Monitoring Of Progression Research Articles

Design Principles of an Engineered Metastatic Niche for Monitoring of Cancer Progression.

Across many types of cancer, metastatic disease is associated with a substantial decrease in 5-year survival rates relative to only a localized primary tumor. Many patients self-report metastatic disease due to disruption of normal organ or tissue function, and earlier detection could enable treatment with a lower burden of disease. We have previously reported a subcutaneous biomaterial implant for early detection by serving as an engineered metastatic niche, which has been reported to recruit tumor cells before colonization of solid organs. In this report, we investigated the design principles of the scaffold and defined the conditions for use in disease detection. Using the metastatic 4T1 triple-negative breast cancer model, we identified that a porous structure was essential to capture tumor and immune cells. Scaffolds of multiple diameters were investigated for their ability to serve as a metastatic niche, with a porous scaffold with a diameter as small as 2 mm identifying disease accurately. Additionally, scaffolds that had been in vivo for 1-5 weeks were able to identify disease accurately. Finally, the sensitivity of the scaffold relative to liquid biopsies was analyzed, with scaffolds accurately detecting disease at earlier time points than liquid biopsy. Collectively, these studies inform the design principles and use conditions for porous scaffolds to detect metastatic disease.

Progress towards sustainable development goals related to sexual health.

Achieving the sexual health components of sexual and reproductive health and rights as outlined in the sustainable development goals (SDGs) is integral to overall physical and mental well-being and a core part of universal health coverage. However, tracking national and global progress towards advancing the sexual health and rights of people is challenging because of the paucity of indicators to examine many of its components. To assess the state of sexual health in populations, determine service provision needs, evaluate the effectiveness of health system interventions and monitor progress in optimizing health, a comprehensive set of indicators is needed to cover every component of sexual health. Without comparable global indicators for each component of sexual health across the individual, health systems and policy levels, and disaggregated across subgroups including all genders, there is a considerable lack of insight into people's sexual health needs and progress towards meeting those needs. This article explores the availability of global indicators for the different components of sexual health by analysing two key sources: the global indicator framework of the SDGs and the indicator index of the Global Health Observatory. We summarize the indicators for each component of sexual health using the Guttmacher-Lancet Commission framework, highlighting gaps in current indicators, and recommend areas where additional indicators are needed along with strategies on how to improve data availability, quality and inclusiveness.

Effectiveness of airborne particle monitoring technique for assessment of wear progression of mechanical components

For effective implementation of smart machine technology, there is a great demand for real-time monitoring of the wear progression of machine components. In this work, the effectiveness of assessing wear by monitoring the airborne wear particles was investigated. Sliding wear tests were performed using different combinations of stainless steel (SUS304) and alumina material pairs while monitoring the size distribution and the number of particles using a particle counter. The results showed that particles less than 2 μm in size accounted for more than 83% of the total number of airborne particles. However, particles greater than 2 μm account for 95% of the volume of airborne particles. Additionally, in the case of wear volume, the total wear volume, which is the sum of the plate and the ball wear volumes, should be similar to that of the total airborne particle volume. For the SUS304/SUS304 pair, the total wear volume and the total airborne particle volume were very similar. However, in the case of alumina/SUS304 and alumina/alumina, the total wear volume and total airborne particle volume were not similar, and the total wear volume was significantly higher than the total airborne particle volume. The effectiveness of the airborne particle monitoring technique depended strongly on the material pairs. This was due to the fact that particle dispersion behavior varied with respect to the wear mechanisms of the materials.

Enhancing Amyloid PET Quantification: MRI-Guided Super-Resolution Using Latent Diffusion Models

Amyloid PET imaging plays a crucial role in the diagnosis and research of Alzheimer’s disease (AD), allowing non-invasive detection of amyloid-β plaques in the brain. However, the low spatial resolution of PET scans limits the accurate quantification of amyloid deposition due to partial volume effects (PVE). In this study, we propose a novel approach to addressing PVE using a latent diffusion model for resolution recovery (LDM-RR) of PET imaging. We leverage a synthetic data generation pipeline to create high-resolution PET digital phantoms for model training. The proposed LDM-RR model incorporates a weighted combination of L1, L2, and MS-SSIM losses at both noise and image scales to enhance MRI-guided reconstruction. We evaluated the model’s performance in improving statistical power for detecting longitudinal changes and enhancing agreement between amyloid PET measurements from different tracers. The results demonstrate that the LDM-RR approach significantly improves PET quantification accuracy, reduces inter-tracer variability, and enhances the detection of subtle changes in amyloid deposition over time. We show that deep learning has the potential to improve PET quantification in AD, effectively contributing to the early detection and monitoring of disease progression.

Estimating Cognitive Workload Using Task-Related Pupillary Responses in Simulated Drilling in Cochlear Implantation.

Training of temporal bone drilling requires more than mastering technical skills with the drill. Skills such as visual imagery, bimanual dexterity, and stress management need to be mastered along with precise knowledge of anatomy. In otorhinolaryngology, these psychomotor skills underlie performance in the drilling of the temporal bone for access to the inner ear in cochlear implant surgery. However, little is known about how psychomotor skills and workload management impact the practitioners' continuous and overall performance. To understand how the practitioner's workload and performance unfolds over time, we examine task-evoked pupillary responses (TEPR) of 22 medical students who performed transmastoid-posterior tympanotomy (TMPT) and removal of the bony overhang of the round window niche in a 3D-printed model of the temporal bone. We investigate how students' TEPR metrics (Average Pupil Size [APS], Index of Pupil Activity [IPA], and Low/High Index of Pupillary Activity [LHIPA]) and time spent in drilling phases correspond to the performance in key drilling phases. All TEPR measures revealed significant differences between key drilling phases that corresponded to the anticipated workload. Enlarging the facial recess lasted significantly longer than other phases. IPA captured significant increase of workload in thinning of the posterior canal wall, while APS revealed increased workload during the drilling of the bony overhang. Our findings contribute to the contemporary competency-based medical residency programs where objective and continuous monitoring of participants' progress allows to track progress in expertise acquisition. Laryngoscope, 134:5087-5095, 2024.

The Impact of Educational Handouts on the Compliance Rate for Bariatric Patient Follow-Up Appointments.

Compliance rates for follow-up appointments are an issue for postoperative sleeve gastrectomy (SG) patients. Without consistent reinforcement and monitoring of patient progress, patients tend to gain the weight back, all of the medical improvements made are lost, and the ability to access patients for potential complications is denied. Patients need much reinforcement during their forever bariatric lifestyle, and the lack of consistent reminders may contribute to follow-up noncompliance and recidivism in SG patients. As time progresses, the follow-up appointment compliance rate decreases. Decreased follow-up can lead to a higher risk for complications such as asymptomatic esophagitis, and current recommendations suggest that esophagogastroduodenoscopy screening should occur 3years postoperatively. After 1 year, the follow-up compliance decreases dramatically so that by the 3-year postoperative period, very few patients are being seen and scheduled for interventions such as an esophagogastroduodenoscopy. The objective of this quality improvement project was to evaluate the effectiveness of a patient educational handout on SG bariatric patient follow-up visit compliance. A quasi-experimental design and retrospective chart review was chosen. An educational handout was developed. Preintervention retrospective chart review consisted of 441 SG patients expecting a follow-up in 12 to 48months. Postintervention included 3months of the handout intervention with data collection totaling 198 patients. Follow-up compliance for 4 year visits noted 0% preintervention/12.2% postintervention (P =.008), for 3 year visits 13.4% preintervention/12% postintervention (P =.846), for 2 year visits 26.3% preintervention/28.6% postintervention (P =.755), for 18months visits 26.3% preintervention/32.6% postintervention (P =.365), and for 12months visits 54.2% preintervention/34.1% postintervention (P =.011). In this quality improvement project, educational handouts did not have a statistical impact on follow-up compliance.

IMU Calibration Effect on Lower Limbs Kinematics Against Optical Motion Capture in Post-Stroke Gait

BackgroundStroke is the most common cause of disabilities worldwide. Rehabilitation is central to restore functions. Inertial measurement units (IMU) can be used to ease goal settings and monitor progression. Contrary to optical motion capture (OMC), IMU are less expensive, portable, and allow large scale data collections in ambulatory settings. Although Xsens MVN system validity has been demonstrated in healthy participants, its validity among post-stroke (PS) patients is yet to be proven. Research questionComputation methods being affected by the calibration type; the goal of this study is to compare lower limbs kinematics from Xsens system, after two calibrations against OMC in slow PS walkers exhibiting reduced ranges of movements. MethodsData was collected for six PS patients. They were equipped with 29 reflective markers and seven IMU. A minimum of two walks with a dynamic calibration and four walks with a static calibration were performed. All trials were accomplished at a self-selected walking speed and PS used their usual walking aids. ResultsFew interactions between the calibration type and side were found for the ankle abduction/adduction (A/A) bias, root mean square error (RMSE), and range of motion difference (ROMd) (p = 0.011, p = 0.048, p = 0.039). Few effects of the side on errors' values were found. We noticed some effects of the calibration type on errors' values, the dynamic calibration showing better results. In the sagittal plane, we reported RMSE values from 3.6 to 4.8°, 5.2 to 6.5°, and 5.0 to 5.9° for the hip, knee, and ankle dynamic calibration. SignificanceThe calibration type, reduced range of movement, and slow walking speed does not seem to impact Xsens' accuracy to a great extent. Nevertheless, dynamic calibration provides slightly better results. Considering the patient's walking ability, we recommend using this calibration.

Результаты культурной адаптации когнитивной стимулирующей терапии (КСТ) для лиц пожилого и старческого возраста с когнитивными нарушениями в России

<p><strong>Background.</strong> In Russia, the problem of maintaining cognitive well-being at a later age and helping elderly patients with dementia is an urgent task in the areas of healthcare and social protection of the population. The dynamics of the demographic situation in the country shows that by 2030, the older generation will make up almost a third of the population. At the same time, Russia is among the countries with the largest number of people with dementia. The aim of this study was the cultural adaptation of the Cognitive Stimulation Therapy (CST) program for elderly people with cognitive decline and dementia in a Russian-speaking sample with a pilot study of the use of CST in residential institutions on a group of elderly people with mild dementia. <strong>Methods.</strong> Cultural adaptation of the program was carried out within the framework of the Formative Method for Adapting Psychotherapy (FMAP) approach. The study used the official Russian translation of the manual for specialists conducting group classes “Making a Difference.” The sample consisted of several groups: (a) specialists (psychologists, medical workers, social workers) who participated in surveys with the aim of cultural adaptation of the management and procedure of the CST program, as well as receiving feedback after its implementation (n=25); (b) elderly people who participated in surveys for the purpose of cultural adaptation of stimulus material for the CST program (n=60, age 55–81 years (M=67.6, SD=6.2)); (c) elderly people with mild cognitive decline who participated in the pilot implementation of the CST program (n=5, age 68—83 years (M=75.8), MMSE and MoCA (n=5, M = 24.8 and 21.6, SD = 0.4 and 2.5, respectively). Six surveys were conducted: three in the form of face-to-face group discussions, two in the form of individual interviews, one survey was conducted online. Directed observation of the participants of the pilot study was also conducted (monitoring of progress, monitoring of support). The results are presented within the framework of the five stages of FMAP according to the “bottom-up” principle applied to the CST intervention. Results of surveys and observations received during the pilot study regarding feedback from program participants, staff of a residential facility for elderly patients with cognitive deficits, and group leaders were analyzed. <strong>Conclusions.</strong> The basic principles, structure of the intervention program and activities proposed in the CST manual are acceptable for use with Russian-speaking elderly people with mild dementia. The “Making a Difference” manual, translated into Russian and culturally adapted, is ready for use and further large-scale implementation of the intervention. The prospects for the study include assessment of effectiveness of CST on a Russian sample in various conditions (in the process of implementation), as well as development an online version of CST for the elderly population.</p>

Relationship between high-resolution computed tomography quantitative imaging analysis and physiological and clinical features in antisynthetase syndrome-related interstitial lung disease

ObjectivesTo explore the association between the extent of CT abnormalities by quantitative imaging analysis (QIA) and clinical/physiological disease parameters in patients with antisynthetase syndrome associated interstitial lung disease (ARS-ILD).MethodsWe analysed...

Incidence, progression, and outcomes of heart failure with improved ejection fraction: The added value of longitudinally assessed ejection fraction

BackgroundThe revised universal definition of heart failure (HF) established a standardized definition for HF with improved ejection fraction (HFimpEF) and emphasized the importance of longitudinally assessing left ventricular EF (LVEF). We aim to investigate the incidence, disease progression, and clinical outcomes of HFimpEF in a longitudinal cohort of hospitalized HF patients. MethodsWe retrospectively included HF patients with baseline LVEF ≤40 % and satisfactory echocardiographic follow-ups. HFimpEF was defined as a ≥ 10-point increase in LVEF to >40 %. Transient HFimpEF was defined as a recurrent LVEF ≤40 % after achieving HFimpEF. Clinical outcomes were all-cause death, cardiovascular death, and HF rehospitalization. ResultsDuring a median follow-up of 47.9 months, 517 of 923 patients met HFimpEF criteria; 65.0 % HFimpEF cases occurred within 12 months. HFimpEF patients had lower risks of all-cause death (hazard ratio [HR] = 0.16, P < 0.001), cardiovascular death (HR = 0.19, P < 0.001), and HF rehospitalization (HR = 0.39, P < 0.001). However, 160 HFimpEF patients experienced LVEF worsening during follow-up; their risks for adverse events were higher (HR = 1.89 for all-cause death, HR = 2.13 for cardiovascular death, HR = 2.13 for HF rehospitalization, P < 0.05 for all) compared to persistent HFimpEF patients, and their capability of LVEF re-improvement was diminished. An inverted U-shaped LVEF profile for HFimpEF—characterized by a slow, modest increase followed by a decline—portended a higher mortality risk. ConclusionsHFimpEF was observed in 56.0 % of HF patients. Longitudinally assessing LVEF helps identify HFimpEF patients and facilitates disease progression monitoring and risk stratification.

A methodological framework for assessing regional climate efforts. Learning from its application in Italy

In multi-level governance systems, regions are key actors in tackling climate change, acting as a bridging authority between the state and municipalities. Regions can provide a common framework and support local action, in particular through ad-hoc or mainstreamed mitigation and adaptation strategies. Despite this, their contribution to multi-level climate planning is still little explored in the scientific literature. This work proposes a methodological framework developed to comprehensively assess the climate efforts of regional governments, based on three dimensions: ambition, robustness, implementation and progress. Ambition qualifies the regions' commitment. Robustness assesses the evidence-based approach of the plan and its link with the regional sustainable development strategy, as well as the regions’ involvement in transnational networks. Implementation and progress, records the availability of indicators to provide evidence of the actions taken, monitor progress, and inform stakeholders. Applying the proposed methodology to the Italian multi-regional case study sheds light on the weaknesses that limit the impact of climate action, while defining the factors that enhance climate performance. The results show that transnational networks can raise the level of ambition for mitigation, but less so for adaptation, where there are no quantitative targets or fixed target years. A science-based approach and a strong link to the regional sustainable development strategy provide a good degree of robustness, while tracking implementation and progress remains the most challenging factor. Good practices were also identified, based on the successful experiences of some Italian regions, which can be profitably transferred between regional authorities, but also to other sub-national governments.

Automatic segmentation of demyelination lesions in multiple sclerosis

Aim – To evaluate the effectiveness of the YOLOv8 algorithm for automatic segmentation of demyelination lesions in various locations in patients with multiple sclerosis. Material and methods. The study included 120 patients with a clinically confirmed diagnosis of multiple sclerosis who underwent contrast-enhanced MRI. MRI data from patients with different types of disease progression were analyzed. T1-weighted, T2-weighted, and FLAIR sequences were used for analysis. The YOLOv8 algorithm was adapted for medical imaging and trained on manually annotated MRI scans. Model performance was evaluated using precision, recall, and F1-Score metrics. Results. The YOLOv8 model demonstrated high segmentation performance with a precision of 0,79, recall of 00,73, and F1-Score of 0.65. The model effectively identified demyelination lesions in various locations typical for multiple sclerosis. However, there remains a need to improve recall to minimize missed lesions. Testing on independent data confirmed the stability of the model’s results. Conclusion. The YOLOv8 algorithm shows significant potential for automatic segmentation of demyelination lesions in multiple sclerosis patients. This method could be successfully implemented in clinical practice, enabling faster diagnosis and improved monitoring of disease progression. Further optimization of the model, through data augmentation techniques and hybrid architectures, may enhance both segmentation accuracy and recall.

Smartphone-assisted Language Training (SaLT) in Aphasia: Insights from the design and development of a multilingual smartphone application

Background Technology-based aphasia rehabilitation has witnessed steep growth over the past decades with the availability of several commercial apps. While such apps facilitate the intensity of rehabilitation, certain limitations including low multi-language capabilities and/or task-customization (for client-specific needs) result in lower uptake in multilingual countries like India. Aim We describe the development and pilot-testing of the Smartphone- assisted Language Training (SaLT) app – a new application for both mono- and multilingual people with aphasia that facilitates cross-lingual and cross-national sharing of intervention resources. Methods SaLT is a novel, clinician-prescribed, android-based therapy application for mono- and multilingual people with aphasia (SaLT-Home). It can be personalized and customized for individual clients through the clinician-operated web application (SaLT-SLP). Further, it permits asynchronous remote monitoring of therapy progress and sharing of therapy resources with other clinicians across the globe. We present details of the development and structure of the app. We also present pilot testing with four multilingual people with aphasia who undertook clinician-delivered therapy and SaLT-based home therapy. The clinician uploaded personalized tasks and training materials for practice into the SaLT app. Participants with aphasia and their caregivers were asked to practice tasks at home. The focus of this study was not on effectiveness but rather on usage and feasibility. We collected both quantitative and qualitative data regarding the use of the app. After the intervention, participants rated the user experience using the User Mobile Rating Scale. Outcomes &amp; Results Three of the four participants with aphasia across two different languages were motivated to practice and used SaLT-Home. These participants were generally positive about the app. They provided useful insights regarding training in the use of app-delivered therapy, the transition to independent use of such apps and need for support during practice. Conclusions The SaLT application, with its customization and multi-language capabilities, hopes to redefine technology-based intervention in aphasia. Further, it provides the scope for collating and sharing therapy resources by clinicians around the world which could foster the rehabilitation of aphasia, globally. The data from pilot testing also provide insights into the prescription and use of mobile-based home therapy applications which is of general applicability to app-based therapy. The results of this study suggest that future exploration of the use of SaLT is warranted in experimentally controlled treatment studies.

An approach based on ecosystem services for assessing progress towards sustainable development goals at both national and provincial levels in China

Ecosystem services (ESs), the benefits nature provides to people, are an important basis for fulfilling sustainable development goals (SDGs). Therefore, an ES-based approach will help deepen our understanding of the relationships between natural systems and human well-being and provide co-benefit pathways for sustainable development. However, monitoring progress towards achieving the SDGs based on the contributions of ESs to SDGs is lacking. Using the linkages between ESs and SDGs, this study quantified progress towards the SDGs in China from 2000 to 2020 and determined future development priorities at both the national and provincial levels. Our results indicated that (1) during the period 2000–2020, China showed decreasing trends in the 11 SDGs and SDG index scores; (2) there were significant differences in the scores for SDGs and the SDG index across 31 provinces; (3) SDG 3, SDG6, SDG11, SDG13, and SDG15 were recognized as the highest national priorities, concerning health and environment; and (4) 31 provinces faced diverse economic, social, and environmental development challenges. The ES-based approach may assist policy-makers in monitoring and comparing progress towards the SDGs in an integrated and composite way, prioritizing local action, and providing a scientific basis for formulating policies to achieve SDG implementation.

Fiber optic sensing technology in underground pipeline health monitoring: a comprehensive review

Pipelines play a critical role in transporting water, oil, and gas and are indispensable for urban development. However, monitoring underground pipelines is challenging due to the complex environment in which they are situated. Traditional sensors have limitations in all-round and real-time monitoring, while fiber optic sensors offer several advantages, including large coverage, high sensitivity, long sensing distance, and corrosion resistance. As such, fiber optic sensing technology (FOST) has emerged as a promising tool for underground pipeline monitoring. This review article provides a comprehensive overview of FOST, including its basic principles, classification, and research progress in underground pipeline monitoring. Specifically, this article focuses on the technology’s application in monitoring pipeline leakage, deformation, corrosion, and geological natural disasters. In addition, the article highlights the need for future research and development in FOST. For example, combining FOST with artificial intelligence can enhance the accuracy and efficiency of pipeline monitoring. Overall, this review article offers valuable insights into the potential of FOST for underground pipeline monitoring and provides essential guidance for future research in this field.

Apparent lncRNAs involvement in pathogenesis of endometriosis

Endometriosis is an estrogen-dependent, debilitating gynecologic disease impacting millions of women globally. One of the main characteristics of this benign condition is the presence of endometrial-like tissue outside the uterus, causing dysmenorrhea, chronic pelvic pain, and infertility. However, despite many reports on the origin and molecular pathogenesis of endometriosis, the etiology of this disease has not been fully explored yet. Recently, significant attention has been paid to long noncoding RNAs (lncRNAs). Numerous studies focused on exploring the association between lncRNAs and the progression of various human diseases. LncRNAs function as competing endogenous RNAs (ceRNAs) interacting with microRNAs as a “sponge” to regulate cell functions. According to multiple studies, lncRNAs seem to have the potential as markers for diagnosing, and monitoring progression and staging in endometriosis. In this review, we summarized the lncRNAs that were found to influence the pathogenesis of endometriosis. Furthermore, we tried to assess its potential in the process of endometriosis transition from benign through atypical forms, up to EAOC (Endometriosis Associated Ovarian Cancer).

Effect of periodontal therapy on serum and salivary Interleukin-1 beta (IL-1β) and malondialdehyde levels in chronic periodontitis.

Chronic periodontitis (CP) is distinguished by an inflammatory reaction and the presence of oxidative stress (OS), which has consequences for overall health. Interleukin-1β (IL-1β) and malondialdehyde (MDA) serve as markers of inflammation and OS, respectively. Analyzing the alterations in their reaction to periodontal therapy can provide valuable insights into the management and monitoring of CP progression. The current study aimed to evaluate the impact of non-surgical periodontal therapy (NST) on IL-1β and MDA levels in the serum and saliva of CP patients and explore their correlation with clinical periodontal indices post-therapy. There were 60 participants in this research, aged 33 to 50, equally split between thirty periodontally healthy controls and 30 patients with CP. Measures were taken of the clinical periodontal parameters, including the bleeding index, probing pocket depth, gingival index, and plaque index. Saliva and blood samples were collected for IL-1β and MDA analysis using ELISA and spectrophotometrically. CP patients received scaling and root planning (SRP) as part of phase I periodontal therapy, and after six weeks, we reevaluated clinical parameters and IL-1β and MDA levels. In CP patients, both saliva and serum IL-1β and MDA levels significantly increased alongside worsening clinical periodontal parameters compared with periodontally healthy individuals. phase I periodontal therapy led to a notable decrease in both saliva and serum IL-1β and MDA levels, accompanied by improvements in clinical parameters. Additionally, following six weeks of scale and root planning treatment, our data showed a strong positive relationship between salivary IL-1β and MDA levels with PPD and CAL. SRP therapy is effective in managing periodontal health, as evidenced by a significant decrease in clinical parameters and biomarker levels after treatment for CP patients. This suggests that salivary IL-1β and MDA may be useful biomarkers for indicating the severity of periodontal disease and the effectiveness of treatment.

Improving Indigenous Stroke Outcomes by Shifting Our Focus from Health to Cultural Literacy.

Stroke incidence and outcomes are disproportionately unfavorable among Indigenous populations in Western colonized countries. These inequities are often attributed to poor health literacy. This paper summarizes recent evidence on the topic of Indigenous health literacy, describes current gaps, and proposes priorities for future work/research. Traditionally, much focus has been placed on improving health literacy for Indigenous Peoples as a key intervention to address Indigenous stroke and other health disparities. Recent literature, however, challenges this approach as it risks stigmatization and marginalization and portrays the deficiencies as sitting with Indigenous people. Increasingly, an emphasis is placed on the need for health literacy approaches to be culturally responsive for the populations of interest, for institutions to provide high quality culturally relevant stroke care, and for providers to upskill in cultural safety to better meet the needs of Indigenous patient populations. Very little evidence exists to indicate that stroke care providers are meeting these needs. To close the health gap and improve stroke care for Indigenous Peoples, the focus needs to shift from promoting health literacy among Indigenous Peoples to providing high quality culturally relevant health care. More research into this topic and monitoring of progress over time is needed.

Studying the current situation of screening, providing assistance, and monitoring elementary school students with learning disabilities in Thailand

This article examines the current situation of screening, providing assistance, and monitoring elementary school students with learning disabilities in Thailand. This research applies a hermeneutic phenomenological approach to study existential ontology by gaining an understanding of the personal experience individuals undergo. 70 Thai Language teachers, special education teachers, guidance counsellors, and school administrators were surveyed. Then, the researchers conducted a focus group involving 10 participants, including teachers, school administrators, and education specialists. Teachers’ responses to the questionnaire and questions in the focus group were analyzed using a selective or highlighting approach. Each researcher analyzed the responses independently. The researchers then discussed the produced codes, categories, and subcategories in several meetings and exchanged their coding results. After there was consensus, every category and every subcategory were closely examined to look for any overlaps. The results of the analysis are presented in three topics: screening, providing assistance and monitoring. There are two themes, strengths and weaknesses, in each topic. The strengths of the screening topic include basic student assistance, systematic workflow, and teachers’ expertise. The weaknesses of the screening topic include limited teacher numbers, teachers lacking expertise, and inappropriate screening timing. In the providing assistance topic, the sub-themes for strengths include student development, teachers’ expertise in providing student assistance, and making teachers aware of students' actual problems. The sub-themes for weaknesses include teachers lacking tools for assisting students, low-quality tools for providing student assistance, and teachers lacking expertise. Lastly, in the monitoring topic, the strengths include teachers continuously receiving students' information, fostering collaboration in caring for and assisting students, and producing reliable system-generated progress reports. The weaknesses of monitoring include teachers lacking knowledge, lacking tools for monitoring students' progress, and the student progress monitoring system lacking quality.

FibroScan's evolution: a critical 20-year review.

FibroScan, initially designed for assessing cheese maturity, has evolved into a crucial medical tool for liver fibrosis diagnosis. This systematicreview explores its development history, functionality, and pros and cons compared to traditional liver biopsy. Precision in various clinical settings is scrutinised, emphasising FibroScan's accuracy in conditions like NAFLD and viral-induced liver disease. The article also delves into its potential in paediatrics, its relevance in monitoring COVID-19-related liver complications, and its role in predicting hepatocellular carcinoma risk, Technical aspects, including transducers, imaging integration, and portability, are examined. Various methods for evaluating liver fibrosis are discussed, highlighting FibroScan's suitability for advanced stages, contrasting with the gold standard of liver biopsy for early stages. The impact of FibroScan on long-term liver conditions is emphasised, focusing on early detection, progression monitoring, reduced invasive biopsies, and hepatocellular carcinoma risk prediction. This systematicreview underscores FibroScan's transformative potential in liver disease treatment and predicts ongoing research to enhance early detection, disease monitoring, and explore new clinical applications. Anticipated advances include FibroScan-guided liver biopsy, artificial intelligence data analysis, and point-of-care device development, promising a further revolution in liver disease management. The article concludes with optimistic prospects for FibroScan's future.