Higher Scores Research Articles

Factors Associated with Persisting Post-Concussion Symptoms Among Collegiate Athletes and Military Cadets: Findings from the NCAA-DoD CARE Consortium.

Persisting post-concussion symptoms (PPCS) is a condition characterized by prolonged recovery from a mild traumatic brain injury (mTBI) and compromised quality of life. Previous literature, on the basis of small sample sizes, concludes that there are several risk factors for the development of PPCS. We seek to identify protective and risk factors for developing slow recovery or persisting post-concussion symptoms (PPCS) by analyzing medical history, contact sport level, setting, and the Sport Concussion Assessment Tool (SCAT) and Brief Symptom Inventory (BSI-18) assessments at baseline and post-injury. We studied 47,860 unique collegiate athletes and Military Service Academy (MSA) cadets enrolled in the 30-site National Collegiate Athletic Association and Department of Defense (NCAA-DoD) Concussion Assessment Research and Education (CARE) Consortium prospective cohort study of baseline and post-injury data from 2014 to 2019. Medical histories and preseason baselines (n = 60,720), along with SCAT and BSI-18 examinations (n = 5379) conducted within 48h post-injury, were analyzed. PPCS is defined as cleared for return to play (RTP) > 29days. Of 5073 concussions, the median (95% CI) and mean (SD) RTP were 15.2 (4.8-82.6) days and 22.2 (23.0) days, respectively, with 891 developing PPCS. Sex, high SCAT score, high BSI-18 score, and delayed reporting produced small effect sizes on RTP (d = 0.22-0.44). Adjusted odds ratios (OR) of developing PPCS indicated the following risk factors: SCAT total score > 45 (OR = 1.91, 95% CI: 1.58-2.30), female sex (OR = 1.80, 95% CI: 1.53-2.13), concussion history (OR = 1.80, 95% CI: 1.29-2.52), and delayed reporting (OR = 1.42, 95% CI: 1.20-1.67). In contrast, protective factors against developing PPCS were: being a limited-contact (OR = 0.34, 95% CI: 0.25-0.47), noncontact (OR = 0.35, 95% CI: 0.24-0.51) or contact sport athlete (OR = 0.34, 95% CI: 0.28-0.41); and receiving the concussion at practice (OR = 0.64, 95% CI: 0.53-0.77) or in competition (OR = 0.44, 95% CI: 0.34-0.56). Athletes diagnosed with a learning disability and taking a neurostimulant were more protected than those who were not (OR = 0.44, 95% CI: 0.26-0.76 versus OR = 0.72, 95% CI: 0.49-1.05, respectively). A prognostic model using these variables offers poor sensitivity (9%) but high specificity (98%) in identifying PPCS (AUC = 0.72). This study of 5073 concussions indicates that female sex, high symptom burden, and prior concussion are risk factors for slow recovery. In addition, learning disability, contact sport, and concussion in competition are protective against slow recovery. The neurostimulant results suggest that clinicians should keep their attention deficit disorder (ADD) and attention-deficit/hyperactivity disorder (ADHD) patients on their current neurostimulant medication after a concussion. A prognostic logistic regression model based on behavioral clinical findings did a poor job of identifying PPCS.

Neural Radiance Fields for High-Fidelity Soft Tissue Reconstruction in Endoscopy.

The advancement of neural radiance fields (NeRFs) has facilitated the high-quality 3D reconstruction of complex scenes. However, for most NeRFs, reconstructing 3D tissues from endoscopy images poses significant challenges due to the occlusion of soft tissue regions by invalid pixels, deformations in soft tissue, and poor image quality, which severely limits their application in endoscopic scenarios. To address the above issues, we propose a novel framework to reconstruct high-fidelity soft tissue scenes from low-quality endoscopic images. We first construct an EndoTissue dataset of soft tissue regions in endoscopic images and fine-tune the Segment Anything Model (SAM) based on EndoTissue to obtain a potent segmentation network. Given a sequence of monocular endoscopic images, this segmentation network can quickly obtain the tissue mask images. Additionally, we incorporate tissue masks into a dynamic scene reconstruction method called Tensor4D to effectively guide the reconstruction of 3D deformable soft tissues. Finally, we propose adopting the image enhancement model EDAU-Net to improve the quality of the rendered views. The experimental results show that our method can effectively focus on the soft tissue regions in the image, achieving higher fidelity in detail and geometric structural integrity in reconstruction compared to state-of-the-art algorithms. Feedback from the user study indicates high participant scores for our method.

COVID-19 with woman academicians' perspective in Türkiye: Hopelessness and well-being

This study aimed to determine the hopelessness and well-being levels of woman academics during the COVID-19 pandemic. This cross-sectional and analytical study was conducted online between February and May 2022 at the end of the fourth wave of the COVID-19 pandemic. The study was conducted with 341 woman academics from state and foundation universities in Türkiye. The mean score from the Beck Hopelessness Scale was 6.02 ± 4.84, and the mean score from the Flourishing Scale (FS) was 43.50 ± 7.24. There was a significant negative correlation between flourishing scores and low, mild, moderate, and high hopelessness scores (p = .038, p < .001, p = .001, p = .034, respectively); as participants’ level of hopelessness increases, their FS scores decrease significantly (r: −.689, p < .001). Revealing the effects of changes in the routine and academic activities of woman academics on hopelessness and well-being during the COVID-19 pandemic process has the potential to reduce possible risks that may develop in pandemics, and contribute to reducing the hopelessness levels and increasing well-being of woman academics.

Towards a Greener Future: Using DEMATEL-ANP for Sustainable Indonesian Fiber Cement Board Manufacturing Company

The Indonesian fiber cement board industry faces increasing pressure to enhance sustainability due to growing environmental global concerns and regulatory demands. The companies in this sector must address multiple sustainability criteria such as waste management, resource utilization, and compliance with environmental regulations to remain competitive and sustainable. However, identifying which criteria are the most influential in driving overall sustainability outcomes presents a challenge. Previous studies have often examined these criteria in isolation, without considering their interdependencies. To address this gap, this study integrates the Delphi method with DEMATEL and ANP to analyze and prioritize key sustainability criteria for a fiber cement board company. By developing a comprehensive framework, this research aims to provide actionable insights that will help companies enhance their sustainability performance. In this research, PT. XYZ, a well-known fiber cement board manufacturer in Central Java, Indonesia, was used as a case study. The result shows that the DEMATEL-ANP method reveals that waste management, compliance with environmental regulations, and resource and material management are the most critical criteria, with high prominence and influence scores. These findings suggest that focusing on these critical areas first, followed by processing other criteria accordingly, can significantly enhance the company’s sustainability performance.

Construction of the bromodomain-containing protein-associated prognostic model in triple-negative breast cancer

BackgroundBromodomain-containing protein (BRD) play a pivotal role in the development and progression of malignant tumours. This study aims to identify prognostic genes linked to BRD-related genes (BRDRGs) in patients with triple-negative breast cancer (TNBC) and to construct a novel prognostic model.MethodsData from TCGA-TNBC, GSE135565, and GSE161529 were retrieved from public databases. GSE161529 was used to identify key cell types. The BRDRGs score in TCGA-TNBC was calculated using single-sample Gene Set Enrichment Analysis (ssGSEA). Differential expression analysis was performed to identify differentially expressed genes (DEGs): DEGs1 in key cells, DEGs2 between tumours and controls and DEGs3 in high and low BRDRGs score subgroups in TCGA-TNBC. Differentially expressed BRDRGs (DE-BRDRGs) were determined by overlapping DEGs1, DEGs2 and DEGs3. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and protein-protein interaction (PPI) network analysis were conducted to investigate active pathways and molecular interactions. Prognostic genes were selected through univariate Cox regression and least absolute shrinkage and selection operator (LASSO) regression analyses to construct a risk model and calculate risk scores. TNBC samples from TCGA-TNBC were classified into high and low-risk groups based on the median risk score. Additionally, correlations with clinical characteristics, Gene Set Enrichment Analysis (GSEA), immune analysis, and pseudotime analysis were performed.ResultsA total of 120 DE-BRDRGs were identified by overlapping 605 DEGs1 from four key cell types, 10,776 DEGs2, and 4,497 DEGs3. GO analysis revealed enriched terms such as ‘apoptotic process,’ ‘immune response,’ and ‘regulation of the cell cycle,’ while 56 KEGG pathways, including the ‘MAPK signaling pathway,’ were associated with DE-BRDRGs. A risk model comprising six prognostic genes (KRT6A, PGF, ABCA1, EDNRB, CTSD and GJA4) was constructed. A nomogram based on independent prognostic factors was also developed. Immune cell abundance was significantly higher in high-risk group. In both risk groups, TP53 exhibited the highest mutation frequency. The expression of KRT6A, ABCA1, EDNRB, and CTSD went decreased progressively in pseudotime.ConclusionA novel prognostic model for TNBC associated with BRDRGs was developed and validated, providing fresh insights into the relationship between BRD and TNBC.

The association of dietary approaches to stop hypertension measured by the food frequency questionnaire with metabolic syndrome and some inflammatory biomarkers in adolescents with obesity: a case-control study

BackgroundGlobally, obesity trends are a serious public health concern. Adolescent obesity is associated with cardiometabolic risk and metabolic disorders in adolescence and may persist into adulthood. The current study was designed to explore the Dietary Approaches to Stop Hypertension (DASH) in adolescents and its relationship with obesity, insulin resistance, metabolic syndrome (MetS), and some inflammatory biomarkers.MethodsA total of 90 adolescents with obesity and 90 adolescents with normal weight, participated in the study. Data from a validated 168-item semi-quantitative food frequency questionnaire were used to calculate the DASH score. The association of DASH score with cardiometabolic risk factors was estimated using multivariable logistic regression models. To assess the correlation between the DASH score and dietary factor, the Pearson correlation coefficient (r) was used.ResultsAdolescents with a high DASH score had significantly higher intakes of potassium, magnesium, vitamin C, and vitamin K and lower intakes of sodium compared with those with a low DASH score (P < 0.05 ). There were no significant differences in the DASH score and its components between adolescents with and without metabolic syndrome. Adolescents with metabolic syndrome had significantly higher concentrations of triglycerides, low HDL-C, and high blood pressure compared with those without metabolic syndrome (P < 0.05). There were no significant associations between DASH score and MetS and other cardiometabolic risk factors in crude and multivariate-adjusted models. In addition, the DASH score was positively associated with potassium, magnesium, sodium, vitamins D and C, docosahexaenoic acid, and soluble fiber (P < 0.05).ConclusionIn the current study, there was no significant association between adherence to the DASH diet and odds of metabolic syndrome, and other cardiometabolic risk factors in adolescent. Further prospective studies are needed to confirm these findings.Trial registrationEthics approval was obtained from the research ethics committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1397.179.).

Integrated Volume Card Game Make A Match Learning Model: Improving Motivation of Learning Outcomes of the Concept of Spatial Building

Purpose of the study: This study aims to design, develop, and evaluate the effectiveness of an innovative interactive learning medium, a volume card game integrated with the Make a Match cooperative learning model, to enhance students' conceptual understanding of volume in mathematics. Methodology: Using an ADDIE model (Analysis, Design, Development, Implementation, Evaluation). Data collection tools included pretest-posttest questionnaires, expert validation sheets, and N-Gain analysis to assess the media’s validity and learning effectiveness. Statistical analysis, including the Paired Samples T-Test, was conducted using SPSS software. Main Findings: The findings revealed that the volume card game achieved a high validity score of 91% according to expert evaluations, indicating that it is well-suited for classroom use. Furthermore, the game significantly improved student learning outcomes, as evidenced by the Paired Samples T-Test results (p = 0.000) and an N-Gain score of 0.7575, which falls in the high category. Positive feedback was overwhelming, with 98.6% of students reporting that the game was engaging, enjoyable, and effective in fostering their understanding of volume concepts. Novelty/Originality of this study: This study introduces an innovative combination of interactive learning tools and cooperative learning strategies, addressing the challenges of teaching abstract mathematical concepts. By merging gamification with collaborative learning, the volume card game provides an engaging and practical approach to enhance motivation and deepen conceptual understanding. The novelty of this research lies in its dual focus on integrating educational games with cooperative learning and demonstrating its scalable potential for application in broader mathematical topics and academic contexts.

From one size fits all to a tailored approach: integrating precision medicine into medical education

BackgroundAs precision medicine gains momentum, the traditional - One Size Fits All - approach to disease prevention and treatment is becoming less reliable. Medical education must prioritize equipping physicians with the knowledge to apply precision medicine effectively. The present study aimed to investigate the knowledge, attitudes, and perceived barriers to precision medicine among medical students, interns, and physicians in Jordan.Materials and methodsAn analytical cross-sectional study, using an online validated and reliable questionnaire to collect data, was conducted. The knowledge, attitudes, and perceptions related to precision medicine were assessed and explored for statistical associations. The strength of each association was further presented by calculating the Cramér’s phi (φc).ResultsParticipants in the present study were 607 individuals, 55.5% were males. 29.6% of participants had low knowledge scores (marks between − 12 and 0). The strongest association was reported between knowledge score and primary care setting followed by age (φc = 0.27 and 0.29, respectively). Physicians at the Ministry of Health had the highest odds of a high knowledge score (OR = 5.3, 95% CI 2.7–10.2, P < 0.001). Most respondents (79.1%) would consider using genome-guided prescribing tools developed by researchers, with only (15.8%) deeming these tools clinically useless. Nevertheless, almost 78% of participants expressed concern regarding patient anxiety with test results. Students showed better perception than physicians (p = < 0.001), but Physicians were more confident to implement precision medicine (P = < 0.0001). Most participants (87.1%) considered expanding their knowledge in precision medicine. Physicians cited limited accessibility as the main barrier to adopt precision medicine (92.9%), while high cost was the primary obstacle reported by students (80.2%).ConclusionMedical students and Physicians share a positive attitude toward implementing Precision Medicine, but barriers must be overcome for successful implementation. Integrating precision medicine and genome-based technologies into medical education is necessary for its successful application in clinical practice.

Life’s Essential 8 and risks of mortality and cardiovascular morbidity in individuals with PRISm and its associations with transition trajectories of PRISm

BackgroundAlthough morbidity and mortality are reportedly increased in individuals with preserved ratio impaired spirometry (PRISm), little is known about how to optimise PRISm-related health.AimsIs Life’s Essential 8 (LE8) associated with...

Long-term incidence of implantable cardioverter-defibrillator therapy in patients with hypertrophic cardiomyopathy: analysis of appropriate and inappropriate interventions

BackgroundTreatment with implantable cardioverter-defibrillators (ICDs) effectively prevents sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). Identifying patients most likely to benefit from a primary prevention ICD remains challenging....

Peningkatan Hasil Belajar Siswa Melalui Media Kotak Sifat Cahaya di Kelas V SDN 09 Palembang

The importance of conceptual understanding in science learning on the material of light properties must be further improved because the value of students' conceptual understanding is not only limited to knowing but students are also able to re-explain the material that has been taught in their own language and can apply it in everyday life. Therefore, this study aims to improve the learning outcomes of fifth grade students of SD 09 Palembang on the material of light properties by using light properties box learning media. The method used is Classroom Action Research (CAR) which is carried out in two cycles. The research was conducted at SD Negeri 09 Palembang on July 29, 2024 to August 5, 2024 with the research subjects being 28 fifth grade students of SDN 09 Palembang. Data was collected through observation and tests. Observations were carried out to determine student activities during learning, while tests were carried out to determine student learning outcomes after learning. Based on the results of the study, information was obtained that there was an increase in student learning outcomes who obtained high scores from Cycle 0 as much as 10.71% to cycle 1 as much as 39.28% and cycle 2. The pretest results showed that 71.42% of students had low understanding between 45 and 72. The results of the study also showed an increase in student activity during learning. Although the results of the study showed success, some students still needed additional support to understand more complex concepts. This study suggests the application of more diverse learning media and adaptation of teaching methods to meet the needs of individual students. The use of interactive and experiment-based media allows students to see and experience light phenomena directly, which reinforces the concepts being taught. This study suggests the application of more diverse learning media and adaptation of teaching methods to meet the needs of individual students

Chromosome-level and haplotype-resolved genome assembly of Bougainvillea glabra

Bougainvillea glabra Choisy, a common perennial shrub or climbing vine in tropical and subtropical areas, has significant ornamental and ecological value due to its showy floriferous blooms and adaptability to multiple environmental stresses. In this study, based on PacBio and Hi-C sequencing data, we presented the haplotype-resolved, and chromosome-level assembled genomes for B. glabra (2n = 34). We obtained two haplotypes with genome size of 2,855,692,602 bp and 2,889,511,499 bp, N50 of 165 Mbp and 167 Mbp, and both anchored to 17 chromosomes with anchor ratio of 97.07% and 97.55%, respectively. Through the BUSCO evaluation process, the two assembled haplotypes both exhibited the high score of 96%. By combining the high-confidence different evidence of genome structure annotation pipeline we annotated each haplotype containing ~33,000 predicted genes, of which 86% were functionally annotated by different databases. These high-quality haplotypes assembly and annotation results will serve as a great genomic resource to explore the ornamental traits and environmental adaptability and accelerate improvement in future.

Psychological safety, Job satisfaction, and the Intention to Leave among German early-career physicians.

Healthcare systems worldwide experience shortages of healthcare professionals. Retention of physicians is becoming an increasing problem. The psychological safety among physicians affects not only performance, but also their emotional well-being and job satisfaction. This study aims to evaluate early career physicians' perception of psychological safety and its influence on job satisfaction and intention to leave. In a cross-sectional study, early career physicians, currently in fellowship programs in Germany were invited to fill in an electronic survey. The instrument consisted of demographic variables and sections from validated and well-established questionnaires. Psychological safety was evaluated on three levels - in relation to the team leader, team as a whole, and peers. Also job satisfaction was assessed with standardized measures, and participants were asked if they were considering leaving their current employer. Participants were recruited via a nationwide learning platform - an online educational portal for medical students and early career physicians. Data analyses included descriptive, correlation analysis and regression analyses to determine univariate and multivariate associations with job satisfaction and intention to leave. The study sample consisted of 432 early career physicians. Most were fulltime employed (85.6%), female (78.2%), and in first three years of their postgraduate education (77.5%). 47.2% indicated intention to leave their current employment. On a Likert-10 agreement scale, with high scores indicating grater psychological safety, the mean scores for leader related, team related and peer related psychological safety were 6.01 (95%CI=5.81 to 6.21), 7.30 (7.11 to 7.49) and 7.95 (7.78 to 8.12), respectively. In correlation analysis, all dimensions of psychological safety showed significant associations with Job Satisfaction and the Intention to Leave. In the multiple regression analyses, female gender (B=-0.10; p=0.04) and age group (B=-0.08; p<0.01) were associated with lower job satisfaction. High leader and team related psychological safety were significantly associated with higher job satisfaction (B=0.18, p<0.01; B=0.10, p<0.01), and negatively related to intention to leave (OR=0.53, p<0.01; OR=0.77, p<0.01). This survey enhances our understanding of the nuances of psychological safety among early career physicians. In Germany, they reported low to medium levels of psychological safety related to the leader and low job satisfaction. Almost every second participant indicated intention to leave the organisation. Leader related psychological safety had highest effect on job satisfaction and intention to leave. Our findings corroborate the eminent role of leadership, workplace and safety culture for job satisfaction and retention of early career physicians, what consequently affects quality and safety of healthcare.

Burnout in Military Orthopedic Surgeons: A Multicenter, Cross-Sectional Study.

High rates of burnout are prevalent in U.S. physicians with evidence that the rates are increasing. Military orthopedic surgeons experience unique circumstances including deployments, relocations, and collateral duties that may place them at an even higher risk for burnout. The purpose of this study was to identify the prevalence and risk factors for burnout in active duty U.S. military orthopedic surgeons. We distributed a voluntary, anonymous, 64-question survey (SurveyMonkey) to the Society of Military Orthopaedic Surgeons listserv, an orthopedic specialty society that includes a large proportion of active duty, reserve, and retired military surgeons. The survey included questions about basic demographics, education and training, work environment, and military-specific variables, including number of deployments, relocations (Permanent Changes of Station), and perceived support from leadership. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to measure burnout. The primary outcome was burnout, defined as high emotional exhaustion or high depersonalization scores as measured on the MBI-HSS. Low personal accomplishment was included as a secondary outcome. A multivariate analysis was performed for each primary domain of the MBS-HSS to determine risk factors for burnout. A total of 191 active duty orthopedic surgeons (138 attendings and 53 residents) completed a survey. Males comprised 82% of respondents while 18% were female. Of all the respondents, 33% (63/191) met criteria for burnout. Military residents reported higher rates of burnout than attending physicians (49% vs. 26%, respectively, P = .002). Age, gender, race, relationship status, military branch, and level of training were not independently associated with burnout. Analysis of the diagnostic domains of burnout showed that a longer remaining active duty service obligation (P = .007) and a rank O5 or higher (P = .04) were associated with high emotional exhaustion. Support of colleagues and leadership (P = .01), a manageable workload (P < .001), and attending a service academy (P = .03) were protective. Residents had higher depersonalization scores than attendings (P<.001). A manageable workload (P < .001), a general practice (no fellowship training) (P = .01), and the rank of O4 (P = .006) were protective against depersonalization. However, being a generalist was associated with low personal achievement scores (P = .04) while fellowship training was protective (P = .05). Only 50% of attendings and 70% of residents indicated that they would join the military again, while 93% of attendings and 86% of residents would choose to enter orthopedics again. Despite several specific additional stressors, the prevalence of burnout in military orthpaedic surgeons is similar to previously reported rates in all orthopedic surgeons. Military-specific challenges such as deployments and relocations unique to military orthopedic surgeons were not associated with increased burnout.

An analysis of literacy differences related to the identification and dissemination of misinformation in Japan

PurposeThis study aims to examine the relationship between various types of literacy on one hand and identification of misinformation and dissemination of such information on the other, in search for better countermeasures against misinformation.Design/methodology/approachBased on data from a large-scale survey, models are constructed and analyzed to assess the relationships of literacy with both the identification of inaccuracies and dissemination behavior.FindingsRegarding the identification of misinformation, individuals with high critical thinking attitudes (subjective literacy) are less likely to recognize misinformation, while other objective literacies do not have a significant relationship. Regarding dissemination behavior, individuals with high information literacy, media literacy and critical thinking scores tend not to disseminate misinformation, whereas those with high critical thinking attitudes are more likely to disseminate such information.Originality/valueFirst, it quantitatively elucidates the relationships various literacies have with the accuracy judgment and dissemination behavior of misinformation. This highlights the effectiveness of objective indicators of literacies and the need for caution regarding subjective literacy – i.e. self-confidence in their own literacy. Second, it provides a cross-disciplinary analysis of the relationships, covering not only oft-studied politics and health care but also various other fields, thereby identifying comprehensive literacy strategies against misinformation. Third, it addresses differences in dissemination methods and offers insights into more practical countermeasures.

Association between mobility decline and health literacy in olderJapanese adults: Onjuku study.

Decline in mobility is a global issue that must be addressed in rapidly aging societies. We aimed to clarify the association between locomotive syndrome (LS), a condition of decreased mobility and health literacy (HL) in community-dwelling Japanese adults aged ≥ 40 years. A descriptive survey was conducted in Onjuku Town, Japan, between 2019 and 2023. The participants performed LS risk tests, including the two-step test, stand-up tests and 25-question geriatric locomotive function scale, to assess mobility. They completed the 14-item health literacy scale to quantify the total HL and functional, communicative and critical HL subscales. Other participant characteristics, such as chronic diseases, bodily pain and physical activity, were also surveyed. The association between LS and HL was assessed using univariate and multivariate logistic regression analyses, adjusted for participant characteristics. We analyzed 492 participants with a median age of 71 years. The total HL score decreased as the LS stage increased, with 56, 54 and 51 points in stages 0, 1 and ≥ 2, respectively (p = 0.004). In the logistic regression analysis, a high total HL score was significantly associated with reduced odds of stage ≥ 2 LS (adjusted odds ratio, 0.95; p < 0.001). Furthermore, functional HL score had an independent association with stage ≥ 2 LS (adjusted odds ratio, 0.88; p = 0.009). Our results suggest that clinicians should provide HL education in addition to known preventive measures, such as promoting physical activity, as a holistic approach to decreased mobility.

InCoLoTransNet: An Involution-Convolution and Locality Attention-Aware Transformer for Precise Colorectal Polyp Segmentation in GI Images.

Gastrointestinal (GI) disease examination presents significant challenges to doctors due to the intricate structure of the human digestive system. Colonoscopy and wireless capsule endoscopy are the most commonly used tools for GI examination. However, the large amount of data generated by these technologies requires the expertise and intervention of doctors for disease identification, making manual analysis a very time-consuming task. Thus, the development of a computer-assisted system is highly desirable to assist clinical professionals in making decisions in a low-cost and effective way. In this paper, we introduce a novel framework called InCoLoTransNet, designed for polyp segmentation. The study is based on a transformer and convolution-involution neural network, following the encoder-decoder architecture. We employed the vision transformer in the encoder section to focus on the global context, while the decoder involves a convolution-involution collaboration for resampling the polyp features. Involution enhances the model's ability to adaptively capture spatial and contextual information, while convolution focuses on local information, leading to more accurate feature extraction. The essential features captured by the transformer encoder are passed to the decoder through two skip connection pathways. The CBAM module refines the features and passes them to the convolution block, leveraging attention mechanisms to emphasize relevant information. Meanwhile, locality self-attention is employed to pass essential features to the involution block, reinforcing the model's ability to capture more global features in the polyp regions. Experiments were conducted on five public datasets: CVC-ClinicDB, CVC-ColonDB, Kvasir-SEG, Etis-LaribPolypDB, and CVC-300. The results obtained by InCoLoTransNet are optimal when compared with 15 state-of-the-art methods for polyp segmentation, achieving the highest mean dice score of 93% on CVC-ColonDB and 90% on mean intersection over union, outperforming the state-of-the-art methods. Additionally, InCoLoTransNet distinguishes itself in terms of polyp segmentation generalization performance. It achieved high scores in mean dice coefficient and mean intersection over union on unseen datasets as follows: 85% and 79% on CVC-ColonDB, 91% and 87% on CVC-300, and 79% and 70% on Etis-LaribPolypDB, respectively.

Effects of Shared Decision-Making, Health Literacy, and Self-Care Knowledge on Self-Care Behavior Among Hemodialysis Patients in Korea: A Cross-Sectional Survey.

Patients undergoing hemodialysis for chronic kidney failure experience various complications and physical and emotional difficulties, leading to decreased quality of life. Self-care behaviors are essential for preventing complications and reducing mortality rates. Effective self-care behaviors significantly depend on shared decision-making, health literacy, and self-care knowledge, each critical in patient self-care performance and disease management. This study aimed to determine the importance and relevance of shared decision-making, health literacy, and self-care knowledge. In particular, it enhances self-care behaviors among hemodialysis patients. Participants were 108 adult hemodialysis patients from the hemodialysis centers of three medical institutions in Cheongju City, Korea. Moreover, the study utilized a descriptive survey research design. Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analyses. The average score for self-care behaviors was 125.28 out of 175 points, with high scores for medication and vascular management. Furthermore, there were low scores for social activities and dietary management. Factors influencing self-care behaviors in hemodialysis patients were identified as sex, age, economic status, health literacy, and self-care knowledge. These factors explained 45.2% of the variance in self-care behaviors. To promote self-care behaviors in hemodialysis patients, it is essential to improve health literacy and self-care knowledge, strengthen tailored educational programs, and promote the explanatory role of nurses and shared decision-making. Additionally, comprehensive interventions, including economic support, are necessary.

Development and Evaluation of a Food Choices Assessment Score (FCAS) Measuring the Healthfulness of Dietary Choices According to 2019 Canada's Food Guide/Canada's Dietary Guidelines, using the Canadian Health Measures Survey Food Frequency Questionnaire.

The objective of this study was to develop and evaluate a Food Choices Assessment Score (FCAS) measuring alignment with 2019 Canada's Food Guide (CFG) and Canada's Dietary Guidelines (CDG) using a non-quantitative food frequency questionnaire (FFQ) data. Cross-sectional data from the Canadian Health Measures Survey (CHMS) (2016 to 2019), including 6,459 participants (≥19 years) and a non-quantitative FFQ (~100 food items) were used. Content and construct validity and assessing reliability were used to evaluate the FCAS, including a comparison of mean FCAS among Canadian subgroups, calculating the FCAS for high quality diet menus, investigating the consistency of the FCAS with the Dietary Approaches to Stop Hypertension (DASH), as a healthy diet linked with lower cardiometabolic risks, and estimating Cronbach's alpha for reliability. The FCAS consisted of nine components for a total of 80 points. The FCAS captured the key recommendations of the 2019 CFG/CDG. Mean (SE) FCAS of the adult Canadian population was 29.3 (0.4) (/80) and was higher in females 32.2 (0.4) and non-smokers 30.3 (0.3) compared to males 26.7 (0.4) and smokers 23.6 (0.9), respectively (p<0.0001). FCAS yielded high scores for healthy menu samples of CDG (80/80) and DASH (70/80) diets. FCAS was correlated with DASH diet score (r=0.83). Cronbach's alpha was found to be moderate (0.5), as expected, which confirmed the multidimensionality of the FCAS components in reflecting different characteristics of diet quality. These analyses suggest adequate validity with multidimensional consistency of the 2019 CFG/CDG FCAS as a new tool for use with non-quantitative FFQ data.

Creating Engaging Flashcard Materials for Young Learners: A Developmental Study on English Language Teaching in Primary Schools

Flashcards have long been recognized as effective tools for enhancing vocabulary acquisition, particularly among young learners. However, much of the existing research has focused on secondary or higher education, leaving a gap in understanding their impact on primary school students. This study addresses the need for a deeper exploration of flashcards as a teaching tool in elementary English language instruction. Specifically, the research focuses on the development and evaluation of flashcard-based instructional materials designed to improve vocabulary retention, student engagement, and motivation in young learners. The research utilized the ADDIE model (Analysis, Design, Development, Implementation, Evaluation) to develop flashcards tailored to young learners, emphasizing visually engaging and interactive materials. The findings demonstrated significant improvements in student engagement and vocabulary retention, with high effectiveness scores and positive feedback from both teachers and students. Data were analyzed using descriptive statistics to evaluate the results from the validity, practicality, and effectiveness tests. The findings reveal that the flashcards significantly enhanced students' vocabulary retention, engagement, and motivation, as demonstrated by high scores in effectiveness tests and positive feedback from both teachers and students. Teachers found the materials practical and easy to implement, while students responded favorably to the visual appeal and interactive nature of the flashcards. The findings highlight flashcards as an effective tool for improving vocabulary acquisition and engagement in primary education, offering a practical strategy for early language development.