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[ "Although an increasing number of network meta-analyses have been conducted on the effectiveness of conservative therapy for knee osteoarthritis, these may have been poorly planned and executed.We aimed to review the qualities of a comprehensive set of network meta-analyses on rehabilitation therapies for knee osteoarthritis and provide an overview of the effectiveness of each therapy.", "The eligibility criteria were as follows: (i) conservative rehabilitation was the primary treatment in the intervention group, (ii) included patients were diagnosed with knee osteoarthritis, and (iii) patient groups were aged ≤75 years, and rehabilitation interventions comprised exercise, orthotic, or physical therapies or patient education.", "Two independent reviewers screened the titles and abstracts of the identified records and selected the eligible reviews; their full texts were further assessed for eligibility.", "Then, a checklist derived from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension statement for the reporting of systematic reviews incorporating network meta-analyses of healthcare Interventions was used to validate the completeness of the reporting of each network meta-analysis.", "Furthermore, the statistical and outcome data regarding the quality of life, knee joint function and pain, adverse events, and physical functions were extracted using a customized spreadsheet.", "Overall, 2701 titles and abstracts were screened, and eight network meta-analyses were ultimately selected.", "Nearly all reviews adequately addressed the PRISMA extension checklist, and the completeness of reporting was adequate; therefore, all expected information could be extracted.", "However, the methodology used to confirm the transitivity assumption was insufficient in many reviews.", "The following interventions were effective in reducing pain and improving physical function: (i) strengthening, flexibility, aerobic, and mind-body exercises, (ii) pulsed ultrasound, (iii) focused and radial extracorporeal shockwave therapy, and (iv) continuous ultrasound.", "The following interventions were effective in improving the quality of life: (i) strengthening, (ii) mixed, and (iii) mind-body exercises.", "Our results suggested that exercise therapies, including muscle-strengthening, aerobic, flexibility, and mind-body exercises, are likely to be effective for pain relief and functional improvement in knee osteoarthritis.", "This may be the first review to provide a comprehensive perspective for considering priorities for future rehabilitation interventions for knee osteoarthritis." ]

[ "Best practice in optometry and ophthalmology recommends regular visits to eye care professionals, as routine eye examinations support early detection of ocular defects and associated systemic, sometimes potentially life-threatening, conditions.", "The study sought to determine the utilisation of ophthalmic services and its associated factors in the Ashanti region of Ghana.", "Fifty electoral areas in 10 of the 43 districts in the Ashanti region of Ghana.", "A total of 1615 participants, aged 18 years and above, were randomly selected in the Ashanti region of Ghana for this population-based, cross-sectional survey.", "The factors associated with having had an eye examination were guided by Andersen's Behavioural Model.", "The data were analysed using multiple logistic regression, employing the IBM SPSS software, version 25.", "After statistical adjustments, compared with the 18-29-year-old age group, older participants were found to be more likely to utilise eye care services: In addition, participants with higher formal education had higher odds for eye care utilisation compared with no former education: Being hypertensive, self-reported vision problems and feeling that regular eye examinations are important, were statistically associated with eye care utilisation.", "There is alarmingly poor utilisation of ophthalmic services in the Ashanti region of Ghana.", "Effective programmes to promote public health by addressing the socio-economic and individual barriers hindering the uptake of ophthalmic services in the Ashanti region of Ghana are thus necessary.Contribution: The study addresses a gap in the knowledge of factors associated with ophthalmic services utilisation in the Ashanti region of Ghana." ]

[ " Cancer is the third leading cause of death in Kenya.", "Yet, little is known about prognostic awareness and preferences for prognostic information.", "To assess the prevalence of prognostic awareness and preference for prognostic information among advanced cancer patients in Kenya.", "Outpatient medical oncology and palliative care clinics and inpatient medical and surgical wards of Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya.", "The authors surveyed 207 adults with advanced solid cancers.", "The survey comprised validated measures developed for a multi-site study of end-of-life care in advanced cancer patients.", "Outcome variables included prognostic awareness and preference for prognostic information.", "More than one-third of participants (36%) were unaware of their prognosis and most (67%) preferred not to receive prognostic information.", "Increased age (OR = 1.04, 95% CI: 1.02, 1.07) and education level (OR: 1.18, CI: 1.08, 1.30) were associated with a higher likelihood of preference to receive prognostic information, while increased symptom burden (OR= 0.94, CI: 0.90, 0.99) and higher perceived household income levels (lower-middle vs low: OR= 0.19; CI: 0.09, 0.44; and upper middle- or high vs low: OR= 0.22, CI: 0.09, 0.56) were associated with lower odds of preferring prognostic information.", "Results reveal low levels of prognostic awareness and little interest in receiving prognostic information among advanced cancer patients in Kenya.Contribution: Given the important role of prognostic awareness in providing patient-centred care, efforts to educate patients in Kenya on the value of this information should be a priority, especially among younger patients." ]

[ " Completion of a research assignment is a requirement for specialist training in South Africa.", "Difficulty with completion delays graduation and the supply of family physicians.", "The aim of this study was to explore the experience of registrars with their research in postgraduate family medicine training programmes.", "An explorative descriptive qualitative study.", "Extreme case purposive sampling selected registrars who had and had not completed their research on time, from all nine training programmes.", "Saturation was achieved after 12 semi-structured interviews.", "The framework method was used for data analysis, assisted by ATLAS.ti software.", "The assumption of prior learning by teachers and supervisors contributed to a sense of being overwhelmed and stressed.", "Teaching modules should be more standardised and focussed on the practical tasks and skills, rather than didactic theory.", "Lengthy provincial and ethics processes, and lack of institutional support, such as scholarly services and financial support, caused delays.", "The expertise of the supervisor was important, and the registrar-supervisor relationship should be constructive, collaborative and responsive.", "The individual research experience was dependent on choosing a feasible project and having dedicated time.", "The balancing of personal, professional and academic responsibilities was challenging.", "Training programmes should revise the teaching of research and improve institutional processes.", "Supervisors need to become more responsive, with adequate expertise.", "Provincial support is needed for streamlined approval and dedicated research time.Contribution: The study highlights ways in which teaching, and completion of research can be improved, to increase the supply of family physicians to the country." ]

[ " Conceptual frameworks are not only necessary for maintaining and preserving nursing knowledge through their unique contribution, but they also assist in the organisation and provision of complex nursing interventions.", "The lack of formal integration of spiritual care in health professions' education is blamed on the unavailability of guiding models among other challenges such as unavailability of relevant theories.", "The objective of this article was to describe the process followed to develop a conceptual framework as the basis for a practice theory for teaching-learning of spiritual care in nursing.", "An overall theory generative methodology was used.", "To develop the conceptual framework, conclusion statements deduced from empirical data using deductive and inductive strategies were applied.", "The main concepts were identified, described, and classified.", "The relationship between concepts promoted synergy of the developed conceptual framework for teaching spiritual care in nursing.", "The developed conceptual framework was founded on the notion that knowledge from different sources can provide a solid base in theory generation.", "Therefore, the concepts of the developed conceptual framework were not only related to what is 'ideal'; instead, their significance was underpinned by the created universal meanings for effective purposeful communication.", "Therefore, sources used to obtain data were critical in the development of the conceptual framework because they constituted different ways of perceiving and understanding the world.Contribution: The conceptual framework does not only guide nursing interventions but framework also provides a philosophical guide in meeting patient-centred diverse needs." ]

[ " Despite its reported positive deliverables, comprehensive sexuality education (CSE) in South African schools is unable to document an influence in reducing alarming statistics regarding adolescent sexual health.", "Prior research points to a gap that exists between what studies suggest and what is implemented in practice.", "Drawing on Freire's theory of praxis, the aim of this study was to involve the voice of adolescents in reforming CSE - specifically, how the programme could be developed with the objective to co-construct a praxis in order to support sexuality educators in a delivery of CSE that is more responsive to the needs of adolescents.", "Ten participants were purposively selected from all five school quintiles in the Western Cape province of South Africa to take part in this study.", "A qualitative descriptive design with aspects of a phenomenological approach was utilised.", "Rich data were collected by means of semistructured interviews and were analysed thematically with ATLAS.ti.", "The results illustrate the suggestions made by the participants towards the improvement of the CSE programme.", "They reported on approaches and strategies used to teach CSE that imply that it is often not delivered comprehensively - confirming the disjuncture between what the curriculum envisages and what is executed in practice.", "The contribution might lead to change in disconcerting statistics and consequently an improvement in the sexual and reproductive health of adolescents.Contribution: The participants from this study assisted in co-constructing a praxis for CSE teachers to inform their practice." ]

[ " Globally, enrolled nurses (ENs) are embarking on an educational journey to become registered nurses (RNs) in order to enhance their knowledge and career opportunities.", "However, their aspiration is not without challenges.", "In Namibia, the experiences of these nurses have not been extensively researched.", "This study aims to explore and describe the experiences and challenges of ENs undertaking a Bachelor of Nursing Science at the University of Namibia.", "A qualitative, exploratory, descriptive and contextual research strategy was followed as the basis of conducting the study.", "A sample of 15 nursing students was purposively selected from the target population of 73 nursing students.", "This sample size was determined by the saturation of data as reflected in repeating themes.", "The collected data were analysed thematically using an inductive approach.", "Three main themes subsequently emerged from the study: ENs' positive experiences advancing in the Bachelor of Nursing Science (BNSc) programme; nurses' negative experiences advancing in the BNSc programme; and recommendations to ensure effective advancement in the BNSc programmeConclusion: The findings of this study revealed that ENs positively experience becoming a RN when it comes to self-development; however, they have negative experiences such as not receiving exemptions for prior learning and having to learn a new curriculum.Contribution: These findings may be used by the Faculty of Health Sciences, School of Nursing and Public Health management in order to develop targeted interventions and ongoing strategies during their curriculum review cycles to ensure positive student experiences and success within the programme." ]

[ " In Kinshasa, Democratic Republic of Congo, there is a low evocation of the diagnosis of sickle cell disease (SCD) by first-level healthcare providers (HCPs), most likely because of poor knowledge of the disease.", "To assess the levels of knowledge and practices of SCD and to identify determinants of the practices among primary HCPs.", "Healthcare facilities in Selembao health zone in Kinshasa, Democratic Republic of the Congo.", "A cross-sectional study of HCPs randomly selected through a two-stage sampling design.", "Data were collected using a pre-tested interviewer-administered questionnaire.", "Univariate and bivariate analysis were done to describe the levels of knowledge and practices of SCD.", "Factors associated with better practices on SCD were determined using multiple linear regression.", "The threshold for statistical significance was p ˂ 0.05.", "A total of 318 HCPs, which included 80 physicians and 238 nurses, participated in the study.", "The participants showed different scores on the components of the knowledge.", "All the participants showed poor practices on SCD.", "Multiple linear regression retained overall knowledge of SCD as a significant predictor of better practice for physicians.", "Knowledge of SCD and duration of work experience were significant predictors of better practices among nurses.", "The practices of healthcare providers on SCD were far from optimal.", "These practices were significantly associated with knowledge and experience of healthcare providers.Contribution: This study highlighted the need for continuing professional education to enhance the management of SCD in the setting." ]

[ " It is well established that provider lack of knowledge in the field of transgender and nonbinary health is as ignificant barrier to care and that training in this area is lacking.", "This study examined how family medicine residents' self-confidence and medical knowledge in providing gender-affirming care changed after completing a novel, online curriculum on transgender and nonbinary care.", "Thirty-nine family medicine residents were invited to complete the curriculum.", "Change inself-confidence was determined by the difference in scores on a Likert scale on a pre- and post-survey.", "Change in medical knowledge was assessed by examining the difference between pre- and post-test scores on a novel multiple-choice examination.", "Only 7% of current residents agreed that their current training is adequate in order to provide comprehensive primary care to transgender and nonbinary people.", "After completion of the curriculum, 100% of participants felt at least somewhat confident providing primary care to transgender and nonbinary people, including hormone therapy.", "Average medical knowledge post-test scores trended higher than the pre-test results (mean (SD) at pre = 11.2 (1.4) vs post = 14.6 (2.8)).", "An online, self-directed curriculum on caring for transgender and nonbinary patients in the primary care setting, including management of gender-affirming hormone therapy, has the potential to increase confidence and knowledge in this field, decreasing barriers to care for this population." ]

[ " Learning portfolios (LPs) provide evidence of workplace-based assessments (WPBAs) in clinical settings.", "The educational impact of LPs has been explored in high-income countries, but the use of portfolios and the types of assessments used for and of learning have not been adequately researched in sub-Saharan Africa.", "This study investigated the evidence of learning in registrars' LPs and the influence of the training district and year of training on assessments.", "A cross-sectional study evaluated 18 Family Medicine registrars' portfolios from study years 1-3 across five decentralised training sites affiliated with the University of the Witwatersrand.", "Descriptive statistics were calculated for the portfolio and quarterly assessment (QA) scores and self-reported clinical skills competence levels.", "The competence levels obtained from the portfolios and university records served as proxy measures for registrars' knowledge and skills.", "The total LP median scores ranged from 59.9 to 81.0, and QAs median scores from 61.4 to 67.3 across training years.", "The total LP median scores ranged from 62.1 to 83.5 and 62.0 to 67.5, respectively in QAs across training districts.", "Registrars' competence levels across skill sets did not meet the required standards.", "Higher skills competence levels were reported in the women's health, child health, emergency care, clinical administration and teaching and learning domains.", "The training district and training year influence workplace-based assessment (WPBA) effectiveness.", "Ongoing faculty development and registrar support are essential for WPBA.Contribution: This study contributes to the ongoing discussion of how to utilise WPBA in resource-constrained sub-Saharan settings." ]

[ " Physician brain drain is of mounting concern worldwide, especially in lower-middle-income countries like Pakistan, where the healthcare sector is overworked, and the exodus of talented health professionals further deteriorates the country's health statistics.", "Our study's objective was to investigate the career and migration intentions of medical undergraduates and graduates in Peshawar.", "A cross-sectional self-structured questionnaire was distributed among 305 fourth- and final-year medical students and demonstrators at Khyber Medical College and graduates working as house officers, medical officers, and training medical officers at its conjugate hospital, Khyber Teaching Hospital, Peshawar.", "The questionnaire consisted of four sections designed to collect demographic details, determine participants' career and migration intentions, evaluate reasons for and against migration, and assess their reasons for establishing these intentions.", "The data were analyzed using IBM Corp.", "Released 2011.", "IBM SPSS Statistics for Windows, Version 20.0.", "Armonk, NY: IBM Corp.  67.5% of our respondents intended to migrate abroad, most of whom were men.", "The UK emerged as the top destination for those wishing to relocate.", "The most common reasons participants wanted to migrate were better quality of training and research, followed by a gain in professional skills over others, and lastly, better remuneration abroad.", "Most of those who wished to stay back chose family ties, a desire to serve the nation, and fixing flaws in the country's healthcare system as the most influential factors behind their decision to stay back.", "The threat of brain drain is far-reaching and profound, putting Pakistan's people's health at risk.", "Policymakers must act to address the country's healthcare workers' concerns." ]

[ " South African female students' consistent condom use is low, possibly due to personal factors, such as knowledge about sexual reproductive health, attitudes towards safe sex, risk perceptions and condom use, self-efficacy.", "This study aimed to investigate the personal factors that influence condom utilisation among female students.", "This study was conducted at a higher education institution in the Northern Cape province in South Africa.", "A quantitative, descriptive survey design was used.", "Three hundred and eighty five participants were selected using convenience sampling.", "The research instrument was a self-administered questionnaire, and the data were analysed using the Statistical Package for the Social Sciences, version 28.", "Almost two-thirds (250, 64.9%) of participants used condoms to prevent pregnancy, sexually transmitted infections (STIs), and human immunodeficiency virus (HIV).", "Although attitudes towards safe sex were generally positive, low risk perceptions were reported.", "Consistent use of condoms was found in 32.2% (124) of participants, while 45.3% (174) participants used condoms inconsistently or never.", "A significant finding was that consistent use increased the likelihood of negotiating for a condom with partners by 9.14 times and confidence in putting one on for a partner by 8.05 times.", "The findings depict average levels of the use of condoms among female students.", "Prevention efforts should concentrate on educating female students to strengthen condom use and self-efficacy.Contribution: This study, supporting existing literature, suggests that preventative efforts should focus on educating young women about condom use, self-efficacy and encouraging STI conversations with sexual partners." ]

[ " The transition from pediatric to adult health care is a vulnerable time period for adolescents and young adults (AYA).", "Guidance on how to effectively implement transition support for AYA with recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) is lacking.", "To address this gap, we formed a consortium of pancreatic centers that would work in coordination to test interventions to improve the transition for AYA with RAP and CP.", "We then performed a baseline assessment of consortium resources and patient transition readiness and developed an educational toolkit for AYA with RAP and CP.", "Results: Our consortium consists of three National Pancreatic Centers of Excellence, each with a multidisciplinary team to work with AYA with RAP and CP.", "While our patients ages 18 to 23 were generally seen at the pediatric centers, the baseline assessment of transition readiness suggests that our patients may have higher transition readiness scores than other populations.", "The educational toolkit contains both pancreas-specific and general guidance to support AYA with RAP and CP during their transition, including guidance on nutrition, pain management, and finding an adult gastroenterologist.", "Conclusions: We have formed a consortium to test interventions to improve the transition to adult health care for AYA with RAP and CP.", "We have completed a baseline assessment and developed our first intervention: an educational tool kit.", "Future work planned includes tests of the tool kit and efforts to improve rates of transfer to an adult provider for YA with RAP and CP." ]

[ " There are no definitive guidelines for clinical decisions for children with cerebral palsy (CP) requiring enteral feeds.", "Traditionally, medical doctors made enteral feeding decisions, while patients were essentially treated passively within a paternalistic 'doctor knows best' approach.", "Although a more collaborative approach to decision-making has been promoted globally as the favoured model among healthcare professionals, little is known about how these decisions are currently made practically.", "This study aimed to identify the significant individuals, factors and views involved in the enteral feeding decision-making process for caregivers of children with CP within the South African public healthcare sector.", "A single-case research design was used in this qualitative explorative study.", "Data were collected using semi-structured interviews and analysed using reflexive thematic analysis.", "Four primary individuals were identified by the caregivers in the decision-making process: doctors, speech therapists, caregivers' families and God.", "Four factors were identified as extrinsically motivating: (1) physiological factors, (2) nutritional factors, (3) financial factors and (4) environmental factors.", "Two views were identified as intrinsically motivating: personal beliefs regarding enteral feeding tubes, and feelings of fear and isolation.", "Enteral feeding decision-making within the South African public healthcare sector is currently still dominated by a paternalistic approach, endorsed by a lack of caregiver knowledge, distinct patient-healthcare provider power imbalances and prescriptive multidisciplinary healthcare dialogues.Contribution: This study has implications for clinical practice, curriculum development at higher education training facilities, and institutional policy changes and development, thereby contributing to the current knowledge and clinical gap(s) in the area." ]

[ " There is growing interest in the demand for and use of homoeopathic medicines by the public; however, little is known about the perspectives of pharmacists regarding the use of these medicines, particularly in the South African private health context.", "A qualitative approach using an exploratory cross-sectional descriptive design was used.", "Data were collected from a purposive sample of 15 participants comprising pharmacy managers, pharmacists and pharmacy assistants from six different conveniently selected private pharmacy retail outlets.", "Data were collected using individual interviews utilising a semi-structured interview guide.", "An audiotape was used to record the data which were transcribed verbatim and analysed thematically, following Tech's steps of data analysis.", "Ethical approval to conduct the study was obtained from the Durban University of Technology's Institutional Research Ethics Committee.", "The findings of this study revealed four superordinate themes related to pharmacists' perceptions and self-reported awareness regarding homoeopathic medicines.", "These are (1) negative perceptions regarding homoeopathic medicines, (2) perceived benefits of homoeopathic medicines, (3) poor knowledge and awareness of homoeopathic medicines and (4) capacity development and curriculum aspects.", "The findings highlight the need for an educational intervention on homoeopathic medicines targeting pre-service and in-service pharmacy practitioners, to enable them to provide effective education regarding all types of medicines as the demand for homoeopathic medicines increases.Contribution: The study findings provide evidence to support advocacy for an educational intervention to improve awareness and knowledge of pharmacists to enable provision of effective health education for patients.", "More research, however, is required to inform the contents of this training intervention for pharmacists." ]

[ " Transitioning to a professional role is difficult for newly qualified professional nurses.", "Given the challenges that these nurses experience during the transition to practice, support is essential for them to become efficient, safe, confident, and competent in their professional roles.", "The purpose of this study was to explore the transition experiences of newly qualified professional nurses to develop a preceptorship model.", "This study employed a qualitative approach to purposively collect data.", "Concept analyses were conducted applying the steps suggested by Walker and Avant, and the related concepts were classified utilising the survey list of Dickoff, James and Wiedenbach's practice theory.", "A preceptorship model for the facilitation of guidance and support in the clinical area for newly qualified professional nurses was developed.", "The model consists of six components, namely, the clinical environment, the operational manager and preceptor, the newly qualified professional nurse, the preceptorship, the assessment of learning, and the outcome.", "The study revealed that newly qualified professional nurses face many transition challenges when entering clinical practice.", "They are thrown far in, experience a reality shock, and are not ready to start performing their professional role.", "The participants agreed that guidance and support are needed for their independent practice role.Contribution: The preceptorship model for newly qualified professional nurses would be necessary for the transition period within hospitals.", "This preceptorship model may be implemented by nursing education institutions as part of their curriculum to prepare pre-qualifying students for the professional role." ]

[ "\"Anubandh\" the existing mentorship program at our institute used to start with enthusiasm but lacked sustainability throughout the year.", "This study aimed to assess the need for designing and conducting a faculty development program (FDP) and evaluating its impact on effective mentoring.", "FDP was designed by assessing the perception of 50 teachers regarding undergraduate (UG) mentoring at a tertiary care teaching institute in central India, the NKP Salve Institute of Medical Sciences and Research Center and Lata Mangeshkar Hospital, Nagpur, India.", "It was developed and conducted by focusing on the global overview, mentoring policies of the institute and rationale while implementing mentorship.", "The effectiveness of FDP was tested by a change in pretest-posttest scores for assessing their knowledge and reflections on undergraduate mentoring.", "In the pre-FDP perceptions by mentors, the majority agreed that mentorship should be an integral part of the UG curriculum.", "Teachers felt that mentorship is an additional workload that needs to be given weightage in self-appraisal forms.", "A total of 81.2% of mentors emphasized on need for academic, social, and personal mentoring.", "After the FDP, there was a statistically significant improvement in the knowledge and attitude of mentors in all the assessed domains (χ2=2.648; df=6; p<0.05) like the need for UG mentoring in medical college and the role of faculties as a mentor.", "FDP sessions were appreciated by mentors for being motivating, interactive, and highly engaging with speakers having good oratory skills and using inspiring techniques with an overall rating of 9.2/10.", "There was an overall positive attitude about mentoring but many expressed the need for training in mentorship.", "The FDP was highly effective in improving the knowledge and attitude of mentors for effective mentoring." ]

[ "\"Hezhe\" (), \"ganqing\" (), and \"nao le bantian\" () are common mood expressions in modern Chinese which have a common function of summarizing the information before (so called 'sum-up') as well as similar pragmatic functions.", "Study on these mood adverbs could reveal how the interactional mechanism molds the original semantic meanings of mood words and leads to new pragmatic functions.", "Five verbal corpora are applied to collect the real materials of usage containing the above three mood adverbs.", "Functional analysis and data statistics have been carried out to categorize the pragmatic functions of these words, calculate their distributions, and reconstruct their evolutional approach through an interactional perspective.", "We have found a core theoretical viewpoint that the similar functions of the three words emerged through the same pragmatic mechanism called \"violation\".", "These functions are: (1) \"unexpectation\" from the violation of psychological expectation; (2) \"criticism\" from the violation of universal principles; (3) \"humor\" from the violation of communicative principles.", "A statistic work of several corpora showed that these functions of the above three words appear broadly in verbal materials, with differences in their proportions according to the communication types and genres.", "In Chinese teaching to speakers of other languages, more attention should be paid to these words stemming from dialects, especially during intermediate and advanced levels." ]

[ "\"How can the integration of Internet of Things (IoT) technology enhance the sustainability and efficiency of green building (G.B.)", "design?\"", "is the central research question that this study attempts to answer.", "This investigation is important because it examines how green building and IoT technology can work together.", "It also provides important information about how to use contemporary technologies for environmental sustainability in the building sector.", "The paper examines a range of IoT applications in green buildings, focusing on this intersection.", "These applications include energy monitoring, occupant engagement, smart building automation, predictive maintenance, renewable energy integration, and data analytics for energy efficiency enhancements.", "The objective is to create a thorough and sustainable model for designing green building spaces that successfully incorporates IoT, offering industry professionals cutting-edge solutions and practical advice.", "The study uses a mixed-methods approach, integrating quantitative data analysis with qualitative case studies and literature reviews.", "It evaluates how IoT can improve energy management, indoor environmental quality, and resource optimization in diverse geographic contexts.", "The findings show that there has been a noticeable improvement in waste reduction, energy and water efficiency, and the upkeep of high-quality indoor environments after IoT integration.", "This study fills a major gap in the literature by offering a comprehensive model for IoT integration in green building design, which indicates its impact.", "This model positions IoT as a critical element in advancing sustainable urban development and offers a ground-breaking framework for the practical application of IoT in sustainable building practices.", "It also emphasizes the need for customized IoT solutions in green buildings.", "The paper identifies future research directions, including the investigation of advanced IoT applications in renewable energy and the evaluation of IoT's impact on occupant behavior and well-being, along with addressing cybersecurity concerns.", "It acknowledges the challenges associated with IoT implementation, such as the initial costs and specialized skills needed." ]

[ "\"Industry 4.0\" aims to build a highly versatile, individualized digital production model for goods and services.", "The carbon emission (CE) issue needs to be addressed by changing from centralized control to decentralized and enhanced control.", "Based on a solid CE monitoring, reporting, and verification system, it is necessary to study future power system CE dynamics simulation technology.", "In this article, a data-driven approach is proposed to analyzing the trajectory of urban electricity CEs based on empirical mode decomposition, which suggests combining macro-energy thinking and big data thinking by removing the barriers among power systems and related technological, economic, and environmental domains.", "Based on multisource heterogeneous mass data acquisition, effective secondary data can be extracted through the integration of statistical analysis, causal analysis, and behavior analysis, which can help construct a simulation environment supporting the dynamic interaction among mathematical models, multi-agents, and human participants." ]

[ "\"Soft theories,\" i.e., \"heuristic models based on reasoning by analogy\" largely drove chemistry understanding for 150 years or more.", "But soft theories have their limitations and with the expansion of chemistry in the mid-20th century, more and more inexplicable (by soft theory) experimental results were being obtained.", "In the past 50 years, quantum chemistry, most often in the guise of applied theoretical chemistry including computational chemistry, has provided (a) the underlying \"hard evidence\" for many soft theories and (b) the explanations for chemical phenomena that were unavailable by soft theories.", "In this publication, we define \"hard theories\" as \"theories derived from quantum chemistry.\"", "Both soft and hard theories can be qualitative and quantitative, and the \"Houk quadrant\" is proposed as a helpful categorization tool.", "Furthermore, the language of soft theories is often used appropriately to describe quantum chemical results.", "A valid and useful way of doing science is the appropriate use and application of both soft and hard theories along with the best nomenclature available for successful communication of results and ideas." ]

[ "\"Student engagement\" (SE) is gaining momentum as an approach to improve the performance of health professions education (HPE).", "Nevertheless, despite the broad studies about the role of students in various areas, little is known about the role of SE in policy and decision-making activities.", "This study aimed to map SE in policy and decision-making regarding terms and definitions, engagement models, influencing factors, outcomes and achievements, and the interconnection between the influencing factors.", "Five databases (PubMed, Scopus, ProQuest, Web of Science, and ERIC) were systematically searched from Jan 1, 1990, to Nov 12, 2022.", "The review was followed according to the Arksey and O'Malley framework for scoping reviews and reported according to the PRISMA-ScR guidelines.", "We included articles published in English focusing on HPE policy and decision-making.", "The authors summarized and synthesized the findings into themes, subthemes, tables, and models.", "Of the 22 articles included in the full-text review, terms and definitions were tabled, and three themes were extracted: 1. models of SE, in which 10 studies (45.5%) presented the highly structured formal models as Organizations, 5 studies (22.7%) reported less-structured community and group as Programs, and 7 studies (31.8%) engaged students only in surveys or interviews as Perspective; 2.", "Factors influencing SE, that were categorized into 7 subthemes: structural, environmental, and motivational factors, member characteristics, training and mentoring, member relationships, valuing and recognizing.", "3.", "Outcomes and achievements of SE related to systems and members.", "The interconnection between influencing factors is also demonstrated as a conceptual model.", "There are various SE models in HPE policy and decision-making, which are mapped and categorized depending on the degree of formality, structuredness, and level of engagement.", "In our study, three more common SE models in HPE policy and decision-making were investigated.", "Additionally, these collaborative methods emphasized curriculum development and quality assurance and employed students in these activities.", "It is worth mentioning that to make SE models more efficient and sustainable, several influencing factors and their interconnections should be considered." ]

[ "\"SuperAgers\" are generally defined as people 80+ years old with episodic memory performance comparable to those 20 years younger.", "Limited knowledge exists to describe characteristics of SuperAgers, with even less known about Hispanic SuperAgers.", "We examined indicators of cognitive, physical, and psychological resilience in relation to the likelihood of being a SuperAger using data from 2 population-based studies of Hispanic older adults (Puerto Rican Elderly: Health Conditions [PREHCO] Study; Health and Retirement Study [HRS]).", "SuperAgers were defined as (1) ≥80 years old, (2) recall scores ≥ the median for Hispanic respondents aged 55-64, and (3) no cognitive impairment during the observation period.", "Overall, 640 PREHCO participants and 180 HRS participants were eligible, of whom 45 (7%) and 31 (17%) met SuperAging criteria.", "Logistic regressions controlling for age and sex demonstrated that higher education (PREHCO: odds ratio [OR] = 1.20, p < .001; HRS: OR = 1.14, p = .044) and fewer instrumental activities of daily living limitations (PREHCO: OR = 0.79, p = .019; HRS: OR = 0.58, p = .077; cognitive resilience), fewer activities of daily living limitations (PREHCO: OR = 0.72, p = .031; HRS: OR = 0.67, p = .068; physical resilience), and fewer depressive symptoms (PREHCO: OR = 0.84, p = .015; HRS: OR = 0.69, p = .007; psychological resilience) were associated with SuperAging, although not all results reached threshold for statistical significance, presumably due to low statistical power.", "Additionally, known indicators of physical health (e.g., chronic conditions and self-rated health) did not relate to SuperAging.", "Increasing access to education and recognizing/treating depressive symptoms represent potential pathways to preserve episodic memory among older Hispanic adults." ]

[ "(1) Background: \"Patient health information\" promote health literacy.", "\"Patient guidelines\" as a sub group reflect the current evidence about illnesses and treatment options adapted to the needs of laypersons.", "Little is known about factors promoting and hindering their use by people affected by mental illness and their relatives.", "(2) Methods: Telephone interviews (N = 15; n = 4 adults affected by mental illness, n = 5 relatives, n = 6 both applicable) were conducted according to the Sørensen model of health literacy.", "Data were recorded, transcribed and content-analyzed following Mayring.", "(3) Results: Health information is used regularly by individuals affected by mental illness and their relatives, but \"patient guidelines\" are largely unknown.", "Yet, there is a great willingness to use them.", "Main barriers are a lack of statistical knowledge, the complexity of health-related topics and cognitive impairment sometimes accompanying mental illnesses.", "Target group-oriented adaptation as well as transparent and even-handed presentation of (dis-)advantages of treatment options can increase trust.", "(4) Conclusions: Health information and guidelines can help affected persons and relatives to make treatment decisions by conveying unbiased, up-to-date knowledge.", "Target group-specific adaptations should be made for psychiatric illnesses and features specific to mental illnesses compared to physical illnesses should be included.", "Clinical practice guidelines must be distributed more widely to increase their impact." ]

[ "(1) Background: Advance directives (ADs) in Portugal have been legalized since 2012.", "What has been observed over time, from the few studies carried out, is that despite the positive attitudes in the population, there is a low level of adherence to ADs.", "To try to understand the reasons for these data, the current study aimed to explore and describe the experiences of the Portuguese population regarding AD.", "(2) Methods: For this exploratory and descriptive qualitative study, the researchers conducted open (unstructured) interviews with a convenience sample aged over 18 years until data saturation was achieved.", "(3) Results: A total of fifteen interviews were conducted-eight with women and seven with men.", "The following four categories emerged from the content analysis of the interviews: (1) AD literacy, (2) AD relevance, (3) AD attitudes, and (4) conditionalities for compiling the ADs.", "(4) Conclusions: The study pointed out the good receptivity of the participants to the ADs; however, literacy on this subject was low, and identifying the conditionalities in the development of ADs could contribute to improvements in implementation in the population.", "The data from this study suggest the need to implement measures to increase the literacy of the Portuguese population on ADs and review the legal framework for improving the accessibility of the citizen population.", "There is also a need to continue researching and obtain more evidence about the ways in which the Portuguese population perceives ADs; thus, in this way, a society can better respond to its citizens' right to freely exercise their prospective autonomy at the end of their lives." ]

[ "(1) Background: AI (artificial intelligence) chatbots have been widely applied.", "ChatGPT could enhance individual learning capabilities and clinical reasoning skills and facilitate students' understanding of complex concepts in healthcare education.", "There is currently less emphasis on its application in nursing education.", "The application of ChatGPT in nursing education needs to be verified.", "(2) Methods: A descriptive study was used to analyze the scores of ChatGPT on the registered nurse license exam (RNLE) in 2022~2023, and to explore the response and explanations of ChatGPT.", "The process of data measurement encompassed input sourcing, encoding methods, and statistical analysis.", "(3) Results: ChatGPT promptly responded within seconds.", "The average score of four exams was around 51.6 to 63.75 by ChatGPT, and it passed the RNLE in 2022 1st and 2023 2nd.", "However, ChatGPT may generate misleading or inaccurate explanations, or it could lead to hallucination; confusion or misunderstanding about complicated scenarios; and languages bias.", "(4) Conclusions: ChatGPT may have the potential to assist with nursing education because of its advantages.", "It is recommended to integrate ChatGPT into different nursing courses, to assess its limitations and effectiveness through a variety of tools and methods." ]

[ "(1) Background: although studies of cognitive functions are still limited in borderline personality disorder (BPD), the initial evidence suggested that BPD patients have deficits of executive functions and social cognition.", "In addition, patients who report physical and psychic traumatic experiences in childhood and adolescence show considerable neurocognitive impairment and severe BPD symptoms.", "The present study has a twofold aim: (1) to evaluate the differences in neurocognitive performances between BPD patients and healthy controls and (2) to verify in the BPD patients group whether neurocognitive deficits have the role of mediating the effect of early traumas on BPD psychopathology.", "(2) Methods: 69 subjects were enrolled: 38 outpatients with a diagnosis of BPD (DSM-5) and 31 healthy controls.", "BPD patients were tested with the Borderline Personality Disorder Severity Index (BPDSI), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF).", "All subjects were evaluated with the Iowa Gambling task (IGT), the Berg card sorting test (BCST), the Tower of London task (ToL), and the Reading-the-mind-in-the-eyes-test (RMET).", "Statistical analysis was performed with the analysis of variance to compare the cognitive performances between BPD patients and controls.", "A mediation analysis was conducted with the Sobel Test in the BPD patients group.", "The significance level was p ≤ 0.05.", "(3) Results: significant differences between the two groups were found for several parameters of all the cognitive tests examined: BCST, IGT, ToL, and RMET.", "Mediation analysis with the Sobel test demonstrated that the percentage of correct answers in the BCST (BCSTc) and the RMET score significantly mediated the relation between the CTQ total score and BPDSI total score.", "(4) Conclusions: BPD patients showed an impairment of the following executive functions: set shifting, decision making, planning and problem solving, and social cognition abilities, in comparison with controls.", "Our results suggested that the effect of early trauma on BPD psychopathology was mediated by a deficit in two cognitive domains: cognitive flexibility and social cognition." ]

[ "(1) Background: Amidst the global rise in type 2 diabetes mellitus (T2DM), effective management of the disease has become increasingly important.", "Health literacy, particularly in non-English speaking populations, plays a crucial role in this management.", "To address the lack of suitable tools for Arabic-speaking diabetic patients, this study developed and validated the Jordanian Diabetic Health Literacy Questionnaire (JDHLQ).", "(2) Methods: A sample of 400 diabetic patients from Jordan, with a balance in gender, age, and educational background, was recruited from an endocrinology outpatient clinic.", "The JDHLQ, consisting of informative and communicative sections, underwent rigorous validation.", "Utilizing principal component analysis and Rasch analysis, the JDHL's reliability and validity were evaluated.", "(3) Results: The results showed moderate proficiency in understanding and communicating diabetes-related information and confirmed the reliability and validity of the JDHLQ.", "(4) Conclusions: These findings emphasize the importance of culturally appropriate health literacy tools in enhancing patient understanding, engagement, and overall management of T2DM in Arabic-speaking communities." ]

[ "(1) Background: Environmental risks such as air pollutants pose a threat to human health and must be communicated to the affected population to create awareness, such as via health literacy (HL); (2) Methods: We analyzed HL in the context of environmental health risks, including sources of information and prior knowledge, in a sample from the German general population using Kendall's rank correlations, regression analyses, and explorative parallel mediation analysis; (3) Results: The survey included 412 German participants aged between 18 and 77.", "HL was found to be problematic to inadequate.", "The internet, family and friends, and newspapers were the most frequently cited sources of information.", "Mobile apps were mostly unknown but were requested by sample subjects.", "Although subjects expressed environmental concerns and exhibited rather good levels of knowledge, the majority perceived no risk to human health and rated air quality quite positively.", "Knowledge on particulate matter, the term \"ultrafine particles\", and protective measures was found to be rather low.", "HL was associated with the use of newspapers and commercials as sources of information.", "The relationship between age and HL is fully mediated by the use of newspapers and information from TV commercials; (4) Conclusions: HL should be promoted by raising awareness of the health effects of environmental pollutants.", "In particular, the information channels preferred by the affected population should be used and further information opportunities such as apps should be publicized, e.g., through campaigns.", "An improved HL can assist policy makers in creating a healthier environment by empowering individuals to become more environmentally aware and protect their own health.", "This, in turn, has the potential to reduce health-related costs." ]

[ "(1) Background: Individuals have to effectively manage their physical activity in order to optimize the associated physical and psychological health benefits.", "Control competence allows the individual to structure and pace physical activity in a health-enhancing way.", "The concept was developed within a model of physical activity-related health competence, and is related to the concepts of health literacy and physical literacy.", "Therefore, the study firstly aimed to validate a self-report scale to measure the physical and psychological facets of control competence in adolescents.", "Secondly, relationships between control competence and its basic elements, knowledge and motivation, as well as between control competence, sport activity, and fitness, were investigated.", "(2) Methods: In two cross-sectional studies, ninth grade adolescents (study A: n = 794, 51% female; study B: n = 860, 52% female) were tested using self-report scales (study A and B), a test for health-related fitness knowledge (study B), and cardiovascular and muscular fitness tests (study B).", "(3) Results: Confirmatory factor analyses confirmed the two-factor structure of the self-report scale for control competence in studies A and B.", "In addition, the results of structural equation modeling in study B showed a relationship between motivation (via control competence) and sport activity, and a relationship between control competence and fitness.", "(4) Conclusion: The questionnaire extends the ability to assess control competence in adolescents.", "Moreover the findings support the importance of control competence in order to achieve health benefits through physical activity." ]

[ "(1) Background: International students with sufficient health literacy are better equipped to respond to public health emergencies and reduce any unintentional harm that may occur during such events.", "This study aims to assess the current status of health literacy among international students and investigate the factors that influence health literacy.", "(2) Methods: A cross-sectional study was conducted in Tokyo on international university students using a questionnaire consisting of the Communicative and Critical Health Literacy and eHealth Literacy Scales.", "The study analyzed 205 valid responses.", "Descriptive statistics were utilized to assess the level of health literacy, and linear regression was used to identify the association of socio-demographic characteristics and disease status with health and e-health literacy.", "(3) Results: Health literacy and e-health literacy were low in 48.29% and 47.29% of international students, respectively.", "The mean scores of CCHL items ranged from 3.13 to 3.26, while the mean scores of eHEALS items ranged from 3.33 to 3.49.", "Both health literacy and e-health literacy were better with unmarried status (p = 0.015), and e-health literacy was worse with higher age (p = 0.007).", "(4) Conclusions: Overall, international students' health literacy and e-health literacy were at intermediate levels, with considerable room for improvement, and affected by certain student attributes." ]

[ "(1) Background: Nutrition labels on the front of food packages have increasingly become the focus of research.", "However, too few studies have placed special emphasis on nutritionally at-risk subpopulations, such as young adults or those with low literacy/numeracy skills.", "The present study aimed to assess both the perception and objective understanding of three front-of-package labeling (FOPL) formats currently in use on the Belgian market, i.e., the Nutri-Score, Reference Intakes, and Multiple Traffic Lights, among students of varying health literacy (HL) levels.", "(2) Methods: A web-based survey was carried out among 2295 students of tertiary education in the province of Liège, Belgium.", "The questionnaire included questions related to general characteristics, objective understanding, and perception in response to the assigned FOPL format and level of HL.", "(3) Results: With respect to objective understanding, the Nutri-Score outperformed all other labels across all HL levels, and it was similarly understood in students of varying HL levels.", "Several students' characteristics appeared to be associated with each cluster of perception, with the Nutri-Score cluster having the highest percentages of disadvantaged students, i.e., those with inadequate HL, from non-university institutions, with low self-estimated nutrition knowledge, and with low self-estimated diet quality.", "(4) Conclusion: Overall, the findings supported the Nutri-Score as particularly effective in guiding students in their food choices.", "Of particular importance is the fact that the summarized and graded color-coded nutritional label would be a useful strategy for those disadvantaged by limited HL." ]

[ "(1) Background: The main activity children engage with is learning through play or formal education.", "The aim of this systematic review is to analyze the role of occupational therapy in the school setting for children with additional support needs or disabilities.", "(2) Method: We conducted a systematic review using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.", "This systematic review was registered in PROSPERO (CDR42022314271).", "The search was performed in the following databases: ERIC, Dialnet Plus, PubMed, OTseeker, Cochrane, Scopus, CINAHL, and PsycINFO.", "(3) Results: In total, 1954 studies were identified, from which 18 articles were selected.", "These studies were heterogeneous and showed different types of intervention of the occupational therapist in school environments.", "(4) Conclusions: The main conclusions highlighted the effectiveness of the occupational therapist within the school environment, the importance of an interdisciplinary team to cover the special needs students within the school and the need for intrinsic motivation for an active and inclusive participation of the students with special needs.", "However, there is a need for more homogeneous studies with a larger sample size that specifically focus on the school context and include the involvement of occupational therapists in order to replicate the findings obtained." ]

[ "(1) Background: the measures applied in Chile to reduce COVID-19 infections have been very strict, mainly for children who have experienced lockdowns and school closures for almost two years.", "Emerging evidence indicates that lockdowns have had several negative effects on children; therefore, the present study seeks to analyze the secular effects of COVID-19 lockdowns on Chilean students' actual motor competence (AMC) and perceived motor competence (PMC).", "(2) Methods: using a sequential cohort design, data from 523 fifth-grade students at nine elementary schools (46.8% girls, age M = 11.11, SD = 0.66) were assessed in 2018-19 (pre-lockdown) (n = 265) and 2022 (post-lockdown) (n = 258).", "(3) Results: in the domain of object control (AMC and PMC), no significant differences were found (AMC p = 0.559; PMC p = 0.682).", "In the self-movement domain of AMC and PMC, the significant differences found presented a small effect size (AMC p = 0.044, ηp2 = 0.01; PMC p = 0.001, ηp2 = 0.03).", "(4) Conclusions: although the differences encountered were not drastic, self-movement skills tended to be greatly affected by the lockdowns resulting from the COVID-19 pandemic.", "These findings broaden information on the negative consequences of the pandemic on students in aspects related to an active and healthy life." ]

[ "(1) Background: This research aims to compare social networks among institutionalized and aging-in-place (AIP) older adults through the validation of a new questionnaire.", "(2) Methods: The cross-sectional study included 100 older adults (mean age: 73.53 ± 5.49 years; age range: 65-85 years), with 48 institutionalized subjects and 52 AIP subjects.", "We developed, validated, and administered a new questionnaire, the Social Network Assessment for Older People Questionnaire (SNAOPQ), to assess older adults' social networks using descriptive and inferential statistical methods.", "(3) Results: The SNAOPQ demonstrated excellent internal consistency (Cronbach's alpha of 0.91 and McDonald's omega of 0.91).", "Statistical analysis revealed significant associations between variables, highlighting differences in social networks between institutionalized and AIP individuals (p ≤ 0.001).", "Sociodemographic factors like age, education, living arrangement status, and number of descendants significantly influenced SNAOPQ scores (p ≤ 0.001).", "Age and residence type notably impacted participants' scores, indicating reduced social network size with age.", "Tertiary education and living in a couple were associated with more extensive social networks, while a higher number of descendants correlated with social network expansion.", "(4) Conclusions: Our study highlights significant differences in social networks among older adults based on residence type, emphasizing the impact of sociodemographic factors such as age, education, living arrangement, and the number of descendants." ]

[ "(1) Background: This study aims to examine pharmacy students' perceptions of their knowledge and competencies in human resource management (HRM) while also investigating their attitudes toward the educational content provided in a didactic HRM course.", "(2) Methods: A survey evaluating both course knowledge (pre and post) and attitudes was administered to students enrolled in an HRM class.", "Data were analyzed using descriptive statistics and measures of associations.", "(3) Results: All 98 course enrollees completed the survey (N = 98), revealing statistically significant knowledge growth across HRM topics from pre- to post-survey (p < 0.05).", "Notably, emotional intelligence, workforce diversity, conflict resolution, and recruitment strategies exhibited the most substantial increases.", "The expert panel session proved highly effective, with 71% reporting it as the most knowledge-enhancing activity.", "\"Global and cultural effectiveness\" emerged as the most valued competency, reflecting a positive overall attitude towards HRM.", "(4) Conclusions: HRM competency is one of the most fundamental skills for pharmacists, as many problems faced by pharmacy organizations and their solutions stem from the workforce.", "Pharmacy schools should therefore assess their curriculum to ensure that HRM is adequately addressed to meet accreditation standards and to prepare students to navigate HRM challenges in their workplaces post-graduation." ]

[ "(1) Background: This study examines the effects of a 6-week swimming intervention on motor competence in children.", "(2) Methods: A total of 107 children (n = 52 boys, n = 55 girls) aged 7.8 ± 0.63 years that were recruited from five primary schools in central England participated in this study, undertaking either an aquatic intervention once a week for six weeks or acting as a control group completing their usual physical education program.", "Participants underwent pre- and post-assessments of general motor competence using the Test of Gross Motor Development, Third Edition (TGMD-3) (a process measure) and a composite of 10 m running sprint time and standing long jump distance (product measures).", "Aquatic motor competence was assessed via the Aquatic Movement Protocol (AMP).", "Fear of drowning and swimming opportunities were also assessed by implementing a questionnaire.", "(3) Results: Following a mixed-model ANOVA, an overall main effect was found from pre (40.05 ± 13.6) to post (48.3 ± 18.6) for TGMD-3 scores (p < 0.05) and pre (38.7 ± 31.7) to post (50.6 ± 36.8) for AMP scores (p = 0.001).", "A negative significant relationship was found between AMP scores with both fear of water (p = 0.01) and fear of drowning (p < 0.05).", "A positive significant relationship was found between swimming opportunities and AMP score (p = 0.001).", "(4) Conclusions: The aquatic-based intervention improves not only aquatic motor competence but also transfers improvements in dryland movement competencies.", "Future research should look to implement control groupings which do not participate in swimming to further investigate the difference between swimmers and non-swimmers; however, due to swimming being a part of the national curriculum in England, this may not be feasible." ]

[ "(1) Background: Various guidelines address patient preparation and its importance for venous blood sampling, such as the GP41 guideline issued by the Clinical Laboratory Standards Institute (CLSI) and the blood collection guidelines published by the World Health Organisation.", "Recommendations provided by national societies or international organisations in the field of radiology, such as The Contrast Media Safety Committee of the European Society of Urogenital Radiology, or in the field of laboratory medicine, such as the Working Group for Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin American Confederation of Clinical Biochemistry (COLABIOCLI), also guide this practice.", "There is a notable lack of understanding regarding the viewpoints held by non-laboratory healthcare professionals concerning the significance of patient preparation for laboratory testing and the impact of typical factors associated with patient preparation.", "This study endeavours to bridge this gap by assessing the attitude of non-laboratory healthcare professionals in Lithuania regarding these pivotal aspects.", "(2) Methods: A self-designed anonymous questionnaire was disseminated among 141 public healthcare institutions in Lithuania.", "The internal consistency of the questionnaire was evaluated by computing Cronbach's alpha.", "Descriptive statistics were utilised for the variables, while comparisons of attitude among groups were conducted using Mann-Whitney U (for two groups) or Kruskal-Wallis (for more than two groups) for categorical and discrete indicators.", "The Kruskal-Wallis post-hoc test was employed for pairwise comparisons.", "A significance level of p-Value < 0.05 was applied to establish statistical significance.", "(3) Results: A total of 158 respondents constituted two distinct groups of healthcare professionals: nurses and physicians.", "Most of the participants either agreed or strongly agreed that patient preparation could introduce bias into laboratory test results.", "Professionals with less than 20 years of work experience or those who attended training in patient preparation for sampling within a 5-year timeframe exhibited stronger agreement regarding different preanalytical factors in patient preparation and their impact on laboratory test results compared to their counterparts.", "(4) Conclusions: Non-laboratory healthcare professionals who participated in this survey consider proper patient preparation for laboratory testing to be a significant step towards obtaining accurate test results.", "They also recognize the commonly acknowledged preanalytical factors as important for ensuring reliable test results.", "However, attitudes towards the importance of several preanalytical factors vary depending on whether non-laboratory healthcare professionals have more or less than 20 years of work experience, as well as whether they have attended any training on this topic within the last five years or have never attended such training." ]

[ "(1) Background: We aimed to analyze the dimensionality, internal consistency, and structural validity of the Preschool Eating, Lifestyle, and Sleeping Attitudes Scale (PRELSA Scale), which is an instrument that was designed to measure obesogenic behaviors.", "(2) Methods: We carried out an observational study by means of an online survey.", "The PRELSA Scale consists of 13 dimensions and 60 items relating to the most common obesogenic behaviors and attitudes.", "Additionally, we obtained sociodemographic characteristics and concrete habits from the sample.", "We obtained the responses of 791 parents and caregivers of preschool children between 2 and 6 years of age in Andalusia (southern Spain).", "We analyzed dimensionality through an Exploratory Factor Analysis (EFA), consistency through Cronbach's Alpha, structural validity through a Confirmatory Factor Analysis (CFA), and measurement invariance with multigroup CFA models.", "(3) Results: The EFA showed a 14-dimensional structure with 48 items.", "The internal consistency was acceptable in all dimensions (Cronbach's Alpha range of 0.72 to 0.97).", "The structure was confirmed in the CFA with good fit indices (CFI and TLI > 0.9 and RMSEA < 0.05).", "We ensured that the scale had measurement invariance regarding education, income, and marital status.", "(4) Conclusions: The PRELSA Scale shows promising properties that have the potential to measure obesogenic behaviors in Spain, which could be the basis for future interventions associated with the prevention of childhood obesity in healthcare and educational settings." ]

[ "(1) Introduction: This research was conducted with the aim of assessing whether an alternative physical education (PE) program could effectively substitute for the traditional PE curriculum and aid in accomplishing the essential goals and objectives of PE among younger elementary school children.", "(2) Materials and Methods: This longitudinal 6-month study included third-grade elementary school children of both genders, who were healthy, lived in urban areas, and were involved in an alternative PE program, as well as the regular PE classes.", "The sample of participants comprised 214 students, with 105 participants in the experimental group and 109 participants in the control group, who underwent pre- and post-intervention measurements.", "For the purposes of this study, 11 variables were applied to assess the parameters of growth and development, motor abilities, and physical and health education.", "MANCOVA and ANCOVA methods were used to determine the effects resulting from the alternative and regular PE programs, and differences between the groups, respectively.", "The data are reported as the mean and standard deviations, and were analyzed using the statistical package SPSS version 20.0 (SPSS Inc., Armonk, NY, USA).", "(3) Results: Based on the research results obtained for motor abilities and physical and health education, it was concluded that both the alternative and regular PE programs had positive effects in achieving the goals and objectives of PE, but without statistical significance at the multivariate and univariate levels.", "The differences between the two groups were found to be negligible (effect size, ES < 0.2).", "(4) Discussion: Sports and PE have distinct objectives and approaches.", "While sports emphasize competition and winning, PE aims to impart fundamental skills and knowledge, prioritizing inclusivity among younger students.", "Success in PE is measured by the number of students meeting these goals, potentially affecting both talented and struggling learners.", "(5) Conclusions: The results obtained from the conducted research indicate that both the alternative PE program and the regular PE program influence changes in motor abilities and physical and health education to a limited extent.", "The alternative PE program proposed in this study, with its modifications to the structure of existing, regular PE program, can fully replace the latter in schools that do not meet the required spatial and material standards." ]

[ "(1) Objectives: This study aimed to assess the 5-year prevalence and clinical profile of attention deficit hyperactive disorder (ADHD) among adult patients seeking care in a tertiary care hospital in Oman.", "(2) Methods: The data were analysed using descriptive and inferential statistics and standardised prevalence estimates were calculated.", "(3) Results: Of the 39,881 hospital visits, 1.77% were made by adults with ADHD.", "This is equivalent to 17.8 visits per 1000 outpatients.", "The year 2021 saw the highest prevalence among the five years considered, while 2020 had the lowest prevalence.", "Although the age distribution indicated that the age group 'under 20' had the highest prevalence, the gender distribution showed that ADHD was more common among adult men.", "Among the various subtypes of ADHD, inattention was the most common.", "(4) Conclusions: This study specifically compared the prevalence and associated factors between an adult cohort with ADHD and those other psychiatric clinic attendees during the same period.", "The study offers important information on the prevalence and clinical profile of adults with ADHD in the population under consideration." ]

[ "(1) Purpose: To assess the oral health literacy (OHL) of parents and its association with the caries experience of their preschool children attending the Hospital University Sains Malaysia (HUSM), Kota Bharu, Kelantan, Malaysia.", "(2) Materials and Methods: This is a descriptive cross-sectional study involving a systematic random sampling method, using a sample of 230 parent/preschool child dyads.", "Among 230 parents, 24 were males and 206 were females (mean age 31.43 ± 5.82); among 230 children, 92 were boys and 138 were girls (mean age 4.82 ± 1.04) attending the pedodontics clinic, HUSM, who participated and met the inclusion criteria.", "A structured, self-administered oral health literacy questionnaire including sociodemographic factors was used in this study.", "A child's oral examination was performed to check the dmft (decayed, missing, filled teeth) status.", "Statistical analysis was done using descriptive and Spearman's correlation analysis and multivariate regression analysis.", "(3) Results: The mean dmft score of children in relation to the OHL level of parents showed a significant difference (p < 0.00).", "The mean dmft score of children in relation to the OHL level of parents showed the following relationships: Inadequate (7.49 ± 4.10) followed by marginal (3.28 ± 2.67) and then adequate (0.55 ± 1.55).", "The incidence of caries amongst children in relation to parental employment was more associated with unemployed parents (6.11 ± 4.43) than with employed parents (2.79 ± 3.65).", "The caries experience amongst children in relation to education of their parents revealed a significant difference (p < 0.001), and the mean dmft score was high amongst preschool children with primary school qualified parents (10.7 ± 4.10) followed by high school (7.04 ± 3.68), vocational (5.81 ± 3.57), diploma (2.61 ± 2.81), and university (1.29 ± 2.27), respectively.", "The results revealed a valid significant difference (negative correlation, rs = -0.753 **) between the OHL of parents with the dmft score of their preschool children.", "The age and gender of parents was not significantly associated with OHL, whereas ethnicity (positive correlation, rs = 0.283 **), education (positive correlation, rs = 0.865 **), and employment (negative correlation, rs = -0.490 **) were found to be significant.", "Conclusion: We conclude that there is a significant association between the OHL of parents with the dmft score of their preschool children.", "The logistic regression showed that after adjustment for sociodemographic factors, parents' gender (OR = 0.067, 95% CI: 0.012-0.360), parents' employment status (OR = 3.247, 95% CI: 0.897-11.754), parents' OHL score (OR = 0.042, 95% CI: 0.016-0.114), and child age (OR = 2.195, 95% CI: 1.249-3.857) were significantly associated with dental caries in children.", "Our study concluded that parents' employment status, age, gender, OHL, and child's age were significantly associated with the caries experience of their preschool children." ]

[ "(1) The aim of our study was to determine the attitudes of medical students toward organ donation in the case of brain death.", "(2) The study was conducted among 1348 medical students from three medical universities in Poland.", "The research tool was the Polish version of the standardized questionnaire concerning attitudes toward organ donation and transplantation (ODT) [PCID-DTO RIOS: A questionnaire designed by the 'International Collaborative Organ Donation project about organ transplantation and donation].", "(3) Some sources of information on organ donation were found to have a significant impact on the recipients' knowledge of brain death.", "These were books, friends, family, lectures in other centers, social media, and the Church.", "Medical students holding the opinion that recovery and leading a normal lifestyle after brain death is impossible were significantly more likely to donate their organs after death, not for religious reasons and not because they wanted to survive their own death.", "(4) The medical students in our study showed a high level of awareness and favorable attitudes toward ODT.", "However, the number of registered donors was low.", "It is important to educate students on these issues to raise the awareness of both future medical professionals and the public on organ transplantation procedures.", "The public should be made aware that transplantation procedures are of a high standard, and that the law protects both donors and recipients.", "These measures would reduce recipients' waiting time, and certainly increase the statistics of the number of life-saving and health-saving procedures." ]

[ "(i) To develop the Falls Health Literacy Scale (FHLS), a health literacy tool specific to falls, (ii) to evaluate the FHLS's construct validity towards differentiating individuals with different fall-related health literacy, and (iii) to determine its reliability, construct validity and structure in an older population.", "The initial FHLS, developed based on Sørensen et al.", "'s health literacy model, was first administered to 144 participants aged ≥18 years for feedback and scale improvement and preliminary analysis to determine the FHLS's construct validity in identifying individuals with different fall-related health literacy.", "After scale refinement, the FHLS was validated in 227 community-living people aged ≥65 years.", "Adult participants with more fall prevention knowledge scored higher on the initial FHLS than those with less fall prevention knowledge (p≤0.001).", "The final FHLS includes a 25-item subjective and a 14-item objective scale.", "Older people with ≥1 fall in the past year reported lower FHLS-subjective scores than those who had no falls (Cohen's [d]=0.29, confidence interval [CI]:0.03-0.56, p=0.03).", "Older people with lower levels of education had lower FHLS-objective scores than their more educated counterparts (d=0.51, CI:0.38-1.43, p≤0.001).", "Factor analysis of the FHLS-subjective generated six subscales, with CFA showing adequate model fit (RMSEA=0.077, CFI=0.883 and χ2/df =2.35).", "FHLS-subjective (25-item) showed good reliability, with Cronbach's alpha=0.93, mean inter-item correlation=0.34 (range -0.03-0.81) and intra-class coefficient =0.86 (95% CI:0.69-0.93).", "The novel, context-specific FHLS displayed good construct validity and reliability.", "The FHLS holds promise as a screening tool to differentiate individuals with different degrees of fall-related health literacy, which may help guide fall prevention interventions." ]

[ "[Background and aim] Early onset epilepsy is a neurological condition with significant developmental consequences, and presents affected children and families with challenges which pervade many aspects of family life.", "Whilst the concerns of parents and the impact on quality of life is well documented in qualitative research, little emphasis has been placed on the context of 'early onset', and the implications of these concerns for research priority setting.", "We aimed to explore parental perspectives regarding concerns and the impact of early onset epilepsy on the child and family, and to identify priorities for future paediatric epilepsy research.", "[Methods] The Brain development in Early Epilepsy: Parent Priorities (BEE-PP) project employed a mixed methods approach to collect information on parents' experience of having a child diagnosed with early onset epilepsy before 36 months old and aged up to 16 years old.", "Parents completed an online survey (n = 15) followed by a focus group (n = 5) to explore their main concerns regarding early onset epilepsy, the impact on family life and research priorities.", "[Results] A thematic analysis of the focus group data generated eight themes related to concerns of parents, the impact on the family and research priorities.", "The three main concerns identified were the expected trajectory of their child's development, a lack of seizure control following diagnosis and adverse behavioural side effects of medication.", "Within family life, early onset epilepsy had an impact on sibling autonomy and psychosocial adaptation, poorer parental wellbeing and restricted social and personal activities.", "The need for clearer information regarding their child's developmental trajectory, and managing the side effects of medication and their interactions with behaviour over time were topics of priority for future epilepsy research.", "[Interpretation] The impact of early onset epilepsy on the family is pervasive and requires the provision of appropriate healthcare service-led support for families to improve quality of life and children's adjustment to epilepsy.", "Regular monitoring of the concerns of parents and the impact of the diagnosis would be beneficial for addressing epilepsy-related and psychosocial needs of the wider family throughout their child's development.", "Implications for future research priority setting with regards to improved clinician-to-parent information sharing and managing the behavioural side effects of medication are discussed." ]

[ "[Purpose] The sagittal shape of the spine is associated with back-pain, balance and quality of life.", "We developed, evaluated and report the responses of a graphical tool to assess sagittal spine shape knowledge (literacy).", "[Participants and Methods] Two hundred and fifty adults were randomly assigned, in a cross-sectional crossover study, to free-hand draw and select the \"ideal\" sagittal spine shape.", "We evaluated the inter and intra-rater reliability and agreement between tests and the sagittal and lordotic spine literacy between the drawing and selection test versions.", "[Results] Drawing test inter- and intra-rater agreement was 79% and 80% respectively.", "Drawing vs. selection agreement was 43%.", "More participants drew than selected the correct spine (30% vs. 21%) (p<0.001) and lumbar lordosis shape (56% vs. 42%) (p<0.001).", "Test order did not affect spine shape literacy scores.", "A significantly poorer literacy trend was observed with spine pain presence (p=0.02).", "[Conclusion] We developed a reliable method to evaluate spine shape literacy and established that only 21% and 42% of our sample demonstrated correct sagittal spine and lordotic spine shape literacy, respectively.", "The low literacy scores suggests that consideration of including spine shape literacy in health literacy and self-management programs may be warranted, especially in ageing populations." ]

[ "[Purpose/Significance]Government open data has been in China for 10 years, however, the actual use of it has been criticised.", "This study analyses citizens' willingness to use government open data from their perspectives and constructs a model, aiming to promote in-depth research on citizens' use of government open data.", "[Methodology/Process] Meta-ethnographic qualitative research method was adopted to synthesise and integrate the 25 original studies.", "[Results/Conclusions] The study finally constructed a model of factors influencing citizens' willingness to use government open data, and identified four dimensions: \"citizen\", \"platform\", \"government\" and \"environment\".", "The four dimensions of \"citizen\", \"platform\", \"government\" and \"environment\" were identified, of which \"citizen\" involves \"intrinsic motivation\", \"behavioural attitude\", \"information attitude\" and \"information security\".", "The four dimensions of \"Citizen\" include \"Intrinsic Motivation\", \"Behavioural Attitude\", \"Information Literacy\", and \"Demographic Characteristics\", while the four dimensions of \"Platform\" include \"Data Quality\", \"Information Literacy\", and \"Demographic Characteristics\".", "platform\" involves the sub-dimensions of \"data quality\" and \"platform quality\", \"government\" involves the sub-dimensions of \"organisational conditions\" and \"policies and regulations\", and \"government\" involves the sub-dimensions of \"organisational conditions\" and \"policies and regulations\".", "government\" involves two sub-dimensions, \"organisational conditions\" and \"policies and regulations\", and \"environment\" involves two sub-dimensions, \"social environment\" and \"type of context\", with each sub-dimension having a different impact on the use of open government data by citizens.", "The different factors under each sub-dimension have different degrees of influence on citizens' use of open government data.", "Finally, suggestions are made to enhance citizens' willingness to use open government data." ]

[ "1.", "To explore the feasibility of a rapid transformation from face to face to virtual simulation and its impact on the simulation process 2.", "To explore the efficacy of a rapid transformation from face to face to virtual simulation and its impact on the simulation process.", "The simulation process (preparation, pre-briefing, simulation, and debriefing) was investigated for feasibility and efficacy from the perspective of the educators and students.", "This study took place very early in the pandemic, thus highlighting the speed at which it needed to be conducted and acknowledging the limitations of technology at the time.", "The faculty (n = 3) involved in the virtual simulation experiment and year one medical students(n = 61) were invited to participate in the study voluntarily.", "The module chosen for this study was the Introduction to the Practice of Medicine, where the students were introduced to the concept of patient safety using simulation-based education.", "The \"Little Room of Horrors\" - is a simulation based educational session emphasising the importance of patient safety.", "Students were taken into a simulated medical ward that demonstrated common hospital-based errors.", "The learners were timed and asked to identify and document as many patient safety hazards as possible.", "The semi structured questionnaire was analysed using descriptive statistics and thematic analysis.", "The Educator's perspective reflected that virtual simulation was technologically dependent and had limitations during debriefing but was also a sustainable and portable standardised process.", "The student's perspective revealed that the objectives were met, and the session helped them support the theory previously learned.", "The average rating was 4.09 on a 5-point scale.", "When resources of the simulation center like space, mannikins, and faculty cannot be accessed for reasons like social distancing during a pandemic, virtual simulation was developed and used as a feasible alternative for our students without impacting the learning objectives.", "This study demonstrates the use of virtual simulation as a valuable option for teaching when face to face simulation is challenging or not possible." ]

[ "1) To determine the effect of neighborhood-level socioeconomic status (SES), which considers the social and physical environment where a person lives, on parental engagement in the Neonatal Intensive Care Unit (NICU); 2) To compare the relationships between parental engagement and individual versus neighborhood-level measures of SES.", "In this cohort study, parents (n=45) of premature neonates ≤ 34 weeks gestation were assessed at two and six weeks after birth from December 2017 to October 2019.", "Neighborhood-level SES was determined using census data per the Association of Maternal and Child Health Programs' methodology, and parents self-reported their education level as an individual-level measure of SES.", "Data on frequency of engagement in NICU activities, including telephone updates, visitation, providing expressed breastmilk, and participating in kangaroo care, were collected from the electronic medical record.", "Parent psychosocial factors were assessed using validated surveys.", "Statistical analysis was performed using Fisher's exact test, t-test, and logistic regression.", "In multivariate regression analysis, disadvantaged neighborhood-level SES was associated with decreased odds of kangaroo care (OR 0.16, 95% CI (0.03- 0.89)) and visitation (OR 0.14, 95% CI (0.02-0.87)), while lower individual-level SES was not significantly associated with kangaroo care, visiting, calling, or pumping (p > 0.05).", "Parental engagement was more consistently and significantly associated with neighborhood-level SES than with individual-level SES.", "Therefore, neighborhood-level SES measures may be more explanatory than individual-level SES measures.", "Further studies and targeted interventions are needed to address disparities in the frequency of kangaroo care and visitation according to SES." ]

[ "2 million children and adolescents between 11 and 19 years old have not yet finished basic education and had left school.", "The current Brazilian scenario reflects the reality in which these children and adolescents are inserted, without sufficient resources for the continuity of basic or elementary education, and often the parents' lack of income leads these young people to seek work, as can be seen in several capitals and inland cities: children selling food at traffic lights, bars, restaurants, and similar situations5.", "According to a study carried out by Abrinq Foundation (Fundação Abrinq), in the last quarter of 2021, there were about 2.36 million adolescents aged between 14 and 17 years old in the labor market or looking for a job, of which 1.2 million were in child labor in disagreement with Brazilian legislation, including work similar to slavery, and activities harmful to health, development, and morality." ]

[ "22q11DS11.2 deletion syndrome (22q11DS) is a complex multisystem syndrome characterized by physical abnormalities, psychiatric comorbidities and cognitive deficits.", "The views of children and young people (CYP) about the challenges associated with their mental health, behaviour, learning and communication difficulties have not been reported.", "The aim of this study was to address this gap and to understand whether they had help and support with these and their views of this.", "A three-phase mixed-methods study was undertaken, involving interviews with CYP with 22q11DS, a follow-up survey for those aged 11-25 years and a stakeholder workshop at which CYP presented their views of living with 22q11DS to health professionals and parents.", "Interview transcripts were thematically analysed, and non-parametric statistics were used to analyse survey data.", "The interviews (n = 13) and survey (n = 32) indicated a mixed picture, with some CYP not reporting ongoing problems; others who had problems received help but a sizeable proportion had unmet needs and wanted to receive help.", "Two-thirds reported often experiencing negative feelings, and almost half had difficulties with social interactions.", "Family members were the main sources of support, with teaching assistants identified as an important support at school.", "The emotional impact of 22q11DS on CYP can be significant: They often do not understand the consequences of having 22q11DS and are frequently not given strategies to understand and manage their feelings, behaviour or problems.", "This leads to a range of emotions that manifest in different ways at home and at school.", "CYP are able to talk about the impact of different aspects of 22q11DS on them, facilitated by the use of creative methods, but they differ in how the condition affects them and their perceptions about that.", "It is imperative that CYP themselves are asked about their experiences, feelings and needs to ensure tailoring of interventions to their individual requirements." ]

[ "30-day mortality after systemic anti-cancer therapy (SACT) has been suggested as a quality indicator primarily for measuring use of chemotherapy towards the end of life.", "Utility across different cancer types is unclear, especially when using immunotherapy and targeted therapies.", "This retrospective study included patients with a diagnosis of lung cancer who received palliative-intent SACT at an Australian metropolitan cancer center between 2015 and 2022.", "Using a prospectively maintained lung cancer database, patient, disease, and treatment characteristics were evaluated against annual 30-day mortality rates following SACT.", "1072 patients were identified.", "Annual 30-day mortality rate after palliative-intent SACT for lung cancer ranged between 9% and 15%, with significant variance between treatment types.", "Calculated rates of 30-day mortality are higher if longer reporting time periods are used.", "Patients who died within 30 days of SACT were more likely to have received targeted therapies or immunotherapy as their final line of treatment, have a poorer performance status at diagnosis, and have received multiple lines of treatment.", "Our data support differential interpretation of 30-day mortality for quality assurance, especially with regard to lung cancer.", "Consistency in population and reporting time periods, and accounting for treatment type is crucial if 30-day mortality is to be utilized as cancer care performance quality indicator.", "Relevance to quality care is questionable in the lung cancer setting." ]

[ "60% of women in Papua New Guinea (PNG) give birth unsupervised and outside of a health facility, contributing to high national maternal and perinatal mortality rates.", "We evaluated a practical, hospital-based on-the-job training program implemented by local health authorities in PNG between 2013 and 2019 aimed at addressing this challenge by upskilling community health workers (CHWs) to provide quality maternal and newborn care in rural health facilities.", "Two provinces, the Eastern Highlands and Simbu Provinces, were included in the study.", "In the Eastern Highlands Province, a baseline and end point skills assessment and post-training interviews 12 months after completion of the 2018 training were used to evaluate impacts on CHW knowledge, skills, and self-reported satisfaction with training.", "Quality and timeliness of referrals was assessed through data from the Eastern Highlands Province referral hospital registers.", "In Simbu Province, impacts of training on facility births, stillbirths and referrals were evaluated pre- and post-training retrospectively using routine health facility reporting data from 2012 to 2019, and negative binomial regression analysis adjusted for potential confounders and correlation of outcomes within facilities.", "The average knowledge score increased significantly, from 69.8% (95% CI:66.3-73.2%) at baseline, to 87.8% (95% CI:82.9-92.6%) following training for the 8 CHWs participating in Eastern Highlands Province training.", "CHWs reported increased confidence in their skills and ability to use referral networks.", "There were significant increases in referrals to the Eastern Highlands provincial hospital arriving in the second stage of labour but no significant difference in the 5 min Apgar score for children, pre and post training.", "Data on 11,345 births in participating facilities in Simbu Province showed that the number of births in participating rural health facilities more than doubled compared to prior to training, with the impact increasing over time after training (0-12 months after training: IRR 1.59, 95% CI: 1.04-2.44, p-value 0.033, > 12 months after training: IRR 2.46, 95% CI:1.37-4.41, p-value 0.003).", "There was no significant change in stillbirth or referral rates.", "Our findings showed positive impacts of the upskilling program on CHW knowledge and practice of participants, facility births rates, and appropriateness of referrals, demonstrating its promise as a feasible intervention to improve uptake of maternal and newborn care services in rural and remote, low-resource settings within the resourcing available to local authorities.", "Larger-scale evaluations of a size adequately powered to ascertain impact of the intervention on stillbirth rates are warranted." ]

[ "A 'proof-of-concept' version of a software tool for making transparent predictions of acute aquatic toxicity has been developed.", "It is primarily limited to semi-quantitative predictions in one species, the ciliated protozoan, Tetrahymena pyriformis.", "A freely available system, 'Eco-Derek', was derived by adapting a well-established, knowledge-based structure-activity and reasoning platform (Derek for Windows, Lhasa Limited).", "The Derek reasoning code was modified to express potency rather than confidence.", "Structure-activity relationship (SAR) development utilised a curated version of a published dataset, supplemented with the CADASTER Challenge datasets.", "Forty-five structural alerts were produced.", "The dependence on log P was examined for each alert and entered into the system as qualitative reasoning rules specifying the predicted potency as Very Low, Low, Moderate, High or Very High.", "Evaluation studies showed: (a) moderate accuracy for the training set but low accuracy for an external test set; (b) non-linearity in the toxicity-log P relationship for chemicals without identified structural alerts; (c) insufficient differentiation of substituent effects in some of the reactivity-based structural alerts resulting in too few chemicals predicted with Very High toxicity; and (d) the need for additional structural alerts covering polar narcosis and less common reactive or metabolically activated chemical functionality." ]

[ "A \"critical access point in the STEM pipeline for Latinx students and other students of color\" (Herrera et al., 2018), community colleges provide a seminal breeding ground for academic pursuits (Bahr et al., 2017).", "However, how personal networks influence STEM pathways of two-year college students remains largely unexplored.", "This mixed methods case study explores influence of personal networks on pursuing STEM fields via social network analysis and qualitative narratives.", "36 women of color STEM majors at a two-year urban Hispanic-Serving Institution were interviewed via social network questionnaire.", "Participants nominated anyone who has influenced their STEM trajectory, which signifies influence to their reason for pursuing a STEM path; they also had an option to qualitatively elaborate on any nomination but this was not required.", "Nominations were counted towards degree centrality and categorized into social relationships.", "Participants nominated diverse relationship influences, with family as the most influential relationship group, followed by college faculty/staff.", "Qualitative narratives revealed that family influenced participants, regardless of relatives' educational attainment level at the high school or lower level.", "In alignment with community cultural wealth, family members provided the impetus for pursuing STEM pathways through influence on participants' (1) aspirational capital, (2) familial capital, and (3) resistant capital." ]

[ "A 2019 report quantified the higher percentage of potentially excess (preventable) deaths in U.S. nonmetropolitan areas compared with metropolitan areas during 2010-2017.", "In that report, CDC compared national, regional, and state estimates of preventable premature deaths from the five leading causes of death in nonmetropolitan and metropolitan counties during 2010-2017.", "This report provides estimates of preventable premature deaths for additional years (2010-2022).", "2010-2022.", "Mortality data for U.S. residents from the National Vital Statistics System were used to calculate preventable premature deaths from the five leading causes of death among persons aged <80 years.", "CDC's National Center for Health Statistics urban-rural classification scheme for counties was used to categorize the deaths according to the urban-rural county classification level of the decedent's county of residence (1: large central metropolitan [most urban], 2: large fringe metropolitan, 3: medium metropolitan, 4: small metropolitan, 5: micropolitan, and 6: noncore [most rural]).", "Preventable premature deaths were defined as deaths among persons aged <80 years that exceeded the number expected if the death rates for each cause in all states were equivalent to those in the benchmark states (i.e., the three states with the lowest rates).", "Preventable premature deaths were calculated separately for the six urban-rural county categories nationally, the 10 U.S. Department of Health and Human Services public health regions, and the 50 states and the District of Columbia.", "During 2010-2022, the percentage of preventable premature deaths among persons aged <80 years in the United States increased for unintentional injury (e.g., unintentional poisoning including drug overdose, unintentional motor vehicle traffic crash, unintentional drowning, and unintentional fall) and stroke, decreased for cancer and chronic lower respiratory disease (CLRD), and remained stable for heart disease.", "The percentages of preventable premature deaths from the five leading causes of death were higher in rural counties in all years during 2010-2022.", "When assessed by the six urban-rural county classifications, percentages of preventable premature deaths in the most rural counties (noncore) were consistently higher than in the most urban counties (large central metropolitan and fringe metropolitan) for the five leading causes of death during the study period.During 2010-2022, preventable premature deaths from heart disease increased most in noncore (+9.5%) and micropolitan counties (+9.1%) and decreased most in large central metropolitan counties (-10.2%).", "Preventable premature deaths from cancer decreased in all county categories, with the largest decreases in large central metropolitan and large fringe metropolitan counties (-100.0%; benchmark achieved in both county categories in 2019).", "In all county categories, preventable premature deaths from unintentional injury increased, with the largest increases occurring in large central metropolitan (+147.5%) and large fringe metropolitan (+97.5%) counties.", "Preventable premature deaths from CLRD decreased most in large central metropolitan counties where the benchmark was achieved in 2019 and increased slightly in noncore counties (+0.8%).", "In all county categories, preventable premature deaths from stroke decreased from 2010 to 2013, remained constant from 2013 to 2019, and then increased in 2020 at the start of the COVID-19 pandemic.", "Percentages of preventable premature deaths varied across states by urban-rural county classification during 2010-2022.", "During 2010-2022, nonmetropolitan counties had higher percentages of preventable premature deaths from the five leading causes of death than did metropolitan counties nationwide, across public health regions, and in most states.", "The gap between the most rural and most urban counties for preventable premature deaths increased during 2010-2022 for four causes of death (cancer, heart disease, CLRD, and stroke) and decreased for unintentional injury.", "Urban and suburban counties (large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan) experienced increases in preventable premature deaths from unintentional injury during 2010-2022, leading to a narrower gap between the already high (approximately 69% in 2022) percentage of preventable premature deaths in noncore and micropolitan counties.", "Sharp increases in preventable premature deaths from unintentional injury, heart disease, and stroke were observed in 2020, whereas preventable premature deaths from CLRD and cancer continued to decline.", "CLRD deaths decreased during 2017-2020 but increased in 2022.", "An increase in the percentage of preventable premature deaths for multiple leading causes of death was observed in 2020 and was likely associated with COVID-19-related conditions that contributed to increased mortality from heart disease and stroke.", "Routine tracking of preventable premature deaths based on urban-rural county classification might enable public health departments to identify and monitor geographic disparities in health outcomes.", "These disparities might be related to different levels of access to health care, social determinants of health, and other risk factors.", "Identifying areas with a high prevalence of potentially preventable mortality might be informative for interventions." ]

[ "A 4-week summer preceptorship offered first-year medical students early exposure to anesthesiology following their preclerkship courses in pharmacology and cardiopulmonary physiology.", "The main objective was to provide students with clinical skills and prepare them for rotations while immersing them in a unique experience, introducing a specialty not covered in core rotations.", "Participants were selected via their responses to an application.", "In addition to shadowing anesthesiologists, curriculum components included weekly faculty lectures on core aspects of anesthesiology (introductory basics, perioperative drugs, airway, and crisis management); multiple simulation labs (workstation setup, intubation clinics, intravenous and central line placement, ultrasound techniques); research opportunities; and mentorship from physicians and senior medical students.", "The program culminated in each student successfully leading a simulated case to receive a certificate of completion.", "A survey of 15 participants revealed significant improvements in ability to intubate (P < 0.05), ability to perform a transthoracic echocardiogram (P < 0.05), interest in anesthesiology as a specialty (P < 0.05), and preparedness for future rotations (P < 0.05).", "This program accelerates clinical exposure for preclerkship students, providing insights into anesthesiology early in their medical journey.", "It provides research and mentorship, fosters professional growth, and enhances individual competitiveness for residency program applications." ]

[ "A capstone course often serves as the final checkpoint of student readiness before the commencement of experiential training.", "The purpose of this study was to determine if the assessment components from the capstone course can serve as predictors of student performance during their Advanced Pharmacy Practice Experiences (APPEs).", "Student data was analyzed to observe the correlation between performance in the Pharmacy Curriculum Outcomes Assessment (PCOA), student performance in the capstone course, and the overall grade point average (GPA) earned during APPEs.", "Spearman rank correlation analysis, multiple linear regression, and Mann-Whitney U test were used for statistical analysis.", "A statistically significant positive correlation was observed between the overall APPE GPA and students' capstone course grade, top drug competency exam score, pharmacy calculation competency exam score, and PCOA exam score.", "A significant regression equation was obtained during the analysis: (F(5, 97) = 5.62, p < 0.001), with an R2 = 0.225 (adjusted R2 = 0.185).", "In the linear regression model, capstone GPA emerged as a significant predictor (β = 0.155; p = 0.019) of APPE GPA amongst the tested variables.", "Additionally, students scoring < 73% on the top drug competency exam in the capstone course or less than the reference group in the PCOA exam were found to have significantly lower GPA during their APPEs compared to other students.", "Performance on the top drug competency exam and the PCOA exam can serve as potential predictors of success during APPEs." ]

[ "A central goal of modern evidence-based medicine is the development of simple and easy to use tools that help clinicians integrate quantitative information into medical decision-making.", "The Bayesian Pre-test/Post-test Probability (BPP) framework is arguably the most well known of such tools and provides a formal approach to quantify diagnostic uncertainty given the result of a medical test or the presence of a clinical sign.", "Yet, clinical decision-making goes beyond quantifying diagnostic uncertainty and requires that that uncertainty be balanced against the various costs and benefits associated with each possible decision.", "Despite increasing attention in recent years, simple and flexible approaches to quantitative clinical decision-making have remained elusive.", "We extend the BPP framework using concepts of Bayesian Decision Theory.", "By integrating cost, we can expand the BPP framework to allow for clinical decision-making.", "We develop a simple quantitative framework for binary clinical decisions (e.g., action/inaction, treat/no-treat, test/no-test).", "Let p be the pre-test or post-test probability that a patient has disease.", "We show that r*=(1-p)/p represents a critical value called a decision boundary.", "In terms of the relative cost of under- to over-acting, r* represents the critical value at which action and inaction are equally optimal.", "We demonstrate how this decision boundary can be used at the bedside through case studies and as a research tool through a reanalysis of a recent study which found widespread misestimation of pre-test and post-test probabilities among clinicians.", "Our approach is so simple that it should be thought of as a core, yet previously overlooked, part of the BPP framework.", "Unlike prior approaches to quantitative clinical decision-making, our approach requires little more than a hand-held calculator, is applicable in almost any setting where the BPP framework can be used, and excels in situations where the costs and benefits associated with a particular decision are patient-specific and difficult to quantify." ]

[ "A challenge for medical educators is to provide learning opportunities that allow students to develop technical and non-technical skills as set by the clearly defined learning objectives within their relevant institutions.", "This is particularly relevant in clinical education, which encompasses a vast majority of medical education.", "Specifically, clinical education is highly variable, with numerous distractions, interruptions and variability in learning experience and quality of clinical educators which often result in underprepared medical students by the time they transition into clinical practice.", "Simulation-based teaching (SBT) has been a key pedagogical approach that has been implemented into curriculum design to assist with addressing some of these educational challenges.", "However, their implementation is highly variable, and research into evidence-based best practice considerations in SBT design and implementation is fundamental to their success in medical student development.", "A narrative review was performed following a computer-assisted search on electronic databases Medline, Embase and Google Scholar.", "Relevant papers that explored the role of SBT in medical education were considered for this review.", "SBT is an important pedagogical approach to support the education of medical students.", "Their use has the benefit of providing a standardised and safe environment that mimics 'real life' as a means of allowing students to hone key skills with respect to clearly defined learning outcomes.", "The role of debriefing and feedback is crucial to the development of efficacious SBT programs, and therefore the upskilling and training of educators is a key aspect of evidence-based SBT design.", "Despite this, medical educators must be cognisant of the limitations of SBT.", "These include the cost and resources required to develop and implement SBT sessions, the effort and conceptualisation required to standardise and ensure these programs reflect real-life situations as well as the degree of training for facilitators to ensure they can best deliver and achieve learning outcomes and provide effective debriefing and feedback for students.", "Understanding the educational frameworks and the evidence-based best practice principles for SBT design and implementation is highly necessary for medical educators given the resource demands of SBT programs." ]

[ "A challenge in accurately identifying and classifying left ventricular hypertrophy (LVH) is distinguishing it from hypertrophic cardiomyopathy (HCM) and Fabry disease.", "The reliance on imaging techniques often requires the expertise of multiple specialists, including cardiologists, radiologists, and geneticists.", "This variability in the interpretation and classification of LVH leads to inconsistent diagnoses.", "LVH, HCM, and Fabry cardiomyopathy can be differentiated using T1 mapping on cardiac magnetic resonance imaging (MRI).", "However, differentiation between HCM and Fabry cardiomyopathy using echocardiography or MRI cine images is challenging for cardiologists.", "Our proposed system named the MRI short-axis view left ventricular hypertrophy classifier (MSLVHC) is a high-accuracy standardized imaging classification model developed using AI and trained on MRI short-axis (SAX) view cine images to distinguish between HCM and Fabry disease.", "The model achieved impressive performance, with an F1-score of 0.846, an accuracy of 0.909, and an AUC of 0.914 when tested on the Taipei Veterans General Hospital (TVGH) dataset.", "Additionally, a single-blinding study and external testing using data from the Taichung Veterans General Hospital (TCVGH) demonstrated the reliability and effectiveness of the model, achieving an F1-score of 0.727, an accuracy of 0.806, and an AUC of 0.918, demonstrating the model's reliability and usefulness.", "This AI model holds promise as a valuable tool for assisting specialists in diagnosing LVH diseases." ]

[ "A challenge in solving the genotype-to-phenotype relationship is to predict a cell's metabolome, believed to correlate poorly with gene expression.", "Using comparative quantitative proteomics, we found that differential protein expression in 97 Saccharomyces cerevisiae kinase deletion strains is non-redundant and dominated by abundance changes in metabolic enzymes.", "Associating differential enzyme expression landscapes to corresponding metabolomes using network models provided reasoning for poor proteome-metabolome correlations; differential protein expression redistributes flux control between many enzymes acting in concert, a mechanism not captured by one-to-one correlation statistics.", "Mapping these regulatory patterns using machine learning enabled the prediction of metabolite concentrations, as well as identification of candidate genes important for the regulation of metabolism.", "Overall, our study reveals that a large part of metabolism regulation is explained through coordinated enzyme expression changes.", "Our quantitative data indicate that this mechanism explains more than half of metabolism regulation and underlies the interdependency between enzyme levels and metabolism, which renders the metabolome a predictable phenotype." ]

[ "A challenge in the pandemic era is to implement effective but flexible practical teaching for biological sciences courses.", "Such teaching needs to deliver conceptual, analytical and practical skills training while having the option to rapidly respond to health and safety issues, local regulations, staff and student concerns.", "In this paper, we describe a set of cell biology practicals (mini-project) that meets many of these requirements and provides flexibility in providing skills training both through online and in practical laboratory environments.", "We have used a human adenocarcinoma cell line A431 stably transfected with a fluorescent cell cycle reporter as a biological model to deliver training through discrete work packages encompassing cell culture, fluorescence microscopy, biochemistry and statistics.", "How such work packages can be modified to, an online format either partially or completely is also described.", "Furthermore, the activities can be adapted for teaching both undergraduate and postgraduate level courses to ensure effective skills training which is applicable to a wide range of biological degree programs and levels of study." ]

[ "A childhood cancer diagnosis is a traumatic experience for patients and their families.", "However, little is known about the effect on grandparents.", "We aimed to investigate the negative psychosocial impact, coping strategies, and positive outcomes of grandparents of childhood cancer patients in Switzerland.", "We collected data using a semi-structured interview guide and applied qualitative content analysis.", "We conducted 20 interviews with 23 grandparents (57% female; mean age = 66.9 years; SD = 6.4; range = 57.0-82.4) of 13 affected children (69% female; mean age = 7.5 years; SD = 6.1; range = 1.0-18.9) between January 2022 and April 2023.", "The mean time since diagnosis was 1.0 years (SD = 0.5; range = 0.4-1.9).", "Grandparents were in shock and experienced strong feelings of fear and helplessness.", "They were particularly afraid of a relapse or late effects.", "The worst part for most was seeing their grandchild suffer.", "Many stated that their fear was always present which could lead to tension and sleep problems.", "To cope with these negative experiences, the grandparents used internal and external strategies, such as accepting the illness or talking to their spouse and friends.", "Some grandparents also reported positive outcomes, such as getting emotionally closer to family members and appreciating things that had previously been taken for granted.", "Grandparents suffer greatly when their grandchild is diagnosed with cancer.", "Encouragingly, most grandparents also reported coping strategies and positive outcomes despite the challenges.", "Promoting coping strategies and providing appropriate resources could reduce the psychological burden of grandparents and strengthen the whole family system." ]

[ "A close relationship between math performance and math anxiety has been demonstrated, but how different presentations of mathematics are associated with math anxiety has not been investigated.", "This study recruited 826 elementary school students in grades 5 and 6.", "All students were given math trait and state anxiety questionnaires; a nonverbal matrix reasoning task; and verbalized, symbolic, and situational fraction problem-solving tasks.", "After data cleaning, 475 boys and 323 girls (798 in total) were included in the analysis (mean age = 11.79, SD = 0.82).", "Partial correlation analysis showed that students' math traits and state anxiety were more closely related to symbolic fraction problem-solving than to verbalized and situational fraction problem-solving.", "Mixed linear model analysis showed that math state anxiety for symbolic problem-solving was significantly greater than that for verbalized and situational problem-solving.", "Based on these findings, we concluded that the presentation of symbolic math is more likely to induce math anxiety than verbalized or situational math.", "This finding has potential practical applications in math anxiety interventions and education." ]

[ "A common application of differential expression analysis is finding genes that are differentially expressed upon treatment in only one out of several groups of samples.", "One of the approaches is to test for significant difference in expression between treatment and control separately in the two groups, and then select genes that show statistical significance in one group only.", "This approach is then often combined with a gene set enrichment analysis to find pathways and gene sets regulated by treatment in only this group.", "Here we show that this procedure is statistically incorrect and that the interaction between treatment and group should be tested instead.", "Moreover, we show that gene set enrichment analysis applied to such incorrectly defined genes group-specific genes may result in misleading artifacts.", "Due to the presence of false negatives, genes significant in one, but not the other group are enriched in gene sets which correspond to the overall effect of the treatment.", "Thus, the results appear related to the problem at hand, but do not reflect the group-specific effect of a treatment.", "A literature search revealed that more than a quarter of papers which used a Venn diagram to illustrate the results of separate differential analysis have also applied this incorrect reasoning." ]

[ "A common problem in meta-analyses is the unavailability of mean and standard deviation (SD).", "Unfortunately, only having values of the median, interquartile range (IQR), or range cannot be directly utilized for meta-analysis.", "Although some estimation and conversion methods have been proposed in the past two decades, there were no published and user-friendly tools developed based on multiple scenarios of missing SD.", "Therefore, this study aimed to provide a collection of possible circumstances of missing sample means or SD with solutions for teaching and research.", "A total of 10 common circumstances of missing SD or mean could have available statistics of p value, t value, z score, confidence interval, standard error, median, IQR, and range.", "Teachers and investigators can use relevant formulas for finding the sample mean and SD according to the available circumstance.", "Due to the complicated computations, our team provides a free available spreadsheet.", "With ever-evolving statistical methods, some formulas may be further improved in the future; therefore, it is recommended to involve statisticians in evidence-based practice or systematic reviews." ]

[ "A common yet untested assumption of cognitive training in children is that activities should be adaptive, with difficulty adjusted to the individual's performance in order to maximize improvements on untrained tasks (known as transfer).", "Working memory training provides the ideal testbed to systematically examine this assumption as it is one of the most widely studied domains in the cognitive training literature, and is critical for children's learning, including following instructions and reasoning.", "This trial aimed to examine children's outcomes of working memory training using adaptive, self-select (child selects difficulty level), and stepwise (difficulty level increases incrementally) approaches to setting the difficulty of training activities compared to an active control condition immediately and 6-month postintervention.", "While the aim is exploratory, we hypothesized that children allocated to a working memory training condition would show greater improvements: (1) on near transfer measures compared to intermediate and far transfer measures and (2) immediately postintervention compared to 6-month postintervention.", "This double-blinded, active-controlled, parallel-group randomized trial aimed to recruit 128 children aged 7 to 11 years from 1 metropolitan primary school in Melbourne, Australia.", "Following baseline testing, children were randomized into 1 of 4 conditions: adaptive, self-select, or stepwise working memory training, or active control.", "An experimental intervention embedded in Minecraft was developed for teachers to deliver in class over 2 consecutive weeks (10 × 20-minute sessions).", "The working memory training comprised 2 training activities with processing demands similar to daily activities: backward span and following instructions.", "The control comprised creative activities.", "Pre- and postintervention, children completed a set of working memory tests (near and intermediate transfer) and the Raven's Standard Progressive Matrices (far transfer) to determine training outcomes, as well as motivation questionnaires to determine if motivations toward learning and the intervention were similar across conditions.", "Caregivers completed the ADHD-Rating Scale-5 to measure their child's attention (far transfer).", "Statistical analysis will include traditional null hypothesis significance testing and Bayesian methods to quantify evidence for both the null and alternative hypotheses.", "Data collection concluded in December 2022.", "Data are currently being processed and analyzed.", "This trial will determine whether the adaptive approach to setting the difficulty of training activities maximizes cognitive training outcomes for children.", "This trial has several strengths: it adopts best practices for cognitive training studies (design, methods, and analysis plan); uses a range of measures to detect discrete levels of transfer; has a 6-month postintervention assessment; is appropriately powered; and uses an experimental working memory training intervention based on our current understanding of the cognitive mechanisms of training.", "Findings will inform future research and design of cognitive training interventions and highlight the value of the evidence-based principles of cognitive training.", "Australian New Zealand Clinical Trials Registry, ACTRN12621000990820; https://www.anzctr.org.au/ACTRN12621000990820.aspx.", "DERR1-10.2196/47496." ]

[ "A complete quantitative account of P. Wason's (1966) abstract selection task is proposed.", "The account takes the form of a mathematical model.", "It is assumed that some response patterns are caused by inferential reasoning, whereas other responses reflect cognitive processes that affect each card selection separately and independently of other card selections.", "The model parameters assess the contributions of different interpretational, inferential, and heuristic factors that jointly determine performance in the selection task.", "The interpretation of most of the model parameters in terms of these different factors is validated experimentally.", "This model of the selection task is the first to account for the observed frequencies of all 16 possible response patterns that can arise." ]

[ "A comprehensive analysis was performed, considering blockchain technology (BT) properties in digital health, addressing medicolegal, privacy, and regulatory considerations.", "Adherence to personal data protection and healthcare regulatory guidelines were analyzed and compared for GDPR (Europe), HIPAA (United States), CCPA (California), PIPEDA (Canada), the Privacy Act of 1988 (Australia), APPI (Japan), and LGPD (Brazil).", "Issues such as health systems, strengthening and aligning policy orientations and initiatives, and emphasizing the role of data analysis in shaping health policies were explored.", "The study addressed conflicts between the legal frameworks and blockchain, comparing and suggesting solutions like the revision of laws and the integration of compliance mechanisms.", "Additionally, it sought to enhance IT-health literacy by integrating the healthcare and legal domains.", "Ongoing collaboration between legal, health, and IT experts is essential for designing systems that effectively balance privacy rights and data protection while maximizing the benefits of disruptive technologies like blockchain." ]

[ "A comprehensive definition of culture encompasses shared norms, beliefs, expectations, language, and customs, all of which are crucial considerations when working with patients with limited English proficiency (LEP).", "In this study, the authors examined how language, external influences, and patient-provider relational factors associated with decisional conflict in prenatal care patients.", "The authors conducted a cross-sectional study to assess decisional conflict related to postpartum contraception, elective induction, and newborn feeding methods.", "The survey included questions about demographics, communication methods, external influences, and provider trust, and was distributed to prenatal care patients who spoke either English or Spanish.", "Data analysis involved using descriptive statistics and chi-square analyses.", "Out of the 23 respondents, 12 were Spanish-speaking and 11 were English-speaking.", "Spanish-speaking participants were less likely to have health insurance compared to English-speaking participants (χ2(1, N = 23) = 3.67, p = 0.016).", "There was no statistically significant difference in decisional conflict between English- and Spanish-speaking participants.", "Religion affected 11 of 23 participants' decisions, while partner expectations influenced 10 of 23 participants.", "Working with an interpreter and the quality of interpretation were crucial for Spanish-speaking individuals.", "Most participants (59%) felt that the provider's understanding of the patient's cultural background was important for decision-making.", "While there was no association between language discordance and decisional conflict, several factors influencing prenatal decision-making were identified.", "The use and quality of interpretation significantly affected decision-making and should be prioritized for patients with LEP.", "Religion and partner expectations were found to be highly influential in decision-making.", "Respondents also emphasized the importance of the provider's understanding of the patient's cultural background." ]

[ "A comprehensive societal change is currently taking place, which also includes the medical field.", "The often heard \"digital transformation\" is also fundamentally transforming the health care system familiar to us, including the medical schools.", "While the Masterplan 2020 includes changes in the medical school structure and in the curricular content, it unfortunately focuses on special competencies, e.g., communication or scientific work, but not on digitization.", "However, precisely these skills are becoming increasingly indispensable in daily routine work.", "The seminar \"Digitization in otorhinolaryngology (ORL)\" was incorporated as a pilot project in the students' curriculum of the Department of ORL, at the University of Freiburg/Germany: the 141 medical students completed and evaluated this seminar as part of their 2 week rotation in otorhinolaryngology during the fall semester 2017/2018.", "The content of the seminar mediated digital competencies on the basis of practical examples.", "The evaluation showed high interest of the students in the topic in general, but also in more detailed subitems of the digitization topic.", "The students were generally open-minded concerning digitization but also critical of the topic.", "The acceptance of this newly implemented seminar was clearly positive.", "Another positive side effect is that this teaching concept can be transferred to other disciplines.", "Hence, we suggest to consider the training of digital competencies when implementing the Masterplan 2020." ]

[ "A conceptionally new 3D molecular descriptor type and methodology are deduced by simple statistical thermodynamic reasoning, based on the free energy change encountered during a transformation of a conformational ensemble of the ligand to an active conformation.", "The performance of the descriptor was first tested on 37 endomorphin analogues with mu-opiate activity.", "The method resulted in predictive 3D-QSAR models, and the active conformation was also predicted.", "Generally, the methodology can be combined with the traditional 3D-QSAR techniques in a 3+3D-QSAR manner.", "This feature was tested on a series of 38 PGF2alphaprostaglandin analogues with antinidatory activity; the extent to which the molecular flexibility explains the variation in the biological activity was estimated and the active conformation was predicted.", "The novel descriptors in combination with the grid-based SOMFA descriptors resulted in 3+3D-QSAR models with good levels of predictivity leading to the approach of separation of the effect of the molecular interaction field of the active conformation and the effect of the conformational free energy loss." ]

[ "A contributing factor to the gap between research publication and clinical implementation is the lack of specificity used when reporting findings.", "This scoping review used the Rehabilitation Treatment Specification System (RTSS) to determine which elements of specificity are most often present and omitted from research using Ayres Sensory Integration® (ASI).", "The following databases were searched: PubMed, CINAHL, PsycINFO, Cochrane Library, and ERIC.", "Eligible studies used ASI in an outpatient setting with children who had sensory integration or processing difficulties.", "Studies selected were quantitative (Level 1, 2, 3, or 4), available in full text, peer reviewed, and published in English within the past 20 yr. Of the 22 studies that met inclusion criteria, 100% included ingredients (actions of the therapist), 63% included mechanisms of action (reasoning behind these actions), 86% included targets, and 23% described client progression.", "We also found that 49% of all ingredients were listed in conjunction with a target, 15% were listed in conjunction with a mechanism of action, and 11% were listed in conjunction with both a target and a mechanism of action.", "Findings indicate that many studies list ingredients but often omit the mechanism of action.", "This omission makes replication of the intervention increasingly difficult and prevents a deeper understanding of the clinical reasoning process behind the intervention.", "Plain-Language Summary: Gaps identified in this scoping review highlight inconsistencies in the reporting of treatment specificity that may affect the replication and translation of Ayres Sensory Integration® (ASI) research into practice." ]

[ "A controversy over the distinction between curiosity and situational interest has recently resurfaced.", "Nonetheless, empirical research comparing the two is noticeably lacking.", "We attempted to fill this gap and provide much-needed evidence of the distinction between curiosity and situational interest by examining the antecedents and consequences of the two constructs.", "We assessed enjoyment, novelty, uncertainty and surprise as potential antecedents and information seeking, individual interest, career intention and achievement as potential outcomes of curiosity and situational interest among 219 Korean sixth graders in the domain of science.", "Of the hypothesized antecedents, enjoyment during science class related most strongly to students' situational interest in science, whereas novelty in science class related most strongly to students' science curiosity.", "Uncertainty and surprise in science class related to only science curiosity and not situational interest in science.", "Among the outcomes considered, situational interest in science related to only students' individual interest in science.", "In comparison, science curiosity related significantly to all science outcomes measured in this study.", "Science curiosity also significantly mediated the relationships between the antecedents and outcomes in science.", "Together, these results support the distinction between curiosity and situational interest and suggest different ways to promote each motivation construct depending on desired outcomes in the science classroom." ]

[ "A core goal of auditory neuroscience is to build quantitative models that predict cortical responses to natural sounds.", "Reasoning that a complete model of auditory cortex must solve ecologically relevant tasks, we optimized hierarchical neural networks for speech and music recognition.", "The best-performing network contained separate music and speech pathways following early shared processing, potentially replicating human cortical organization.", "The network performed both tasks as well as humans and exhibited human-like errors despite not being optimized to do so, suggesting common constraints on network and human performance.", "The network predicted fMRI voxel responses substantially better than traditional spectrotemporal filter models throughout auditory cortex.", "It also provided a quantitative signature of cortical representational hierarchy-primary and non-primary responses were best predicted by intermediate and late network layers, respectively.", "The results suggest that task optimization provides a powerful set of tools for modeling sensory systems." ]

[ "A cornerstone of surgical residency training is an educational program that produces highly skilled and effective surgeons.", "Training structures are constantly being revised due to evolving program structures, shifting workforces, and variability in the clinical environment.", "This has resulted in significant heterogeneity in all surgical resident education, training tools utilized, and measures of training efficacy.", "We systematically reviewed educational interventions for technical skills in neurosurgery published across PubMed, Embase, and Web of Science over four decades.", "We extracted general characteristics of each surgical training tool while categorizing educational interventions by modality and neurosurgical application.", "We identified 626 studies which developed surgical training tools across eight different training modalities: textbooks and literature (11), online resources (53), didactic teaching and one-on-one instruction (7), laboratory courses (50), cadaveric models (63), animal models (47), mixed reality (166), and physical models (229).", "While publication volume has grown exponentially, a majority of studies were cited with relatively low frequency.", "Most training programs were published in the development and validation phase with only 2.1% of tools implemented long-term.", "Each training modality expressed unique strengths and limitations, with limited data reported on the educational impact connected to each training tool.", "Numerous surgical training tools have been developed and implemented across residency training programs.", "Though many creative and cutting-edge tools have been devised, evidence supporting educational efficacy and long-term application is lacking.", "Increased utilization of novel surgical training tools will require validation of metrics used to assess the training outcomes and optimized integration with clinical practice." ]

[ "A critical health literacy (CHL) approach is recommended for promoting health in the school context.", "This construct is complex and includes three interconnected domains: (A) appraisal of critical information, (B) awareness of the social determinants of health (SDH), and (C) collective action to promote health and well-being.", "In recent literature reviews, no measurement instrument that covers all three domains of CHL in the school-context was found.", "Our aim was to develop self-reported measurement scales for each domain of CHL.", "The development process reported in this study was conducted in two stages.", "In the first stage, an initial item pool was generated based on literature reviews and focus group interviews (N = 15) with adolescents (steps 1-2).", "In the next steps, items were adjusted and removed based on the feedback from an expert panel and from representatives from the target group (steps 3-5).", "In stage two, we aimed to reduce the number of items and develop scales for each domain.", "We then piloted the current draft, which consists of 28 items (N = 114).", "A sub-sample (N = 10) of the participants were interviewed after they completed the survey to examine the instrument's face validity.", "Cronbach's α was used to assess the internal reliability of the scales; the reliability was promising for scales A (α = 0.83) and C (α = 0.85) but was below the recommended value for scale B (α = 0.61).", "The model fit indices were promising (TLIscaleA = 0.97, RSMEAscaleA = 0.055, TLIscaleB = 1.05, RMSEAscaleB = 0.00, TLIscaleC = 0.95, RMSEAscaleC = 0.074).", "The piloted version of scales A and C were positively correlated with subjective health literacy, health-related quality of life, and subjective health; however, we found no such correlations for scale B.", "The post-survey group interviews led to some adjustments in scales A and B.", "The revised version of CHLA-Q must be tested using a larger sample; this will enable more robust statistical testing of the properties of the items and the scale." ]

[ "A cross-sectional study retrospectively evaluating the perceived usefulness of attending a multi-disciplinary, roundtable, educational prenatal clinic for mothers expecting children with myelomeningocele is presented.", "Mothers who currently have children with SB completed a survey which evaluated their overall preparedness, spina bifida education, delivery plans, surgical expectations, and expectations in terms of quality of life and development.", "Open comments were also collected.", "Statistical analysis was performed to identify differences between those who attended prenatal counseling and those who did not.", "Approximately half of these mothers received some form of prenatal SB counseling.", "Mothers who attended prenatal counseling reported that they felt more informed and prepared throughout their pregnancy, during the delivery of their child and during their initial hospital stay than mothers who did not.", "They reported that the roundtable discussions were beneficial, and the education they received was useful in helping them form accurate expectations and feel more at ease.", "This suggests that prenatal counseling and the High-Risk Pregnancy Clinic (HRPC) provides perceived utility to families and mothers and that the HRPC is an effective method of providing prenatal counseling to mothers whose unborn children have been diagnosed with myelomeningocele." ]

[ "A crucial feature of life is its spatial organization and compartmentalization on the molecular, cellular, and tissue levels.", "Spatial transcriptomics (ST) technology has opened a new chapter of the sequencing revolution, emerging rapidly with transformative effects across biology.", "This technique produces extensive and complex sequencing data, raising the need for computational methods for their comprehensive analysis and interpretation.", "We developed the ST browser web tool for the interactive discovery of ST images, focusing on different functional aspects such as single gene expression, the expression of functional gene sets, as well as the inspection of the spatial patterns of cell-cell interactions.", "As a unique feature, our tool applies self-organizing map (SOM) machine learning to the ST data.", "Our SOM data portrayal method generates individual gene expression landscapes for each spot in the ST image, enabling its downstream analysis with high resolution.", "The performance of the spatial browser is demonstrated by disentangling the intra-tumoral heterogeneity of melanoma and the microarchitecture of the mouse brain.", "The integration of machine-learning-based SOM portrayal into an interactive ST analysis environment opens novel perspectives for the comprehensive knowledge mining of the organization and interactions of cellular ecosystems." ]

[ "A culture centered on relationships and communication is necessary to improve the quality of life of older adults living in nursing homes.", "To examine the effects of a storytelling program by examining the cognitive, emotional, and psychosocial changes in older adults in facilities and explore staff experience of changes in care.", "This mixed method study delivered a 6-week storytelling program based on relationship-centered care for residents of nursing homes (aged >65 years).", "Changes in emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and the person-centered environment as perceived by older adults were quantitatively analyzed using pre-intervention and post-intervention surveys.", "Qualitative data were collected through weekly stories created by residents, followed by focus group interviews with nursing home staff, analyzed using reflexive thematic analysis to enhance understanding of the program's outcomes.", "The 42 residents reported significant changes in their emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and person-centered environment scores after the 6-week intervention.", "Analysis of the residents' stories identified 5 themes.", "The staff focus group interviews identified 2 themes and 7 subthemes.", "Intervention group residents were more likely to initiate conversations, express themselves, carefully observe themselves and others, and actively participate in social activities.", "The storytelling program was useful in reducing older adults' negative emotions by allowing them to express their thoughts and feelings and improve their relationships, creating opportunities for social interaction.", "These effects could help foster relationship- and communication-centered facility cultures." ]

[ "A curriculum is a fundamental tool for educators, and teaching bioethics is fundamental to good medical practice.", "Studies report a lack of consensus on the teaching of bioethics in undergraduate medicine, and a critical issue is that there remain no minimum curricular parameters.", "This study performed an analysis between the bioethics curricula of the medical schools of Brazil and Portugal and UNESCO's Core Curriculum, in addition to proposing key criteria for designing a core bioethics curriculum.", "This is a cross-sectional, descriptive study that analyzes the bioethics curricula of the medical schools in Brazil and in Portugal.", "The design of the study includes a qualitative summative content analysis-based approach and a quantitative analysis by means of descriptive statistics.", "Bioethics is taught in both Brazil and Portugal in a diversified way.", "The results showed that 65.5% of the medical schools analyzed provided at least the 30-h minimum workload recommended by the UNESCO Core Curriculum.", "Furthermore, bioethics sporadically offered at the end of the medical program in the vast majority of schools studied.", "The most important points to take away from this study are the diversity of the curricular structure of bioethics courses and the lack of formalization of bioethics in the curricula of medical schools in Brazil and Portugal.", "Given the value of bioethics in clinical practice, we propose that medical schools in Portugal and Brazil update their curricula to encompass minimum criteria, which should be similar to one another and based on common sources, but which should also be tailored to each culture." ]

[ "A cursory review of relevant research works published in the Journal of Nursing Education suggests that our community may unnecessarily rely on η2 when reporting results of their ANOVA models.", "Although η2 is convenient, the statistic possesses many limitations that warrant our community adopting a wider set of effect size statistics and practices to promote a valid science of nursing education.", "We specifically call attention in this article to ω2.", "[J Nurs Educ.", "2023;62(9):532-533.", "]." ]

[ "A decisive factor for obtaining high yields and selectivities in organic synthesis is the choice of the proper solvent.", "Solvent selection is often guided by the intuitive understanding of transition state-solvent interactions.", "However, quantum-mechanical tunneling can significantly contribute to chemical reactions, circumventing the transition state and thus depriving chemists of their intuitive handle on the reaction kinetics.", "In this Account, we aim to provide rationales for the effects of solvation on tunneling reactions derived from experiments performed in cryogenic matrices.The tunneling reactions analyzed here cover a broad range of prototypical organic transformations that are subject to strong solvation effects.", "Examples are the hydrogen tunneling probability for the cis-trans isomerization of formic acid which is strongly reduced upon formation of hydrogen-bonded complexes and the [1,2]H-shift in methylhydroxycarbene where a change in product selectivity is predicted upon interaction with hydrogen bond acceptors.Not only hydrogen but also heavy atom tunneling can exhibit strong solvent effects.", "The direction of the nearly degenerate valence tautomerization between benzene oxide and oxepin was found to reverse upon formation of a halogen or hydrogen bond with ICF3 or H2O.", "But even in the absence of strong noncovalent interactions such as hydrogen or halogen bonding, solvation can have a decisive effect on tunneling as evidenced by the Cope rearrangement of semibullvalenes via heavy-atom tunneling.", "Can quantum tunneling be catalyzed?", "The acceleration of the ring expansion of 1H-bicyclo[3.1.0.", "]-hexa-3,5-dien-2-one by complexation with Lewis acids provides a proof-of-concept for tunneling catalysis.Two concepts are central for the explanation and prediction of solvation effects on tunneling phenomena: a simple approach expands the Born-Oppenheimer approximation by separating nuclear degrees of freedom into intra- and intermolecular degrees.", "Intermolecular movements represent the slowest motions within molecular aggregates, thus effectively freezing the position of the solvent in relation to the reactant during the tunneling process.", "Another useful approach is to treat reactants and products by separate single-well potentials, where the intersection represents the transition state.", "Thus, stabilization of the reactants via solvation should result in an increase in barrier heights and widths which in turn lowers tunneling probabilities.", "These simple models can predict trends in tunneling kinetics and provide a rational basis for controlling tunneling reactions via solvation." ]

[ "A deeper comprehension of accountability is beneficial for identifying and fostering tactics to boost accountability and raise the standard of healthcare.", "The main objective of the present paper is to measure the level of customers' perception of accountability of healthcare diagnostic service providers and to identify the factors that influence the perception of accountability of healthcare diagnostic service customers.", "A questionnaire survey was used to collect data from 393 customers of various diagnostic centers in the city of Guwahati from the state of Assam in India.", "The reliability of the data was tested using Cronbach's Alpha.", "Statistical tests were used for the mean, percentage, standard deviation, etc.", "Factor analysis was performed to find out the factors affecting customers' perception of accountability.", "It was found that the overall level of perception of the customers with respect to the accountability of diagnostic centers in Guwahati is of high level.", "The study reveals four variables that affect how customers perceive the accountability of diagnostic service providers.", "These are Competency, Responsiveness, Compliance with protocol, and Problem-solving approach.", "Significant contributions have been made by the present study in terms of the development of a scale to measure customers' perception of accountability of diagnostic centre, and the development of a theoretical model to explain this accountability." ]

[ "A deferral takes place when donors fail to meet the eligibility criteria for donating blood during their visit to a blood collection site.", "Deferral periods, which can be either permanent or temporary, are implemented to protect the well-being of both the donor and the recipient.", "This study aimed to investigate the frequency of deferrals and the various factors contributing to them.", "A retrospective analysis was conducted at the Transfusion Medicine Unit of Hospital Universiti Sains Malaysia (USM), utilizing data obtained from blood donors during the period from January 2022 to June 2023.", "The research included a cohort of 18,751 donors who visited our transfusion unit for blood donation.", "Data, including gender, age, and reasons for deferral, were collected by reviewing the records of donors who were deferred.", "Descriptive statistics were employed to analyze the data of deferral blood donors.", "Out of 18,751 blood donors, 3,533 (18.84%) were deferred, consisting of 1,267 males (35.86%) and 2,266 females (64.14%).", "The age group of 18-25 years accounted for the highest number, comprising 1,875 donors (53.07%).", "Among the deferred cases, 53.33% were first-time donors, followed by 25.28% regular donors and 21.40% lapsed donors.", "The deferral of blood donors resulted from various reasons.", "The most common cause of overall deferral among blood donors was low hemoglobin (38.33%), followed by upper respiratory tract infections (8.38%), chronic medical illness (7.08%), and high blood pressure (7.02%).", "Temporary deferrals were more prevalent than permanent deferrals, accounting for 91.57% of cases compared to 8.43% for permanent deferrals.", "Voluntary non-remunerative blood donors constitute the backbone for a safe and reliable blood supply in transfusion services.", "Utilizing a comprehensive database will enable effective counseling of temporarily deferred donors, providing insights into the reasons for their deferral, the expected duration, and the appropriate treatments.", "This information is crucial for motivating these donors to recruit again in the donor pool.", "Public education initiatives aimed at raising awareness about the causes of deferral and promoting regular health check-ups can play a pivotal role in minimizing these deferrals." ]

[ "A developed IPE (Interprofessional Education)-communication course was first implemented at Universitas Pelita Harapan/UPH via online learning due to the COVID-19 pandemic.", "This study aimed to analyze the effectiveness of a newly developed IPE-online communication course offered to medical (MS) and nursing (NS) students.", "This study was a quantitative study using a pre-post design without control.", "The IPAS (Interprofessional Attitude Scale) assessed students' attitudes toward IPE.", "Satisfaction with the program was also measured following its completion.", "The questionnaire was administered via Survey Monkey to 535 respondents (MS = 250; NS = 285).", "Univariate and bivariate statistical analyses were employed.", "Before and after the IPE program, 161 MS and 146 NS completed the IPAS questionnaire (n = 307).", "The attitude of MS and NS were not improved significantly (p-value >0.05).", "Moreover, several subscales of attitudes decreased significantly, including \"Diversity and Ethics\" with a low-size effect for medical students and \"Teamwork, Roles, and Responsibilities\" and \"Patient-Centeredness\" with a low-size effect for nursing students.", "Both students (n = 307) were also satisfied with the IPE course (Mean MS: 4.28 and NS: 4.34).", "This study suggests that online IPE communication course may not be effective in fostering student attitudes.", "The IPE communication course should be accomplished through in-person class instead of online learning.", "Further IPE course evaluations are required to improve the acceptability, applicability, and effectiveness of IPE in health education." ]

[ "A diabetic foot ulcer is a preventable complication of diabetes, which could lead to lower extremity amputation and increased mortality and morbidity.", "Self-care behaviors play a key role in the prevention of diabetic foot ulcers.", "This study aimed to estimate the total score of diabetic foot self-care behaviors.", "We searched databases such as Web of Science, Medline (PubMed), and Scopus using various keywords, including diabetic foot, diabetic feet, diabetic problem, diabetic foot ulcer, and self-care, for relevant articles with no time limit.", "The heterogeneity of the studies was assessed using Cochran's Q test and I2 statistic.", "Data were analyzed using STATA software version 12 using the meta-analysis method and a random effects model.", "In total, eight studies were analyzed with a sample size of 2,493.", "The pooled score of diabetes foot self-care was 62.84% and this score was higher in the studies conducted on two groups of patients with type I and type II diabetes compared to those performed only on patients with type II diabetes.", "The results also indicated correlation between the self-care score and year of publication (P < 0.001), and the self-care scores significantly declined during 2015-2021 (P < 0.001).", "Overall, the diabetic foot self-care score was moderate, which highlights the need to provide self-care education to diabetic patients." ]

[ "A digital divide exists for people from rural and regional areas where they are less likely and confident to engage in digital health technologies.", "The aim of this study was to evaluate the digital health literacy and engagement of people from rural and regional communities, with a focus on identifying barriers and facilitators to using technology.", "Forty adults living in rural/regional areas completed a survey consisting of the eHealth Literacy Scale (eHEALS) with additional items surveying participants' experience with a range of digital health technologies.", "All participants had used at least one digital health technology.", "Most (80%) participants had an eHEALS score of 26 or above indicating confidence in online health information.", "Commonly reported barriers to digital health technology use centred on product complexity and reliability, awareness of resources, lack of trust, and cost.", "Effective digital health technology use is becoming increasingly important, there may be a need to prioritise and support people with lower levels of digital health literacy.", "We present opportunities to support community members in using and accessing digital health technology." ]

[ "A digitally literate nursing workforce can support the delivery of safe, effective care and improve patient outcomes.", "However, digital literacy among nurses is variable.", "Electronic patient records (EPRs), which require the digital documentation of all patient encounters, can be used to generate data that will inform strategies to improve patient care and patient safety.", "Nurse leaders at Imperial College Healthcare NHS Trust acknowledged that although ward nurses were providing excellent patient care, there were gaps in their digital documentation of that care.", "To address the issue, the trust implemented a model of education informed by data analytics and aimed at developing nurses' digital skills and increasing their engagement with digital workflows.", "This article describes how applications extracting data from the EPR system are used to identify nurses' digital literacy training needs and how a team of digital clinical practice educators delivers targeted educational strategies to meet those needs." ]