Continuous Acquisition Research Articles

Research on the Performance of Continuous Mergers and Acquisitions of Enterprises from the Perspective of Platform Economy

Research on the Performance of Continuous Mergers and Acquisitions of Enterprises from the Perspective of Platform Economy

Preventive Preservation of Rammed Earth Historical Heritage Through Continuous Monitoring, Architectural Inspections, and Data Fusion

Rammed earth construction, an ancient and sustainable building technique, faces significant preservation challenges, particularly in historical contexts. This study aims to enhance the preventive preservation of rammed earth historical heritage through a comprehensive methodology combining continuous monitoring, architectural inspections, and data fusion. By integrating nondestructive testing techniques such as ultrasound, thermography, and ground-penetrating radar with operational modal analysis and modeling, the proposed approach allows for early detection and assessment of structural vulnerabilities. This methodology was applied to the Tower of Muhammad in the Alhambra of Granada, Spain, demonstrating its effectiveness in identifying and quantifying damage and predicting structural health. Using multi-source data (documentation, inspections, nondestructive tests, and continuous monitoring), a finite element model was built, calibrated (achieving an avg. error in modal frequencies of 1.28% and a minimum modal assurance criterion value of 0.94), and used to develop a surrogate model able to predict the modal properties of the tower in 0.02 s, becoming compatible with continuous system identification. The presented results highlight the importance of continuous data acquisition and advanced diagnostic tools for safeguarding rammed earth structures against environmental and anthropogenic threats. This study advocates for the adoption of digital twins in historical preservation, facilitating informed decision-making and sustainable management of cultural heritage.

X-ray image reconstruction for continuous acquisitions with a generalized motion model

Continuous X-ray imaging is known to reduce mechanical vibrations and scan time compared to a step-and-shoot acquisition approach. However, motion during X-ray exposure leads to blurred projections and consequently to loss of spatial resolution and contrast in conventionally reconstructed images. Recent works that aim to reduce continuous motion blur focus only on rotational motion and often include linearization approximations, while many applications would benefit from a more generalized continuous acquisition strategy. In this paper, we propose a dedicated reconstruction technique for rotational, translational, and roto-translational motion, without requiring a linearization approximation. Through simulations and real experiments, we show that motion blur artifacts caused by roto-translational continuous scanning are substantially reduced, allowing for faster scanning while retaining image quality.

Three-stage ocean wave elements extraction using deep learning based on in-situ monocular videos from offshore infrastructure

Ocean wave elements refer to statistical descriptions of waves in ocean engineering, serving to evaluate the fatigue and damage of offshore infrastructures and expand the operational time window for offshore construction activities. In-situ measurement of waves is an effective approach to acquire wave elements. However, traditional non-contact equipment is costly and unsuitable for continuous wave elements acquisition near offshore structures. Therefore, this study utilizes monocular vision to extract marine information, focusing on the accurate recognition of significant wave height and peak frequency near infrastructures. A three-stage wave elements extraction method is proposed: preprocessing with infrared enhancement and highlight removal, Convolutional Neural Network (CNN) feature extraction phase, and convolutional Long Short-Term Memory (convLSTM) regression network based on a self-attention memory mechanism. This approach accurately regresses significant wave heights and peak frequencies from in-situ monocular videos of the ocean, achieving mean absolute percentage errors (MAPE) of 3.01% for significant wave height and 4.07% for peak frequency. Additionally, ablation experiments are conducted at each stage to validate the effectiveness of the method.

The capability of Acoustic Emission features to monitor diamond-coated burr grinding wear and effectiveness

Within manufacturing there is a growing need for autonomous Tool Condition Monitoring (TCM) systems, with the ability to predict tool wear and failure. This need is increased, when using specialised tools such as Diamond-Coated Burrs (DCBs) for grinding high strength ceramics or glass, in which the random nature of the tool, inconsistent manufacturing methods and high wear rates create large variance in tool life. This unpredictable nature leads to a significant fraction of a DCB tool's life being underutilised due to premature replacement. Workpiece surface damage, increased grinding forces and large-scale diamond grain pullout could all be the result of high levels of runout and in-circularity common within electroplated DCBs. As such it is important to not only monitor the overall tool wear but also tool condition. Acoustic Emission (AE) presents as an indirect on-machine sensing method highly suited to grinding applications. The high frequency range of AE, >20 kHz, prevents machine noise from dominating the acquired signals, isolating the micro-scale machining processes within noises machine environments. AE resulting from the grinding process has the potential to monitor not only tool wear but also runout and circularity. A series of DCB wear tests have been conducted, each consisting of the continuous acquisition of AE during grinding and frequent tool surface measurements. Preliminary results demonstrate AE kurtosis can be seen as an indicator of each tool’s runout, representing the fraction of time the tool and workpiece are in contact during a revolution. As a result, an indirect monitoring system capable of monitoring wear and tool state with AE could be utilised within the manufacturing sector.

Optimization of Conditions for Conidial Production in Bipolaris oryzae Isolated from Rice

Conidial production is a critical factor in testing pathogenicity and studying the physiology and ecology of fungal pathogens. Therefore, selecting an appropriate condition and medium for consistent conidia production is essential. In this study, we investigated light conditions and suitable medium conditions using the slide culture method to establish optimal conditions for continuous spore acquisition of <i>Bipolaris oryzae</i>. Primarily, we observed conidial production using two <i>B. oryzae</i> isolates, CM23-042 and 23CM10, under two different light conditions: (1) consistent near-ultraviolet (NUV) with fluorescent light, and (2) a 12-hr shift of the NUVdark cycle. Secondly, we examined conidial formation under seven different media on potato dextrose agar (PDA), V8-Juice agar, minimal medium (MM), sucrose-proline agar (SPA), rabbit food agar (RFA), rice bran agar (RBA), and rice leaf agar (RLA). Under consistent NUV light with fluorescent conditions, conidia were induced in both isolates, whereas conidia were not produced under other conditions after 7 days post-inoculation (dpi). Moreover, <i>B. oryzae</i> isolate CM23-042 produced the highest number of conidia in MM, while isolate 23CM10 yielded the highest number of conidia in PDA after 7 dpi. In summary, our data demonstrated that the consistent NUV light with fluorescent conditions were most conducive for conidia induction in <i>B. oryzae</i>. The selection of a medium for conidiation may vary depending on the <i>B. oryzae</i> isolates, but using MM and PDA or SPA and RFA medium could be effective for spore induction. These findings will contribute to improving conidiation according to the characteristics of collected isolates of <i>B. oryzae</i>.

An adaptive Epithelial-Mesenchymal Transition Program Enables Basal Epithelial Cells to Bypass Stress-Induced Stasis and Contributes to Metaplastic Breast Cancer Progenitor State.

Human mammary epithelial cell (HMEC) cultures encounter a stress-associated barrier termed stasis, during which most cells adopt a senescence-like phenotype. From these cultures, rare variants emerge from the basal epithelial population, re-initiating growth. Variants exhibit pre-malignant properties, including an aberrant epigenetic program that enables continued proliferation and acquisition of genetic changes. Following oncogenic transformation, variants produce tumors that recapitulate the histopathological characteristics of metaplastic breast cancer (MBC), a rare subtype characterized by squamous and mesenchymal differentiation. Using the conventional serum-free HMEC culture system, we probed the capacity for phenotypic plasticity inherent to basal epithelial cell populations from human breast tissue as they navigated stasis and emerged as variant populations. We observed robust activation of a TGF-β-dependent epithelial-mesenchymal transition (EMT) program in basal epithelial cells during stasis, followed by subsequent attenuation of this program in emerging variants. Inhibiting the TGF-β pathway or depleting the EMT regulators Snail or Slug allowed basal epithelial cells to collectively bypass stasis, demonstrating that cellular dysfunction and arrest resulting from TGF-β and EMT activation are central to this in vitro barrier. The spontaneous emergence of variants from stasis cultures was associated with a restricted EMT trajectory, which diverted cells away from a complete mesenchymal state characterized by irreversible growth arrest, and instead limited variants to epithelial and intermediate EMT states associated with greater proliferative capacity and stemness. Epigenetic mechanisms, which contributed to the dysregulated growth control characteristic of the variant phenotype, also contributed to the constrained EMT program in variants. By overcoming the cellular dysfunction and growth arrest resulting from TGF-β and EMT activation, variants exhibited increased oncogenic transformation efficiency compared to pre-stasis basal epithelial cells. Inhibiting the TGF-β pathway prior to stasis significantly reduced EMT in the basal epithelial population, alleviated selective pressure driving variant emergence, and enhanced oncogenic transformation efficiency, resulting in tumors with markedly diminished metaplastic differentiation. This study reveals how adaptive EMT reprogramming governs basal epithelial cell fate decisions and contributes to the development of MBC progenitors by restricting access to terminal mesenchymal states that induce growth arrest and, instead, favoring intermediate states with enhanced tumorigenic potential.

Holacracy: redefining organizational ontology and epistemology

Purpose This paper aims to examine Holacracy as a self-management system and its implications for organizational theory. By exploring its distinctive ontology and epistemology, the paper explains how Holacracy redefines organizational structures and contributes to organizational change. Design/methodology/approach Adopting a conceptual approach, this essay draws upon existing literature to explore Holacracy’s departure from conventional organizational theories. Findings The paper discusses how Holacracy challenges traditional organizational concepts, defining its holarchical approach, and emphasizing dynamic hierarchies and role-based organization. It also highlights Holacracy’s focus on emergent intelligence, continuous feedback loops and structured knowledge acquisition through roles and organization spaces. By examining its unique ontology and epistemology, the paper offers insights into how Holacracy aligns with an emergent paradigm known as integral, metamodern or teal. Research limitations/implications Further empirical research is needed to assess its practical implementation and long-term effects on organizational performance and employee well-being. Future studies could also explore challenges and limitations associated with adopting Holacracy in different organizational contexts. Practical implications Organizations considering alternative ways of working should examine Holacracy. Implementing Holacracy requires understanding its principles and may involve significant changes, with potential benefits such as increased agility and employee engagement. Social implications Holacracy’s departure from traditional structures and approach to power can have broader social implications and contribute to more democratic and participatory cultures. Originality/value This paper is a pioneering contribution to the under-researched domain of alternative organizational models. It sheds light on the originality and distinctiveness of Holacracy, highlighting its unique approach to hierarchy, role-based organization and consciousness within organizations.

Development of the algorithm for determining the thickness of the structural layers of the non-rigid pavement and searching for local inclusions using sub-surface georadiolocation methods

Problem. The article is part of the authors' research in the field of road construction using GPR technologies. Ensuring a certain level of pavement reliability on highways requires the development of methods and means for continuous information acquisition and processing in real time, taking into account the parameters of structural heterogeneity, heterogeneity of physical and mechanical parameters of structures, as well as their changes over time. The solution of this problem is limited by the complexity of tasks of obtaining and interpreting the data of subsurface sensing and the associated errors in determining the parameters of structures, imperfection of methods of flaw detection of structures with subsurface inhomogeneities, multifactorial tasks of estimation of physical and mechanical parameters of multicomponent materials. Goal. Improving the accuracy and reliability of determining the boundaries of layers of non-rigid pavement structure, which have a low level of electrodynamic contrast due to interpenetration of layer materials or changes in their physical and mechanical properties. The solution of this problem is connected with the development of a method of obtaining reflected GPR signals and the improvement of algorithms for their processing. Methodology. The development of methods for the analysis of the electromagnetic field with a variable state of polarization makes it possible to assess the localization of violations of the integrity of the pavement structure at a qualitatively new level and allows the positioning of small inclusions even with a slight contrast in the dielectric constant. The proposed method of recording the reflection of an ultra-wideband GPR pulse signal at different polarizations is implemented by measuring the reflected signal from a metal sheet at oblique incidence and parallel polarization, recording the reflected pulse at perpendicular polarization, followed by measuring the reflection coefficient from the structure of the nonrigid pavement under study at parallel and perpendicular polarization. The electrophysical parameter recovery procedure is based on the solution of inverse scattering problems and ensures the accuracy of determining the low-contrast boundaries of the pavement structure and increases the accuracy of positioning subsurface heterogeneities. GPR signal processing algorithms are based on procedures for analyzing their polarization state, which allows determining the geometric parameters of subsurface heterogeneities. Practical value. The combination of the obtained results increases the accuracy and reliability of the results of GPR diagnosis and assessment of the condition of non-rigid pavement based on the most complete and reliable information about the subsu

3D printed Ti3C2@Polymer based artificial forest for autonomous water harvesting system

The escalating scarcity of freshwater resources presents significant challenges to global sustainability, demanding innovative solutions by integrating cutting-edge materials and technologies. Here we introduce an autonomous artificial forest (3D AF) for continuous freshwater acquisition. This system features a three-dimensional (3D) architecture incorporating a carbon nanofiber (CNF) network and MXene@polypyrrole (Ti3C2@PPy), enhancing surface area, light absorption, heat distribution, and surface wettability to improve solar vapor generation and fog collection efficiency. The autonomous operation is facilitated by an integrated photothermal actuator that adjusts to the day and night conditions. During daylight, the 3D AF tilts downward to maximize solar exposure for water evaporation, while at night, it self-adjusts to optimize fog particle collection. Notably, our device demonstrates the ability to harvest over 5.5 L m−2 of freshwater daily outdoors. This study showcases the potential of integrating advanced materials and technologies to address pressing global freshwater challenges, paving the way for future innovations in water harvesting.

Endoscopic Endonasal Skull Base Surgery: Analysis of the Results in the Author’s Initial 200 Cases

Background Endoscopic endonasal approaches represent currently an important tool for approaching the skull base. The evolution of new techniques is based in the continuous acquisition of skills and abilities and it is paramount to determine the safety and effectiveness of new approaches. Based on that, the aim of this study is to analyze our results after the first 200 cases. Material and methods We performed a retrospective review of all cases operated on through an endoscopic endonasal approach in our Skull Base Unit, between January 2007 and May 2018. We analyze the results and all the per-operative complications associated. Results In this study we included 200 cases, comprising 105 female (52,2 %) and 95 male (47,5 %), with a mean age of 45,6 (range 21-85 years-old). The most commonly reported pathology was the pituitary adenoma, comprising 121 cases (60,5 %), followed by 13 meningocele (6,5 %), 9 chordoma (4,5 %), 6 skull base meningioma (3 %) and 7 cranyopharingioma (3,5 %). 161 cases (81 %) represented first surgery. The most frequently reported complication was diabetes insipidous in 17 % of all cases, followed by CSF leak, represented by 15 cases (7,5 %). 12 CSF leak cases were successfully treated by external lumbar draining and 3 patients required second surgery to skull base repair. In the last 50 cases, only one CSF leak has been reported, representing an incidence of 2 %, successfully treated by endoscopic repair. This decrease in CSF leak represents the impact of the learning curve in skull base reconstruction. 5 % of patients suffered meningitis and 5 % presented permanent anosmia. In our serie we reported 1,6 % of transient neurologic deficit represented by oculomotor palsy and 1,6 % of permanent neurologic deficit due to infarction. 3 patients in this serie has died, two due to malignant ICA occlusion and 1 due to infection (overall mortality 1,5 %). The most commonly used approach was the transsphenoidal transsellar approach (58 %), followed by transplanum-transtubercullum approach (8 %). Gross total resection was achieved in 76 % of tumoral pathology, 71 % in cases of pituitary adenomas. Conclusion From this review we can conclude that, in our serie, endoscopic endonasal surgeries represent safe approaches to the skull base to a huge variety of pathologies. Progressive acquisition of skills and experience is paramount to improve the results, avoiding and reducing complications. Appropriate patient and pathology selection is also mandatory.

From Clicks to Calm: Investigating the Link Between Mindfulness and Digital Hoarding Behavior Among Chinese Youth.

Digital hoarding refers to the continuous acquisition of digital content and the difficulty in disposing of it. This behavior is increasingly common among today's youth. This study aims to explore the impact of mindfulness on digital hoarding behavior, investigating self-control as a mediator and upward social comparison via social media as a moderator. A total of 956 young individuals participated in this cross-sectional study. The research instruments used included the Mindfulness Measure, the Self-Control Scale, the Social Comparison Scale, and the Digital Hoarding Behavior Questionnaire. Data analysis included descriptive statistics and correlation analysis. For more complex analyses, we examined the mediating role of self-control and the moderating effects of upward social comparison via social media in the relationship between mindfulness and digital hoarding behavior. 1) Mindfulness significantly negatively predicted digital hoarding. 2) Self-control mediated the relationship between mindfulness and digital hoarding. 3) Upward social comparison via social media moderated the relationship between mindfulness and self-control, specifically the first segment of the mediation pathway. This research is pioneering in exploring mindfulness as a protective factor against digital hoarding, offering fresh insights into this nascent field. The findings also suggest prevention and intervention strategies for digital information management disorder in young people.

Fast, automated, real-time 3D passive balloon catheter tracking during MRI-guided cardiac catheterization using orthogonal projection imaging and real-time image-based catheter detection.

MRI-guidance of cardiac catheterization is currently performed using one or multiple 2D imaging planes, which may be suboptimal for catheter navigation, especially in patients with complex anatomies. The purpose of the work was to develop a robust real-time 3D catheter tracking method and 3D visualization strategy for improved MRI-guidance of cardiac catheterization procedures. A fast 3D tracking technique was developed using continuous acquisition of two orthogonal 2D-projection images. Each projection corresponds to a gradient echo stack of slices with only the central k-space lines being collected for each slice. To enhance catheter contrast, a saturation pulse is added ahead of the projection pair. An offline image processing algorithm was developed to identify the 2D coordinates of the balloon in each projection image and to estimate its corresponding 3D coordinates. Post-processing includes background signal suppression using an atlas of background 2D-projection images. 3D visualization of the catheter and anatomy is proposed using three live sagittal, coronal, and axial (MPR) views and 3D rendering. The technique was tested in a subset of a catheterization step in three patients undergoing MRI-guided cardiac catheterization using a passive balloon catheter. The extraction of the catheter balloon 3D coordinates was successful in all patients and for the majority of time-points (accuracy >96%). This tracking method enabled a novel 3D visualization strategy for passive balloon catheter, providing enhanced anatomical context during catheter navigation. The proposed tracking strategy shows promise for robust tracking of passive balloon catheter and may enable enhanced visualization during MRI-guided cardiac catheterization.

Navigating the Future of PCOS Treatment: The Precision Medicine Paradigm

Abstract: Polycystic Ovary Syndrome (PCOS) is a condition affecting women of reproductive age, characterized by a heterogeneous array of symptoms. This study aims to examine the role of Precision and Personalized Medicine (PPM) in managing PCOS, given the diverse manifestations of the disease and any genetic factors involved. In this review, we have analyzed the existing literature on the heterogeneity in PCOS symptoms, efforts to acquire PPM data for the characterization of molecular changes in PCOS, and the impact of advances in artificial intelligence on precision medicine. PCOS symptoms present differently in each individual, making traditional therapies ineffective. By tailoring treatment to each individual's genetic and molecular profile, PPM offers a promising approach to addressing the complex nature of PCOS. Understanding PCOS molecular underpinnings requires continuous acquisition of PPM data. Advances in artificial intelligence have greatly enhanced precision medicine's potential applications. Precision medicine could become a standard component of PCOS care, similar to its application in treating serious conditions like cancer and heart disease, due to its ability to address the condition's complexity through individualized treatment approaches.

(Invited) Wearable Pocket-Sized Fully Non-Contact Cardiorespiratory Sensor

Cardiovascular and respiratory diseases have emerged as the leading cause of global mortality over the past decade, encompassing conditions such as atrial fibrillation and chronic obstructive pulmonary disease. Consequently, continuous monitoring plays a crucial role in managing these conditions, as it enables early detection, improves patient survival rates, and alleviates the burden on emergency medical resources. Our research group has developed a wearable pocket-sized fully non-contact cardiorespiratory sensor that utilizes electromagnetic induction technology to measure dynamic changes in electrical conductivity resulting from cardiac contractions and pulmonary volume variations. This enables the continuous acquisition of eddy current damping response signals to achieve cardiorespiratory monitoring. In comparison to commercially available ECGs, PPG smartwatches, and respiratory sensors, our proposed pocket-sized sensor offers three major advantages: exceptional concealment, convenience, and comfort for health monitoring due to its pocket-sized and micro-structured design; simultaneous acquisition of two-dimensional cardiac and respiratory signals, facilitating comprehensive cardiorespiratory health monitoring; and the ability to adjust sensing depth through frequency modulation of the electromagnetic field, thus eliminating variations in physiological structures among subjects and achieving optimized sensing and personalized medical benefits.

Monitoring Multi-Drug Resistant Klebsiella pneumoniae in Kitagata Hot Spring, Southwestern Uganda: A Public Health Implication.

The concerning frequency of K. pneumoniae in various recreational settings, is noteworthy, especially regarding multi-drug resistant (MDR) strains. This superbug is linked to the rapid spread of plasmids carrying these resistance genes. The objective of this study was to evaluate the spatiotemporal prevalence of MDR-K. pneumoniae in the Kitagata hot spring, Southwestern Uganda. A laboratory-based descriptive longitudinal study was conducted between May and July 2023. During rainy and dry seasons, we collected eighty water samples in the morning and evening from the hot spring. The temperature at each point was measured prior to sample collection, and two samples were obtained at varying depths. 5 mL of each homogenized sample were pre-enriched in brain heart infusion broth, and subsequently in both blood and violet red bile agar. The Kirby-Bauer disk diffusion method was performed, followed by the detection of carbapenemase (CR) and extended-spectrum β-lactamase (ESBL) production. Polymerase chain reaction showed resistance genes viz. bla TEM, bla CTX-M and bla KPC. Data were analyzed using SPSS-20 to obtain chi-square tests and regression analysis. K. pneumoniae accounted for 30.0% of isolates obtained from Kitagata hot springs, with all isolates classified as multi-drug resistant. All isolates were resistant to ampicillin, rifampicin, ceftazidime, and azithromycin (79.2%). Additionally, 95.8% of isolates harbored bla TEM gene alone and both bla TEM and bla CTX genes, followed by bla KPC alone (33.3%), with 25% harboring all three resistance genes. During the dry season, K. pneumoniae had a higher prevalence (35.0%) compared to the wet season (25.0%). The prevalence of MDR-K. pneumoniae significantly increased over the course of the study. The presence of the three studied resistance genes in the isolates showed a positive correlation with the second phase of sample collection and the dry season but exhibited a negative correlation with temperature, except for isolates harboring either bla TEM alone or bla TEM+KPC+CTX genes. Kitagata hot spring serves as a hotspot for continuous dissemination and acquisition of MDR-K. pneumoniae harboring resistance genes that encode for ESBL and CR production. The healthcare sector ought to implement an ongoing monitoring and surveillance system as well as robust antimicrobial resistance stewardship programs aimed at delivering health education to the community.

THz-TDS as a PAT tool for monitoring blend homogeneity in pharmaceutical manufacturing of solid oral dosage forms: A proof-of-concept study

The process analytical technology (PAT) framework is well established and integral to facilitate process understanding, enable a transition from batch to continuous manufacturing, and improve product quality. Near-infrared (NIR) spectroscopy has been established as a standard PAT tool for many process analytical challenges, including monitoring powder blend homogeneity. However, alternative technologies for monitoring powder blending are of interest due to the importance of the blending step in manufacturing solid oral dosage forms. Terahertz time-domain spectroscopy (THz-TDS) is therefore explored in this study as an alternative tool for monitoring blend homogeneity with the potential for endpoint control in a batch blending process. Powder blends of microcrystalline cellulose (MCC) and dibasic calcium phosphate dihydrate and blends of MCC and granulated α-lactose monohydrate were investigated non-invasively at various compositions using THz-TDS in transmission mode for acquiring spectra from samples enclosed in the blending container. It was found that attenuation- and phase-related parameters acquired with THz-TDS could reliably resolve physical changes related to the homogeneity of the blend. Further evaluations revealed that changes in the bulk density of the blend, in addition to the intrinsic optical properties of the materials, played a critical role in the observed trends for both systems. In contrast, the scattering contribution of the powder was mainly crucial for the attenuation-related parameter in blends with materials of high refractive indices. Finally, THz-TDS measurements were acquired throughout a blending process mimicking a continuous acquisition. The method could follow blending dynamics and resulted in reasonable predictive errors of the content of 0.5 – 2.5 %. Relative standard deviations for high content blends (20 %) were acceptable (3 – 7 %) whereas at low contents (5 %) significantly higher values (9 – 35 %) were found. Based on these findings, THz-TDS is a feasible PAT tool for monitoring blend homogeneity and controlling high content blend processes, although precision and accuracy is considered to improve with a more suitable interface.

Association of Changes in A1C Following Continuous Glucose Monitoring Acquisition in People with Sub-Optimally Treated Type 2 Diabetes Taking GLP-1 RA Therapy.

Both glucagon-like peptide-1 receptor agonists (GLP-1 RA) and continuous glucose monitoring (CGM) improve glycemia in patients with type 2 diabetes (T2D). However, it is unknown whether adding CGM to GLP-1 RA therapy further improves A1c. We evaluated changes in A1c levels 6months after initiation of FreeStyle Libre (FSL) in adults with sub-optimally controlled T2D already on GLP-1 RA therapy. This retrospective, observational study used Optum's de-identified Market Clarity Data, a linked electronic health record-claims database to assess changes in A1c after FSL acquisition. Inclusion criteria were T2D diagnosis, ≥ 18years, baseline A1c ≥ 8%, with the first FSL acquisition between 2018 and 2022. Patients were required to be on GLP-1 RA prior to FSL with at least one GLP-1 RA prescription within 90days of FSL acquisition. GLP-1 RA initiation was defined as the earliest GLP-1 RA prescription from 2017 onwards. Paired changes in A1c were assessed at 6months after initial FSL acquisition. The study cohort included 1454 adults with T2D (age 55 ± 10years, 52% male, 38% with intensive insulin therapy, median 471days from GLP-1 RA initiation to FSL, and baseline A1c 9.8 ± 1.5%). After FSL acquisition, patients experienced an A1c decrease of 1.5 ± 1.9% (p < 0.001). Patients with a baseline A1c > 10% had the largest reduction (n = 497, - 2.7 ± 2.2%, p < 0.001). Significant improvements were observed in subgroups based on insulin therapy and GLP-1 RA formulation. Those initiating GLP-1 RA therapy > 24months before FSL acquisition also showed improvements in A1c (n = 478; - 1.3 ± 1.7%, p < 0.001). In a large, real-world study of adults with T2D, those on prior GLP-1 RA therapy experienced significant A1c improvements after acquiring FSL, irrespective of GLP-1 RA duration, GLP-1 RA formulation, or insulin therapy type. These findings support the use of FSL in adults with T2D treated with GLP-1 RA.

Learning beyond borders: lifelong learning and learning culture in Islamic institutions in the pursuit of quality education

Purpose The concept of lifelong learning and learning culture in education generally refers to the continuous acquisition of knowledge and skills throughout one's life, extending beyond formal education while learning culture is the creation of learning opportunities, resources and support systems that empower individuals to continuously enhance their knowledge and skills. Lifelong learning and a learning culture contribute significantly to the realization of SDG 4 by promoting inclusive, equitable and quality education that prepares individuals for a lifetime of learning and adaptation in a changing world. This paper aims to identify the level of understanding of school’s community regarding these concepts and measuring the implementation level and readiness of primary schools across Malaysia. Design/methodology/approach Employing a mixed-methods approach, the initial qualitative phase involved interviewing teachers to know their level of understanding regarding the concept of lifelong learning and learning culture. The subsequent quantitative phase assessed the readiness and implementation level of 35 primary schools across Malaysia. Findings An interview that been done has successfully collected the viewpoints of teachers about lifelong learning and learning culture. A survey administered to primary schools affiliated with the MUSLEH organization affirmed the readiness and implementation level of schools in which it was found that most of the schools has high degree of awareness and understanding regarding the significance of the concepts to be implemented in the education system. Originality/value This study's contributions extend beyond academia, offering insights for educators and policymakers alike. The findings can inform education ministries, curriculum developers and stakeholders, aiding them in providing substantial support to educators aligning with the principles of the Sustainable Development Goals (SDG).

Determinants of adherence to post-stroke/transient ischemic attack secondary prevention medications: A cohort study.

Adherence to post-stroke secondary prevention medications mitigates recurrence risk. This study aimed to measure adherence to secondary prevention medications during 3 years post-ischemic stroke/transient ischemic attack, using prescription and dispensing data, and identify factors associated with suboptimal adherence. This multicenter, prospective, cohort study involved patients from the STROKE 69 cohort, which included all consecutive patients with suspected acute stroke admitted between November 2015 and December 2016 to any emergency department or stroke center in the Rhône area in France. Prescription data for antihypertensive agents, antidiabetic agents, lipid-lowering drugs, and antithrombotics were collected. Dispensing data were provided by the French regional reimbursement database. Adherence was calculated using the continuous medication acquisition index. Associations between suboptimal adherence and potential influencing factors across the World Health Organization's five dimensions were explored through univariate and multivariate analyses. From 1512 eligible patients, 365 were included. Optimal adherence to overall treatment (≥90%) was observed in 61%, 62%, and 65% of patients in the first, second, and third years, respectively. Education level (high school diploma or higher: OR = 3.24, 95% CI [1.49; 7.36]) and depression (Hospital Anxiety and Depression Scale-Depression scores 8-10: OR = 1.90, 95% CI [1.05; 3.44]) were significantly associated with suboptimal adherence. Overall adherence to secondary prevention medications was fairly good. Having an initial diagnosis of transient ischemic attack, a high level of education, or depression was associated with increased odds of suboptimal adherence, while having a history of heart rhythm disorder was associated with lower odds.