Abstract Widowed women constitute a majority of India’s older female population. Increasing numbers seek shelter in institutional homes. This qualitative study examines the relocation of older widows into not-for-profit old age homes in India, focusing on their motivations for moving and on resilience practices they employ in the new environment. The research took place in Mangalore, Karnataka, involving in-depth interviews with 15 widows (aged 60 and above) residing in four homes, along with interviews with five staff members and a focus group with ten ageing experts. Findings reveal that financial scarcity, accompanied by multi-level neglect by family and community emerged as the primary trigger for widows’ relocation – a pattern rooted in specific gendered vulnerabilities towards existing social structures, economic conditions and cultural commitments. The decision to relocate was often initiated by the widows themselves as a means to escape severe neglect. Post-relocation, the widows experienced improved living conditions and expressed deep appreciation for the care, routine, and companionship available in the homes. These institutional environments, despite limited resources, provided safety and social support that mitigated loneliness and enhanced the women’s emotional resilience to experienced stress and trauma. The study’s insights underscore the importance of viewing free of charge old age homes as a potential supportive environment for vulnerable older women, especially in the context of a rapidly ageing population, decreasing social support and rising numbers of older widows. It also highlights the need for further examining how older, vulnerable women maintain a sense of functionality and dignity in later life.

Background:The aim of this study was to analyze fracture fixation case logs from residents training at a level 1 trauma center to assess variability across residents' surgical experiences within a single residency program. The authors hypothesize that notable variability exists between residents' surgical experiences in fracture care.Methods:A retrospective case series was conducted at a single, urban residency program with a level 1 trauma center. Completed case logs were collected from program graduates from 2022 to 2024. All surgical cases involving fracture fixation at the level 1 trauma center were included for analysis. The anatomic region of the fracture surgery was determined by translating the case log current procedural terminology (CPT) code entry into the corresponding “bone” and “segment” per the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association fracture classification system. For external validation and generalizability, resident cases were compared with those from a recent multicentered epidemiologic study using a two-proportion z-test. Variations in resident case logs were tested using analysis of covariance.Results:A total of 4,616 fracture fixation cases were identified across the 14 graduate case logs. The average number of fracture cases per resident was 329.7 (SD = ±80.3). No significant difference was observed in resident surgical experience at the home institution when comparing the anatomic region of the fracture surgery (P = 0.189). When compared with a multicenter epidemiologic study, our institution had significantly fewer proximal femur fractures (P < 0.001) and significantly more ankle fractures (P < 0.001).Conclusion:While assuring consistency of clinical experience within orthopaedic resident training is an exceptionally difficult task, it seems that residents in this program received similar exposure to varying fracture trauma pathologies. However, there may exist regional differences or other variables that contribute to differences in fracture location and/or volume from one institution to another. It remains essential for residents to take an active role in ensuring that they gain sufficient surgical volume to achieve clinical competence.

More than one-third of surgery residents - most of whom identified as non-White - report a lack of meaningful mentorship at their home institution. The purpose of this study is to (1) Develop a program to assist residents who lack mentorship at their home institutions, (2) evaluate a national mentorship network one-year post-implementation, and (3) identify areas for improvement. The Association for Academic Surgery (AAS) and the SECOND Trial partnered to create a national mentorship network to address the lack of local mentorship. 123 resident mentees were recruited through SECOND Trial intervention programs, and 85 mentors were recruited and trained through AAS. Residents were matched with faculty mentors outside their institutions based upon desired mentor qualities. After one year, participants were surveyed. Residents were 73.2% female, 61.4% non-White or Hispanic, and 13.6% LGBTQ+; 95.1% identified with at least one minoritized identity. One-year evaluations were completed by 44 residents (35.8%) and 38 faculty (44.7%). 68.2% of residents (30/44) enrolled due to unmet mentorship needs at their home institution, with 53.3% (16/30) wanting an identity-concordant mentor. 77.3% (34/44) of resident respondents had met with their mentors. Mental health was addressed by 44.1% (15/34) of pairs. 64.7% of residents rated their mentors as a good fit, and 44.1% reported their mentors had provided them with opportunities they would not have otherwise had. Of faculty, 68.4% agreed, "Participation in this program has been meaningful to me." Suggestions for improvement included participation reminders (39.7%) and discussion guides (25.3%). A national mentorship network may help compensate for the lack of local identity-concordant mentorship.

The increasing importance and predictive power of modern molecular modeling, driven by physics- and machine-learning-based methods, necessitates a new collaborative architecture to replace the isolated, traditional model of software development. The traditional approach often led to redundant engineering effort, high costs, and opaque systems that limit reproducibility, independent scrutiny, and scientific independence. Additionally, it results in taxpayer-funded research being left siloed in commercial tools where it cannot have as much impact as if it were returned to the general public. This Perspective advocates for permissively licensed open source software as a scientific and economic multiplier by reducing the duplication of effort and enabling scientific validation of modeling tools and frictionless experimentation with new ideas. Coordinated multiproject consortia, such as Open Force Field, Open Free Energy, OpenFold, and OpenADMET, have formed to collaboratively build shared computational infrastructure and release all methods under permissive licenses. The success of these large-scale efforts requires organizational structures that extend beyond code. The Open Molecular Software Foundation (OMSF), a U.S. nonprofit, serves as a domain-specific institutional home and fiscal sponsor. By providing governance, administrative infrastructure, and dedicated research software engineers, OMSF aligns incentives across academic and industrial stakeholders. This framework enables a synergistic ecosystem where projects interoperate to accelerate innovation, eliminate duplication, and ensure long-term software sustainability, thereby creating durable foundations that elevate the entire molecular modeling community.

This study explores Chinese STEM graduates from Japanese universities who returned to China, highlighting their significant contributions to education, research, and international collaboration at home institutions. Findings reveal that returnees significantly enhance laboratory standards, graduate education quality, research, and international collaborations at their home institutions. They apply Japanese-style supervision methods, facilitate global academic partnerships, and elevate their institutions’ international standing. However, challenges persist, including limited research time, frequent evaluations, and political influences on academic exchanges. Social networks within academia also affect the implementation of new programs. Despite these challenges, returnees contribute to patent development, technological advancements, demonstrating their broader societal impact.

Summary: The development of standardized disaster medicine curricula for frontline providers is lacking in the international platform. This report describes the approach utilized by the State University of New York (SUNY) Downstate, an Academic Medical Center in New York. SUNY offers one of the few disaster medicine fellowships in the United States, which also accepts international applicants and non-emergency Medicine (EM) physicians. Previous examples of non-traditional graduates from the program include the Director of the SUNY Pediatric Intensive Care Unit, a Critical Care specialist in India, and an EM physician in Ghana. Each of the non-traditional graduates completes a “virtual” version of the traditional Disaster Medicine Fellowship. The curriculum includes topic-based modules during which the fellows attend online courses, create and/or update their home institutions’ disaster protocols, create and deliver training to their institution’s staff, conduct disaster drills for their community, produce original research, and participate with local disaster response partners. With each topic-based module, the program’s benefits extend beyond the fellow gaining pertinent knowledge. Intentionally, the curriculum design enables the institution and community where the fellow works to gain staff training, updated disaster protocols, and increased coordination among local response agencies. The two main goals of the SUNY Global Disaster Medicine fellowship are to increase access to a global disaster medical curriculum and to strengthen the emergency preparedness for communities that have fellows in the program. The next steps for this program are creating a formal annual virtual class of ten participants from an academic medical center in Kuala Lumpur, Malaysia. The proposal has been signed by leaders from both centers and is scheduled to begin in July 2025. Beyond that, future goals are to expand this program to multiple academic centers globally that do not currently have access to a disaster medical fellowship program.

Risks of Failure in Advanced Trauma Life Support Courses.

ABSTRACT This article locates Stellenbosch zoologist, C.S. (Coert) Grobbelaar at its centre to engage the history of physical anthropology and the study of race within a particular institutional, intellectual and political context at Stellenbosch University. An engagement with Grobbelaar’s career reveals that his scientific practice was deeply entrenched in political ideology. This was shaped by Afrikaner nationalism and a home institution which emphasised its intellectual connection with Germany rather than the Commonwealth in the interwar period. The alliance with Germany ultimately shaped Grobbelaar’s disciplinary orientation as well as the disciplinary identity of physical anthropology at Stellenbosch University. Grobbelaar pursued his science in the context of Afrikaner nationalism at an institution where science was meant to serve the interests of the Afrikaner volk. During his career Grobbelaar missed profound international departures in the study of race. He could ultimately not detach his scientific practice from the political context in which it operated.

Atrial fibrillation is one of the most common cardiac arrhythmias. It is a condition that significantly increases the risk of stroke and cardiac complications, making its early diagnosis and intervention a crucial part of improving long-term patient prognosis. This study evaluates the accuracy of an atrial fibrillation detection algorithm in a Korotkoff sound blood pressure (BP) monitor. A total of 312 inpatients and outpatients were recruited for this study, with a Korotkoff sound BP monitor used to measure the BP and screen for atrial fibrillation. The study cohort included 148 patients with atrial fibrillation (mean age 73.3 ± 9.0 years) and 164 controls with sinus rhythm (mean age 44.7 ± 14.6 years). During BP measurement, a hand-held single-lead ECG device was used to simultaneously record ECGs for evaluating the accuracy of the atrial fibrillation detection algorithm. The device accurately identified all 148 confirmed atrial fibrillation patients, reliably triggering 'AFib' alerts in every instance. Throughout the evaluation of 164 non-atrial fibrillation subjects, the device maintained perfect specificity with zero false positive events. These results demonstrate 100% sensitivity and 100% specificity for atrial fibrillation detection. The Korotkoff sound BP monitor with atrial fibrillation detection algorithm exhibits excellent diagnostic accuracy. This device is of significant clinical value for early atrial fibrillation screening, serving as a convenient, efficient, and reliable tool for both home and primary medical institutions. Its capability for timely atrial fibrillation detection may contribute to reduced risks of stroke and other atrial fibrillation-related cardiovascular complications.

Background: Eight Global Ophthalmology (GO) fellowship programs are available in the United States, and more than 30 U.S. GO fellows are now alumni. There are no standardized learning objectives for these programs, and fellows’ experiences vary widely between institutions. Purpose: To survey GO fellowship program directors in the United States to elucidate differences in learning objectives, duration of time abroad, funding sources, and other differences between GO fellowships. Methods: All program directors at all institutions with current GO fellowship programs in the United States were sent a 25-question questionnaire via email from October through December 2022. The questionnaire included distinct domains regarding the GO fellowship experience, care delivery, didactics, and best practices. Most questionnaire items were quantitative; 3 were qualitative. Responses to the quantitative and qualitative questions items were summarized descriptively. Results: All 10 program directors from the 8 GO fellowship programs that were current at the time of the survey participated. GO fellowship positions at most (88%) institutions were funded, in part, by the billing of care services provided by the fellows, with 50% of programs receiving supplemental funding from donations and 25% from nongovernmental organizations. Non-GO duties at the program home institutions constituted 29.5% of the time spent during the fellowships, on average. Policy advocacy occupies 2.3% of fellowship time, on average. Specific didactic topics covered in the GO programs and director perspectives on the pragmatic best practices for GO outreach varied considerably; however, inclusion of at least some public health topics and ethics appeared to be consistent among all of the programs. Conclusions: These findings provide insights into the landscape of GO fellowship programs in the United States, highlighting variations in funding, formal educational opportunities, and the allocation of time fellows spent working at the program home institution. Establishing standardized core competencies for fellows is recommended.

Abstract Background With the accelerated development of social transformation and the digital age, college students are facing multiple pressures such as academic, employment, and interpersonal relationships. Their mental health problems are becoming increasingly prominent, and psychological crisis events occur frequently. The traditional psychological crisis intervention model for college students has limitations such as information lag, scattered resources, and low response efficiency. The flourishing development of digital technology provides a new path to solve this dilemma. The research aims to build a collaborative system centered on a digital platform that effectively integrates resources and strengths from families, schools, medical institutions, and communities (known as home school medical cooperatives) to achieve scientific prevention, precise identification, and efficient intervention of psychological crises among college students. Methods The research adopts a mixed research method that combines theory with practice. Firstly, through literature analysis and expert interviews, the pain points and digital requirements of existing collaborative models are identified. Then, an integrated digital collaboration platform was designed. The platform includes three core modules: student end, school management end, and collaboration end. Among them, the student end integrates regular psychological tests, dynamic emotional diaries, and resource navigation functions. The school management end is equipped with an algorithm based intelligent warning dashboard, task assignment, and process tracking system. The collaborative end provides a controllable information sharing portal, online consultation, and referral channel for home school medical cooperatives. The study selected a vocational and technical college to conduct a 12-month experimental research. Students were randomly divided into an experimental group (using a collaborative system, n = 1500) and a control group (using a traditional working mode, n = 1500). Collect process data through the platform and evaluate the effectiveness before and after the study using the Psychological Crisis Vulnerability Scale, Collaborative Satisfaction Questionnaire, and semi-structured interviews. Results The research results showed that during the intervention period, the identification time of high-risk students in the experimental group was shortened by an average of 67%. The sensitivity of the warning dashboard in predicting subsequent psychological crisis events is 82.5%, which is about 30% higher than traditional screening methods. The satisfaction survey showed that the satisfaction of school psychologists, participating parents, and cooperative medical institutions with the collaborative process was significantly higher than that of the traditional model (p&amp;lt;.01). The post test showed that the total score of psychological crisis vulnerability of the experimental group students was significantly lower than that of the control group (p&amp;lt;.05), and their psychological resilience factor score was significantly improved. Discussion The research results indicate that a digital based collaborative system between home, school, and medical institutions can effectively optimize workflow and improve the timeliness and precision of psychological crisis prevention and intervention for college students. The digital hub drives collaborative action through standardized processes, shifting prevention interventions from passive response to proactive management. Future research will focus on deepening cross regional medical school cooperation mechanisms and exploring more universal and low-cost technological solutions.

Menarche is a crucial stage among adolescent girls, and body composition differs significantly between pre-menarcheal and post-menarcheal females, with variations among different ethnic groups in India. The present study is an endeavor to assess the nutritional status of adolescent girls, compare the anthropometric and body composition measures between pre-menarcheal and post-menarcheal girls, and ascertain the impact of body composition on the attainment of menarche among the institutionalized adolescent girls of South 24 Parganas, West Bengal, India. A total of 116 adolescent girls aged 11–16 years were purposively recruited from an institutional home named “Save the Children”, located in Thakurpukur, South 24 Parganas, West Bengal, India. Data on age, menstrual status, and age at menarche were obtained via a self-administered pre-structured schedule. Anthropometric measurements were obtained following standard protocol, and indices were calculated accordingly. Kolmogorov-Smirnov test, T-test, Mann-Whitney test, Chi-square test, Principal Component Analysis (PCA), and binary logistic regression were performed using IBM SPSS version 26. The median age at menarche was found to be 12.0 years. The majority of the variables related to overall, central adiposity, and bone mass significantly differ between the pre-menarcheal and post-menarcheal girls. The upper limb, upper trunk, and lower trunk subcutaneous fat deposition, total body fat, body mass, bone mass, and fat-free mass significantly influence the attainment of menarche. The present study has potential implications for understanding the involvement of regional adipose tissues in menarche, emphasizing the health of future mothers and the development of chronic illnesses in maturity.

Mathematical modeling can be a useful approach to explore potential impact of malaria interventions and thereby inform resource prioritization decisions. However, expertise for applied modeling for public health decision-making is limited in malaria-endemic countries. A 4-month faculty enrichment program (FEP) in applied malaria modeling was implemented at Northwestern University, USA, in 2022 and 2023 with components including technical skills development, communication skills development, and domain knowledge on malaria epidemiology. Two cohorts of FEP participants and instructors were interviewed at baseline, midline, and endline to understand their expectations, experiences, and challenges with the program. Participants valued their growth in technical expertise, research skills, and communication ability, as well as clear opportunities for knowledge transfer at their home institutions. Participants reported challenges with cross-disciplinary learning, balancing program components, and adapting to new teaching and learning styles. Instructors adapted program structures and teaching approaches to adjust to participant needs and reported strengthening of their own technical capacity. Training programs for technical skill development must be informed by the needs and priorities of prospective participants and include continuous feedback mechanisms to respond to emerging needs. Multi-pronged approaches increase long-term program value to participants and help establish pathways for knowledge transfer.

The Impact of Geographical Background on the Orthopedic Surgery Residency Match.

Obstetrics and Gynecology Residency: A Time Motion Analysis Evaluating Time Allocation and Duty Hours.

The 13th Global Conference on Global Warming (GCGW 2025) was held in conjunction with the International Conference on Sustainable Energy and Green Technology 2025 (SEGT 2025) from 17 to 20 August 2025 in Kuala Lumpur, Malaysia, serving as a dynamic and enriching platform for knowledge exchange and networking. Organized under the theme “Innovative Solutions for a Better Environment and Sustainable Development,” the joint event aimed to foster dialogue and collaboration among leading academics, researchers, engineers, and industry practitioners. The conference was co-organized by Ontario Tech University, the home institution of the GCGW founding chair, together with Universiti Malaya and De La Salle University as Conference Chairs. The group of Conference Co-Chairs included representatives from Universiti Tunku Abdul Rahman (UTAR), Universiti Tenaga Nasional (UNITEN), Southeast University, Southwest Minzu University, the Research Center of Energy Conservation (RCEC), and Nanjing University of Aeronautics and Astronautics (NUAA). The GCGW-SEGT 2025 received over 280 abstract submissions, welcoming participants from more than 20 economies worldwide, including Malaysia, Thailand, Canada, China, the Philippines, Taiwan, Singapore, Indonesia, Hong Kong, Japan, India, Vietnam, South Korea, Australia, the United Kingdom, United States, Turkey, Saudi Arabia, Qatar, etc. The program featured plenary sessions, parallel oral presentations by keynote and invited speakers, poster sessions, workshops, and technical tours, covering a wide range of topics in energy transition, sustainable technologies, and green innovations. The plenary sessions were delivered by two distinguished scholars, Prof. Ibrahim Dincer (Ontario Tech University, Canada) and Prof. Fariborz Haghighat (Concordia University, Canada). In addition, four keynote speakers include Prof. Yinping Zhang (Tsinghua University, China), Prof. Jianlei Niu (Hong Kong Polytechnic University, Hong Kong), Prof. Ernest Chua Kian Jon (National University of Singapore, Singapore), Prof. Qihong Deng (Zhengzhou University School of Public Health, China), and Prof. Wei-Hsin Chen (National Cheng Kung University, Taiwan) together with two invited speakers, Dr. Qianru Yang (Southwest Minzu University, China) and Assistant Prof. Rahul R. Bhosale (University of Tennessee Chattanooga, USA), contributed to the event. List of Committee of GCGW-SEGT 2025 and Group photo are available in this PDF.

ABSTRACT The study on The Role of Higher Education Institutions' capacity‐building programs in Promoting Transnational Education (TNE) in Uganda focuses on both host and home institutions. The research aimed to assess the impact of TNE, investigate challenges affecting its sustainability, and suggest strategies for improvement. A qualitative exploratory design was adopted, wherein data were collected from university administrators, lecturers, and student leaders at Makerere University. Their responses were coded, transcribed, and analysed thematically. Findings revealed that TNE plays a significant role in expanding access to higher education by offering students international learning opportunities, enhancing academic advancement, and providing global exposure, thereby improving education quality. However, challenges such as inadequate funding and regulatory inconsistencies hinder the long‐term sustainability of TNE programs. The study concludes that Transnational Education is instrumental and fundamental in transforming the host university's infrastructure and technology, on top of promoting quality education. The study recommends increased government funding for local universities, through grants, subsidies, and policy incentives, to improve their competitiveness in the TNE space. Additionally, the National Council for Higher Education (NCHE) should establish clear regulatory frameworks to harmonise TNE policies, ensuring quality education and supporting the sustainability of both host and home institutions in Uganda.

The COVID-19 pandemic presented unprecedented challenges to hospital system and critical care resources, leading to significant changes to operations and patient care. There are limited national data on these changes and instances of unsanctioned deviations from patient care, yet understanding the COVID response is key to future preparedness efforts. We sought to understand how hospitals and states navigated scarcity during COVID-19, particularly in the absence of a declaration of crisis standards of care. Between February 2022 and September 2022 we conducted 34 interviews with 36 leaders of U.S. states' COVID-19 planning and response efforts. Interviews were transcribed verbatim and verified. We analyzed interviews using iterative inductive thematic analysis for descriptions of resource scarcity and changes to policies and procedures to prevent rationing lifesaving care. Nearly all participants described equipment and personnel scarcity in their home institution or state during COVID-19. Hospitals across regions and states developed formal and informal coordination processes for load and resource sharing in response to influxes of high-acuity patients, avoiding formal rationing of lifesaving resources in many regions. Participants also described unsanctioned patient triage, early discharge, and patients counseled to accept less aggressive care (e.g., premature transition to hospice) in states that had not declared crisis standards of care. Extending limited resources and inter-institutional collaboration helped avoid formal rationing. Yet, patient care was unquestionably impacted due to scarcity, both real and perceived. Reports of using hospital triage protocols to deny patients lifesaving care outside of formally recognized crisis conditions and attempts to nudge patients to accept less-resource-intensive care are concerning. This may have had disproportionate effects on older adults, individuals with disabilities, and racial and ethnic minoritized groups. To avoid unsanctioned deviations from standard practice in future health emergencies, we recommend that transparent and equitable triage protocols are implemented with robust oversight.

INTRODUCTION:In a national US-based group, we sought to describe barriers identified by sexual and gender minority (SGM) patients and primary care providers (PCPs) that challenge the provision of SGM-affirming digestive health care by qualitative methodology.METHODS:Forty patient participants and 24 PCPs were recruited from a random sample of 18 states within the 9 principal US Census Divisions and 2 states near the home institution. Patient participants selected completed a virtual semi-structured qualitative interview regarding their experiences with digestive health care and their views on barriers to engaging in digestive health care. PCPs were interviewed on treating SGM patients with gastrointestinal (GI) disorders and interactions with GI consultants. Interviews were conducted until thematic saturation was achieved. The study was conducted from November 2023 to August 2024.RESULTS:Thematic saturation was achieved at 36 patient participants and 21 PCPs. Major themes included SGM discrimination in digestive health care, SGM issues in engaging in digestive health care, GI symptoms and other aspects of health-specific conditions, and ways to improve digestive health care for the SGM community. Participants noted a link between psychological distress in the SGM population and GI symptoms and offered actionable suggestions to improve SGM-focused digestive health care.DISCUSSION:Systematic deficiencies were identified in the provision of SGM-affirming digestive care, related to bias within health care systems and a lack of understanding of unique SGM-related needs throughout the United States. Further research studying improved shared clinician and SGM GI patient engagement is needed to address these sources of health inequity.

We examine public funding for health research through the United States National Institutes of Health Fogarty International Center's AIDS International Training and Research Program, which sought to strengthen scientific capacity in AIDS-endemic countries by providing African researchers with training opportunities in the U.S. We use a difference-in-differences framework with information on scientists who participated in the program and the research activities of African scientists working at their home institutions in adjacent topics of neglected tropical diseases. Relative to comparable scientists, those at institutions with returning trainees subsequently publish more on HIV-related topics, receive more grant funding, engage in more clinical trials, and their work contributes to a greater number of policy documents. These patterns suggest that following the Fogarty program, research, innovation, and health policy related to the AIDS epidemic in African countries became more active.