Long-term Impact Research Articles

Abstract B114: Enhancing understanding and engagement: Investigating the impact of education on clinical trial participation

Abstract Institutions: Thomas Jefferson University Department of Oncology Funded by: NIH/NCI 3P30CA056036-22S1 Background Clinical trials (CT) advance knowledge in cancer care. Access to CT may be facilitated by patient knowledge. We evaluated the impact of a tailored CT educational video intervention via a pre- and post-test survey on CT interest and enrollment. Methods Participants included persons with cancer (PwCa) as well as persons without cancer—general population (GP). A McNemar test was used to assess the differences in survey scores for patients knowledge (11 questions) and intention-to-participate in future CT (6 questions). Results 363 (GP) and 116 (PwCa) participated; 178 and 55 participants completed both pre- and post-surveys, respectively. GP: 148 (70%) men, 58 (28%) women, 2 (1%) transgender, 2 (1%) non-binary; white, non-Latinx 125 (60%), Black 60 (29%), Asian 2 (1%), Latinx 52 (25%). PwCa: 48 (47%) men, 48 (53%) women; white, non-Latinx 71 (79%), Black 8 (9%), Asian 7 (7%), Latinx 5 (6%).The mean age was 30 yrs (sd: 7 yrs) [GP] and 55 yrs (sd: 17.8 yrs) [PwCa]. PwCa scores significantly improved for “In a CT, a patient will always get the new medicine or treatment being tested” (p=0.003). GP scores significantly improved for “You can only join a CT after you have tried all other options (p=0.002)”, “CTs test whether a new medicine or treatment works (p=0.031)” and “Once I sign a consent form, I must stay in the CT until my doctor tells me I'm done (p=0.0001).” The intention to participate in CT improved significantly in PwCa (p<0.05). The intention to gain more information about CT from their physicians and discussing CT with family (p<0.05) improved significantly in GP. Conclusions The tailored educational intervention significantly impacted PwCa’s intention to participate in CT and GP’s intention to learn more about CT and to share the CT information learned. The GP group was more diverse. Ongoing research is monitoring whether PwCa participants enroll in a CT, thereby assessing the long-term impact of the educational intervention on decision-making regarding CT participation taking into account CT availability and eligibility. Citation Format: Jesutomisola Onafowokan, FNU Nikita, Iqra Siddiqui, Ana Maria Lopez. Enhancing understanding and engagement: Investigating the impact of education on clinical trial participation [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B114.

SARS-CoV-2 infection induces hyaluronan production in vitro and hyaluronan levels in COVID-19 patients relate to morbidity and long-term lung impairment: a prospective cohort study

ABSTRACT We previously demonstrated that the lungs of deceased COVID-19 patients were filled with a clear hydrogel consisting of hyaluronan (HA). In this translational study, we investigated the role of HA at all stages of COVID-19 disease to map the consequences of elevated HA on morbidity and identify the mechanism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced HA production. A reduced alveolar surface area was observed in the lungs of deceased COVID-19 patients compared to healthy controls, as visualized by a 3D rendering of lung morphology using light-sheet fluorescence microscopy. We confirmed the presence of HA in lung biopsies and found large quantities of proinflammatory fragmented HA. The association of systemic HA in blood plasma and disease severity was assessed in patients with mild (WHO Clinical Progression Scale, WHO-CPS, 1–5) and severe COVID-19 (WHO-CPS, 6–9) during the acute and convalescent phases and related to lung function. We found that systemic levels of HA were high during acute COVID-19 disease, remained elevated during convalescence, and were associated with a reduced diffusion capacity. In vitro 3D-lung models, differentiated from primary human bronchial epithelial cells, were used to study the effects of SARS-CoV-2 infection on HA metabolism, and transcriptomic analyses revealed a dysregulation of HA synthases and hyaluronidases, both contributing to increased HA in apical secretions. Furthermore, corticosteroid treatment reduced the inflammation and downregulated HA synthases. Our findings demonstrate that HA plays a role in COVID-19 morbidity and that sustained elevated HA concentrations may contribute to long-term respiratory impairment. IMPORTANCE This study provides insights into the role of hyaluronan (HA) in the severity and long-term impact of COVID-19 on lung function. Through extensive morphological examination of lung tissues and a multicenter study, we identified that HA levels are significantly elevated in COVID-19 patients, correlating with a reduced lung diffusion capacity during convalescence. Using a 3D-lung model, we further uncovered how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 infection causes a dysregulated HA metabolism, leading to increased HA production. Our findings provide valuable insights into the pathogenesis of SARS-CoV-2 and suggest that targeting HA metabolism could offer new therapeutic avenues for managing COVID-19, particularly to prevent long-term lung impairment. Additionally, HA holds potential as a biomarker for predicting disease severity, which could guide personalized treatment strategies.

Advancing Arbitration for Multinational Construction Projects in Saudi Arabia Through Flexibility and Legal Reforms

The role of arbitration in resolving multinational construction disputes in Saudi Arabia is explored, focusing on procedural flexibility, confidentiality, and the impact of recent legal reforms. Multinational companies prefer arbitration over traditional litigation due to its closed process, which protects sensitive information—crucial in Saudi Arabia's privacy-focused business environment. Using qualitative methods like case studies, interviews, and legal document analysis, the research highlights key themes such as the need for arbitrators with technical expertise and cultural understanding, enhancing the arbitration process. Confidentiality is a major factor in choosing arbitration, offering protection from public exposure. Additionally, arbitration’s procedural flexibility allows for customized solutions, leading to faster dispute resolution. Legal reforms, including the Saudi Arbitration Law 2012 and the Saudi Center for Commercial Arbitration (SCCA), have strengthened the arbitration framework, boosting investor confidence and improving efficiency. Future research should examine the long-term impact of these reforms, assess the effectiveness of new arbitration institutions, and explore challenges in maintaining confidentiality and selecting competent arbitrators across sectors.

A Specialised Antenatal Music Therapy (SAMT) programme for pregnant women with mental health conditions: A mixed-methods proof-of-concept study in Ireland

ABSTRACT Introduction Perinatal mental health has a long-term impact on maternal and infant well-being. Non-pharmacological treatment options are needed for pregnant women and emerging evidence has shown the potential of music therapy to improve perinatal mental health and antenatal attachment. However, research is lacking on individual music therapy for pregnant women with mental health conditions and formal music therapy services are currently absent within perinatal mental health care in Ireland. This mixed-methods, proof-of-concept study aimed to assess the feasibility and preliminary evidence on the effectiveness of a specialised antenatal music therapy (SAMT) programme for pregnant women attending the Specialist Perinatal Mental Health Service (SPMHS). Method Pregnant women between 25 and 33 weeks gestation with various mental health conditions were recruited through the SPMHS to receive six in-person or online sessions of SAMT. Feasibility outcomes included retention, adherence, and fidelity.\\ Assessment of participants’ wellbeing, anxiety, and antenatal attachment were conducted before and after SAMT and each session. Semi-structured interviews were conducted and analysed using thematic analysis. Results Twelve pregnant women were included and nine completed SAMT and assessments, demonstrating a 75% retention rate. High levels of adherence and fidelity were reported. Significant improvements were observed in participants’ wellbeing, anxiety levels, and antenatal attachment. Qualitative findings highlighted the therapeutic benefits, the accessibility and challenges of the online setting, distinctive therapeutic experiences, and participants’ recommendations. Discussion The findings suggest implementing SAMT within the Irish SPMHS is feasible and beneficial. The study offers insights into the therapeutic mechanisms of SAMT and supports the progression to a larger trial.

Long-term effects of siponimod on cardiovascular and autonomic nervous system in secondary progressive multiple sclerosis

BackgroundSiponimod, a second-generation, selective sphingosine 1-phosphate receptor (S1PR) 1 and 5 modulator, represents an important therapeutic choice for active secondary progressive multiple sclerosis (SPMS). Besides the beneficial immunomodulatory effects, siponimod impacts cardiovascular function through S1PR1 modulation. Short-term vagomimetic effects on cardiac activity have proved to be mitigated by dose titration. However, long-term consequences are less known.ObjectivesThis study aimed to investigate the long-term impact of siponimod on cardiac autonomic modulation in people with SPMS (pwSPMS).MethodsHeart rate variability (HRV) and vascular hemodynamic parameters were evaluated using Multiple Trigonometric Regressive Spectral analysis in 47 pwSPMS before siponimod therapy and after one, three, six and 12 months of treatment. Autonomic activation tests (tilt test for the sympathetic and deep breathing test for the parasympathetic cardiac modulation) were performed at each examination.ResultspwSPMS preserved regular cardiovascular modulation responses during the autonomic tests reflected in the variation of several HRV parameters, such as RMSSD, pNN50, total power of HRV, high-frequency and low-frequency bands of the spectral domain or hemodynamic vascular parameters (Cwk, Zao, TPR, MAP) and baroreflex sensitivity (BRS). In the long-term follow-up, RMSSD, pNN50, total power, BRS and CwK presented a significant decrease, underlining a reduction of the parasympathetic and a shift towards sympathetic predominance in cardiac autonomic modulation that tends to stabilise after 1 year of treatment.ConclusionDue to dose titration, the short-term effects of siponimod on cardiac autonomic modulation are mitigated. The long-term impact on cardiac autonomic modulation is similar to fingolimod. The autonomic activation tests showed normal cardiovascular responses during 1-year follow-up in pwSPMS, confirming the safety profile of siponimod. Further research on autonomic function could reveal whether the observed sympathetic activation is a compensatory response to S1P signaling intervention or a feature of the disease, while also shedding light on the role of S1PR modulation in MS.

The Influence of Pyrolysis Temperature and Feedstocks on the Characteristics of Biochar-Derived Dissolved Organic Matter: A Systematic Assessment

Biochar is a carbon-rich product obtained by pyrolyzing biomass under oxygen-limited conditions and has a wide range of potential for environmental applications. In particular, dissolved organic matter (DOM) released from biochar has an important impact on the fate of pollutants. The study aimed to systematically assess how varying pyrolysis temperatures and biomass feedstocks influence the characteristics of biochar-derived DOM. DOM samples were comprehensively characterized utilizing UV-vis spectroscopy and excitation–emission matrix (EEM) fluorescence spectroscopy, coupled with parallel factor (PARAFAC) analysis. The study discovered that pyrolysis temperature significantly affects DOM characteristics more than feedstock type. An increase in pyrolysis temperature correlated with a notable decrease in dissolved organic carbon content, aromaticity, and fluorescence intensity, alongside a marked increase in pH and hydrophilicity. PARAFAC analysis identified three distinct DOM components: two humic-like substances (C1 and C2) and one protein-like substance (C3). The proportion of protein-like substances increased with higher pyrolysis temperatures, while the humic-like substances’ proportion declined. The compositional shifts in DOM with pyrolysis temperature may significantly influence its environmental behavior and functionality. Further research is necessary to explore the long-term environmental impact and potential applications of biochar-derived DOM.

Strengthening China’s National Essential Public Health Services Package for hypertension and diabetes care: protocol for an interrupted time series study with mixed-methods process evaluation and health economic evaluation

BackgroundDespite major primary health care (PHC) reforms in China with the 2009 launch of the National Essential Public Health Service Package, the country experiences many challenges in improving the management of non-communicable diseases in PHC facilities. “EMERALD” is a multifaceted implementation strategy to strengthen the management of hypertension and type-2 diabetes mellitus (T2DM) in PHC facilities. The study aims to: (1) examine the effectiveness of EMERALD in improving hypertension and T2DM management; (2) evaluate the implementation of the interventions; and (3) use the study findings to model the long-term health economic impact of the interventions.MethodsThe EMERALD intervention components include: (1) empowerment for PHC providers through training and capacity building; (2) empowerment for patient communities through multi-media health education; and (3) empowerment for local health administrators through health data monitoring and strengthening governance of local PHC programs. An interrupted time series design will be used to determine the effectiveness of the interventions based on routinely collected health data extracted from local health information systems. The primary effectiveness outcome is the guideline-recommended treatment rates for people with hypertension and T2DM. Secondary effectiveness outcomes include hypertension and T2DM diagnosis and control rates, and enrolment and adherence rates to the recommended care processes in the National Essential Public Health Service Package. A mixed-methods process evaluation will be conducted to evaluate the implementation of the interventions, including the reach of the target population, adequacy of adoption, level of implementation fidelity, and maintenance. Qualitative interviews with policy makers, health administrators, PHC providers, and patients with hypertension and/or T2DM will be conducted to further identify factors influencing the implementation. In addition, health economic modelling will be performed to explore the long-term incremental costs and benefits of the interventions.DiscussionThis study is expected to generate important evidence on the effectiveness, implementation, and health economic impact of complex PHC interventions to strengthen the primary care sector’s contribution to addressing the growing burden of non-communicable diseases in China.Trial registrationThe study has been registered on Chinese Clinical Trial Registry at https://www.chictr.org.cn/ (Registration number ChiCTR2400082036, on March 19th 2024).

Influence of Organic Compounds on Ni, Co, Cu, Cr, and Pb Accumulation by Nodules in Agro-Dark-Humus Podbels (Planosols) in the South of Primorskii Region

The involving of organic compounds in accumulation of Ni, Co, Cu, Cr, and Pb by Fe–Mn nodules in agro-dark-humus podbels (Planosols (Aric)) under different types of long-term agrotechnical impact has been studied in the south of Primorskii region. The profile patterns of the level of SOC content in soils and in nodules indicate the active deposition of organic compounds in nodules in the lower parts of soil profiles in the of fallow and phytomeliorative variants of the experiment. Fulvic acids were noted to predominate in the composition of humus in the nodules in these variants. The long-term application of organic fertilizers contributed to the decrease of SOC incorporation into nodules and to the increase of the part of humic acids in nodules. Nodules were characterized by a high accumulation levels of Co and Pb in all variants of the experiment. Accumulation of Ni, Cr, and Cu was recorded in nodules from particular horizons of studied soils. The intensity of elements accumulation in nodules of different variants of the experiment varied. Accumulation of Ni was controlled by the content of Mn-containing compounds. The most active sorption phases of nodules from soils with a longer period of organic matter transformation (fallow variant and long-term addition of manure variant) were Fe-containing and organic compounds.

Time series decomposition of land surface temperature for long-term trend forecasting and impact on nesting sea turtle habitats in the Arabian Gulf

Abstract Improving Land Surface Temperature (LST) modeling is vital for mitigating climate change effects on various ecosystems and marine habitats such as on important sea turtle habitats. Over the past decade, extreme temperatures have likely significantly affected nesting sea turtle habitats in the Arabian Gulf, with predominantly female hatchlings creating an imbalance in the sex ratio. Such shifts have profound implications for these habitats' long-term survival and conservation management. This study leverages statistical machine learning models to measure ongoing temporal variations in LST. We break down the LST time series into trend, seasonal, and noise components using classical decomposition methods like X11, SEATS, and the Seasonal and Trend decomposition using Loess (STL) approach. The long-term trends in LST data are driven by climate change rather than seasonal fluctuations. We employed Neural Network Auto Regression (NNAR), BaggedETS, Exponential Smoothing models, and STL method to project future LST values. We also explored advanced forecasting models like Dynamic Harmonic Regression, TBATS, and SARIMA for comparative performance analysis. Extended warm periods were identified for Abu Ali Island between 2017 and 2018 through several decomposition methods, likely linked to the 2015-2016 El Niño event. We also conducted a Marine Heat Wave (MHW) analysis from 2010-2020, establishing a pronounced impact of the 2015-2016 El Niño on the Arabian Gulf. In nesting beach environments with high LST, marine heatwaves could have a significant impact on sea turtle populations without human intervention such as artificially cooling the nest temperature. SARIMA model showed higher forecasting precision for in-situ weather data while NNAR model demonstrated superior performance with remotely sensed data.

The Determined Struggle of Nakhchivan’s Population for Freedom and Independence Before Autonomy

This article explores the historical struggle of Nakhchivan’s population for independence and autonomy in the early 20th century, focusing on the challenges posed by neighboring states and the influence of Soviet Russia. The people of Nakhchivan, driven by a strong sense of national identity, engaged in a determined resistance against Armenian and Soviet incursions, culminating in the region being granted autonomous status under Soviet rule. The article examines key figures, important battles, and diplomatic efforts that shaped Nakhchivan’s path to autonomy, as well as the long-term impact of this struggle on the region’s political and cultural identity. By analyzing Nakhchivan’s journey toward autonomy, the article highlights the enduring significance of this historical period in shaping the region's contemporary status as an autonomous republic within Azerbaijan.

How does the method of farmland transfer affect the “non-grain” of farmland in China?

IntroductionThe phenomenon of “non-grain” of farmland poses a major threat to food security. Currently, there is still debate about the relationship between farmland transfer and the “non-grain” of farmland. Currently, there is no consensus on the relationship between farmland transfer and the non-grain use of farmland. This article focuses on the evolution of farmland transfer methods, examines the impact of farmland transfer methods on the non-grain use of farmland, and highlights the importance of effectively promoting farmland transfer, curbing the non-grain use of farmland, and ensuring food security.MethodsBased on the China Rural Revitalization Survey (CRRS) data, this paper uses probit and ivprobit models to estimate the causal relationship between farmland transfer methods and the “non-grain” of farmland. Grouped regressions are conducted from three dimensions of geographical environment, village governance, and economic development to test the heterogeneity of the impact of farmland transfer methods. Finally, the pathways of action are analyzed from the perspectives of farmers’ identity transformation and contract signing.ResultsThe organized transfer can significantly reduce the degree of “non-grain” of farmland, and its effect is stronger when the village party secretary has a higher level of education and also serves as the village head. This effect is mainly manifested through increasing the probability of farmers becoming new agricultural operators, joining cooperatives, signing formal contracts, and determining the lease term.DiscussionThe policy implications of this study emphasize that to curb the “non-grain” of farmland and ensure food security, it is important not only to increase the rate of farmland transfer but also to promote the organization of farmland transfer transactions. This includes facilitating the transfer of farmland from inefficient smallholders and cultivating new agricultural operators. Simultaneously, leveraging the supervisory and management role of village collectives can encourage farmers to sign more formal written contracts, clarify the purpose of farmland transfer, and supervise and manage the use of farmland during the subsequent contract execution stage. A limitation of this study is that it relies on cross-sectional data and does not observe the time variation of farmland transfer methods for the same farmers or their long-term impact on the “non-grain” of farmland.

The Importance of Capacity-Building in Watershed Groups: Lessons from the Hudson River Watershed, USA.

Municipalities face challenges meeting environmental protection and conservation goals due to a lack of resources, capacity, and political will. As a result, grassroots environmental organizations often emerge to help meet these challenges by filling gaps in governmental operation and structure. At the watershed scale, environmental organizations and groups are critical for effective watershed governance, often helping with collaboration as well as providing municipalities with additional support and resources. Despite the vital role environmental organizations and groups can play, they continue to face challenges such as insufficient resources, inconsistent leadership, and lack of organizational structure, thus limiting the contributions they can deliver. In this manuscript, we present case study research on watershed groups exploring their capacity to meet their mission and goals. Drawing from a needs assessment study conducted in the Hudson River watershed in 2019-2021, we found that while watershed groups are generally in need of technical resources, participation, and funding, our research suggests capacity (such as internal structure, strategic planning, and leadership) is most important for successful and sustainable groups. Therefore, we argue that support for capacity is more likely to help sustain groups and their long-term beneficial impact. To make this argument we present qualitative interview and focus group data to articulate watershed group goals, challenges, and needs, with an emphasis on capacity-related themes that emerged around expertise, leadership, structure, and planning. We then conclude with recommendations that can be applied to other watershed groups in the United States, and likely beyond.

Relationship between weight-adjusted-waist index and all-cause and cardiovascular mortality in individuals with type 2 diabetes.

To investigate the relationship between the weight-adjusted-waist index (WWI) and all-cause mortality as well as cardiovascular mortality in individuals with type 2 diabetes. We used data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 and the UK Biobank database. Restricted cubic spline curves and Cox proportional hazards models were employed to assess hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality. In the UK Biobank database, compared with the lowest WWI quartile, the HR for all-cause and cardiovascular death in the highest quartile was 1.846 (95% CI 1.687-2.019) and 2.118 (95% CI 1.783-2.517), respectively, in the fully adjusted model. In the NHANES database, compared with the lowest WWI quartile, the highest quartile had an HR of 1.727 (95% CI 1.378-2.163) for all-cause death and 1.719 (95% CI 1.139-2.595) for cardiovascular death in the fully adjusted model. Our study indicates that WWI has a long-term synergistic negative impact on all-cause mortality and cardiovascular mortality in individuals with type 2 diabetes. The WWI is an independent predictor of mortality in individuals with type 2 diabetes.

A four year follow-up survey on the teledidactic TELUS ultrasound course: long-term benefits and implications

BackgroundThe COVID-19 pandemic disrupted traditional medical education, prompting innovative teaching methods for practical skills training. The teledidactic TELUS ultrasound course, launched in 2020–2021, aimed to provide remote instruction in ultrasound techniques.ObjectiveThis study assesses the long-term impact of the teledidactic ultrasound course conducted during the study years on current clinical practice.MethodsIn 2024, a follow-up survey was conducted with former TELUS course students now practicing as physicians across various specialities. Participants rated their confidence in ultrasound examinations and its frequency in practice.Results21 out of 30 participants (70%) completed the survey. 71.4% rated the course experience as excellent (5/5 points). Most reported significant learning gains, especially in the FAST module. While all agreed the course enhanced their ultrasound skills, its impact on patient care received mixed reviews. Frequency of ultrasound use varied widely among specialities, with high use in surgery and internal medicine but less in psychiatry, neurology, and ophthalmology. Notably, 42,9% had not pursued further ultrasound training post-course.ConclusionThe teledidactic ultrasound course effectively provided remote education, integrating skills into practice. Mixed reviews on patient care impact and speciality-specific ultrasound use suggest sustained integration depends on relevance and ongoing education. Self-assessment results support online ultrasound courses, indicating potential use in resource-limited or geographically constrained settings.

Investigating the Impact of Learning Modality Shifts on K-12 Students’ Physical Activity Participation During the COVID-19 Pandemic

The COVID-19 pandemic created many challenges for K-12 schools during the 2020-2021 school year (e.g., establishing social dis-tancing measures, decisions regarding testing protocols, and transition from in-person to distance learning). Changes in teaching and learning modalities, from in-person to remote learning options, quickly became a reality for many students [an estimated 95%, according to Engzell et al. (2021)]. With an increase in distance learning came changes in stu-dents’ structured and unstructured physical activity participation. The impact of these changes is unknown and justifies research investigating the effect modality shifts held on students’ participation in physical activity and any associated outcomes. A mixed-methods survey was administered to examine changes in K-12 students’ learning modality, 521Chiara et al.participation in physical activity, and associated outcomes. Changes in learning modality from in-person to online were most frequently in-dicated (90%). Respondents stated both challenges and success stories associated with students’ participation in physical activities resulting from modality shifts (e.g., decreased social engagements, decreased ex-posure to structured and facilitated physical education, and increased outdoor play). Positive outcomes were most prevalent in children engaging in moderate PA. However, 85% of respondents indicated a decrease in their child’s physical activity participation. Our findings justify further investigation of the immediate and long-term impact of school modality shifts on students’ engagement in physical activities.

Theory - Practice integration for Chinese Postgraduates in Pathophysiology: Innovative Teaching Strategies

Background: Pathophysiology plays a pivotal role in medical education by bridging basic sciences and clinical medicine. However, traditional teaching approaches in China often lack integration between theory and clinical practice, hampering postgraduates' understanding of disease mechanisms and diagnostic abilities. This study explores innovative strategies to effectively integrate theory and practice, enhancing Chinese medical postgraduates' learning.Methodology: A comprehensive literature review analyzed the current educational landscape and identified innovative teaching strategies aligning theoretical concepts with clinical applications. The implementation methods and potential to foster autonomous and innovative learning were examined.Results: Several student-centred strategies were identified, including problem-based learning (PBL), case-based learning (CBL), flipped classrooms, and integrated teaching models. These approaches emphasize active learning, critical thinking, and applying theoretical knowledge to clinical scenarios. Adopting these strategies can improve postgraduates' learning efficiency, problem-solving abilities, and clinical reasoning skills while promoting self-directed learning and innovative thinking.Conclusion: Integrating theory and practice through innovative teaching strategies is crucial to enhance the quality of pathophysiology postgraduate education in China. Educators should implement student-centred approaches like PBL, CBL, flipped classrooms, and integrated models to stimulate autonomous learning and cultivate innovation. Providing opportunities for active learning and clinical application can significantly improve postgraduates' learning outcomes and preparedness for future practice. Further research evaluating the long-term impact on postgraduate performance and patient care is warranted.

INFLUENCE OF ENGLISH LANGUAGE EXPOSURE MEDIA ON THE STUDENTS’ SPEAKING ABILITY

This research was conducted to find out whether English Language Exposure Media influence students’ speaking ability or not. This research also concentrated on utilizing different types of English language exposure media within the curriculum, including music videos, podcasts, and songs. All of the media were presented in English language to give them the exposure of the language. A pre-experimental design was utilized, incorporating a pre-test, post-test, and two treatment phases. Data were gathered using a measurement technique that involved a speaking test. The research findings revealed that the pre-test score averaged 54.60, while the post-test score averaged 78.33. The mean score difference between the pre-test and post-test was 25.73, indicating an improvement in students' speaking abilities following the treatments. The effect size (ES) was calculated to be 2.38, which is classified as a strong effect (ES > 1.00). The research demonstrated a substantial improvement in students' speaking ability, with a mean score increase from 54.60 to 78.33, indicating the effectiveness of English language exposure media. Future research could explore the long-term impact of English language exposure media on students' speaking skills. Additionally, examining the effectiveness of different types of media and their influence on various language skills would provide a more comprehensive understanding.

Wearable nitric oxide-releasing antibacterial insert for preventing device-associated infections

Medical device-associated infections are a pervasive global healthcare concern, often leading to severe complications. Bacterial biofilms that form on indwelling medical devices, such as catheters, are significant contributors to infections like bloodstream and urinary tract infections. This study addresses the challenge of biofilms on medical devices by introducing a portable antimicrobial catheter insert (PACI) designed to be efficient, biocompatible, and anti-infective. The PACI utilizes nitric oxide (NO), known for its potent antimicrobial properties, to deter bacterial adhesion and biofilm formation. To achieve this, a photoinitiated NO donor, S-nitroso-N-acetylpenicillamine (SNAP), is covalently linked to a polydimethylsiloxane (PDMS) polymer. This design allows for higher NO loading for long-term impact and prevents premature donor leaching, a common challenge with SNAP-blended polymers. The SNAP-PDMS material was applied to a side-glowing fiber optic and connected to a wearable light module emitting 450 nm light, creating a functional antimicrobial insert. Activation of the fiber optic, accomplished with a one-click mechanism, enables real-time NO release, maintaining controlled NO levels for a minimum of 24 h. The therapeutic levels of NO released via photocatalysis from the PACI demonstrated remarkable efficacy, with >90 % reduction in bacterial viability against S. aureus, S. epidermidis, and P. mirabilis without any cytotoxic impact on mammalian cells. This study underscores the potential of the NO-releasing insert in clinical settings, providing a portable and adaptable solution for preventing catheter-associated infections.

Impact of organic acid molecular length and structure on rock oil-wetting rapidity and stability

The oil-wetting properties of organic acids play a crucial role in various industrial applications, including enhanced oil recovery, oil spill remediation, surface modification, and so on. This study investigated the impact of organic acid molecular length and structure on oil-wetting rapidity and stability on sandstone and carbonate. Model oils prepared by dissolving organic acids in n-decane, and crude oil, were used as the oil phase. Their oil-wetting behavior was evaluated by contact angle values. The maximum molecular length of each organic acid was approximated based on its molecular structure. Our results indicate that organic acids change wettability much faster in carbonate rock than in sandstone. Longer organic acid molecules exhibit enhanced oil-wetting potential due to increased hydrophobic interactions with oil phases. Water film does not have a long-term impact on the oil-wetting process by organic acid on Indiana limestone. However, the existence of a water film largely inhibited the oil-wetting process for Indiana limestone in crude oil, and for Berea sandstone in crude and model oil. Furthermore, molecular structure, such as the presence of functional groups, significantly influences oil-wetting properties. Organic acids with an aromatic ring demonstrated a more stable oil-wetness against wettability alteration induced by surfactant treatment. Gemini surfactants with benzene ring(s) in the spacer removed aromatic organic acid more efficiently than surfactants without benzene ring. Overall, this study provides insights into the design and optimization of organic acids for applications requiring effective oil-wetting and oil-wetness stability, as well as the designing of surfactant structures with higher oil removal efficiency.

Longitudinal Assessment of Selective Motor Dysfunction in Service Members With Combat-Related Mild TBI.

Evaluations of clinical outcomes in service members with mild traumatic brain injury (TBI) sustained in combat have largely focused on neurobehavioral and somatic symptoms, neurocognitive functioning, and psychological/psychiatric health. Questions remain regarding other domains, such as gross or fine motor abilities, that could be impacted and are mission-critical to functional warfighters. The objective of the current study was to evaluate longitudinal motor function in U.S. Military personnel with and without mild TBI sustained in combat to assess the possible long-term impact. Data from the EValuation Of Longitudinal outcomes in mild TBI active duty military and VEterans (EVOLVE) study were leveraged for analysis. The EVOLVE study has evaluated and followed service members from combat and following medical evacuation with and without blast-related mild TBI, as well as blunt impact mild TBI, and noninjured combat-deployed service members, tracking 1-, 5-, and 10-year outcomes. Longitudinal demographic, neuropsychological, and motor data were leveraged. Cross-sectional differences in outcomes at each year among the 4 injury groups were assessed using rank regression, adjusting for age, education, sex, branch of service (Army vs. other), subsequent head injury exposure, and separation from service. To understand the possible performance impact of time on all the measures, mixed-effects rank regression was employed, assessing time with adjustments for group, age, education, subsequent head injury exposure, and service separation status, followed by Benjamini-Hochberg correction for multiple comparisons. Evaluation for cognitive performance across 19 primary measures of interest at 1, 5, and 10 years did not identify any significant differences; however, gross motor function was found to be significantly different across groups at all time points (adjusted P < .001 at 1 year, P = .004 at 5 years, and P < .001 at 10 years) with both TBI groups consistently performing slower on the 25-Foot Walk and Grooved Pegboard than the nonblast control groups. While there were no cross-sectional differences across groups, many cognitive and motor measures were found to have significant changes over time, though not always in the direction of worse performance. Selective motor impairment in both TBI groups was identified compared to nonblast controls, but all groups were also found to exhibit a level of motor slowing when comparing performance at 1- to 10-year follow-ups. Assessment of gross motor function reflected a consistent pattern of significantly slower performances for blast and nonblast TBI groups compared to controls, over all follow-up intervals. Fine motor function performance reflected a similar significant difference pattern at 1- and 5-year follow-up intervals, with a reduced difference from control groups at the 10-year follow-up. Maintenance of high-level motor functions, including overall motor speed, coordination, and reaction time, is a primary component for active warfighters, and any motor-related deficits could create an increased risk for the service member or unit. While the service members in this longitudinal study did not meet criteria for any specific clinical motor-related diagnoses or movement disorders, the finding of motor slowing may reflect a subclinical but significant change that could be a focus for intervention to return to preinjury levels.