Ongoing Evaluation Research Articles

Why the Delay? A Quality Improvement Initiative for Delayed Cord Clamping in Preterm Infants.

To improve delayed cord clamping (DCC) rates for preterm infants (≤ 34 + 0 weeks' gestation) and establish DCC as standard practice using quality improvement (QI) methods. A multi-departmental initiative was undertaken. An audit of DCC for preterm infants born at or before 34 + 0 weeks was performed. Using this data and feedback from multidisciplinary staff meetings, barriers to DCC implementation were identified and targeted QI interventions were introduced. Ongoing data surveillance monitored the effects of these interventions. DCC rates were evaluated for 862 preterm infants from January 2014 to August 2022. This QI project commenced in February 2018, with a detailed audit of 225 preterm infants across three time periods: epoch 1 (immediately prior to QI initiative), epoch 2 (QI implementation phase), and epoch 3 (immediate post-implementation surveillance). Inconsistent documentation of cord clamp time and admission hypothermia were identified as potential barriers to implementation of DCC. Over the course of the initiative, the documentation rate increased from 16% to 92.6%. Hypothermia at admission decreased from 76% in epoch 1 to 43.2% in epoch 3. The baseline rate of DCC was low in epoch 1 (12%), but improved to 70% in epoch 3, with this change sustained in ongoing DCC rate evaluation to August 2022. There has been a significant and sustained improvement in DCC for preterm infants at our centre. A structured approach to QI and collaboration between multiple departments were each integral in effecting this improvement in clinical care.

Total Cost of Ownership and Evaluation of Google Cloud Resources for the ATLAS Experiment at the LHC

The ATLAS Google Project was established as part of an ongoing evaluation of the use of commercial clouds by the ATLAS Collaboration, in anticipation of the potential future adoption of such resources by WLCG grid sites to fulfil or complement their computing pledges. Seamless integration of Google cloud resources into the worldwide ATLAS distributed computing infrastructure was achieved at large scale and for an extended period of time, and hence cloud resources are shown to be an effective mechanism to provide additional, flexible computing capacity to ATLAS. For the first time a total cost of ownership analysis has been performed, to identify the dominant cost drivers and explore effective mechanisms for cost control. Network usage significantly impacts the costs of certain ATLAS workflows, underscoring the importance of implementing such mechanisms. Resource bursting has been successfully demonstrated, whilst exposing the true cost of this type of activity. A follow-up to the project is underway to investigate methods for improving the integration of cloud resources in data-intensive distributed computing environments and reducing costs related to network connectivity, which represents the primary expense when extensively utilising cloud resources.

Competency Gaps Among Governmental Public Health Employees With and Without a Formal Public Health Degree: Where Are We Now?

The purpose of this study is to examine whether differences in self-reported core competency skill gaps among U.S. governmental public health workers with and without a formal degree in public health have changed since the last assessment in 2017. This cross-sectional study utilizes data from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS). Bivariate relationships were analyzed by conducting chi-square tests of respondents' supervisory level and reported skill gaps. Multivariate logistic regressions of reported skill gaps were performed holding gender, age, race/ethnicity, public health certificate attainment, role type, current employer, and tenure in public health practice constant. A nationally representative sample of U.S. government public health employees. 36,752U.S. governmental public health employees across local and state health agencies representing 47 states. Self-reported competency skills gaps. In 2021, among both nonsupervisors and supervisors, having a formal public health degree (bachelors, masters, or doctorate) was significantly associated with reduced odds of reporting a skill gap across more than half of the competency skills assessed (14 of 23 skills and 17 of 24 skills, respectively). Nonsupervisors and supervisors with a formal public health degree had fewer skill gaps in 2021 than in 2017. Furthermore, whereas in 2017, when having a public health degree had no effect on executives reporting a skill gap, in 2021, having a public health degree was significantly associated with reduced odds of reporting 2 skill gaps. Overall, across all position levels (ie, nonsupervisory, supervisor, executive), public health workers with a public health degree experienced fewer competency skill gaps in 2021 than in 2017. These findings from PHWINS 2021 illustrate that formal public health education generally decreases competency gaps across numerous competency domains. However, the variability in reported gaps across supervisory levels shows the need for ongoing evaluation and adaptation of formal public health degree programs.

Neonatal Nutrition and Brain Structure at 7 Years in Children Born Very Preterm

Neonatal protein intake following very preterm birth has long lasting effects on brain development. However, it is uncertain whether these effects are associated with improved or impaired brain maturation. To assess the association of neonatal protein intake following very preterm birth with brain structure at 7 years of age. This cohort study involved children born very preterm before or after a change in neonatal intensive care unit nutritional protocol that increased protein intake at the National Women's Hospital in Auckland, New Zealand. The children completed magnetic resonance imaging (MRI) scanning at 7 years. There were 128 children who were initially eligible. MRI data were ineligible for analysis if excessive head motion or clinical brain abnormalities were present. Data were collected from July 2012 to January 2016, and data analysis took place from January 2017 to March 2024. Neonatal intensive care unit nutritional protocol. Those who were born before the protocol change took place (July 2005 to December 2006) were in the old protocol group, while those who were born after the protocol change (January 2007 to October 2008) were in the new protocol group. Observers were blind to participant grouping. All actual enteral and parenteral intakes of protein, fat, energy, and breast milk for days 1 to 7 and days 1 to 14, and growth velocity to postnatal day 28 were calculated for each infant. Preplanned outcomes were group comparisons between regional brain volumes and diffusion parameters of major white matter tracts along with analyses with both groups combined exploring associations of nutrition with brain metrics. Data from 99 children were analyzed, including 42 in the old protocol group (26 female [55%]; mean [SD] gestational age at birth, 27 [2] weeks) and 57 in the new protocol group (27 female [47%]; mean [SD] gestational age at birth, 26 [2] weeks). Protein intake differed between the groups at both 7 days (old protocol: mean [SD] intake, 17 [2] g/kg-1; new protocol: mean [SD] intake, 21 [2] g/kg-1) and 14 days after birth (old protocol: mean [SD] intake, 41 [6] g/kg-1; new protocol: mean [SD] intake, 45 [7] g/kg-1). The new protocol group had smaller brain volume as a percentage of intercranial volume than the old protocol group (mean [SD], 80% [4%] vs 86% [7%]) but absolute brain volumes were similar. The new protocol group had significantly thinner lateral occipital and lateral parietal cortices than the old protocol group. With both groups combined, those with greater protein, fat, energy, and breast milk intake had more mature diffusion tensor metrics (higher fractional anisotropy and less diffusion) across multiple tracts, although this finding did not reach statistical significance for every tract. In this cohort of children born very preterm, children with greater neonatal protein intake had a more mature profile of brain metrics assessed with MRI at 7 years of age. These results contribute to the ongoing evaluation of optimal nutrition for infants born very preterm and suggest that the protein intake experienced by the new protocol group may promote brain maturation in a way that is still observable at 7 years of age.

Use of Go-Beyond as a Self-Directed Internet-Based Program Supporting Veterans' Transition to Civilian Life: Preliminary Usability Study.

The transition from military service to civilian life presents a variety of challenges for veterans, influenced by individual factors such as premilitary life, length of service, and deployment history. Mental health issues, physical injuries, difficulties in relationships, and identity loss compound the reintegration process. To address these challenges, various face-to-face and internet-based programs are available yet underused. This paper presents the preliminary evaluation of "Go-Beyond, Navigating Life Beyond Service," an internet-based psychoeducational program for veterans. The study aims to identify the reach, adoption, and engagement with the program and to generate future recommendations to enhance its overall impact. This study exclusively used data that were automatically and routinely collected from the start of the Go-Beyond program's launch on May 24, 2021, until May 7, 2023. When accessing the Go-Beyond website, veterans were asked to complete the Military-Civilian Adjustment and Reintegration Measure (M-CARM) questionnaire, which produces a unique M-CARM profile of results specifying potential areas of need on the 5 domains of the measure. Users were then automatically allocated to Go-Beyond modules that aligned with their M-CARM profile. Additionally, quantitative and qualitative data were collected from a survey on aesthetics, interactivity, user journey, and user experience, which was optional for users to complete at the end of each module. Results show a conversion rate of 28.5% (273/959) from the M-CARM survey to the Go-Beyond program. This rate is notably higher compared with similar internet-based self-help programs, such as VetChange (1033/22,087, 4.7%) and resources for gambling behavior (5652/8083, 14%), but lower than the MoodGYM program (82,159/194,840, 42.2%). However, these comparisons should be interpreted with caution due to the limited availability of published conversion rates and varying definitions of uptake and adoption across studies. Additionally, individuals were 1.64 (95% CI 1.17-2.28) more likely to enroll when they express a need in Purpose and Connection, and they were 1.50 (95% CI 1.06-2.18) times more likely to enroll when they express the need Beliefs About Civilians, compared with those without these needs. The overall completion rate for the program was 31% (85/273) and modules' individual completion rates varied from 8.4% (17/203) to 20% (41/206). Feedback survey revealed high overall user satisfaction with Go-Beyond, emphasizing its engaging content and user-friendly modules. Notably, 94% (88/94) of survey respondents indicated they would recommend the program to other veterans, family, or friends. The Go-Beyond program may offer promising support for veterans transitioning to civilian life through digital technology. Our study reveals insights on user engagement and adoption, emphasizing the need for ongoing evaluation to further address the diverse needs of military personnel. Future research should explore predictors of engagement, the addition of peer or facilitator support, and the use of outcome measures for effectiveness assessment.

Unleashing the Power of Covalent Drugs for Protein Degradation.

Targeted protein degradation (TPD) has emerged as a significant therapeutic approach for a variety of diseases, including cancer. Advances in TPD techniques, such as molecular glue (MG) and lysosome-dependent strategies, have shown substantial progress since the inception of the first PROTAC in 2001. The PROTAC methodology represents the forefront of TPD technology, with ongoing evaluation in more than 20 clinical trials for the treatment of diverse medical conditions. Two prominent PROTACs, ARV-471 and ARV-110, are currently undergoing phase III and II clinical trials, respectively. Traditional PROTACs are encountering obstacles such as limited binding affinity and a restricted range of E3 ligase ligands for facilitating the protein of interest (POI) degradation. Covalent medicines offer the potential to enhance PROTAC efficacy by enabling the targeting of previously considered "undruggable" shallow binding sites. Strategic alterations allow PROTAC to establish covalent connections with particular target proteins, including Kirsten rat sarcoma viral oncogene homolog (KRAS), Bruton's tyrosine kinase (BTK), epidermal growth factor receptor (EGFR), as well as E3 ligases such as DDB1 and CUL4 associated factor 16 (DCAF16) and Kelch-like ECH-associated protein 1 (Keap1). The concept of covalent degradation has also been utilized in various new forms of degraders, including covalent molecule glue (MG), in-cell click-formed proteolysis targeting chimera (CLIPTAC), HaloPROTAC, lysosome-targeting chimera (LYTAC) and GlueTAC. This review focuses on recent advancements in covalent degraders beyond covalent PROTACs and examines obstacles and future directions pertinent to this field.

Comparative evaluation of several toric intraocular lens calculators for predicting postoperative refractive astigmatism in cataract surgery: a real-world study

BackgroundThis study aims to comprehensively evaluate the predictive accuracy of six widely used toric intraocular lens (IOL) calculators in eyes undergoing cataract surgery with toric IOL implantation.MethodsThis retrospective study reviewed 53 eyes of 53 patients that underwent cataract extraction with toric IOL implantation using Zeiss 709 M. Six toric IOL calculators were evaluated: Barrett toric calculator (with predicted PCA, measured PCA, and TK), Kane formula (predicted PCA), and EVO 2.0 formula (predicted and measured PCA). Postoperative refractive astigmatism prediction errors were comprehensively calculated and analyzed using vector analysis.ResultsThe mean absolute prediction error (APE) ranged from 0.56 ± 0.37 D (Barrett TK) to 0.63 ± 0.46 D (Barrett predicted PCA, PPCA). The proportions of eyes achieving APE ≤ 1.0 D were highest for Barrett TK and Kane predicted PCA (90.6%). The highest proportions of eyes achieving APE ≤ 0.25 D and ≤ 0.50 D were observed with Barrett measured PCA (18.9% and 56.6%, respectively), while the lowest with Barrett PPCA (9.4% and 50.9%, respectively). The study found no statistically significant differences in mean absolute prediction error (APE) among the six calculators (χ² = 6.88, P = 0.23) and the centroid of PE (P = 0.93). A difference in mean APE was observed between the Barrett predicted PCA and Barrett TK calculators (P = 0.02).ConclusionThe study confirms the importance of considering posterior corneal astigmatism remains essential to achieving precise refractive outcomes but also underscores the need for ongoing refinement and evaluation to optimize surgical outcomes.

Preserving and Promoting Saudi Heritage Nationally and Globally: The Role of the Saudi Heritage Commission

This paper is to investigate the pivotal role of the Saudi Heritage Commission in the preservation and promotion of Saudi heritage and culture, both locally and internationally. By addressing the research question, "How does the Saudi Heritage Commission contribute to the preservation and promotion of Saudi heritage?" I explore three sub-questions focusing on local preservation strategies, international cultural promotion efforts, and the measurable impacts of these initiatives. Utilizing a qualitative methodology, It examines various strategies employed by the Commission, including community engagement, technological integration, and cultural diplomacy. The findings reveal a multi-faceted approach that successfully enhances global awareness of Saudi culture while promoting cultural pride and economic benefits. However, challenges such as resource allocation and authentic representation persist, highlighting the need for ongoing evaluation and adaptation. This study contributes to the understanding of cultural heritage preservation and offers insights for similar initiatives worldwide.

Healthy cities: a visual conceptual framework for moving health knowledge into urban planning practice

ABSTRACT Despite the increasing recognition of health as a fundamental dimension in urban design and planning, it remains insufficiently incorporated into urban planning practice and policymaking. This study reexamines the ‘Knowledge Translation’ (KT) process through a literature review (N = 53) to address the gap between the public health and urban planning arenas. By analyzing the key KT components – knowledge, guidance, and implementation – we identified additional factors influencing the process and highlighted gaps and opportunities for improvement. Building on these insights, we developed a visual conceptual framework that synthesizes existing knowledge and addresses critical gaps to support urban practitioners and policymakers in creating ‘healthy cities’. The framework conceptualizes KT as a dynamic, iterative process guided by three key drivers: (i) continuous interaction among knowledge, guidance and implementation, all tailored to local contexts and shaped by decision-making processes; (ii) interdisciplinary and cross-sector collaboration, including active engagement with local communities to create a shared vision of a healthy city; and (iii) a ‘control center’, that integrates these components, facilitates training, and ensures ongoing evaluation and calibration.

Alcohol withdrawal syndrome presentations to emergency departments in the United States from 2015 to 2023.

Alcohol withdrawal syndrome (AWS) is a common condition prompting emergency department (ED) presentation. However, there are limited recent, large-scale, robust data available on the incidence, admission, and medical treatment of AWS in the ED. This was a retrospective cohort study of ED presentations for AWS from January 1, 2016, to December 31, 2023, using Epic Cosmos. All ED visits with ICD-10 codes corresponding to AWS were included. Outcomes included percentage of total ED visits, percentage admitted, length of stay (LOS), and medications administered. Binary logistic regression models were used to measure the relationship between time and dependent variables and reported as odds ratios (ORs) with 95% confidence intervals (CIs). Out of 242,804,798 ED encounters, 670,430 (0.28%) visits were due to AWS with a rise over time (OR 1.074, 95% CI 1.072-1.075). Of these, 386,618 (57.7%) were admitted (46.2% inpatient floor, 11.5% ICU). Median (IQR) hospital LOS was 3 (2-5) days and median (IQR) ICU LOS was 2 (1-4) days. Among all ED patients, benzodiazepine use declined over time (84.9% to 77.1%; OR 0.917, 95% CI 0.914-0.920), while phenobarbital (4.0% to 21.2%; OR 1.255, 95% CI 1.250-1.259) and gabapentin (11.0% to 16.3%; OR 1.054, 95% CI 1.050-1.057) use increased. Oral and intravenous (IV) benzodiazepines were common (63.1% and 66.6%, respectively). Among IV benzodiazepines, lorazepam was most common (59.9%). Among those discharged from the ED, 29.0% were prescribed benzodiazepines (chlordiazepoxide 21.1%, lorazepam 5.5%, diazepam 1.9%). Anticraving medications, such as gabapentin (1.5%), naltrexone (0.4%), and acamprosate (<0.1%) were uncommon, but rising over time. AWS represents a common reason for ED presentation, with most patients being admitted. We identified a rising incidence with a shift in management to include agents such as phenobarbital and gabapentin. These findings provide important evidence on current trends in AWS to inform health policy and knowledge translation efforts as well as emphasizing the need for ongoing research and evaluation of clinical practices to optimize outcomes for patients with AWS.

Supervised exercise-based rehabilitation for people with intermittent claudication-Study protocol for a Danish implementation process (StRiDE).

Intermittent claudication is a peripheral artery disease caused by arteriosclerosis. People with intermittent claudication experience leg cramping during walking, with relief of symptoms during rest. Evidence shows that by participating in supervised exercise therapy and smoking cessation programs, people with intermittent claudication can reduce those symptoms and improve health-related quality of life and maximal walking distance while minimizing the need for an operation. However, implementation of such health-promoting initiatives in clinical practice in Denmark and other countries is limited. This is a protocol presenting the implementation process of supervised exercise therapy and smoking cessation in a region of Denmark. The implementation process is a collaboration between the municipalities in the Region of Zealand and the Department of Vascular Surgery at University Hospital Zealand. The study uses a convergent mixed-methods prospective clinical cohort design, and the theoretical frame of this implementation process follows the framework for Adapting an existing intervention to a new context (ADAPT). The process involves stakeholder engagement, ongoing evaluation through key performance indicators and relevant outcomes that will inform the implementation process across and within each municipality. Dissemination will happen throughout the process through continued meetings with stakeholders and dissemination of performance indicators and outcome results obtained through a database. All information about the study and material will be freely available. The project is registred on Clinicalgov (NCT06299956).

Development and Testing of the Spinal Cord Injury Bladder and Bowel Control Questionnaire (SCI-BBC-Q).

Recovery of lower urinary tract (LUT) and lower gastrointestinal tract (LGIT) is a high priority for people with lived experience following spinal cord injury (SCI). A universally accepted validated patient-reported outcome (PRO) measure of the individual sensory and motor components of LGIT and LUT function, which allows tracking of recovery is lacking. To address this literature gap, the SCI Bladder and Bowel Control Questionnaire (SCI-BBC-Q) was developed. The SCI-BBC-Q was developed as a direct assessment of the micturition and defecation experiences of an individual with SCI with possible neurogenic LUT and LGIT dysfunction. The SCI-BBC-Q development process consisted of two phases, measure development and evaluation. Measure development was guided by a conceptual framework, review of existing instruments and literature, and an iterative process of item incorporation, review, feedback, and consensus revision. Evaluation included cognitive interviewing, and assessments of feasibility, reliability, and content validity. The final 6-item SCI-BBC-Q is a PRO, which assesses motor and sensory function related to micturition and defecation, requiring ~5 min to complete. Assessments of clarity of the instrument components with regard to understanding of what is being asked in the questionnaire, feasibility of administration, reliability, internal consistency, and agreement with proxy measures have demonstrated that the SCI-BBC-Q provides consistent, stable, and reproducible data. Significant correlations were found between SCI-BBC-Q scores and the anorectal motor and sensory components of the International Standards for the Neurological Classification of SCI. The SCI-BBC-Q is a practical and reliable method for baseline and ongoing evaluation of patients with neurogenic LUT and LGIT dysfunction, especially in the acute and subacute period when function is changing due to neurological plasticity. It is also appropriate for use in monitoring response to treatments related to neurological recovery.

Comparison of safety and immunogenicity in the elderly after receiving either Comirnaty or Spikevax monovalent XBB1.5 COVID-19 vaccine.

The emergence of SARS-CoV-2 variants necessitates ongoing evaluation of vaccine performance. This study evaluates and compares the safety and immunogenicity of the Comirnaty and Spikevax monovalent XBB.1.5 COVID-19 vaccines in an elderly population. Altogether, 129 elderly individuals were recruited between 2 January and 3 February 2024, and received a booster dose of either Comirnaty (n=59) or Spikevax (n=70) monovalent XBB.1.5 COVID-19 vaccine. Blood samples were collected at before and one month after vaccination. Immunogenicity was assessed by measuring the percentage of IFNγ+CD4+ and IFNγ+CD8+ T cells, and neutralizing antibody titers (NT50) using a surrogate virus neutralization test (sVNT). Adverse reactions were recorded and analyzed. Both vaccines significantly increased the percentage of IFNγ+CD8+ T cells against XBB.1.5 and wild-type (WT) SARS-CoV-2 at one-month post-vaccination. Spikevax induced a significantly higher percentages of IFNγ+CD8+ and CD4+ T cells against XBB.1.5 than Comirnaty (p<0.001). The proportion of participants showing a positive T cell response to XBB1.5 after vaccination was higher in the Spikevax group (64.3% CD8, 71.4% CD4) than in the Comirnaty group (42.4% CD8, 57.6% CD4). Spikevax also elicited higher NT50 levels against XBB1.5, JN.1 and the latest variant KP.2 than Comirnaty (XBB1.5: p<0.01; KP.2: p<0.05). Fever was more common in the Spikevax group (fever: p=0.006). However, all side effects were short-term and resolved on their own. Both vaccines induce neutralizing antibody to XBB1.5, JN.1 and KP.2. Specifically, Spikevax induces higher cellular and humoral immune responses than Comirnaty in the elderly, but it is also associated with a higher incidence of fever. These findings can guide public health strategies for vaccinating the elderly population.

Evolution and effectiveness of bilateral and multilateral development assistance for health: a mixed-methods review of trends and strategic shifts (1990–2022)

BackgroundDevelopment assistance for health (DAH) plays a vital role in supporting health programmes in low- and middle-income countries. While DAH has historically focused on infectious diseases and maternal and child...

A Framework for Implementing Community-Based Dental Education.

Community-based dental education (CBDE) is essential for equipping dental students with the practical skills required for independent practice while simultaneously addressing the oral health needs of the community through real-world experiential learning. The success of CBDE initiatives rely on effective collaboration across stakeholders, including educational institutions, community organisations, and students, to address both faculty educational goals and community oral health needs. This paper introduces a practical toolbox to support CBDE program implementation. Developed from an extensive literature review, analysis of relevant case studies, and insights from the authors' experiences, the toolbox provides structured, evidence-based guidance on planning, administration, and ongoing evaluation for CBDE programs. Key components include strategies for fostering robust partnerships with community organisations, designing program components that maximise student engagement, and implementing continuous quality improvement practices. The toolbox emphasises creating an adaptable framework that ensures CBDE programs remain responsive to the evolving needs of both students and the communities they serve and sustain long-term collaborations.

The Experiences of Mentors and Mentees with Mentorship in the Agricultural Education Discipline

While mentorship is valued and studied across disciplines, it is not well known within the broadly defined discipline of agricultural education. This study consisted of interviews with mentors and mentees in the discipline to understand why they engaged in the mentorship process and what affected their mentoring relationships. There were 12 participants in the project, equally split between mentors and mentees. There were two themes for why participants engaged in mentorship: Mentorship is an opportunity to learn and people seek out mentorship for guidance. There were five themes for what affected participants’ mentoring relationships: Personal experiences and values drive mentorship, compatibility influences mentorship, mentorship is a personal relationship, communication preferences vary, and comparisons of formal and informal mentorship. For mentees, it was recommended that they take ownership of their mentoring experiences, including cultivating multiple mentors to meet various needs. For mentors, it was recommended to focus on mentees’ needs and fostering connections between their mentees and other potential mentors. While they were not preferred by participants, formal mentorship programs are still recommended to help ensure all junior faculty are served in the discipline. To ensure their success, efforts need to be made to ensure a good fit between mentors and mentees. Programs also need a clear structure, training for mentors, and ongoing evaluation to adapt to participants’ needs. Future research is needed to assess more aspects of mentorship in the discipline, including graduate students and tenured faculty members mentorship needs.

Test, track, treat using wearable sensors for management of Parkinson's disease: 12‑month prospective observational United Arab Emirates study using Parkinson's Kinetograph (EmPark-PKG Study).

Parkinson's disease (PD) is a progressive neurodegenerative disorder marked by both motor and non-motor symptoms that necessitate ongoing clinical evaluation and medication adjustments. Home-based wearable sensor monitoring offers a detailed and continuous record of patient symptoms, potentially enhancing disease management. The EmPark-PKG study aims to evaluate the effectiveness of the Parkinson's KinetoGraph (PKG), a wearable sensor device, in monitoring and tracking the progression of motor symptoms over 12months in Emirati and non-Emirati PD patients. Fifty PD patients (32% Emirati, 68% non-Emirati) were assessed at baseline and a 12-month follow-up. Clinical evaluations included levodopa equivalent daily dosage (LEDD) and motor and non-motor assessments. Concurrently, the PKG provided metrics such as bradykinesia score (BKS) and dyskinesia score (DKS). Statistical analyses were conducted to determine changes from baseline to six months, differences between Emirati and non-Emirati groups, and correlations between PKG metrics and clinical assessments. Significant reductions in LEDD and improvements in both motor and non-motor scores were observed from baseline to six months (p < 0.05). PKG-guided medication adjustments were associated with enhanced motor and non-motor outcomes (p < 0.05). Specifically, non-Emirati patients exhibited a significant reduction in LEDD (Z = -2.010, p = 0.044), whereas Emirati patients did not (Z = -0.468, p = 0.640). Both groups showed significant improvements in motor scale scores and motor complication scores. Spearman correlation analysis revealed strong relationships between PKG metrics and subjective clinical assessments (p < 0.001). The EmPark-PKG study demonstrates the potential benefits of remote PKG monitoring for personalised motor symptom management in PD. PKG supports a stepped care paradigm by enabling bespoke medication titration based on objective data, facilitating tailored and effective patient care.

Engineering antibodies with cancer‐associated binding sites

AbstractCancer immunotherapy has appeared as a prospective therapeutic modality. Therapeutic antibodies induced in an in vitro expression system act as “targeting missiles” against tumor‐associated binding sites, and subsequently, immune system attack on tumors is restored or boosted. These antibody regimens are engineered towards enhanced Fc efficacy, humanization, and fragmentation to specifically recognize and bind to effective tumor‐associated targets. The challenge lies in obtaining efficient therapeutic regimens with low response rates, acquisition of resistance, and immune‐related undesirable effects of artificially designed therapeutic antibodies, which is crucial for enhancing clinical efficacy. This review provides an in‐depth introduction to antibodies that perform direct/indirect roles in cancer treatment by binding to immune checkpoints, co‐stimulatory receptors, and extracellular membrane receptors. It also discusses how antibodies kill tumors and modulate microenvironment of tumor through these targets. The classification of expression systems for antibody production is summarized to guide appropriate selection based on different specificities. Understanding antibody sources, ongoing evaluation of engineered antibodies, and tumor‐associated antigen research pave the way for designing appropriate antibody‐based immunotherapy regimens.

CAD Technology Workshop with the Pierre Bougher Approach in Building Traditional Wooden Ships at Kelompok Usaha Bersama (KUB) Nenang Berlayar North Penajam Paser

Program in the form of a CAD Technology Workshop using the Pierre Bouguer approach aims to improve the skills of traditional wooden ship craftsmen in the Kelompok Usaha Bersama (KUB) Nenang Berlayar, Penajam Paser Utara. This activity introduces Computer-Aided Design (CAD) technology as a modern solution to increase the precision, efficiency and quality of wooden ship designs without eliminating traditional values. Pierre Bouguer's approach which focuses on the stability and balance of the ship through drawing lines plans was applied to produce a better design from a technical and safety perspective. Implementation methods include intensive training, technical assistance, and ongoing evaluation, supported by lecturers and students from the Kalimantan Institute of Technology (ITK). The results of the activity showed a significant increase in craftsmen's understanding and ability to use CAD, as seen from the post-test results of participants who achieved an application level above 90%. This program not only helps craftsmen adopt modern technology but also creates a sustainable learning ecosystem through an online-based community. It is hoped that the application of CAD technology can encourage innovation in traditional wooden shipbuilding, increase competitiveness, and provide added economic value for craftsmen amidst the challenges of modernizing the maritime industry.

Implementation of Phil-Iri Program and English Competence in Oral Read-ing of Grade 6 Pupils

This study explored the implementation of the Phil-IRI Program and its impact on the English oral reading competence of Grade 6 pupils in public elementary schools in San Marcelino, Zambales, Philippines. Using a descriptive-correlational approach with 557 pupils and 26 teachers in the district of San Marcelino, Zambales, it assessed oral reading competence levels before and after the program's implementation. Results showed that most pupils were at the instructional level pre-implementation but demonstrated significant improvements post-implementation. The findings highlight the value of regular reading assessments and interventions in addressing reading comprehension challenges. The study recommends ongoing evaluation of reading programs and professional development for teachers to enhance literacy outcomes and instructional effectiveness.