Geographic Barriers Research Articles

A EDUCAÇÃO NÃO FORMAL : PROCESSOS DE APRENDIZAGENS E SABERES

This work is an excerpt from the Master’s Dissertation that addresses MEDICINAL PLANTS IN NON-FORMAL EDUCATION: A STUDY OF TRADITIONAL KNOWLEDGE IN THE COVID-19 PANDEMIC IN BENJAMIN CONSTANT-AM. Medicinal plants, having the ability to help cure or treat various diseases, have been identified and used throughout the history of humanity. The use of plants as medicine is based on non-formal knowledge and the culture of each people. This study has the general objective of understanding how people use medicinal plants in the treatment of coronavirus only with popular knowledge, which is the basis for non-formal education. The present study reports the benefits of medicinal plants used by residents during the COVID-19 pandemic. The research was carried out using a quantitative and qualitative approach. It can be noted that people know some benefits that medicinal plants have, having family culture as their main source of knowledge. The use of medicinal plants in the treatment of diseases goes beyond ethnic, social and geographic barriers. Phytotherapy is among the most widespread health practices in the world.

Mobile Health (mHealth) Applications for Stroke Rehabilitation: A mini review.

Mobile Health (mHealth) applications are transforming stroke rehabilitation, through personalized care and datadriven insights. These applications employ AI-driven algorithms, tele-rehabilitation, wearable technologies, and gamification to enhance recovery process. The objective of this mini review is to explore the transformative role of Mobile Health (mHealth) applications in stroke rehabilitation, highlighting its capacity to transcend geographical barriers and establish extensive support networks connecting stroke survivors, caregivers, and healthcare professionals. Particularly in developing countries like Pakistan, where healthcare resources may be limited, mHealth offers a viable solution to bridge the gap in stroke care. By facilitating access to rehabilitation services, mHealth can significantly improve outcomes for stroke survivors in these regions. This integration of mobile technology with stroke rehabilitation not only promises personalized and more effective rehabilitation but also presents a unique blend of technology and compassion. This evolution in healthcare holds the potential to redefine stroke recovery, marking a significant milestone in the journey towards more inclusive, efficient, and compassionate care solutions.

Genome-wide SNP analysis coupled with geographic and reproductive-phenological information reveals panmixia in a classical marine species, the Japanese jack mackerel (Trachurus japonicus)

Identification of genetic population structures in classical marine species—species with large population sizes, wide range distributions, and high dispersal potential—can be a challenging task because of expectedly weak genetic signals of population structure. The Japanese jack mackerel, Trachurus japonicus, is a classical marine species and one of the most important fishery resources in the East Asian seas. In this study, we tested the hypothesis of genetic panmixia in the Japanese jack mackerel using genome-wide SNP analyses coupled with geographic and reproductive phenology information. We generated a highly contiguous genome assembly and performed Genotyping by Random Amplicon Sequencing-Direct (GRAS-Di) to produce at least 19,904 SNPs that were genotyped in 614 samples from seas around the Japanese archipelago. Genetic population structure analyses did not reveal any evidence of genetic differentiation. Neither geographical barriers in the Japanese archipelago nor phenological differences in reproductive timing affected the genetic population structure. Overall, these findings were consistent with the interpretation of genetic panmixia, providing evidence for high genetic connectivity across the population’s distribution. Considering the current knowledge about the distribution and life history of T. japonicus, we suggest that the panmictic status may reflect a metapopulation structure with source-sink dynamics and/or extensive gene flow across the distribution range.

Scientific Production Dynamics in mHealth for Diabetes: Scientometric Analysis.

The widespread use of mobile technologies in health care (mobile health; mHealth) has facilitated disease management, especially for chronic illnesses such as diabetes. mHealth for diabetes is an attractive alternative to reduce costs and overcome geographical and temporal barriers to improve patients' conditions. This study aims to reveal the dynamics of scientific publications on mHealth for diabetes to gain insights into who are the most prominent authors, countries, institutions, and journals and what are the most cited documents and current hot spots. A scientometric analysis based on a competitive technology intelligence methodology was conducted. An innovative 8-step methodology supported by experts was executed considering scientific documents published between 1998 and 2021 in the Science Citation Index Expanded database. Publication language, publication output characteristics, journals, countries and institutions, authors, and most cited and most impactful articles were identified. The insights obtained show that a total of 1574 scientific articles were published by 7922 authors from 90 countries, with an average of 15 (SD 38) citations and 6.5 (SD 4.4) authors per article. These documents were published in 491 journals and 92 Web of Science categories. The most productive country was the United States, followed by the United Kingdom, China, Australia, and South Korea, and the top 3 most productive institutions came from the United States, whereas the top 3 most cited articles were published in 2016, 2009, and 2017 and the top 3 most impactful articles were published in 2016 and 2017. This approach provides a comprehensive knowledge panorama of research productivity in mHealth for diabetes, identifying new insights and opportunities for research and development and innovation, including collaboration with other entities, new areas of specialization, and human resource development. The findings obtained are useful for decision-making in policy planning, resource allocation, and identification of research opportunities, benefiting researchers, health professionals, and decision makers in their efforts to make significant contributions to the advancement of diabetes science.

Challenges, Barriers, and Facilitators in Telemedicine Implementation in India: A Scoping Review.

Telemedicine has revolutionized healthcare access by breaking geographical barriers and facilitating remote consultations. The eSanjeevani platform has been pivotal in India, especially during the COVID-19 pandemic. Despite its benefits, implementing telemedicine faces various challenges and barriers. This scoping review aims to identifythese challenges, barriers, and facilitators in the Indian context. This review follows the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A comprehensive literature search was conducted using PubMed and Google Scholar to identify studies published between January 2019 and January 2024. Studies on telemedicine adoption, barriers, and facilitators in India were included. Data were extracted and synthesized from 26 quantitative, qualitative, and mixed-methods research studies. Individual-level challenges include limited digital literacy, particularly among older adults and those in rural areas, and health literacy issues. Barriers such as limited smartphone access, unreliable internet connectivity, and socio-cultural preferences for in-person consultations were identified. Facilitators at this level include family involvement, training programs, and community outreach. Provider-level challenges involve a lack of training and concerns about care quality, while barriers include insufficient infrastructure and medico-legal concerns. Facilitators include ongoing training, clear guidelines, and user-friendly telehealth systems. System-level challenges include integrating telemedicine into existing infrastructure and ensuring data security. Barriers include inadequate funding and resistance to change, while facilitators include policy support, investment in infrastructure, and collaborative efforts. Telemedicine holds great potential to enhance remote healthcare access in India, but its successful implementation requires addressing significant challenges and barriers. Strengthening digital infrastructure, enhancing digital literacy, standardizing protocols, and developing clear regulatory frameworks are essential. Collaborative efforts and tailored approaches that respect local cultures can further facilitate telemedicine adoption. Continuous research and public awareness campaigns are necessary to ensure telemedicine's sustainable and effective use in India.

Prolongation of the Time Window From Traumatic Limb Amputation to Replantation From 6 to 33 Hours Using Ex Vivo Limb Perfusion.

Continuous extracorporeal perfusion (ECP), or machine perfusion, holds promise for prolonged skeletal muscle preservation in limb ischemia-reperfusion injury. This study aimed to extend the amputation-to-replantation time window from currently 6 hours to 33 hours using a 24-hour ECP approach. Six large white pigs underwent surgical forelimb amputation under general anesthesia. After amputation, limbs were kept for 9 hours at room temperature and then perfused by 24-hour ECP with a modified histidine-tryptophan-ketoglutarate (HTK) solution. After ECP, limbs were orthotopically replanted and perfused in vivo for 12 hours. Clinical data, blood, and tissue samples were collected and analyzed. All 6 forelimbs could be successfully replanted and in vivo reperfused for 12 hours after 9 hours of room temperature ischemia followed by 24 hours ECP. Adequate limb perfusion was observed after replantation as shown by thermography and laser Doppler imaging. All pigs survived without severe organ failure, and no significant increase in inflammatory cytokines was found. Macroscopy and histology showed marked interstitial muscular edema of the limbs, whereas myofiber necrosis was not evident, implying the preservation of muscular integrity. The use of a 24-hour ECP has successfully extended limb preservation to 33 hours. The modified histidine-tryptophan-ketoglutarate perfusate demonstrated its ability for muscle protection. This innovative approach not only facilitates limb replantation after combat injuries, surmounting geographical barriers, but also broadens the prospects for well-matched limb allotransplants across countries and continents.

Health system barriers to hypertension care in Peru: Rapid assessment to inform organizational-level change.

Traditional patient- and provider-level hypertension interventions have proven insufficient to halt hypertension as the leading cause of morbidity and mortality globally. Systems-level interventions are required to address factors challenging hypertension control across a social ecological framework, an under-studied topic particularly salient in low- and middle-income countries (LMICs) such as Peru. To inform such interventions, we sought to identify key health systems barriers to hypertension care in Puno, Peru. A participatory stakeholder workshop (October 2021) and 21 in-depth interviews (October 2021-March 2022) were conducted with 55 healthcare professionals (i.e., doctors, nurses, midwives, dentists, nutritionists), followed by a deductive qualitative analysis of transcripts and notes. Participating healthcare providers indicated that low prioritization and lack of national policies for hypertension care have resulted in limited funding and lack of societal-level prevention efforts. Additionally, limited cultural consideration, both in national guidelines as well as by some providers in Puno, results in inadequate care that may not align with local traditions. Providers highlighted that patient care is also hampered by inadequate distribution and occasional shortages of medications and equipment, as well as a lack of personnel and limited opportunities for training in hypertension. Multiple incompatible health information systems, complicated referral systems, and geographic barriers additionally hinder continuity of care and care seeking. Insights gained from health providers on the healthcare system in Puno provide essential contextual information to inform development of organizational-level strategies necessary to improve provider and patient behaviors to achieve better hypertension care outcomes.

Teleoperated Magnetic Endoscopy: A Case Study and Perspective

Teleoperated robotic surgery is a rapidly growing field that promises to overcome geographical barriers and share expertise over long distances for a variety of minimally invasive procedures. A particularly promising technology for teleoperation is robotic magnetic navigation. In contrast to conventional surgical robots, a robotic magnetic navigation system generates external magnetic fields to safely and dexterously steer soft magnetic devices within the human body, enabling a versatile, economical, and accessible telesurgery platform for a variety of procedures. This perspective highlights the recent research efforts in robotic magnetic platforms for telesurgery and their translation to clinical settings in the context of endoscopic procedures. This discussion is supported by a case study performed at the Multi‐Scale Medical Robotics Center in Hong Kong, where an in vivo gastroscopy in a porcine model is performed in tandem with two operators, alternating between a clinician controlling the procedure from the operating room in Hong Kong and a remote expert controlling the procedure from an operator console in Zurich. The achievements and challenges of this study highlight the capabilities and future potential of robotic magnetic navigation for telesurgery.

Across a phylogeographic break in the Qinling Mountains-Huaihe River Line: Quaternary evolutionary history of a medicinal and edible homologous plant (Allium macrostemon) in China

Biogeographic barriers to gene flow are central to studies of plant phylogeography. There are many physical and geographic barriers in China, but few studies have used molecular ecological evidence to investigate the natural geographic isolation barrier of the Qinling Mountains-Huaihe River Line (QHL). Allium macrostemon is a precious Chinese perennial herb belonging to the Amaryllidaceae family. It is used as a food and medicine, with a variety of health and healing properties. Five SSR markers, three chloroplast DNA (cpDNA) markers (psbA-trnH, rps16 and trnL-F), one nuclear ribosomal DNA (nrDNA) marker (ITS), and simplified genome GBS sequencing were used to analyse the genetic diversity and structure of A. macrostemon. Combining SSR, cpDNA, nrDNA ITS data and GBS analysis results, we divided A. macrostemon populations into northern and southern groups, with the southern group further divided into southwestern and central-southeastern groups. Niche simulation results reveal that the distribution area of A. macrostemon will reach its maximum in the future. These data indicate that the regional separation of A. macrostemon has been maintained by the combined influence of a geographical barrier and Quaternary climate, and that the back-and-forth fluctuations of QHL and Quaternary climate have played an important role in this process. QHL acts as a north-south dividing line in phylogeography and population genetic structure, promoting physical geographic isolation. This study provides a theoretical basis for the conservation, development, and utilization of A. macrostemon resources. It further provides a reference for understanding the systematic geographical pattern of the large-scale spatial distribution of plants in China and enriches our understanding of Quaternary plant evolution in areas with complex terrain.

Pediatric subspecialty outreach clinics: reach and impact on access to care

BackgroundRecent research highlighting a shortage of pediatric subspecialists in the United States has shown wide variations in the distance from children to the nearest subspecialists but has not accounted for subspecialty outreach clinics, in which specialists may improve access in rural areas by periodically staffing clinics there. This study aimed to determine the impact of pediatric subspecialty outreach clinics on the driving times to the nearest pediatric subspecialists for children in Maine.MethodsThis cross-sectional study utilized administrative data on the schedule and location of pediatric subspecialty clinics in Maine in 2022 to estimate the driving time from each ZIP-code tabulation area to the nearest subspecialist, with and without the inclusion of outreach clinics. Using 2020 census data, we calculated the median and interquartile ranges of driving times for the state’s overall child population, as well as for children living in urban and rural areas.ResultsOf 207,409 individuals under 20 years old in Maine, 68% were located closer to an outreach location than to a clinical hub. Across the seven subspecialties offering outreach clinics, outreach clinics decreased median driving times to the nearest pediatric subspecialist by 5 to 26 minutes among all children, and by 16 to 46 minutes among rural children.ConclusionsPediatric subspecialty outreach clinics can substantially reduce the driving time to the nearest pediatric subspecialist , especially for children living in rural areas. The use of outreach clinics should be accounted for in research describing the geographic access or barriers to care. Expanding the number of outreach clinics should be considered by policymakers hoping to improve access.

Whole genome resequencing reveals the evolutionary history and geographic isolation of the eastern Asian Hickory (Carya)

Societal Impact StatementUnraveling the genetic intricacies and evolutionary history of Asian Hickories through advanced genome sequencing gives valuable insights into their ecological adaptations. Understanding the impact of historical dynamics, climate fluctuations, and geographical barriers on Asian hickories not only contributes to scientific knowledge but also empowers policymakers with evidence‐based decisions and guides conservationists in their efforts to protect vulnerable species. The identification of potential habitats, especially for the endangered Carya kweichowensis, offers a promising avenue for targeted conservation efforts, aligning with global initiatives to preserve Earth's precious biodiversity, but also ensures the conservation of a vital genetic reservoir for nut‐bearing economic tree species.SummaryBiogeographic characteristics of disjunct distribution play a vital role in plant geography and the endangered mechanism. The whole genome resequencing provides an opportunity to study the genetic relationship, population diffusion, and floristic evolution of disjunctive‐distribution flora. Based on the SNPs (single nucleotide polymorphisms) data generated by the whole genome deep resequencing of five EA (Eastern Asian) Carya species, we constructed the phylogenetic tree, genetic structure, and species distribution modeling to clarify the phylogenetic relationships and to predict the potential distribution area of EA Carya. Phylogenetic analysis of Carya revealed two distinct clades, separating EA Carya from NA (North America) Carya. C. kweichowensis, an endangered species, showed the lowest nucleotide diversity and the earliest divergence among studied EA Carya species. Species distribution modeling predicted suitable habitats for five EA Carya species, revealing the potential distribution of endangered C. kweichowensis. Importantly, minimal spatial overlap was observed among distribution regions of EA Carya species during different time periods. The uneven regional distribution of EA Carya is believed to be a consequence of Quaternary climate fluctuations, mountain barriers hindering species dispersal, and the limited cold tolerance of these trees. EA Carya highlights the significant role of climate and geological changes in their regional distribution and migration routes in Asia. Furthermore, the discovery of potential habitats offers a promising avenue for the conservation of C. kweichowensis.

No test medical abortion - a review of the evidence on selective use of preabortion testing.

The last decade has seen a cascade of different telemedicine models for medical abortion (MA) being tested and implemented. Among these service delivery models is the 'no-test' MA model, in which care is provided remotely and eligibility for the MA is based on history alone. The purpose of this review is to provide an overview of the existing evidence for no-test MA. The evidence base for no-test MA relies heavily on cohort and noncomparative studies predominantly from high resource settings. Recent findings indicate that no-test MA is safe, effective, and highly acceptable. Diagnoses of ectopic pregnancy and underestimation of gestational age were rare. Identified advantages included shortening time to access MA and mitigating access barriers such as cost, and geographical barriers. Abortion seekers valued omitting the ultrasound citing reasons such as privacy concerns, costs, more flexibility, and control. The impacts of no-test MA on unscheduled postabortion contacts and visits and on contraceptive use were unclear due to limited evidence. No-test MA can be provided to complement other care pathways including those with some or no in-person care. Further research is needed to allow for widespread adoption of no-test MA and scale-up in a variety of contexts, including low-resource settings.

Islands of ice: Glacier‐dwelling metazoans form regionally distinct populations despite extensive periods of deglaciation

AbstractAimGlaciers cover considerable portion of land and host diverse life forms from single‐celled organisms to invertebrates. However, the determinants of diversity and community composition of these organisms remain underexplored. This study addresses the biogeography, population connectivity and dispersal of these organisms, especially critical in understanding during the rapid recession of glaciers and increased extinction risk for isolated populations. By reconstructing the Quaternary biogeographic history of Fontourion glacialis, a widespread in Northern Hemisphere glacier obligate species of Tardigrada, we aim to understand how populations of glacier‐dwelling metazoans receive immigrants, respond to disappearing glaciers and to what extent remaining glaciers can serve as refugia.LocationGlaciers across Svalbard, Scandinavia, Greenland and Iceland.MethodsWe analysed mtDNA (COI gene) variability of 263 F. glacialis specimens collected across the distribution range. Phylogeographic and coalescent‐based approaches were used to detect population differentiation patterns, investigate most likely models of gene flow and test the influences of geographical and climatic factors on the distribution of F. glacialis genetic variants.ResultsOur findings indicate that the distribution of F. glacialis genetic variants is primarily influenced by geographical rather than climatic factors. Populations exhibit a dispersal‐limited distribution pattern, influenced by geographical distance and local barriers, even between neighbouring glaciers. Significantly, the genetic structure within Scandinavia suggests the existence of “southern” glacial or low‐temperature refugia, where F. glacialis may have survived a period of extensive deglaciation during the Holocene climatic optimum (8–5 kyr ago).Main ConclusionThe study uncovers complex metapopulation structures in F. glacialis, with impacts of local barriers, population bottlenecks as well as historical ice sheet fluctuations. It suggests that such populations can endure extended periods of deglaciation, highlighting the resilience of glacial refugia. The study highlights the necessity of understanding the diversity and population structure of ice‐dwelling fauna in both spatial and temporal contexts.

Understanding barriers to spinal cord injury rehabilitation services in Nepal: A qualitative study of rehabilitation professionals' perspectives.

This study aims to explore the perspectives of rehabilitation professionals regarding the barriers to spinal cord injury (SCI) rehabilitation services in Nepal. A qualitative study involved 15 rehabilitation professionals working in the Spinal Injury Rehabilitation Center in Nepal. After obtaining informed consent, in-depth semistructured interviews were conducted using Zoom and phone calls between June and July 2023. Braun and Clarke's thematic analysis approach was utilized to analyze the interviews and generate themes from the participants' responses. The participants represented nine different rehabilitation professions. Over half of them were female (53.33%), and 86.67% had one to 10 years of experience in SCI rehabilitation. From in-depth interviews, four themes depicting barriers to rehabilitation were identified: (a) resource constraints within the rehabilitation centers, (b) concerns related to finance, awareness, and support mechanisms, (c) systemic problems coupled with geographical and physical barriers, and (d) beliefs and practices influencing access and adherence to rehabilitation. Delivering effective rehabilitation services for people with SCI presents a range of barriers. Considering the critical importance of rehabilitation for this population, the findings underscore the necessity of engaging stakeholders at multiple levels, individuals, communities, and government agencies to address the identified barriers and improve rehabilitation services in Nepal. The implications of the findings are further discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Influence of Altitude, Urbanization, and Local Vaccination Centers on Vaccine Uptake within an Italian Health District: An Analysis of 15,000 Individuals Eligible for Vaccination.

In Italy, free vaccinations for Herpes Zoster (HZ), pneumococcal (PCV), and influenza (FLU) are recommended each year for individuals turning 65. Despite this, achieving optimal vaccination coverage remains challenging. This study assesses coverage rates for HZ, PCV, and FLU in Forlì, Northern Italy, and examines how altitude, urban planning, and health organization variables (such as the presence of a vaccination center) impact vaccine uptake. Vaccination coverages were calculated for birth cohorts between 1952 and 1958 for each municipality in the Forlì area as of 1 March 2024. The geographical factors influencing the vaccination uptake were extracted from the Italian National Institute of Statistics (ISTAT) records and evaluated through a multivariate analysis. The sample analyzed included 15,272 vaccine campaign targets from Forlì's province (185,525 citizens); the vaccine uptake rates for HZ, PCV, and FLU were 26.9%, 36.7%, and 43.5%, respectively. Gender did not appear to influence vaccine uptake. Living in a flat area appeared to increase vaccine uptake in a statistically significant way for all the vaccinations when compared to a mountainous area (HZ: OR: 1.50, PCV: OR: 1.33, FLU: OR: 1.67). The presence of a vaccine service in low-urbanized areas was shown to increase vaccine uptake for all vaccinations (HZ: OR: 1.65, PCV: OR: 1.93, FLU: OR: 1.53) compared with low-urbanized areas without a vaccination center or more urbanized areas with a vaccination center. This study emphasizes the significance of the territorial context, along with the ease of access to vaccinations and geographic barriers, as key determinants in achieving vaccination targets. Local health authorities should consider these factors when implementing vaccination campaigns.

Technological Developments, Exercise Training Programs, and Clinical Outcomes in Cardiac Telerehabilitation in the Last Ten Years: A Systematic Review.

Cardiovascular diseases (CVDs) are associated with very high rates of re-hospitalization and mortality worldwide, so the complexity of these pathologies requires frequent access to hospital facilities. The guidelines also emphasize the importance of cardiac rehabilitation (CR) programs, which have demonstrated a favorable effect on outcomes, and cardiac telerehabilitation (CTR) could represent an innovative healthcare delivery model. The aim of our review is to study how technologies used in rehabilitation have changed over time and also to understand what types of rehabilitation programs have been used in telerehabilitation. We searched randomized controlled trials (RCTs) in three electronic databases, PubMed, Web of Science, and Scopus, from January 2015 to January 2024, using relevant keywords. Initially, 502 articles were found, and 79 duplicates were identified and eliminated with EndNote. In total, 16 RCTs fulfilled the pre-defined criteria, which were analyzed in our systematic review. The results showed that after CTR, there was a significant improvement in main outcome measures, as well as in relation to technological advances. Moreover, compared to center-based rehabilitation, CTR can offer further advantages, with better cost-effectiveness, the breakdown of geographical barriers, and the improvement of access to treatment for the female population, which is traditionally more socially committed.

Seasonal migration patterns of Siberian Rubythroat (Calliope calliope) facing the Qinghai–Tibet Plateau

BackgroundSmall songbirds respond and adapt to various geographical barriers during their annual migration. Global flyways reveal the diverse migration strategies in response to different geographical barriers, among which are high-elevation plateaus. However, few studies have been focused on the largest and highest plateau in the world, the Qinghai–Tibet Plateau (QTP) which poses a significant barrier to migratory passerines. The present study explored the annual migration routes and strategies of a population of Siberian Rubythroats (Calliope calliope) that breed on the north-eastern edge of the QTP.MethodsOver the period from 2021 to 2023, we applied light-level geolocators (13 deployed, seven recollected), archival GPS tags (45 deployed, 17 recollected), and CAnMove multi-sensor loggers (with barometer, accelerometer, thermometer, and light sensor, 20 deployed, six recollected) to adult males from the breeding population of Siberian Rubythroat on the QTP. Here we describe the migratory routes and phenology extracted or inferred from the GPS and multi-sensor logger data, and used a combination of accelerometric and barometric data to describe the elevational migration pattern, flight altitude, and flight duration. All light-level geolocators failed to collect suitable data.ResultsBoth GPS locations and positions derived from pressure-based inference revealed that during autumn, the migration route detoured from the bee-line between breeding and wintering grounds, leading to a gradual elevational decrease. The spring route was more direct, with more flights over mountainous areas in western China. This different migration route during spring probably reflects a strategy for faster migration, which corresponds with more frequent long nocturnal migration flights and shorter stopovers during spring migration than in autumn. The average flight altitude (1856 ± 781 m above sea level) was correlated with ground elevation but did not differ between the seasons.ConclusionsOur finding indicates strong, season-dependent impact of the Qinghai–Tibet Plateau on shaping passerine migration strategies. We hereby call for more attention to the unexplored central-China flyway to extend our knowledge on the environment-migration interaction among small passerines.

Factors Associated with Delayed Presentation to the Hospital Among Breast Cancer Patients in Asian Countries : A Review

Introduction: Breast cancer constituted 13.6% of all reported new cancer in India, with a notable mortality rate due to late presentation. The current research aims to address the extent of delay in presentation to the hospital and the factors that contribute to delayed presentation among breast cancer patients. Methods: Comprehensive literature search was conducted through databases, including PubMed. Both quantitative and Qualitative studies were included. The database search yielded 17 articles and 4 articles were obtained through a manual search. The search was narrowed to article between 2014 to 2024 conducted in Asian countries. Results: A total of 21 studies were included. Among all the factors from patients and providers Knowledge and awareness about breast cancer is the major factor that contributed to delayed presentation to the hospital among breast cancer females as supported by qualitative studies. Across Asia, various other factors also contribute to delayed hospital presentation, including socioeconomic and demographic factors, cultural beliefs and stigma, healthcare system barriers, psychological and family support, use of alternative and complementary medicines, and physical and geographical barriers. Conclusion: Breast cancer is a prevalent cancer. The significant worry lies in delays in seeking medical attention and the tendency for individuals to present at advanced stages.

Geospatial Demand for Approved Cleft Care in the United States.

Geographic information systems are powerful tools for characterizing the geospatial factors influencing access to care. As patients with cleft lip and/or palate (CL/P) require long-term care, with numerous operations and therapies, access to timely, quality care is extremely important. This study uses population level analysis and geographic information systems to identify United States counties with limited access to American Cleft Palate Association-approved cleft teams. Natality data were queried from the National Vital Statistics System. Population and geographic data were obtained from the US Census Bureau. The Social Vulnerability Index (SVI) was utilized to account for social inequality. Total births with CL/P, population estimates, SVI, distance to the nearest center, and total centers within 50 km were used to generate the cleft care demand index (CCDI). Ninety-two counties had CCDIs between 66.7 and 100. The highest scoring county, Hidalgo County, Texas, had 62 births with CL/P, population estimate of 888,367 persons, distance to the nearest cleft center of 368.4 km, and SVI of 0.99. This study demonstrates the power of geographic information systems for identifying areas with limited access to approved cleft teams. The CCDI measures cleft burden, socioeconomic disadvantage, and geographic barriers to quantify the demand for approved cleft care in each county. Utilizing these scores can help direct future interventions, outreach efforts, and cleft care center planning.

Building a Community of Practice for Computer Science Educators in Nigeria: Strategies, Challenges, and Outcomes

This study explores the development and impact of a community of practice (CoP) among computer science educators in Nigeria. With the increasing demand for effective computer science education, there is a critical need for collaborative networks that support professional growth and pedagogical innovation. This research employs a mixed-methods approach, involving surveys and interviews with educators across various regions of Nigeria, to assess the current state of collaboration, identify barriers, and evaluate the outcomes of participating in a CoP. The findings reveal significant improvements in teaching practices, professional satisfaction, and student outcomes. However, challenges such as resource limitations and geographical barriers persist. The study offers actionable recommendations for policymakers and educational institutions to foster and sustain these communities. The implications of this research underscore the potential of CoPs to transform computer science education in Nigeria.