization and corrected lysosomal swelling. In conclusion, GHF-201 is a viable candidate for treating GSDIII as it recovered a wide range of its pathologies in vivo, in vitro, and ex vivo.

Patient safety is one of the indicators of the quality of health services in the hospital, for that, it is necessary to have efforts from the hospital to create a system that can minimize the occurrence of errors and unexpected events that can harm patients, nurses as health workers who are the most numerous in the home. sick and with the patient for 24 hours, has an important role in maintaining patient safety. This study aims to explain how the role of nurses and cooperation between health workers in implementing patient safety measures in the hospital. The method used in this study is a literature review by analyzing and exploring relevant articles and focusing on interprofessional collaboration to improve patient safety. The articles used in this study were taken from 3 direct, Proquest, Pubmed science databases published in the last 3 years, namely between 2019-2021, nurses as part of the health team are required to be able to work together with other health professionals in hospitals with various characteristics, including education, gender, age, employment status and length of work, nurses are required to be committed to maintaining patient safety in the hospital.

Implantation of two electrical stimulators of different cranial nerves in one patient is rare. We report the case of a forty-seven-year-old patient already implanted with a trigeminus nerve stimulator. In addition, this patient suffered from hearing problems. In one ear, the patient was deaf. On the other side, the patient wore a bone conduction hearing aid to improve hearing. In this complex situation, we decided to check the possibility of cochlear implantation on the deaf side. Finally, we managed to provide electrical stimulation of the auditory pathway of the deaf ear to improve the patient’s hearing tests. In addition, this case report shows how the trigeminus stimulator interferes with the electrical stimulation in auditory evoked potentials measurements of the auditory brainstem and cortex via EABR (evoked auditory brainstem response) resp. EALR (evoked auditory late response).

A method for generating fluoroscopic (time-varying) volumetric images using patient-specific motion models derived from 4-dimensional cone-beam CT (4D-CBCT) images is developed. 4D-CBCT images acquired immediately prior to treatment have the potential to accurately represent patient anatomy and respiration during treatment. Fluoroscopic 3D image estimation is done in two steps: 1) deriving motion models and 2) optimization. To derive motion models, every phase in a 4D-CBCT set is registered to a reference phase chosen from the same set using deformable image registration (DIR). Principal components analysis (PCA) is used to reduce the dimensionality of the displacement vector fields (DVFs) resulting from DIR into a few vectors representing organ motion found in the DVFs. The PCA motion models are optimized iteratively by comparing a cone-beam CT (CBCT) projection to a simulated projection computed from both the motion model and a reference 4D-CBCT phase, resulting in a sequence of fluoroscopic 3D images. Patient datasets were used to evaluate the method by estimating the tumor location in the generated images compared to manually defined ground truth positions. Experimental results showed that the average tumor mean absolute error (MAE) along the superior-inferior (SI) direction and the 95th percentile in two patient datasets were (2.29 mm and 5.79 mm) for patient 1 and (1.89 mm and 4.82 mm) for patient 2. This study has demonstrated the feasibility of deriving 4D-CBCT-based PCA motion models that have the potential to account for the 3D non-rigid patient motion and localize tumors and other patient anatomical structures on the day of treatment.

Finding an optimal combination of features and classifier is still an open problem in the development of automatic heartbeat classification systems, especially when applications that involve resource-constrained devices are considered. In this paper, a novel study of the selection of informative features and the use of a random forest classifier while following the recommendations of the Association for the Advancement of Medical Instrumentation (AAMI) and an inter-patient division of datasets is presented. Features were selected using a filter method based on the mutual information ranking criterion on the training set. Results showed that normalized R-R intervals and features relative to the width of the QRS complex are the most discriminative among those considered. The best results achieved on the MIT-BIH Arrhythmia Database were an overall accuracy of 96.14% and F1-scores of 97.97%, 73.06%, and 90.85% in the classification of normal beats, supraventricular ectopic beats, and ventricular ectopic beats respectively. In comparison with other state of the art approaches tested under similar constraints, this work represents one of the highest performances reported to date while relying on a very small feature vector.

Patient derived model systems are important tools for studying novel anti-cancer therapies. Patient derived xenografts (PDXs) have gained favor over the last 10 years as newer mouse strains have improved the success rate of establishing PDXs from patient biopsies. PDXs can be engrafted from head and neck cancer (HNC) samples across a wide range of cancer stages, retain the genetic features of their human source, and can be treated with both chemotherapy and radiation, allowing for clinically relevant studies. Not only do PDXs allow for study of patient tissues in an in vivo model, they can also provide a renewable source of cancer cells for organoid cultures. Herein, we review the uses of HNC patient derived models for radiation research including approaches to establishing both orthotopic and heterotopic PDXs, approaches and potential pitfalls to delivering chemotherapy and radiation to these animal models, biological advantages and limitations, and alternatives to animal studies that still use patient-derived tissues.

Mitochondria are involved in many cellular processes and their main role is cellular energy production. They constantly undergo fission and fusion, and these counteracting processes are under strict balance. The cytosolic dynamin-related protein 1, Drp1 or dynamin-1-like protein (DNM1L) mediates mitochondrial and peroxisomal division. Defects in the DNM1L gene results in a complex neurodevelopmental disorder with heterogeneous symptoms affecting multiple organ systems. Currently there is no curative treatment available for this condition. We have previously described a patient with a de novo heterozygous c.1084G>A (p.G362S) DNM1L mutation and studied the effects of a small molecule, Bezafibrate, on mitochondrial functions in this patient’s fibroblasts compared to controls. Bezafibrate normalized growth on glucose-free medium, ATP production, oxygen consumption and s improved mitochondrial morphology in patient’s fibroblasts, albeit concomitantly causing a mild increase ROS production. Further studies would be needed to show the consistency of the response to Bezafibrate, possibly using fibroblasts from patients with different mutations in DNM1L, and this treatment should be confirmed in clinical trials. However, taking into account the favorable effects in our study, we suggest that Bezafibrate could be a possible treatment option for patients with certain DNM1L mutations.

Aims: This study aims to evaluate the impact of family-centered empowerment on Jordanian adolescents with type 1 diabetes (T1DM), focusing on their HbA1c levels, self-efficacy, and quality of life (QOL). Background: Poor glycemic management in adolescents with type 1 diabetes increases complications. Improved control is linked to various variables, but few studies focus on Middle Eastern populations. Methods: An experimental study involved 68 adolescents with T1DM visiting Jordanian Royal Medical Services' clinics. Two sets of participants were created: control (n = 34) and intervention (n = 34). Data was collected through face-to-face interviews and medical records. Results: The study found significant differences in self-efficacy scores between the intervention and control groups, with the intervention group experiencing a significant decrease in HbA1c readings and a significant difference in QOL between pre-program and post-program phases. Discussion: Family empowerment can significantly improve the lives of Jordanian teenagers with type 1 diabetes. This strategy leads to improved glycemic management, increased self-efficacy, and improved quality of life. Future treatments and health policies should recognize and value the critical role families play in the care of this population. Conclusion: The study suggests that patients with T1DM should receive continuous care education sessions, including self-care training, to improve their health. Nurses should also incorporate these training into treatment plans and educational programs for adolescents to enhance their QOL.

A handheld NIR spectrophotometric method was developed, validated and applied for determination of tadalafil in tablets. The aim of our work was to develop analytical methods based on vibrational techniques and using low-cost portable equipment. Based on different chemometric modeling, we attempt to validate the method, that gave encouraging results from the principal component analysis (PCA), DD-SIMCA and PLS modeling. Then came optimization using an appropriate experiment plan. For validation, we used the total error approach with acceptance limits set at ±10% with a risk level of 5%. The method showed that it was possible to perform both qualitative and quantitative analysis of pharmaceutical products using low-cost portable NIR systems with chemometric tools. The developed approach enabled to cross the first step in implementing a NIR method for quality control of Tadalafil-based drugs in the DRC. Validation difficulties of PLS method resulted from the lack of information about inter-days serial variations of spectral responses. This would be interesting to extend the study to a larger calibration interval in order to correct uncertainties that may result from the variability observed under different conditions, and to verify robustness. These are the limitations of this work, but the results are nevertheless very encouraging.

Secondary prevention after SCA (acute coronary syndrome) is of paramount importance to reduce the incidence of MACE and improve prognosis in follow-up. The control of avoidable risk factors, lifestyle modifications, but especially careful control of cholesterolemia (with a target of LDL-C

The present study discusses how adopting cryptos affects financial inclusion in developing economies. Primary constructs like Financial Inclusion (FI), Perceived Economic Empowerment (PEE), Trust in Financial Institutions (TFI), User Satisfaction (US), and Cryptocurrency Adoption (CA) were tested through Structural Equation Modeling (SEM). The results indicated that CA significantly and positively influenced FI, US, TFI, and PEE. These relationships extend to the interaction effects: US, TFI, and PEE all positively related to FI. It is a reflection of cryptocurrencies as an opportunity to redress most of the afflictions characteristic of traditional finance systems and to promote financial inclusion and economic empowerment in developing countries. Future research should also investigate whether digital literacy and regulatory environments support cryptocurrency access.

In the context of digital empowerment, the digital literacy level of tea farmers has a significant impact on the intelligent development and transformation of the tea industry. This study extends the original model of UTAUT theory by introducing Personal innovativeness theory and Self-efficacy theory, and constructs a new model to explore the influencing factors of moderate scale tea farmers' digital literacy improvement behavior. There are a total of 22 research hypotheses. Using structural equation modeling and collecting questionnaire data for analysis, the following research results were obtained: (1) Performance expectancy, social influence, effort expectancy, personal innovativeness and self-efficacy all significantly positively affect the willingness of tea farmers to improve their digital literacy, and then according to the path coefficient, in descending order, social influence (0.226)>self-efficacy (0.224)>effort expectancy (0.178)>performance expectancy (0.157)> personal innovativeness (0.155); (2) Facilitating condition and willingness to improve digital literacy have a significant positive impact on tea farmers' digital literacy improvement behavior，and then from the size of the path coefficient, the willingness to improve (0.271)>facilitating condition (0.106); (3) The willingness of tea farmers to improve their digital literacy plays a complete mediating role between personal innovativeness and self-efficacy on their digital literacy improvement behavior, and partially mediates between performance expectancy, social influence, and effort expectancy on their digital literacy improvement behavior, and according to the proportion of indirect effects, the order is effort expectancy (27%), performance expectancy (47%), and social influence (49%); (4) The gender and age of tea farmers have a significant positive moderating effect on the impact of performance expectancy on the willingness to improve digital literacy; age and experience have a significant positive moderating effect on the impact of effort expectancy on the willingness to improve digital literacy; the age of tea farmers has a significant positive moderating effect on the improvement of digital literacy behavior through facilitating condition. This study extends the applicability of the UTAUT theoretical model and proposes strategies to improve the digital literacy of tea farmers, providing practical guidance for tea farmers to improve their digital literacy and providing reference for research related to farmers' digital literacy.

The emergence of three-dimensional human organoids has opened the door for development of patient-derived cancer organoid (PDO) models, which closely recapitulate parental tumor tissue. Mainstays of preclinical cancer modeling include in vitro cell lines and patient-derived xenografts, but these models lack the cellular heterogeneity seen in human tumors. Moreover, xenograft establishment is resource- and time-intensive, rendering these models difficult to use to inform clinical trials and decisions. PDOs, however, can be created efficiently and retain tumor-specific properties such as cellular heterogeneity, cell-cell and cell-stromal interactions, tumor microenvironment, and therapeutic responsiveness. PDO models and drug screening protocols have been described for several solid tumors and, more recently, for gliomas. Since PDOs can be developed in clinically relevant timeframes and share many characteristics of parent tumors, they may enhance the ability to provide precision oncologic care for patients. This review explores the current literature on cancer organoids, highlighting the history of PDO development, organoid models of glioma, and potential clinical applications of PDOs.

Providing patient-centered care to manage chronic pain and opioid use disorder (OUD) is associated with improved health outcomes. However, adopting a holistic approach to providing care is often challenging in rural communities. This study aims to identify and contrast challenges to providing patient-centered care from the perspective of patients and providers. A participatory design approach was adopted to elicit the perceptions of providers and patients with lived experiences of chronic pain and OUD in Jefferson County, Wisconsin. Two focus groups were conducted with each stakeholder group to identify problems that participants face with respect to chronic pain management and OUD and possible solutions. Four interviews were conducted with providers experienced in chronic pain management. Analysis of focus group sessions and interviews show consensus among patients and providers that lack of behavioral health and recovery resources create barriers to effectively manage OUD and chronic pain. However, there was discordance among the two groups about other barriers such as patient and provider attitudes, tapering approach, and access to medications for OUD. This tension among patients and providers can influence patients’ retention in therapy. More efforts are needed to mitigate stigma among providers in rural communities and support psychosocial needs of patients.

Therapeutic patient education (TPE) aims to empower the patients and their caregivers to effectively care for and manage their conditions. Such educational programs have been shown to improve health behaviors, disease outcomes and quality of life among different patient populations. The field of TPE has evolved extensively over decades, owing to interdisciplinary research. No study so far has been done to map this field, to identify the stakeholders and gaps requiring future research. By leveraging the theory of co-citation, Citespace was used to visualize the bibliographic data pertaining to TPE research. A total of 54,533 articles published in English language were analyzed to identify influential funders, regions and institutes contributing to this field. Besides these, important theoretical and empirical work that has shaped this field has also been mapped. Our analysis revealed several important insights. Most of the important theories which helped shape TPE were inspired from the social sciences. Five important themes of research were identified including disorders, study designs utilized in TPE research, scope of the TPE literature, and outcomes, and populations. The research focused on improving perceptions, behaviors, and attitudes for health promotion, reducing stigma as well as self-management and medication adherence. Most of the research was developed in the context of high income countries. The future research should more involve patients and use digital technology. Meta-analytical studies need to be done to identify the specificities of TPE interventions across different disorders. More research should involve low and middle income countries (LMIC) to ensure knowledge and technology transfer.

Arboviruses of medical and veterinary significance have been identified on all 7 continents with every human and animal population at risk for exposure. Like arboviruses, chronic neurodegenerative diseases like Alzheimer’s and Parkinson’s disease are found wherever there are humans. Viral parkinsonism has been documented for a variety of human pathogens though there are few studies that evaluate the effects of viral infection on degenerative neurological diseases. Significant differences in baseline gene and protein expression have been determined between Human Induced Pluripotent Stem Cell lines derived from a non-Parkinson’s disease individual and from an individual with reported Parkinson’s disease. While the organoids generated from each cell line were physically indistinguishable, significant differences were observed in gene and protein expression for neurotransmission and immunity. It was hypothesized that these inherent differences would impact cerebral organoid responses to viral infection. In this preliminary observational study, cerebral organoids from a non-Parkinson’s and Parkinson’s patient were infected with Chikungunya virus and observed for 2 weeks. Parkinson’s organoids lost mass and exhibited a dysfunctional antiviral response. Neurotransmission data from both non-Parkinson’s and Parkinson’s organoids had dysregulation of IL-1, IL-10, IL-6. These cytokines are associated with mood and could be contributing to persistent depression seen in patients following CHIKV infection. Both organoid types had increased expression of CCR5 and CXCL10 which are linked to demyelination, highlighting a potential mechanism for virus-associated parkinsonism. The dysfunctional antiviral response of Parkinson’s organoids highlights the need for more research in neurotropic infections in a neurologically compromised host.

Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL: hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients’ literacy skills by encouraging the implementation of autonomy-supportive patient centered communication (PCC), which in turn requires the enhancement of patient engagement. Our main hypothesis is that the well-known relationship between autonomy-supportive PCC and HL is mediated by patient engagement which is known to play a role in HL promotion and that is related to PCC as well. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking PCC to patient engagement and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of patient engagement between PCC and HL. Results show that the theoretical model has a good fit indexes and that patient engagement fully mediates the relationship between PCC and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.

: The global impact of the COVID-19 pandemic has resulted in substantial morbidity and mortality rates. Consequently, there is a pressing need for clinical research focused on the prevention, diagnosis, and treatment of this disease. To comprehensively study the course of COVID-19 in the Philippine population, it is essential to have a comprehensive dataset that includes relevant treatment and diagnostic information. While individual patient reports related to the disease are available at various institutions in the Philippines, there is a need for a more extensive and representative database to facilitate robust analysis. The purpose of this review is to elucidate various challenges and opportunities as well as propose solutions for the development and implementation of a prospective COVID-19 patient registry within a regional context in the Philippines. The primary clinical objective of establishing this registry was to enhance the accuracy of disease diagnosis. In this review, we present a comprehensive explanation of the systematic rationale, design, and execution of a COVID-19 patient registry in the Western Visayas region of the Philippines. Based on this review, several factors exist that hinder the implementation of a COVID-19 patient registry in the regional setting in the Philippines including lack of funding, facilities, infrastructure, manpower, expertise, and unwillingness of some hospitals to pursue research. We also discussed herewith the proposed program implementation for the establishment of such registry in a regional setting in the Philippines.

Since the beginning of the year 2020, the global healthcare system has been challenged by the threat of the SARS-COV 2 virus. Molecular, antigen, and antibody testing are the mainstay to identify infected patients and fight the virus. Molecular and antigen tests that detect the presence of the virus are relevant in the acute phase only. Serological assays detect antibodies to the Sars-CoV-2 virus in the recovering and recovered phase. Each testing methodology has its advantages and disadvantages. To evaluate the test methods, sensitivity (percent positive agreement - PPA) and specificity (percent negative agreement – PNA) are the most common metrics utilized, followed by the positive and negative predictive value (PPV and NPV), the probability that a positive or negative test result represents a true positive or negative patient. In this paper, we illustrate how patient risk and clinical costs are driven by false-positive and false-negative results. We demonstrate the value of reporting PFP (probability of false positive results), PFN (probability of false negative results), and costs to patients and healthcare. These risk metrics can be calculated from the risk drivers of PPA and PNA combined with estimates of prevalence, cost, and Reff number (people infected by one positive SARS COV-2).

Systemic inflammation and coronary microvascular endothelial dysfunction are essential pathophysiological factors in heart failure with preserved ejection fraction (HFpEF) that support the use of statins. The pleiotropic properties of statins, such as anti-inflammatory, antihypertrophic, antifibrotic, and antioxidant effects, are generally accepted and may be beneficial in HF, especially in HFpEF. Numerous observational clinical trials have consistently shown a beneficial prognostic effect of statins in patients with HFpEF, while the results of two larger trials in patients with HFrEF have been controversial. Such differences may be related to a more pronounced impact of the pleiotropic properties of statins on the pathophysiology of HFpEF and pro-inflammatory comorbidities (arterial hypertension, diabetes mellitus, obesity, chronic kidney disease) that are more common in HFpEF. This review discusses the potential mechanisms of statin action that may be beneficial for patients with HFpEF, as well as clinical trials that have evaluated the statin effects on left ventricular diastolic function and clinical outcomes in patients with HFpEF.

A 68-year-old man with malignant metastatic melanoma in complete remission after Pembrolizumab treatment, developed 10 months after Pembrolizumab cessation due a grade 3 diarrhea, confusion, altered mental status, progressive memory loss, gait disturbance. He was admitted to the neurologic department and comprehensive neurological workup, brain magnetic resonance imaging, cerebral fluid analysis, EEG, blood test allowed the diagnosis of autoimmune encephalitis. The patient was treated with plasmapheresis, high dose of intravenous steroids and intravenous immunoglobulins. The patient improved and he is now well with a performance status 1. This case is interesting since the AE developed approximately 10 months after the cessation of immunotherapy, the underlying cancer was in complete remission and the AE showed a good response to the treatment done.