Focal Areas Research Articles

Streamlining Acute Stroke Processes and Data Collection: A Narrative Review

(1) Background: Acute ischemic stroke treatment has been thoroughly studied to identify strategies to reduce treatment times. However, many centers still struggle to achieve fast treatment times. Additionally, studies primarily focus on larger, more advanced centers; yet, smaller centers often face longer treatment times. (2) Objectives: The aim of this study is to analyze the existing literature reviewing stroke treatment processes in primary and comprehensive stroke centers that investigated or reduced treatment times. The articles identified were categorized based on the focus areas and approaches used. (3) Results: Three main categories of improvements were identified in the literature: (1) standardization of processes, (2) resource management, and (3) data collection. Both primary and comprehensive stroke centers were able to reduce treatment times through standardization of the processes. However, challenges such as variations in hospital resources and difficulties incorporating data collection software into workflow were highlighted. Additionally, many strategies to optimize resources and data collection that can benefit primary stroke centers were only conducted in comprehensive stroke centers. (4) Conclusions: Many existing strategies to improve stroke treatment times, such as pre-notification and mass stroke team alerts, have been implemented in both primary and comprehensive stroke centers. However, tools such as simulation training are understudied in primary stroke centers and should be analyzed. Additionally, while data collection and feedback are recognized as crucial for process improvement, challenges persist in integrating consistent data collection methods into clinical workflow. Further development of easy-to-use software tailored to clinician needs can help improve stroke center capabilities to provide feedback and improve treatment processes.

A Review on Seed and Varietal Replacement in Indian Agriculture and Its Impact for Farmers Income

This article provides a complete overview on the Seed and Varietal Replacement Rates in India and examines the significant advancements in seed technology and their transformative impacts on Indian agriculture. As technological innovations and policy reforms have introduced high-yielding, good quality and resistant varieties for biotic and abiotic stresses, these improvements have greatly influenced seed replacement rates and varietal adoption in different climatic conditions. The study highlights how these developments contribute to enhanced crop productivity, better resource use efficiency, and increased food security. Key areas of focus include the role of biofortification in improving nutritional quality, the adoption of drought-tolerant crops to combat climate challenges, and the benefits of high-quality certified seeds. The article emphasizes that optimizing seed replacement rates and integrating advanced seed technologies are crucial for achieving sustainable agricultural practices and maximizing farm profitability. Continued investment in research and effective extension services are essential to support the widespread adoption of these innovations and drive future advancements in Indian agriculture.

Developmentalism, technocracy and legitimacy crises of humanities: A Third World perspective

PurposeThe visible ill-effects of the developmental enterprises in the ex-colonies and the tendency towards technocratic totalitarianism, in many ways, have altered the way modern humans perceived the idea of “progress” and “development” historically since the Cold War. This paper presents a deconstructive-transdisciplinary critique of the pervasive ideology by focusing on three nodal points in the stages of “development”: (1) the rise of technocratic modern science; (2) the making of the Third World; and (3) de-legitimisation of its indigenous knowledge paradigms.Design/methodology/approachDrawing on the first-hand accounts of the researchers, social scientists, activists and environmentalists, this paper presents an extensive critique of the violence involved in the development enterprises and recommends possible ways to move beyond the developmental hegemony. This paper is a theoretical investigation that adopts an interpretative, pluralistic, transdisciplinary approach, in order to deconstruct the development ideology and analyse the ramifications of the developmental propaganda and practice as they unfolded in the Global South.FindingsThis paper highlights the need to decondition the social imaginary from the hegemony of developmentalism and its by-product scientism and “technological rationality” for an inclusive, pluralistic, democratic social order.Research limitations/implicationsThe focal area of this work is India in particular and Global South in general. It studies the era between the 1950s and 1980s when the major development enterprises took place and studies the consequences they entailed.Social implicationsThe scope of this paper encompasses every socio-economic, ecological and epistemological domain affected by the detrimental effects of the developmental enterprises in the Global South.Originality/valueThe originality of this work lies in its transdisciplinary approach. The scope of this paper is extensive and covers nearly every domain of human existence that has been affected by the development debacle and technocratic totalitarianism in the post-War era.

Promoting Mental Health of City Residents: Stress Management and The Role of Salutogenic Design

Introduction. Salutogenic, or health-promoting design, suggests that the designed environment should not only provide comfortable living space but also support the health and well-being of individuals. However, the rapid process of urbanization is accompanied by significant changes in people's lifestyles and negatively affects mental health. Thus, it is necessary to study the impact of urban environment on the citizens mental health, as well as to summarize and analyze technologies of health-promoting design in urban environment. Objective. To justify the problem of high prevalence of chronic stress among citizens and to summarize the best practices of applying the principles of salutogenic design in the urban environment to overcome stress and prevent psychological problems. Materials and methods. We conducted a non-systematic narrative literature review in the following databases: PubMed, Google Scholar, eLibrary.ru. Search request depth covered 20 years from 2003 to 2023. Results. Urban planning based on the principles of salutogenic design is one of the important tools for ensuring the health of citizens, extending beyond the scope of healthcare system. Moreover, addressing chronic stress, referred to as the «epidemic of the 21st century», can be considered a key direction in implementing salutogenic design in urban planning. The main focus areas of salutogenic design in the urban environment are regulating the density of urban development, creating public spaces, providing landscape design and greenery, offering convenient and safe urban navigation and using arts. Conclusions. Stress levels in cities are influenced by various factors. Effective urban planning that incorporates salutogenic design principles can contribute to improving public health and creating a supportive urban environment.

The Rutgers Integrated Care Evaluation (RICE) Research Framework: An Innovative and Rigorous Set of Methods to Evaluate Integrated Care Programs.

Integrated care programs that prioritize comprehensive service delivery for behavioural health and medical conditions have the potential to improve patient outcomes. Few programs, however, use data-driven methods to guide program evaluation and implementation, limiting their effectiveness, as well as the scope of findings in the research literature. To address these gaps, we describe an innovative and rigorous evaluative research framework: the Rutgers Integrated Care Evaluation (RICE) Research Framework, designed to be tailorable across conditions and care settings. The RICE Research Framework is guided by two core concepts: (1) an approach built on engaging as equal partners and (2) data source triangulation. For the former, the approach relies on multiple teams (Project, Clinical Site, Evaluation, and Consumer) working in collaboration. While teams have specific roles, all teams engage frequently as equal partners to facilitate performance and advance research deliverables. For the latter, we provide a template with recommended primary and secondary data sources with areas of focus, applicable methods, and samples. These sources, when used in combination, can guide implementation, advance replicability, develop/refine health care programs, and foster dissemination of scientific findings. We recommend clinicians and scientists implement the RICE Research Framework to enhance their integrated care programs.

Bioinformatics in Russia: history and present-day landscape.

Bioinformatics has become an interdisciplinary subject due to its universal role in molecular biology research. The current status of Russia's bioinformatics research in Russia is not known. Here, we review the history of bioinformatics in Russia, present the current landscape, and highlight future directions and challenges. Bioinformatics research in Russia is driven by four major industries: information technology, pharmaceuticals, biotechnology, and agriculture. Over the past three decades, despite a delayed start, the field has gained momentum, especially in protein and nucleic acid research. Dedicated and shared centers for genomics, proteomics, and bioinformatics are active in different regions of Russia. Present-day bioinformatics in Russia is characterized by research issues related to genetics, metagenomics, OMICs, medical informatics, computational biology, environmental informatics, and structural bioinformatics. Notable developments are in the fields of software (tools, algorithms, and pipelines), use of high computation power (e.g. by the Siberian Supercomputer Center), and large-scale sequencing projects (the sequencing of 100 000 human genomes). Government funding is increasing, policies are being changed, and a National Genomic Information Database is being established. An increased focus on eukaryotic genome sequencing, the development of a common place for developers and researchers to share tools and data, and the use of biological modeling, machine learning, and biostatistics are key areas for future focus. Universities and research institutes have started to implement bioinformatics modules. A critical mass of bioinformaticians is essential to catch up with the global pace in the discipline.

Ethosuximide-loaded bismuth ferrite nanoparticles as a potential drug delivery system for the treatment of epilepsy disease.

Encapsulating antiepileptic drugs (AEDs), including ethosuximide (Etho), into nanoparticles shows promise in treating epilepsy. Nanomedicine may be the most significant contributor to addressing this issue. It presents several advantages compared to traditional drug delivery methods and is currently a prominent area of focus in cancer research. Incorporating Etho into bismuth ferrite (BFO) nanoparticles within diverse controlled drug delivery systems is explored to enhance drug efficacy. This approach is primarily desired to aid in targeted drug delivery to the brain's deepest regions while limiting transplacental permeability, reducing fetal exposure, and mitigating associated adverse effects. In this investigation, we explored Etho, an antiepileptic drug commonly employed for treating absence seizures, as the active ingredient in BFO nanoparticles at varying concentrations (10 and 15 mg). Characterization of the drug-containing BFO nanoparticles involved scanning electron microscopy (SEM) and elemental analysis. The thermal properties of the drug-containing BFO nanoparticles were evaluated via differential scanning calorimetry (DSC) analysis. Cytotoxicity evaluations using the MTT assay were conducted on all nanoparticles, and human neuroblastoma cell line cultures (SH-SY5Y) were treated with each particle over multiple time intervals. Cell viability remained at 135% after 7 days when exposed to 15 mg of Etho in BFO nanoparticles. Additionally, in vitro drug release kinetics for Etho revealed sustained release lasting up to 5 hours with a drug concentration of 15 mg.

Integrating health screening for non-communicable diseases into dental services: what do we know?

This narrative review describes the impetus for health screening for non-communicable diseases in dental settings and highlights important considerations for evaluating such interventions. Real world cases are presented that showcase health screening interventions implemented in the UK. Non-communicable diseases including diabetes and cardiovascular disease are a global public health challenge. They are largely preventable by implementing lifestyle changes such as healthy eating and participation in physical activity, regular health screening for disease prevention, and/or early initiation of treatment. Hypertension case finding and control is one of the key five areas of focus for adult health, and oral health and diabetes are two of five key clinical areas for children and young people where efforts should be focused to intervene, improve outcomes and reduce inequalities. Links between oral and chronic diseases have been discussed in recent years. Therefore, screening for diabetes and cardiovascular disease has become of greater relevance to the dental profession. There is emerging evidence indicating that screening for the risk factors of cardiovascular diseases and diabetes in dental settings shows promise for improving health outcomes and may offer a cost-effective preventive approach for the detection of diabetes. Real-world services implementing health screening in dental settings have highlighted possibilities for the future and highlight the potential for the role of the dental team in detecting chronic diseases.

Qualitative Insights Into Healthcare Professionals’ Perceived Barriers in Providing Equitable and Patient-Centered Care to Members of the LGBTQI+ Community in Greece

LGBTQI+ individuals often face health disparities, with encumbered outcomes. We investigated the perspectives of a wide range of Greek health professionals using a battery of questionnaires examining LGBTQI+ health-related knowledge, attitudes, and clinical preparedness, while exploring the potential challenges they face when providing care for LGBTQI+ patients via qualitative analysis of their free text answers. In total, 220 health professionals participated, including physicians, nurses, dentists, physiotherapists, social workers, nutritionists, medical laboratory professionals, pharmacists, radiographers, and health promotion specialists. Four main themes were revealed concerning the barriers to providing equitable and patient-centered care to LGBTQI+ individuals: (1) Inadequate knowledge (1a. Distinctive health issues of the LGBTQI+ community, 1b. Community-related terminology), (2) Insufficient communication skills (2a. General approach of LGBTQI+ patients, 2b. Addressing LGBTQI+ individuals, 2c. Managing critical attitudes of colleagues/third parties), (3) Personal perceptions (3a. Attitudes toward the LGBTQI+ community, 3b. Perceptions on the necessity of sexual health history), and (4) Ambiguous bureaucratic procedures. Self-identification, contact with community members in personal life, as well as LGBTQI+ patients’ openness during the encounter were reportedly enabling inclusive care. Most participants (83.2%) expressed willingness for further training on LGBTQI+ health issues. Going forward, study participants identified this field, in conjunction with communication skills, as important areas of focus for training health providers and empowering them to provide equitable, patient-centered, high-quality care to the LGBTQI+ community.

The Impact of Political Stability on Regional Economic Growth in India: A Comparative Study of State-Level Development

This study explores the intricate dynamics of Indian politics, focusing on the interplay between historical legacies, electoral processes, and socio-economic factors shaping contemporary governance. As the world's largest democracy, India offers a unique perspective on political evolution influenced by colonial history, diverse cultural contexts, and rapid economic changes. The analysis covers the historical foundations of India's political system, the impact of major political parties and leaders, and the role of elections in determining policy outcomes. Key areas of focus include the influence of caste and religion on voting behavior, the effects of political campaigns and media, and the evolution of political alliances. The study also addresses current challenges such as corruption, governance inefficiencies, and the impact of globalization on domestic politics. Findings indicate that while India's democratic institutions are resilient, significant disparities in political representation and governance persist, highlighting the need for reforms to enhance transparency and address socioeconomic divides. This examination provides valuable insights into the complexities of democratic governance in a diverse and rapidly evolving society. Additionally, the study underscores the role of regional politics and local governance structures in shaping national policies. It highlights how regional parties and state-level leaders influence broader political trends and contribute to the complexity of India's federal system. By incorporating these perspectives, the analysis offers a comprehensive understanding of how local and national forces interact, shaping the overall political landscape of India

Revolutionizing Cancer Treatment: Recent Advances in Immunotherapy.

Cancer immunotherapy has emerged as a transformative approach in oncology, utilizing the body's immune system to specifically target and destroy malignant cells. This review explores the scope and impact of various immunotherapeutic strategies, including monoclonal antibodies, chimeric antigen receptor (CAR)-T cell therapy, checkpoint inhibitors, cytokine therapy, and therapeutic vaccines. Monoclonal antibodies, such as Rituximab and Trastuzumab, have revolutionized treatment paradigms for lymphoma and breast cancer by offering targeted interventions that reduce off-target effects. CAR-T cell therapy presents a potentially curative option for refractory hematologic malignancies, although challenges remain in effectively treating solid tumors. Checkpoint inhibitors have redefined the management of cancers like melanoma and lung cancer; however, managing immune-related adverse events and ensuring durable responses are critical areas of focus. Cytokine therapy continues to play a vital role in modulating the immune response, with advancements in cytokine engineering improving specificity and reducing systemic toxicity. Therapeutic vaccines, particularly mRNA-based vaccines, represent a frontier in personalized cancer treatment, aiming to generate robust, long-lasting immune responses against tumor-specific antigens. Despite these advancements, the field faces significant challenges, including immune resistance, tumor heterogeneity, and the immunosuppressive tumor microenvironment. Future research should address these obstacles through emerging technologies, such as next-generation antibodies, Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR)-based gene editing, and AI-driven drug discovery. By integrating these novel approaches, cancer immunotherapy holds the promise of offering more durable, less toxic, and highly personalized treatment options, ultimately improving patient outcomes and survival rates.

Heritage BIM (HBIM) applied in emergency scenarios: a case study of the National Museum in Brazil

Heritage buildings, integral to preserving culture and history, play a vital role in shaping regional identity and collective memory. To address the intricate complexities of conserving such tangible cultural heritage, Heritage Building Information Modeling (HBIM) emerges as a compelling avenue, uniting technology, historic preservation, and architectural expertise. Nonetheless, a remarkable research gap exists, particularly in its application within emergency scenarios involving fire accidents during post-recovery phases. This research aims to bridge this gap by proposing key areas of focus for applying HBIM in the aftermath of fire incidents, redefining disaster recovery for heritage sites. The proposed areas are informed by a thorough assessment of the case study related to the post-recovery process undertaken by the Brazilian National Museum after the devastating fire of 2018. This case study combines gathering documentary evidence, on-site assessments, 3D model development within the BIM environment, and interdisciplinary collaboration. By emphasizing informed decision-making, precise damage assessment, and meticulous reconstruction planning, this study advances HBIM's transformative role in heritage conservation and disaster recovery, resulting in a novel approach to safeguarding cultural heritage.

Affirming sexual and gender diversity in an elementary school after school program: a case study

Research demonstrates that programming and curricula that is affirmative and inclusive of sexual and gender minority (SGM) people is potentially lifesaving for students in middle and high school. There has been little examination, however, of SGM-affirmative programming at the elementary school level. Elementary school level programming has the potential to benefit SGM youth and families, as well as lead to more affirmative attitudes in later school settings. This study reports on the factors that create and sustain an elementary after school program that has implemented SGM-affirmative programming within a social justice and arts framework for over 20 years. We conducted thematic analysis of interviews with teachers, administrators, and parents in the program and the associated elementary school to identify factors that contribute to the program’s success in affirming and including SGM people. Findings highlight affirmative policies and systems (inclusive mission statements, policies encouraging expression, and hiring diverse staff) and consistent enactment of inclusive and affirmative behaviors (affirming diversity, implementing inclusive curriculum, using inclusive language, and disrupting normativity and implementing restorative practices) as key components of an SGM-affirmative program with elementary-aged students. Results highlight that creating an SGM-affirmative elementary level program is possible and provide an exemplar of this programming in action. Implications and potential focus areas for policy and practice implementation are discussed.

Abstract C032: Take Charge during Treatment: A randomized exercise trial for breast cancer patients

Abstract Introduction. Breast cancer (BC) is the most frequently diagnosed cancer with over 4 million survivors living in the United States. Recent treatment (Tx) advances such as in targeted (e.g. anti-HER2), systemic (e.g. anthracyclines), or combined therapies have supported the increased survival rates but continue to present adverse effects. Cardiotoxicity, which may be induced during or after Tx, is the second highest cause of mortality in BC survivors and also negatively impacts quality of life (QoL). Black/African American (B/AA) patients have higher rates of this effect along with a higher incidence of aggressive BC types. Limited research has targeted vascular function as an area of focus in the cardio-oncology field. Methods. The Discovery and Elimination of Cardio-Oncology Disparities Toward Equity in the Heartland Center is examining how anti-cancer treatments impact vascular function, the potential mitigating effects of exercise and how socioenvironmental factors moderate these effects. The Take Charge during Treatment randomized trial within this Center is testing the feasibility and acceptability of an exercise during treatment program for B/AA and non-Hispanic White (NHW) women newly diagnosed with BC. The study also examines and compares the effects of exercise on VO2 peak and QoL in participants. The 16-week intervention promotes adherence to the American College of Sports Medicine exercise guidelines for cancer survivors and is guided by a certified exercise trainer. To evaluate the intervention, patient's complete surveys including the FACT-B for QoL, a VO2 peak assessment, physical assessments, and anthropometry measurements at baseline (before BC Tx), after the 16-week program, and at a 12-month timepoint. Socioenvironmental factors are examined using participant addresses. Results. To date, 1330 patients were assessed for eligibility, 60 consented, and 49 enrolled and randomized. Herein, we present data on 45 of the 49 (35 NHW, 10 B/AA). The mean age of participants is 52 years (SD=12), most were diagnosed with Stage I or II BC, and they have varied education and income levels. Baseline (pre-treatment) differences are noted by racial group for QoL (Total score – 88 (SD=9) for NHW vs 74 (SD=29) for B/AA; Physical function – 25 (SD=3) for NHW vs 22 (SD=5) for B/AA; Functional – 21 (SD=4) for NHW vs 18 (SD=8) for B/AA), VO2 peak (22 (SD=5) for NHW vs 17 (SD=6) for B/AA), and obesity (NHW – 30%, B/AA – 70%). Cognitive function, pain interference, social isolation and perceived stress were similar across groups. B/AA women were more likely to report living in a highly redlined area (50%) compared to NHW women (3%), with lower percent tree canopy (13% vs 24%) and lower perceived social cohesion (15 vs 19). Reports of discrimination and resilience were similar across groups. Conclusions. Preliminary baseline results suggest that B/AA women enter BC Tx more vulnerable to developing QoL challenges and cardiotoxicity. Neighborhood environmental factors will be further examined to understand the association with adverse outcomes. Citation Format: Estefania Alonso, Melinda Stolley, Kirsten Beyer, Alison Kriegel, Shane Phillips, Matt Durand, Michael E. Widlansky, Amanda L. Kong, Kent Hoskins, Andreas Beyer. Take Charge during Treatment: A randomized exercise trial for breast cancer patients [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C032.

Commentary: Environmental RNA and the assessment of organismal function in the field

Environmental RNA (eRNA) is an emerging technique with significant potential for the assessment of organismal function in field settings. It has the advantage of being non-invasive, facilitating insight into the physiological status of an organism without complications associated with processes such as capture, handling, and transportation from the field to the laboratory. It is hypothesised that eRNA approaches will be especially valuable for assessing sublethal stress of species living in environmental settings undergoing change and could therefore be integral for examining population health and for testing hypotheses regarding organismal physiology developed from laboratory studies. However, the successful application of eRNA approaches requires further data regarding the stability and persistence of eRNA in natural substrates; established and validated relationships between molecular biomarkers and the physiological processes they participate in; and an understanding of the contributions of different epithelia in direct contact with the environment (skin, gill, gut) to the eRNA transcriptome. The utility of microRNA as a component of the eRNA pool should be an area of specific future research focus. Ultimately, eRNA has the potential to provide fundamental physiological information regarding the responses of organisms in their natural settings and could increase the sensitivity and acuity of biomonitoring efforts.

A Systematic Review of the Use and Effect of Virtual Reality, Augmented Reality and Mixed Reality in Physical Education

New technologies are tools that are present in daily life on a regular basis. In order to improve the didactic process, education must take into account these new technologies. In the field of physical education, the significance of these technologies is reflected in the existence of applications that can be carried out within the field, both for educational purposes and for physical fitness and health. This is due to the potential presented by virtual reality, augmented reality and mixed reality. The objective of this study was to examine the utilisation and impact of AR, VR and MR technologies in physical education at the compulsory stage. In order to achieve this objective, a design based on the PRISMA methodology for conducting systematic reviews was employed. The databases of WOS, Scopus, PubMed and Google Scholar were subjected to analysis. The results indicate that there has been a notable increase in research activity in this field in recent years. The analysis yielded four principal areas of focus, namely the utilisation of pedagogical methodologies, the enhancement of motor and health-related competencies, and moreover, the facilitation of optimal integration of students in physical education. The utilisation and consequences of novel technologies represent a suitable instrument for enhancing the educational experience of students enrolled in physical education programmes.

Artificial intelligence and machine learning in corporate governance: A bibliometric analysis

BACKGROUND: The study deeply explores the thriving domains of artificial intelligence (AI) and machine learning (ML) in corporate governance. OBJECTIVE: The study aims to thoroughly examine the rapidly developing fields of artificial intelligence (AI) and machine learning (ML) in corporate governance. METHODS: After completing an in-depth analysis of 229 research studies published between 2008 and 2023 (using software tools such as RStudio, VOSviewer, and Excel),), the study reveals a notable increase in publications since 2022. Corporate social responsibility (CSR), environmental, social, and governance (ESG) issues, executive remuneration, and sustainability are all considered as important key focal areas of focus. Scholars in this field are notably at the forefront from Taiwan, the United States, and China. IMPLICATIONS: However, the study stress the necessity for further researches to estimate the efficacy of different AI and ML methodologies. This may guide evidence-based governance practices various industries and geographical areas.

A Systematic Review on Fostering Appropriate Trust in Human-AI Interaction: Trends, Opportunities and Challenges

Appropriate Trust in Artificial Intelligence (AI) systems has rapidly become an important area of focus for both researchers and practitioners. Various approaches have been used to achieve it, such as confidence scores, explanations, trustworthiness cues, or uncertainty communication. However, a comprehensive understanding of the field is lacking due to the diversity of perspectives arising from various backgrounds that influence it and the lack of a single definition for appropriate trust. To investigate this topic, this paper presents a systematic review to identify current practices in building appropriate trust, different ways to measure it, types of tasks used, and potential challenges associated with it. We also propose a Belief, Intentions, and Actions (BIA) mapping to study commonalities and differences in the concepts related to appropriate trust by (a) describing the existing disagreements on defining appropriate trust, and (b) providing an overview of the concepts and definitions related to appropriate trust in AI from the existing literature. Finally, the challenges identified in studying appropriate trust are discussed, and observations are summarized as current trends, potential gaps, and research opportunities for future work. Overall, the paper provides insights into the complex concept of appropriate trust in human-AI interaction and presents research opportunities to advance our understanding on this topic.

A clinical decision support tool for metabolic dysfunction-associated steatohepatitis in real-world clinical settings: a mixed-method implementation research study protocol.

Aim: A clinical decision support (CDS) tool for metabolic dysfunction-associated steatohepatitis (MASH) was developed to align health systems with clinical guidelines detailed in the MASH Clinical Care Pathway and improve patients' proactive self-management of their disease. The tool includes a provider-facing web-based application and a mobile application (app) for patients. This protocol outlines a pilot study that will systematically evaluate the implementation of the tool in real-world clinical practice settings. Materials & methods: This implementation research study will use a simultaneous mixed-methods design and is guided by the Consolidated Framework for Implementation Research. The CDS tool for MASH will be piloted for ≥3months at multiple US-based sites with eligible gastroenterologists and hepatologists (n=5-10 per site) and their patients (n=50-100 per site) with MASH or suspected MASH. Each pilot site may choose one or all focus areas within the tool (i.e., risk stratification, screening and referral, or patient care management), based on on-site capabilities. Prior to and at the end of the pilot period, providers and patients will complete quantitative surveys and partake in semi-structured interviews. Outcomes will include understanding the feasibility of implementing the tool in real-world clinical settings, its effectiveness in increasing patient screenings and risk stratification for MASH, its ability to improve provider and patient knowledge of MASH, barriers to adoption of the tool and the tool's capacity to enhance patient engagement and satisfaction with their care. Conclusion: Findings will inform the scalable implementation of the tool to ensure patients at risk for MASH are identified early, referred to specialty care when necessary and managed appropriately. Successful integration of the patient app can contribute to better health outcomes for patients by facilitating their active participation in the management of their condition.

Research on Wildfires, Soil Erosion and Land Degradation in the XXI Century

This study carries out a comprehensive bibliometric analysis of scientific production on wildfires, soil erosion and land degradation, with the aim of understanding trends, critical gaps in scientific knowledge and research patterns. A total of 1400 articles published between 2001 and 2023 were analyzed with bibliometric tools (Bibliometrix and VOSviewer), revealing a steady growth in the number of publications over time. International collaboration between countries such as the United States, Spain, China and Portugal is evident, highlighting the global approach to tackling these issues, as well as the mobility and collaboration between scientists. Analyzing the conceptual structure through the co-occurrence of keywords reveals central themes such as “soil erosion” and “wildfire”, indicating areas of primary focus in research. This study highlights the continuing importance of these themes and the need for global collaboration to tackle the environmental challenges affecting forest ecosystems, and particularly the soil layer, caused by wildfires, which affect wildlands all over the world.