Numerous Definitions Research Articles

Assessment of Knowledge About Accreditation of Medical Schools Among Medical Students of school of medicine at Ahfad University for women 2021

Introduction: accreditation was defined by World Federation of Medical Education (WFME) as the certification of the suitability of medical education programs, and of the competence of medical schools in the delivery of medical education that ensures patient safety and competent practicing doctors. It’s extremely important that students understand the concept of accreditation, its nine criteria and six processes. Method: This study was an institutional based cross-sectional study, conducted in 2021.This study was carried out in one phase among 333 medical students in the university of Ahfad school of medicine, aged <18 and >21 were enrolled in the study. The questionnaires were formed in Google form which made data easy to collect and analyze, especially considering the obstacle of the Corona pandemic. These forms were formed to evaluate the knowledge and understanding of students toward accreditation of medical schools. Statistical analysis was performed using SPSS version 20. Result: Basically Concerning the medical students’ knowledge about accreditation, the results revealed that the majority of them (63.1%) mentioned they have information about accreditation, while the rest of them (36.9%) mentioned they have no information about accreditation. While accreditation is defined as the official approval given by an organization stating that a subject or thing has achieved a required standard. In medical education terminology, accreditation has numerous definitions. But according to the World Health Organization (WHO) accreditation is "a voluntary peer-review process designed to test the educational quality of new and established medical programs".(1) Conclusion: From the study findings it can be concluded that; while the general knowledge on accreditation was unsatisfactory, the students’ knowledge about standard of accreditation and accreditation process and their roles in it was rather poor

On Defining Smart Cities using Transformer Neural Networks

Cities worldwide are rapidly adopting “smart” technologies, transforming urban life. Despite this trend, a universally accepted definition of “smart city” remains elusive. Past efforts to define it haven’t yielded a consensus, as evidenced by the numerous definitions in use. In this paper, we endeavored to create a new “compromise” definition that should resonate with most experts previously involved in defining this concept and aimed to validate one of the existing definitions. We reviewed 60 definitions of smart cities from industry, academia, and various relevant organizations, employing transformer architecture-based generative AI and semantic text analysis to reach this compromise. We proposed a semantic similarity measure as an evaluation technique, which could generally be used to compare different smart city definitions, assessing their uniqueness or resemblance. Our methodology employed generative AI to analyze various existing definitions of smart cities, generating a list of potential new composite definitions. Each of these new definitions was then tested against the pre-existing individual definitions we’ve gathered, using cosine similarity as our metric. This process identified smart city definitions with the highest average cosine similarity, semantically positioning them as the closest on average to all the 60 individual definitions selected.

Curricular innovation in the knowledge society

Introduction: the problematization of the phenomenon of curricular innovation has been approached by research in the international and local context and confronting positions have emerged around the curriculum; and in order to make effective the transformation in the educational field and in a peculiar way in the decisions of the Curriculum, it is necessary to assume policies of change in the educational management. The objective of this work focuses on the characterization, reflection and theoretical deepening of curricular innovation within the framework of the knowledge and information society. Methods: qualitative-hermeneutic, narrative and exploratory study based on literature review. Results: the concept of curriculum is polysemic, with numerous definitions that indicate the richness of this concept and also the difficulty of its study; Furthermore, the need to think from a curricular vision the principles for educational innovation and as a model of socio-political transformation in decision making as a contribution to the culture of peoples, promoting the search for and production of knowledge, and that as a collective process the emergence of the knowledge society will require, among other things, reflection and practices on the effective conditions of possibility of its social, political and economic nature through appropriate educational policies that need to be elucidated and explored collectively as a challenge of Curricular Innovation. Conclusions: in relation to the phenomenon of curricular innovation and based on the bibliographic exploration, a series of descriptive studies emerged that problematize the subject from an analysis of the local reality, therefore many questions remain to be asked regarding curricular innovation such as: what is the most important and substantive change in the curriculum, how does the innovative intention of the curriculum originate, how should one proceed in the search for curricular innovation, how is the innovative intention of the curriculum transmitted to the political levels?

MACHINE LEARNING CLASSIFICATION OF THE EPIDEMIOLOGIC STAGES OF INFLAMMATORY BOWEL DISEASE ACROSS GEOGRAPHY AND TIME

Abstract BACKGROUND Epidemiologic stages of inflammatory bowel disease (IBD) have been proposed: 1. Emergence (low incidence and prevalence); 2. Acceleration in Incidence (rapidly rising incidence, low prevalence); and 3. Compounding Prevalence (stabilizing incidence, rapidly rising prevalence). To date, these stages have been theoretical without quantified definitions of incidence and prevalence. AIM To use machine learning to determine incidence and prevalence ranges corresponding to the epidemiologic stages and provide stage classifications across time for global regions. METHODS We built a supervised random forest classifier in R to determine epidemiologic stages of IBD from population-based studies (n=340), a subset derived from a systematic review on the incidence and prevalence of IBD. A labelled training data set comprising rates of incidence and prevalence of Crohn’s disease (CD) and ulcerative colitis (UC) extracted from the systematic review was used to predict classifications of stage 1, stage 2, or stage 3 for each region, stratified by decade (1960–2019). Model accuracy was measured using a blind validation data set. The validated model was then used to predict stage classifications for regions in the data set. Interquartile ranges for incidence and prevalence of CD and UC were calculated on the random forest output, and the distributions were compared using negative binomial regression. RESULTS The random forest’s classification accuracy on the blinded validation data was 93.7% (95%CI: 90.6, 96.1) indicating an appropriate model fit and performance. Significant differences between all stages for the incidence and prevalence of CD and UC (p<0.001) were found. The clear distinction across stages defines the incidence and prevalence ranges (25th–75th, per 100,000) for IBD as: CD incidence 0.0–0.3, UC incidence 0.2–0.7, CD prevalence 0.3–2.2, and UC prevalence 1.7–8.1 for stage 1; CD incidence 1.0–4.4, UC incidence 2.3–6.3, CD prevalence 9.0–33.9, and UC prevalence 22.8–73.3 for stage 2; and CD incidence 6.6–14.0, UC incidence 10.1–18.1, CD prevalence 163.2–274.7, and UC prevalence 189.1–323.2 for stage 3 (Figure 1). A decade-by-decade analysis shows global regions transitioning across the epidemiologic stages (Figure 2). By the 2010s, North America, Scandinavia, Western Europe, Australia, and New Zealand were in stage 3. Most regions in Asia and Latin America were in stage 1 in the last half of the 20th century, with many transitioning to stage 2 in the 2010s. DISCUSSION Temporal incidence and prevalence data show that regions transition across epidemiologic stages. Numerical definitions of the epidemiologic stages can be used to establish the anticipated burden growth of IBD by providing estimated rates of the number of incident and prevalent IBD cases a region can expect as it transitions between IBD epidemiologic stages in the future. Figure 1 Coalescing ranges for incidence (panel A) and prevalence (panel B) by Crohn’s disease and ulcerative colitis at epidemiologic stage 1, stage 2, and stage 3. Data were categorized by data type (incidence or prevalence), disease type (Crohn’s disease or ulcerative colitis), and epidemiologic stage, as per results from the random forest classifier. The 25th and 75th percentiles were calculated using the rates across all regions included in the analysis for all available time points for each box group. Figure 2 Global maps depicting epidemiologic stages of IBD evolution from 1960 to 2019 broken down by decade, as predicted by the random forest model. Panel A contains stage classifications from 1960 to 1969; panel B contains stage classifications from 1970 to 1979; panel C contains stage classifications from 1980 to 1989; panel D contains stage classifications from 1990 to 1999; panel E contains stage classifications from 2000 to 2009; and panel F contains stage classifications from 2010 to 2019.

Resilience following childhood adversity: The need for a heuristic multilevel dynamic framework

Both Childhood Adversity (CA) and resilience are heterogeneous constructs that are differently conceptualized and operationalized across studies. CA in any operationalization is associated with mental and physical health problems across the lifespan, but some individuals fare quite well after CA exposure. The large body of studies investigating CA and its consequences includes a growing number of studies on resilience following CA exposure. However, large heterogeneity in study design and conceptualization of resilience hampers integration of findings and our understanding of positive outcomes after CA. Collaborative efforts to move the field forward have been valuable yet insufficient, as a consensus on the conceptualization and study of resilience in the context of CA is still lacking. Therefore, we postulate the need for the practical implementation of a comprehensive multilevel dynamic framework of resilience after CA, which aims to guide the integration of I) the contextual diversity of CA, II) the heterogeneity of resilience operationalization in the context of CA, and III) time dynamics of resilience after CA. We build upon earlier frameworks and postulate that CA occurs in and is impacted by different contexts, such as the direct family environment and the broader community context. Second, we show that studies on resilience following CA measure outcomes across different functional levels (inflammatory, endocrine, brain structure and function, cognitive/emotional/behavioral/social functioning, and health, well-being, and quality of life), adhere to numerous definitions, and are inconsistent in referring to the integral dynamic nature of resilience. In addition, we present a multilevel dynamic framework reporting checklist to encourage practical implementation of our framework and facilitate an explicit conceptualization and assessment of resilience during or after CA exposure. Our framework and corresponding checklist could promote transparency, facilitating the synthesis of research findings, aiding in the identification of gaps for future research, and enabling multilevel modeling on the dynamic interplay between various domains of our framework.

Surveying the Syllabus: What Syllabi Communicate About Service-Learning at Four-Year Institutions

Seeking to advance knowledge and understanding of service-learning, this study analyzed how 270 syllabi from 193 four-year institutions that were recipients of the Carnegie Elective Classification for Community Engagement communicated frameworks and expectations of service-learning courses. Findings revealed variance in how syllabi identified, defined, and discussed service-learning as well as differences in how syllabi communicated the work and expectations of service experiences tied to courses. Specifically, findings revealed that numerous terms and definitions invoked throughout syllabi are used to describe academic work linked to community-based experiences. Findings also revealed a lack of clarity within syllabi regarding community work (e.g., whether service was mandatory or optional, the time required in service, whether credit was awarded for service) as well as a lack of specifics on community partnerships. Through this survey of the field, syllabi were used to visualize service-learning practice, explore its contours, and raise pertinent questions that invite further examination about the field.

The role and activities of the public in the implementation of anti-corruption reforms

The article is devoted to an important and topical issue of legal description of the role and activities of the public in the implementation of anti-corruption reforms.
 Countering corruption has always been an important task for Ukraine. It has been proven that the public is the most interested stakeholder in the fight against corruption. It is the members of civil society who want to live in a state governed by the rule of law, where the principles of equality, publicity and transparency are truly in place. And the success of anti-corruption changes depends on the willingness and participation of every member of civil society.
 It is noted that civil society involves active participation of citizens in political processes, civil dialogue and various public initiatives. Its main goal is to protect the rights and interests of citizens, as well as to oversee the activities of government agencies and prevent possible abuses.
 The legal and numerous doctrinal definitions of the concept of “public” and its components in the context of anti-corruption reforms are analysed.
 It is substantiated that the experience of involving the public in the implementation of anti-corruption reforms can be successful only if representatives of public authorities and business are open and transparent.
 It is emphasised that citizens and civil society organisations play an important role in combating corruption, as they serve as advocates for the public interest, provide independent oversight, mobilise communities, protect whistleblowers, advocate for policy reforms and promote transparency, accountability and good governance. In particular, citizens are empowered to demand responsibility, act as whistleblowers, influence policy and elections, raise public awareness and promote ethical values. Their participation is essential for the development of transparent, accountable and corruption-free societies. Civil society organisations are also important actors in the anti-corruption fight in Ukraine. Their independent oversight, advocacy, support for whistleblowers, policy analysis and engagement with citizens contribute significantly to the promotion of transparency, accountability and good governance in the country.

What are the key dimensions that CE emphasizes on? A systematic analysis of circular economy definitions

Today, the concept of the circular economy (CE) has different meanings for various scholars. There are numerous definitions that focus on highlighting different aspects and principles of CE. However, there has been little effort made regarding the focus of CE definitions on various environmental aspects, such as waste management, wastewater treatment, biodiversity, carbon emissions and climate change. To clarify this complex environment, this paper examines the research endeavors surrounding the CE by analyzing 136 descriptions sourced from various entities and researchers. In particular, a more thorough investigation of CE is warranted to explore the possible ways of adopting its principles. To achieve this, Microsoft Excel and Leximancer™ software are employed to thematically and content-wise analyze the descriptions. The results reveal that "waste" and "recycling" are central concepts in CE descriptions, which align with the goals set forth in Union legislative acts, the "Roadmap for a Resource-Efficient Europe," and the European Green Deal aimed at increasing recycling rates and eliminating waste.

Global birth prevalence of Robin sequence in live-born infants: a systematic review and meta-analysis.

Robin sequence (RS), a congenital disorder of jaw maldevelopment and glossoptosis, poses a substantial healthcare burden and has long-term health implications if airway obstruction is suboptimally treated. This study describes the global birth prevalence of RS and investigates whether prevalence estimates differ by geographical location, ethnicity or study data source (registry versus non-registry data). The protocol was prospectively registered with PROSPERO.Databases were searched using keywords and subject terms for "Robin sequence", "epidemiology", "incidence" and "birth prevalence". Meta-analysis was performed fitting random effects models with arcsine transformation.From 34 eligible studies (n=2722 RS cases), pooled birth prevalence was 9.5 per 100 000 live births (95% CI 7.1-12.1) with statistical heterogeneity. One third of studies provided a case definition for RS and numerous definitions were used. A total of 22 countries were represented, predominantly from European populations (53% of studies). There was a trend towards higher birth prevalence in European populations and lower prevalence from registry-based studies. Only two studies reported ethnicity.This study indicates that RS occurs globally. To investigate geographical differences in prevalence, additional studies from non-European populations and reporting of ethnicity are needed. Heterogeneity of estimates may be due to variable diagnostic criteria and ascertainment methods. Recently published consensus diagnostic criteria may reduce heterogeneity among future studies.

Radiation Oncologists' Perspectives on Oligometastatic Disease: A Korean Survey Study.

Perspectives of radiation oncologists on oligometastatic disease was investigated using multi-layered survey. Online survey on the oligometastatic disease was distributed to the board-certified regular members of the Korean Society for Radiation Oncology. The questionnaire consisted of four domains: five questions on demographics; five on the definition of oligometastatic disease; four on the role of local therapy; and three on the oligometastatic disease classification, respectively. A total of 135 radiation oncologists participated in the survey. The median length of practice after board certification was 22.5 years (range, 1 to 44 years), and the vast majority (94.1%) answered affirmatively to the clinical experience in oligometastatic disease management. Nearly two-thirds of the respondents considered the number of involved organs as an independent factor in defining oligometastasis. Most frequently perceived upper limit on the numerical definition of oligometastasis was 5 (64.2%), followed by 3 (26.0%), respectively. Peritoneal and brain metastasis were nominated as the sites to be excluded from oligometastastic disease by 56.3% and 12.6% of the participants, respectively. Vast majority (82.1%) agreed on the role of local treatment in the management of oligometastatic disease. Majority (72%) of the participants acknowledged the European Society for Radiotherapy and Oncology (ESTRO)-European Organisation for Research and Treatment of Cancer (EORTC) classification of oligometastatic disease, however, only 43.3% answered that they applied this classification in their clinical practice. Underlying reasons against the clinical use were 'too complicated' (66.0%), followed by 'insufficient supporting evidence' (30.0%), respectively. While most radiation oncologists supported the role of local therapy in oligometastatic disease, there were several inconsistencies in defining and categorizing oligometastatic disease. Continued education and training on oligometastatic disease would be also required to build consensus among participating caregivers.

Color-kinematics dual representations of one-loop matrix elements in the open-superstring effective action

The α′-expansion of string theory provides a rich set of higher-dimension operators, indexed by ζ values, which can be used to study color-kinematics duality and the double copy. These two powerful properties, actually first noticed in tree-level string amplitudes, simplify the construction of both gauge and gravity amplitudes. However, their applicability and limitations are not fully understood. We attempt to construct a set of color-kinematics dual numerators at one loop and four points for insertions of operator combinations corresponding to the lowest four ζ2-free operator insertions from the open superstring: ζ3, ζ5, {zeta}_3^2 , and ζ7. We succeed in finding a representation for the first three in terms of box, triangle, and bubble numerators. In the case of ζ7 we find an obstruction to a fully color-dual representation related to the bubble-on-external-leg type diagrams. We discuss two paths around this obstruction, both of which signal an incompatability between color-kinematics duality and manifesting certain desired properties. Using the constructed color-dual numerators, we find two different Bern-Carrasco-Johansson double copies that produce candidate closed-string-insertion numerators. Both approaches to the double copy match the kinematics of the cuts, with relative normalization set by either summing over both double copies including degeneracy or by including an explicit prefactor on the double-copy numerator definitions.

How is Flash Drought Understood?—Experts’ Definitions and Decision-Makers’ Perceptions

Abstract Because flash drought is a relatively new phenomenon in drought research, defining the concept is critical for scientists and decision-makers. Having detrimental impacts on many sectors, it is important to have a consistent definition and understanding of flash drought, between experts and stakeholders, to provide early warning to the community. This study focuses on onset and progression of conditions and demonstrates the difference in flash drought identification for 15 events across six quantitative definitions of flash drought that use the U.S. Drought Monitor (USDM). Five flash drought events have been studied in the literature while 10 additional events have been perceived as flash drought by stakeholders. The results show that two of six definitions consistently capture the earliest onset of flash drought and include a large percent area in the identification. A qualitative analysis of management challenges and needs determined by stakeholders was completed using survey data. The results found that managing impacts and better communication and education were the top challenges and more data and enhanced and efficient communication as the top needs to better monitor, manage, and respond to flash droughts. The results demonstrate the need for assessing the characteristics of the definitions to enhance communication and monitoring strategies for large and small-scale flash droughts. Significance Statement The purpose of this study is to better understand how different numerical flash drought definitions characterize multiple flash drought events and how these definitions are useful in addressing the needs and challenges of stakeholders. This is important because definitions may capture different areas in flash droughts, which can impact how end users identify a flash drought. Further, this study uses events identified by the literature and by people familiar with drought monitoring. From these findings, definitions that capture flash drought earliest would help address the challenge of rapid onset and the need of quicker data. Further, definitions by sector would be beneficial to address the scale of impacts. This study identifies the importance of definitions for early warning systems.

Serum anti-tissue transglutaminase IgA and prediction of duodenal villous atrophy in adults with suspected coeliac disease without IgA deficiency (Bi.A.CeD): a multicentre, prospective cohort study

Whether coeliac disease in adults can be diagnosed with serology alone remains controversial. We aimed to evaluate the accuracy of serum anti-tissue transglutaminase IgA (tTG-IgA) in the diagnosis of coeliac disease. In this multicentre, prospective cohort study, adult participants (aged ≥18 years) with suspected coeliac disease without IgA deficiency who were not on a gluten-free diet and who had a local serum tTG-IgA measurement, were enrolled from Feb 27, 2018, to Dec 24, 2020, by 14 tertiary referral centres (ten from Europe, two from Asia, one from Oceania, and one from South America) to undergo local endoscopic duodenal biopsy. Local serum tTG-IgA was measured with 14 different test brands and concentration expressed as a multiple of each test's upper limit of normal (ULN), and defined as positive when greater than 1 times the ULN. The main study outcome was the reliability of serum tests for the diagnosis of coeliac disease, as defined by duodenal villous atrophy (Marsh type 3 or Corazza-Villanacci grade B). Histology was evaluated by the local pathologist, with discordant cases (positive tTG-IgA without duodenal villous atrophy or negative tTG-IgA with duodenal villous atrophy) re-evaluated by a central pathologist. The reliability of serum tests for the prediction of duodenal villous atrophy was evaluated according to sensitivity, specificity, positive predictive value, negative predictive value, and the area under the receiver operating characteristic curve (AUC) for categorical and continuous data. We enrolled 436 participants with complete local data on serum tTG-IgA and duodenal histology (296 [68%] women and 140 [32%] men; mean age 40 years [SD 15]). Positive serum tTG-IgA was detected in 363 (83%) participants and negative serum tTG-IgA in 73 (17%). Of the 363 participants with positive serum tTG-IgA, 341 had positive histology (true positives) and 22 had negative histology (false positives) after local review. Of the 73 participants with negative serum tTG-IgA, seven had positive histology (false negatives) and 66 had negative histology (true negatives) after local review. The positive predictive value was 93·9% (95% CI 89·2-98·6), the negative predictive value was 90·4% (85·5-95·3), sensitivity was 98·0% (95·3-100·0), and specificity was 75·0% (66·6-83·4). After central re-evaluation of duodenal histology in 29 discordant cases, there were 348 true positive cases, 15 false positive cases, 66 true negative cases, and seven false negative cases, resulting in a positive predictive value of 95·9% (92·0-99·8), a negative predictive value of 90·4% (85·5-95·3), a sensitivity of 98·0% (95·3-100·0), and a specificity of 81·5% (73·9-89·1). Either using the local or central definition of duodenal histology, the positive predictive value of local serum tTG-IgA increased when the serological threshold was defined at increasing multiples of the ULN (p<0·0001). The AUC for serum tTG-IgA for the prediction of duodenal villous atrophy was 0·87 (95% CI 0·81-0·92) when applying the categorical definition of serum tTG-IgA (positive [>1 × ULN] vs negative [≤1 × ULN]), and 0·93 (0·89-0·96) when applying the numerical definition of serum tTG-IgA (multiples of the ULN). Additional endoscopic findings included peptic gastritis (nine patients), autoimmune atrophic gastritis (three), reflux oesophagitis (31), gastric or duodenal ulcer (three), and Barrett's oesophagus (one). In the 1-year follow-up, a midgut ileum lymphoma was diagnosed in a woman on a gluten-free diet. Our data showed that biopsy could be reasonably avoided in the diagnosis of coeliac disease in adults with reliable suspicion of coeliac disease and high serum tTG-IgA. None.

Defining opioid naïve and implications for monitoring opioid use: A population-based study in Alberta, Canada.

Reducing initial exposure of "opioid naïve" patients to opioids is a public health priority. Identifying opioid naïve patients is difficult, as numerous definitions are used. The objective is to summarize current definitions and evaluate their impact on opioid naïve measures in Alberta. An exploratory data analysis of the literature was conducted over the last 10 years to identify definitions commonly used in the literature to define opioid naïve. Then, using these definitions as a guide, we descriptively report the proportion of patients in Alberta between 2017 and 2021 who would be considered as opioid naïve using these definitions and all opioid dispensing data. Three categories of definitions were broadly identified: (1) no opioid use within the previous 30 days/6 months/1 year, based on dispensation date; (2) no opioid use based on dispensation date plus days of supply; and, (3) exclusion of codeine from Definitions 1 and 2. Applying these definitions to the Alberta population showed a very wide range in the proportion who would be considered as opioid naïve. Overall, 36.4% of Albertans (n = 1 551 075) had an opioid dispensation in 2017-2021. The average age was 46.6 ± 18.8 and 52.8% were female. The proportion of opioid naïve were most affected by the "opioid free" period, with 97.4%, 83.2%, and 65.6% being classified as opioid naïve using time windows from Definition 1 (30 days, 6 months, 1 year of no prior opioid use). Definitions 2 and 3 did not materially change the results. Further extending the "opioid free" period to 2 years showed only 35% were opioid naïve. The most convenient definition for "opioid naïve" was the use of an "opioid free" period. The choice of window would depend on how the information may be used to assistant in clinical decisions with longer windows more likely to reflect true opioid naïve patients. Irrespective of definition used, a large proportion of opioid users would be considered opioid naïve in Alberta.

Pilot study to define criteria for Pituitary Tumors Centers of Excellence (PTCOE): results of an audit of leading international centers

PurposeThe Pituitary Society established the concept and mostly qualitative parameters for defining uniform criteria for Pituitary Tumor Centers of Excellence (PTCOEs) based on expert consensus.Aim of the study was to validate those previously proposed criteria through collection and evaluation of self-reported activity of several internationally-recognized tertiary pituitary centers, thereby transforming the qualitative 2017 definition into a validated quantitative one, which could serve as the basis for future objective PTCOE accreditation.MethodsAn ad hoc prepared database was distributed to nine Pituitary Centers chosen by the Project Scientific Committee and comprising Centers of worldwide repute, which agreed to provide activity information derived from registries related to the years 2018–2020 and completing the database within 60 days. The database, provided by each center and composed of Excel® spreadsheets with requested specific information on leading and supporting teams, was reviewed by two blinded referees and all 9 candidate centers satisfied the overall PTCOE definition, according to referees’ evaluations. To obtain objective numerical criteria, median values for each activity/parameter were considered as the preferred PTCOE definition target, whereas the low limit of the range was selected as the acceptable target for each respective parameter.ResultsThree dedicated pituitary neurosurgeons are preferred, whereas one dedicated surgeon is acceptable. Moreover, 100 surgical procedures per center per year are preferred, while the results indicated that 50 surgeries per year are acceptable. Acute post-surgery complications, including mortality and readmission rates, should preferably be negligible or nonexistent, but acceptable criterion is a rate lower than 10% of patients with complications requiring readmission within 30 days after surgery. Four endocrinologists devoted to pituitary diseases are requested in a PTCOE and the total population of patients followed in a PTCOE should not be less than 850. It appears acceptable that at least one dedicated/expert in pituitary diseases is present in neuroradiology, pathology, and ophthalmology groups, whereas at least two expert radiation oncologists are needed.ConclusionThis is, to our knowledge, the first study to survey and evaluate the activity of a relevant number of high-volume centers in the pituitary field. This effort, internally validated by ad hoc reviewers, allowed for transformation of previously formulated theoretical criteria for the definition of a PTCOE to precise numerical definitions based on real-life evidence. The application of a derived synopsis of criteria could be used by independent bodies for accreditation of pituitary centers as PTCOEs.

Hybrid Warfare: India’s New Policy Instrument

Hybrid warfare has gained significant attention since Russia annexed Crimea in 2014. Despite numerous definitions, a clear understanding of this phenomenon remains elusive. This study aims to define hybrid warfare by synthesizing expert opinions and organizational viewpoints. It also examines how hybrid warfare has been executed using an analytical framework developed by European nations. Recent claims by Pakistan, China, and others about India’s use of hybrid warfare prompt analysis of India's strategic application of this approach for national security objectives. The study concludes with practical recommendations for policymakers to counter Hybrid Warfare challenges effectively. Overall, this study contributes to comprehending, analyzing, and addressing the complexities of Hybrid Warfare in contemporary security contexts.

KONSEP MODAL KEROHANIAN MENURUT PERSPEKTIF EKONOMI ISLAM The Concept of Spiritual Capital from Islamic Economic Perspective

Spiritual capital is essential for promoting the quality of economic growth. Spiritual capital is a multidimensional and flexible concept. Consequently, the concept has been discussed in numerous social science and humanities disciplines, such as theology, economics, sociology, etc. The discussion has produced numerous definitions of the concept of spiritual capital. Therefore, the purpose of this study is to examine the concept of spiritual capital from an Islamic economics perspective. Qualitative methode has been used in this research where relevant literatures have been critically reviewed. Spiritual capital, according to Islamic economics, is an intangible asset in the form of a source of inner strength that is fueled by the accumulation of religious knowledge and spiritual practices based on both obligatory and supererogatory worships in Islam, which can have a positive impact on those who invest in it.

Bioelectrochemical Systems (BES) for Biomethane Production—Review

Bioelectrochemical systems (BESs) have great potential in renewable energy production technologies. BES can generate electricity via Microbial Fuel Cell (MFC) or use electric current to synthesize valuable commodities in Microbial Electrolysis Cells (MECs). Various reactor configurations and operational protocols are increasing rapidly, although industrial-scale operation still faces difficulties. This article reviews the recent BES related to literature, with special attention to electrosynthesis and the most promising reactor configurations. We also attempted to clarify the numerous definitions proposed for BESs. The main components of BES are highlighted. Although the comparison of the various fermentation systems is, we collected useful and generally applicable operational parameters to be used for comparative studies. A brief overview links the appropriate microbes to the optimal reactor design.

Characterizing Highly Effective Technology and Engineering Educators

There have been numerous definitions and models proposed in attempts to better conceptualize effective educators; however, there is no consensus on a definition or model that characterizes effective educators in all contexts. Specific to technology and engineering (T&amp;E) education, the Standards for Technological and Engineering Literacy (STEL) proposed three elements (core standards and benchmarks, T&amp;E practices, and T&amp;E contexts) for standardization of instruction to ensure more effective T&amp;E educators. However, this requires educators to possess a broad spectrum of integrative knowledge and practices to guide authentic T&amp;E teaching and learning experiences, something which the literature has shown is not always correlated with teaching experience. This article examines various definitions and characteristics of effective educators as presented throughout the literature considered within the context of T&amp;E education. The information presented in this article has implications for helping educators, educator preparation programs, and professional development providers identify and develop competencies that the literature suggests can result in more effective T&amp;E educators.

Clinical and Genomic Differences Between Advanced Molecular Imaging-detected and Conventional Imaging-detected Metachronous Oligometastatic Castration-sensitive Prostate Cancer

In metastatic castration-sensitive prostate cancer (mCSPC), disease volume plays an integral role in guiding treatment recommendations, including selection of docetaxel therapy, metastasis-directed therapy, and radiation to the prostate. Although there are multiple definitions of disease volume, they have commonly been studied in the context of metastases detected via conventional imaging (CIM). One such numeric definition of disease volume, termed oligometastasis, is heavily dependent on the sensitivity of the imaging modality. We performed an international multi-institutional retrospective review of men with metachronous oligometastatic CSPC (omCSPC), detected via either advanced molecular imaging alone (AMIM) or CIM. Patients were compared with respect to clinical and genomic features using the Mann-Whitney U test, Pearson’s χ2 test, and Kaplan-Meier overall survival (OS) analyses with a log-rank test. A total of 295 patients were included for analysis. Patients with CIM-omCSPC had significantly higher Gleason grade group (p = 0.032), higher prostate-specific antigen at omCSPC diagnosis (8.0 vs 1.7 ng/ml; p < 0.001), more frequent pathogenic TP53 mutations (28% vs 17%; p = 0.030), and worse 10-yr OS (85% vs 100%; p < 0.001). This is the first report of clinical and biological differences between AMIM-detected and CIM-detected omCSPC. Our findings are particularly important for ongoing and planned clinical trials in omCSPC. Patient summaryMetastatic prostate cancer with just a few metastases only detected via newer scanning methods (called molecular imaging) is associated with fewer high-risk DNA mutations and better survival in comparison to metastatic cancer detected via conventional scan methods.