Partial credit scoring, introduced with the Next Generation NCLEX (NGN), aims to better measure clinical judgment and knowledge. This project evaluated the impact of partial credit scoring on unit exam performance for students repeating a third-semester prelicensure nursing course asking: Is partial credit scoring a helping hand, or a crutch? A retrospective, comparative design was used to analyze unit exam scores of repeating students across two semesters: Fall 2024 using traditional scoring and Spring 2025 using NGN-aligned partial credit models. Paired samples t-tests were used for analysis. Statistically significant score improvements were found across all four unit exams (p < .05). However, repeating students' averages did not consistently exceed the overall cohort average. Partial credit scoring improved student exam performance measurement without evidence of grade inflation. Findings suggest this scoring method supports more accurate assessment, making it a pedagogically sound option for nursing education programs.

Patient portals provide patients with access to their health information, including medical history and conditions, lab results, and upcoming appointments and ability to message their care team. However, not all patients have access to their portal. A cross-sectional survey of 233 adult family medicine patients from 4 community health clinics and a local community organization was conducted. The survey assessed patient demographics, internet usage, device ownership, and engagement with patient portals. Nearly half (47%) of patients had never accessed any portal, whether their own, a friend's, or family member's. Among patients without home internet, 66% had never used a portal. 36% of laptop owners, 37% of desktop owners, and 34% of tablet owners had never used a portal. Across different self-identified identities, 46% of White patients, 41% of Black patients, and 53% of Hispanic/Latino patients had never used a portal. Among English speakers, 42% had never used a portal, compared with 59% of Spanish speakers. Roughly one-third (32%) of patients were interested in portal training, with more than half preferring individualized training. Significant disparities in patient portal access exist in safety net practices. In addition to limited access to digital technology, lack of awareness of portal benefits and lack of clinician discussion and assistance likely contribute to inequities. Many patients desire individual portal training.

This article presents qualitative findings from interviews with participants in an outdoor activity programme aimed at assisting them to alleviate symptoms of military-related post-traumatic stress disorder (PTSD). Aside from exploring if and how participants felt the programme helped them manage their PTSD symptoms, the study also sought to identify factors that may help to inform future programme development. Thematic analysis of transcripts drawn from semi-structured interviews focused on respondents’ reflections on programme participation, early life experiences, military and post-military experiences, and mental health issues. The results supported the conclusion that the outdoor activities in a natural environment provided participants with a setting redolent of previously positive military experience, in which these former soldiers felt they could safely reveal and discuss troubling mental health and military matters, without fear of stigma. They also reported the benefits of the calm, tranquil environment aiding not only openness with peers but providing immediate beneficial effects on feelings of safety, sleep, and subsequent wellbeing. Conclusions indicate that such nature-based interventions may be a useful adjunct in the toolbox of treatments striving to reduce military-related PTSD symptomology.

Non-progressive neurological conditions such as cerebral palsy, childhood stroke, brain tumors, and traumatic brain injury commonly impair movement, balance, posture, speech, and swallowing, with speech and swallowing difficulties affecting up to 80% of children with developmental delay. These complex clinical conditions place a significant burden on children and their caregivers, leading to long-term physical, psychological, social, and economic challenges that markedly reduce quality of life. This qualitative study aimed to explore the psychosocial experiences of mothers caring for children with speech and swallowing difficulties associated with non-progressive neurological disorders in Pakistan. Face-to-face semi-structured interviews were conducted with 25 purposively selected mothers enrolled in the Person with Disability Program at the Helping Hand Institute of Rehabilitation Sciences, Mansehra. Interviews lasted approximately 45 minutes, were audio-recorded with informed consent, and analyzed using interpretative phenomenological analysis. The findings highlight that mothers experience extensive psychosocial difficulties, often compounded by inadequate family and societal support. The study concludes that caregivers of children with speech and swallowing difficulties in a developing country context face multidimensional challenges, underscoring the need for comprehensive, family-centered rehabilitation and psychosocial support programs to enhance caregiver well-being and improve child care outcomes.

The existence of Artificial Intelligence (AI) can be seen in everyday scenarios. Nowadays, the produced data by bothmachine and human is overwhelming in which exceeded the ability of humans to understand and digest to makedecisions depending on that data. Thus, a hand of help from AI is needed to overcome such challenges. The 5G LTEcommunication system is a promising solution to provide a high user experience in terms of the provided speed,amount of data, and cost. However, and due to its complexity, the technology of LTE needs some improvement interms of resource management and optimization. With the aid of AI, these two challenges can be overcome. In thispaper, the AI represented by improved Q-learning algorithm with the Self-Organizing Network (SON) concept inLTE will be used to manage and optimize Handover (HO) parameters and process in the system. The ns-3 simulatorresult shows that AI managed to improve and optimize the LTE system performance.

Abstract Background Artificial Intelligence (AI) has revolutionized healthcare, offering opportunities to improve decision-making and patient outcomes. However, dependency on AI among health professionals and students raises concerns regarding its role in healthcare delivery. This study aimed to develop and validate a scale to assess AI dependency among healthcare professionals and students, exploring its dual role as a “Helping Hand” or “Barrier”. Methodology A mixed-methods study was conducted in two steps. The qualitative phase in-depth interviews and group discussions were conducted with healthcare professionals and students to identify factors influencing AI dependency. The findings helped to develop a preliminary scale with 7 items. In the quantitative phase, the scale was tested on a larger sample ( n = 374) for psychometric evaluation. The Reliability and validity was assessed using Cronbach’s alpha and conformatory factor analysis. Results The outcome measure consists of excellent reliability (Cronbach’s alpha = 0.799). The factor analysis (ANOVA, t test) is confirmed to be a good model with a significant p value of 0.000. The study findings show that the outcome measure is reliable and valid to evaluate the AI dependency in students and healthcare professionals. Conclusion The newly developed scale is a reliable and valid tool for assessing AI dependency among health professionals and students. Insights from this scale can guide strategies to balance AI integration, ensuring it serves as a helping hand rather than a barrier in healthcare.

Intraoperative ultrasound (IOUS) is an increasingly adopted adjunctive intraoperative visualization method in spinal tumor surgery, offering real-time imaging that improves lesion localization, exposure planning, and resection control. This paper focuses on IOUS findings in rare intradural entities (neuroenteric/respiratory cysts, chronic spinal subdural hematoma, tethered cord/scarring, intradural extramedullary hemangioblastomas, and arachnoid cysts) where evidence remains limited. Across these lesions, IOUS typically depicts cysts as anechoic or hypoechoic cavities with definable walls and occasional septations; CSSDH is also delimited by hypoechoic subdural collections bounded by echogenic membranes; hemangioblastomas, as well as circumscribed, homogeneous nodules often with cystic components; and arachnoid webs/cysts with their boundaries and subtle subarachnoid communications. Doppler and micro-Doppler can delineate feeding and draining vessels in highly vascular tumors, while shear wave elastography provides quantitative stiffness changes that support effective detethering. IOUS complements preoperative MRI, shortens exposure, helps tailor bone and dural openings, and allows immediate assessment of residual disease. Taken together, current data and our experience support IOUS as a safe, cost-effective, and versatile intraoperative tool for rare intradural spinal pathology, while underscoring the need for prospective studies to refine sonographic criteria and validate outcome benefits.

2.83 “Motivation Requires a Helping Hand”: Piloting a Contingency Management–Based Substance Use Intervention Tailored To Young Adults Experiencing Homelessness

Background: Stroke frequently results in postural instability, gait impairment, and elevated fall risk due to hemiplegia and associated neuromuscular deficits, necessitating effective rehabilitative strategies to restore function and independence. Mirror therapy (MT) and modified constraint-induced movement therapy (mCIMT) are interventions proposed to enhance neuroplasticity and motor recovery, yet their comparative efficacy for lower limb rehabilitation remains insufficiently defined. Objective: To compare the effects of mirror therapy and modified constraint-induced movement therapy on risk of fall, balance, and gait in individuals with subacute and chronic stroke. Methods: In this single-blind randomized controlled trial conducted at the Helping Hand Comprehensive Physical Rehabilitation Program, Mansehra, Pakistan, from September 2023 to February 2024, 36 stroke patients aged 21–47 years were randomly allocated to MT (n=18) or mCIMT (n=18) groups. Participants received respective interventions thrice weekly for eight weeks. Outcomes were assessed at baseline, 2nd, 4th, and 8th weeks using the Berg Balance Scale (BBS), 10-Meter Walk Test (10MWT), and Performance-Oriented Mobility Assessment (POMA). Data were analyzed with mixed ANOVA and one-way ANOVA. Results: Both groups showed significant within-group improvements across all outcomes (p&lt;0.001). Between-group comparisons revealed superior improvements in mCIMT for gait speed (10MWT) and balance (POMA) at later time points, while early improvements were comparable. Conclusion: Both MT and mCIMT effectively improve balance, gait, and fall risk post-stroke, but mCIMT demonstrates greater efficacy, supporting its clinical application in lower limb rehabilitation. Keywords: Stroke, Mirror Therapy, Modified Constraint-Induced Movement Therapy, Balance, Gait, Fall Risk

Background: Cerebral palsy (CP) is the leading cause of childhood motor disability, often associated with impaired, poor balance and spasticity, which limits daily activities and reduces quality of life. Treadmill training has emerged as a promising therapeutic intervention aimed at enhancing these impairments. Objective: To evaluate the effects of treadmill training on motor function, balance, and Spasticity in Spastic CP children Methods: The randomized control trial was conducted at Helping Hand Comprehensive Physical Rehab Centre, Lower Dir, from June 2024 to January 2025. A total of n=36 children with spastic CP aged 4-12 with GMFCS levels I and II were included in the study. The GMFCS, pediatric balance scale (PBS), and modified Ashworth scale (MAS) were used to assess motor function, balance, and spasticity. Out of n=36 CP children, n=18 individuals received treadmill training along with conventional therapy, and n=18 received conventional therapy only. The assessments were done at the beginning, after 4 weeks, 8 weeks, and 12 weeks of training. Results: The mean age of 8.17±2.21 years, having 42.6% male and 24.15% female. A non-significant interaction effect between intervention and time effect on spasticity {F(3,102)=0.81, p=0.489, ηp²=0.02} measured by modified Ashworth scale. While in PBS {F(3,102)=36.41, p=0.489, ηp²=0.517} significant interaction effect observed. Regarding motor functions, the Friedman test did not indicate overall significant (p≥0.05) change in GMFCS scores over time in both the experimental and control groups, and Wilcoxon signed-rank tests also confirmed insignificant (p≥0.05) changes between adjacent time points. Conclusion: Progressive treadmill protocol when combined with conventional therapy, can produce clinically meaningful improvements in balance and spasticity in children with CP, even though it may not alter gross motor function classification in the short term. Keywords: balance; cerebral palsy; motor function; spasticity; treadmill training. Clinical Trail #: NCT06463301

IntroductionVirtual fracture clinics (VFCs) were established to improve the efficiency of orthopedic care by reducing unnecessary face-to-face consultations, decreasing waiting times, and providing timely specialist advice. This study aims to evaluate the utilization of the VFC at Addenbrooke’s Hospital, Cambridge University Hospital NHS Foundation Trust (Cambridge, GBR), over 12 months and assess its effectiveness in managing patients referred from emergency departments and minor injury units.MethodsThis retrospective study included all patients referred to the VFC between January 2023 and January 2024. Data were collected from hospital electronic records and analyzed using SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA). Patients were assessed by a consultant orthopaedic surgeon based on referral details and imaging findings. Clinical outcomes were documented as face-to-face consultation, discharge with patient-initiated follow-up (PIFU), or referral to subspecialty clinics.ResultsA total of 5,034 patients were reviewed by the VFC. The most common injuries involved the wrist, hand, foot, ankle, shoulder, and knee. Of the total patients, 62% were discharged with PIFU, while 30.4% required face-to-face consultation. Among patients initially discharged with PIFU, 16.9% were subsequently rebooked into subspecialty clinics for further evaluation. Statistical analysis demonstrated a significant association between injury type and VFC outcome, indicating a moderate effect size.ConclusionsThe VFC model effectively managed a substantial proportion of patients referred from emergency departments and minor injury units, providing safe and efficient care while reducing the burden on traditional fracture clinics.

Viral suppression is essential for individuals living with HIV, as it is linked to improved clinical outcomes and long-term health. Research has documented age and racial disparities in HIV viral suppression. Men who have sex with men (MSM) are particularly affected by HIV infections, especially in the Southern United States. Studies indicate that substance use among people with HIV in the U.S. presents significant barriers to engaging in HIV care. This study investigated the relationships between age, race, MSM status, and viral suppression among men living with HIV (MLWH), who participated in the Helping HAND program at an academic medical center in a Southern state. The analysis included 746 male participants, primarily Black/African American. The results showed that increases in age were positively associated with a greater likelihood of viral suppression, even after adjusting for harmful or hazardous drinking, problematic substance use, race, and MSM status. Younger MSM participants were less likely to achieve viral suppression than older MSM participants. In this male only sample, neither race nor MSM status was found to be related to viral suppression. Additionally, harmful or hazardous drinking and problematic substance use did not moderate the associations between age, race, or MSM and viral suppression. These findings highlight disparities in viral suppression across different age groups among men living with HIV. The results emphasize the need for targeted outreach initiatives specifically designed for younger age cohorts living with HIV, including MSM.

The crucial role of plant–microbe interactions in seagrass growth and overall fitness is widely recognized and known to influence plant response to stress. Human-induced changes in coastal ecosystems necessitate efficient descriptors for seagrass monitoring. Recently, for Posidonia oceanica meadows, an integrative approach combining ecophysiological descriptors with bacterial communities has been successfully applied. Conversely, the mycobiota remains largely unexplored and fungal communities cannot be included yet as a putative descriptor. This study aims to evaluate the ecological status of two P. oceanica meadows in the Akrotiri Bay (Cyprus), located under different geomorphological features (depth and seabed type) and degrees of human pressure (port proximity vs. Marine Protected Area). A set of descriptors including morphometry, biochemical markers and bacterial communities collected in 2023 are compared with those collected, at the same sites, in 2017. Furthermore, the investigation of the leaf-associated microbial community included the underrepresented fungal communities, in addition to the bacterial ones, to evaluate their usefulness in evaluating the plant conservation status. Results indicated a good P. oceanica conservation status at both sites, showing an amelioration in the Limassol port meadow from 2017. In 2023, the biometrical/biochemical descriptors were found comparable across sites as the bacterial communities, differing from 2017 results. Noteworthy, fungal communities exhibited significant differences between sites, with a clear reduction, in the Limassol port meadow, of the dominant Posidoniomyces atricolor which is known as a specific colonizer of P. oceanica roots. These results confirm the strong relationship between P. atricolor and P. oceanica host, and suggest its sensitivity to environmental changes, able to keep track of ecological shifts.

BackgroundNon-suicidal self-injury (NSSI) is a common and serious mental health concern among young adults. It is also highly stigmatised, which can impede disclosure and recovery. To advance the literature on NSSI stigma, we explored what young adults who self-injure believe different age-groups (i.e., young adults, parents, middle-aged, and older adults) think about NSSI and people who self-injure.MethodParticipants (n = 187) with a mean age of 19.07 (SD = 1.52) took part in an online survey and answered open-ended questions about the above beliefs. Responses were examined via reflexive thematic analysis.ResultsFindings yielded three primary themes namely: They Just Don’t Get It, Ignorance is Bliss, and Willing to Lend a Helping Hand. Overall, our results indicate that all age-groups asked about are believed to harbour stigmatising views (e.g., NSSI is selfish and attention-seeking, people who self-injure are weak and crazy). Perceptions regarding the prominence of these beliefs, however, varied across age-groups.ConclusionExpectancy beliefs and differences in anticipated stigma across age groups may stem from prior experiences with others and may play a role in disclosure. The present findings thus have implications for research, anti-stigma initiatives, and supportive practices.

By Mark Lee, Mark W Ashton. Surgeons providing a second opinion after an adverse outcome should be guided by the four pillars of medical ethics to help ensure they act for the benefit of their patients.

Background: The empowerment of women is contingent upon the attitudes of both women and men, especially when there is no opposition from men. The project study sought to explore the barriers that hinder women to challenge themselves to be capable for their own development. The study, in the form of a social analysis, was initiated along with a project that served as a social action, within the period of 2021–2023. It was a collaboration between Mama’s Helping Hand community-based group, which emanated from the support of ASA International to the two women’s groups in Bosore and Abriem communities (Salvation Army Group and Amazing Grace Group respectively). Methods. The study employed a qualitative approach, which involved 40 women aged between 20 and 65 years. Non-probability sampling was adopted, in regards to purposive sampling and snowball sampling for focus group discussions (10 participants each for 4 groups). A vignette design for an open-ended structured discussion guide was used for data collection. The process was framed within the characteristics and principles of Participatory Action Research (PAR). Thematic analysis was employed, in which the retrieved data were transcribed and coded. Subsequently, the data were interpreted by sorting them into broad themes per the 9 central human functional capabilities of Martha Nussbaum, and their subtopics. One of the 10 human capabilities, being the 8th (other species: to live with animals/plants and concern for), was omitted as the study goal did not focus on the women’s ability to live with the world of nature. Results. The data discovered how the actions of the communities and existing barriers that conform to the system of the communities which recognized social institutions tend to limit the women’s capabilities to be empowered. Such existing barriers include traditions, gendered values and roles that create gender hierarchy, lack of family support, and religious practices that build submissive women. Some of the women hold barriers like traditions and gender roles high esteem, as some do not. In such cases, social expectations and the actions of the local people that are based on locally held beliefs, make the women face difficulties to decide and perform paid jobs aside from their domestic responsibilities. Stigmatization happens to both men and women. Those of the women, who choose to go against the gendered traditional practices, are sometimes stigmatized. At the same time, the men, who choose to support and empower their wives to be economically active, are also stigmatized. Wise sayings were revealed as a heritage of their traditions, which administer the femininity of females and the masculinity of males in the communities, as the people are socialized as such. Conclusion. The concept of women empowerment is also significant to the consideration of the role of men. This is because the involvement of men will enable them to gain the necessary understanding of the positive aspects of women’s development and the negative consequences that may arise when women remain underdeveloped.

Introduction. Support is defined as an action addressed to an individual or a group, which fosters overcoming difficult situations. It is a form of assistance consisting in mobilizing the strengths of the supported person for action, building self-confidence and triggering predispositions to overcome difficulties. With respect to the experience of caring for a chronically ill patient, social support can make a significant difference. Aim. The aim of the study was to determine the social support of caregivers of people with multiple sclerosis. Material and Methods. The study group consisted of 107 caregivers. The study was conducted at the Department of Neurology with Cerebral Stroke Subdivision of the John Paul II Subcarpathian Regional Hospital in Krosno, the Department of Neurology and Cerebral Stroke and the Department of Neurological Rehabilitation with General Rehabilitation Subdivision of the L. Rydygier Specialist Hospital in Krakow and the Helpful Hand Foundation in Kraków. A diagnostic survey method using the Berlin Social Support Scale (BSSS) and the Author’s Survey Questionnaire was used. Approval for the study was obtained from the Bioethics Committee No. 176/KBL/OIL/2018. Results. According to the Berlin Social Support Scale, there was a statistically significant difference p=0.0256 between the age of the respondents and the support currently provided. The results showed a statistically significant difference p=0.0067 between respondents’ marital status and support-seeking. Gender, place of residence education and income did not statistically significantly differentiate the social support of caregivers. Statistically significant differences were found between the duration of MS and the caregiver support currently provided and currently received, and between mental illness in the course of MS in patients and the buffering and protective support of caregivers. Conclusions. Social support is one of the resources for coping with difficult, stressful situations related to the course of the disease, which can be conditioned by various factors, including sociodemographic variables or the duration of the disease. (JNNN 2024;13(4):139–146)

In this article, I present the first comprehensive study in Russian historiography of the Obukhov Steel-Foundering Works of the Naval Ministry and its role in supplying the Russian army with artillery goods and products during the First World War. I explore how the plant created new types of guns and shells, developing production to meet the troops' urgent needs for essential combat means. I analyze the extent of the enterprise’s participation in supplying the front with artillery systems, ammunition, and optical instruments.

It was all because of Anne Tsui's vision, leadership, and never-exhausted energy that nurtured MOR to be born out of a scholarly scratch. I happened to be within proximity to lend her a helpful hand.

Background: Farmers are particularly exposed to a large number of allergens including fertilizers, plant allergens, soil, and manure which may be aggravated by sun exposure. Hand eczema can cause significant morbidity affecting the patient’s occupational work. Patch test is an important diagnostic tool in differentiating between irritant contact dermatitis and allergic contact dermatitis and in the latter, to identify the culprit allergen causing hand eczema. Aims: This study aimed to identify the role of patch tests in hand eczema in farmers and to identify the common causative allergens of hand eczema in farmers. Materials and Methods: Fifty farmers aged 18 years and above presenting with hand eczema were enrolled in the study after taking approval from the institutional ethics committee. Patients who were pregnant, lactating, on systemic steroids, and immunosuppressants were excluded from the study. Patch test was done using the Indian Standard series of 20 allergens approved by the Contact Dermatoses Forum of India applied to the back of the patient. The first reading was taken at 48 h, 30 min after removal of the patch, and another reading was taken at 96 h. The results were interpreted according to the International Contact Dermatitis Research Group criteria. Results: Out of 50 patients, there were 28 males and 22 females. Hyperkeratotic eczema was the most common morphology (38%). The most common allergen was parthenium (44%) followed by potassium dichromate (22.7%) and nickel (9%). Limitations: A larger sample size would have helped to better substantiate the findings of the study. Conclusion: There is an undeniable relationship with the occupation of the individual wherein agriculturists and masons had the maximum predisposition. The most common cause of hand eczema in this study was parthenium in farmers and also other allergens played an important role such as potassium dichromate, nickel, and paraphenylenediamine.