Specific Criteria Research Articles

Fostering Equity in Rural Education: a Literature Review on Student Dropout and Retention Strategies

Purpose: The purpose of the study was to analyze the causes of student dropout in rural universities. The objective was to understand a complex phenomenon that represents a major obstacle to development and equal opportunities in the rural educational context. Theoretical framework: Different scientific publications were reviewed in all the academic platforms with the highest impact in the scientific field. This allowed the researchers to broaden their knowledge and, ultimately, to deepen their understanding of the subject studied in this work. Design/Methodology/Approach: The methodology of the study included a documentary review, with content analysis as the main strategy. The databases Scopus, Redalyc, SciELO Dialnet and Google Scholar were used, with specific inclusion criteria related to the period of publication, type of study, languages and availability in open format. Findings: The data found revealed that university dropout occurs due to various situations, such as individual and socioeconomic factors, geographic and access barriers, quality of education and available resources. In addition, cultural and social aspects, and sometimes the lack of empathy on the part of authorities, professors and peers, cause university dropouts. Social, practical and research implications: The study has important implications for understanding and reducing dropout in the rural university context, which will have implications for areas such as education, policy and social development. Originality/value: It is crucial that education policy makers and university institutions work in a coordinated manner to design comprehensive strategies tailored to the specific needs of each rural community. Continued research and analysis of the elements that influence dropout will identify new opportunities for improvement and ensure equitable access to higher education. This will contribute to the academic, professional and social development of rural students and strengthen the educational fabric of these regions. Taken together, these suggestions aim to strengthen student retention and provide equitable educational opportunities in rural areas, thus contributing to greater equality of opportunity and the integral development of these communities.

Analyzing the impact of data visualization applications for diagnosing the health conditions through hesitant fuzzy-based hybrid medical expert system

Effectively managing healthcare data is crucial for accurate diagnosis and personalized patient care. As the utilization of healthcare data grows for personalized care, concerns about reliability, privacy, and security have emerged. To address these issues, this research explores the fusion of analytical techniques with interactive visual representations, known as visual analytics, as a promising solution. The focus is on evaluating the trustworthiness of healthcare data in Kingdom of Saudi Arabia, particularly the capability of visual analytics tools in facilitating accurate and secure healthcare data analysis. This study tackles challenges such as the absence of specific evaluation criteria, the need to process vast healthcare datasets, the establishment of trust, and the necessity for automation. In response, a hybrid medical decision support system is introduced, leveraging hesitant fuzzy decision systems. The primary objective is to evaluate trustworthiness of visual analytics tools for disease diagnosis within healthcare data. Within the framework of hesitant fuzzy logic, the paper employs a medical multi-criteria decision-making system that integrates the analytic network process and the technique for order of preference by similarity to an ideal solution. Rigorous validation ensures the accuracy and reliability of the findings. The research not only provides valuable insights but also conducts comparative analyses of the proposed models against existing ones, demonstrating the practicality of optimal decision-making in Saudi Arabia environment of healthcare scenarios. Several popular alternatives of healthcare based tools have been used in this study such as Tableau, JupyteR, Zoho Reports, QlikView, Visual.ly, DOMO BI, SAS Visual Analytics. From the results achieved DOMO BI visual analytics tool is found to be most secure and robust tool for healthcare professionals. This effort aims to enhance patient care and outcomes, ultimately contributing to the improvement of the overall healthcare landscape in Saudi Arabia.

Effects of game-based physical education program on enjoyment in children and adolescents: a systematic review and meta-analysis

ObjectiveThe objective of this study was to conduct a systematic review to summarize and assess the advancements lately made on the enjoyable impacts of game-based physical education interventions on children and adolescents. Additionally, it attempted to identify the effects and variables influencing the enjoyable outcomes of children and adolescents’ engagement in physical education games, through meta-analysis.MethodsThis study involves a comprehensive search of different databases like Web of Science, PubMed, Embase, EBSCOhost, Cochrane, and Scopus. Specific criteria are established for the selection process to make sure the relevant literature included. The quality assessment of the included researches is conducted based on the guidelines outlined in the Cochrane 5.1 handbook. Review Manager 5.3 software is employed to synthesis the effect sizes. Additionally, bias is assessed using funnel plots, and to identify potential sources of heterogeneity, subgroup analyses are performed.ResultsA total of 1907 academic papers, out of which 2 articles were identified via other data sources. The present study examined the impact of a pedagogical intervention involving physical education games on the enjoyment experienced by children and adolescents. The results indicated a significant positive effect (MD = 0.53, 95%CI:[0.27,0.79], P < 0.05) of this intervention on enjoyment. Subgroup analyses further revealed that both boys (MD = 0.31, 95%CI:[0.13,0.50], P < 0.05) and girls (MD = 0.28, 95%CI:[0.05,0.51], P < 0.05) experienced increased pleasure compared to traditional physical education. Additionally, children under 12 years of age (MD = 0.41, 95%CI:[0.17,0.64], P < 0.05) benefited from sessions lasting at least 30 minutes or more per session (MD = 0.40, 95%CI:[0.19,0.60], P < 0.05), occurring 1 to 3 times per week (MD = 0.28, 95%CI:[0.16,0.40], P < 0.05), and lasting for more than 3 weeks (MD = 0.81, 95%CI:[0.29,1.34], P < 0.05). These findings suggest that the implementation of physical education games can be an effective approach to teaching this subject.Conclusions1) Interventions using physical games have been shown to yield beneficial outcomes in terms of enhancing the enjoyment experienced by children and adolescents. 2) The effectiveness of treatments aimed at promoting enjoyment among children and adolescents is influenced by several aspects, including gender, age, duration and frequency of physical activity, as well as the specific cycle of activity used.

Alterations of sleep deprivation on brain function: A coordinate-based resting-state functional magnetic resonance imaging meta-analysis.

Sleep deprivation is a prevalent issue that impacts cognitive function. Although numerous neuroimaging studies have explored the neural correlates of sleep loss, inconsistencies persist in the reported results, necessitating an investigation into the consistent brain functional changes resulting from sleep loss. To establish the consistency of brain functional alterations associated with sleep deprivation through systematic searches of neuroimaging databases. Two meta-analytic methods, signed differential mapping (SDM) and activation likelihood estimation (ALE), were employed to analyze functional magnetic resonance imaging (fMRI) data. A systematic search performed according to PRISMA guidelines was conducted across multiple databases through July 29, 2023. Studies that met specific inclu-sion criteria, focused on healthy subjects with acute sleep deprivation and reported whole-brain functional data in English were considered. A total of 21 studies were selected for SDM and ALE meta-analyses. Twenty-one studies, including 23 experiments and 498 subjects, were included. Compared to pre-sleep deprivation, post-sleep deprivation brain function was associated with increased gray matter in the right corpus callosum and decreased activity in the left medial frontal gyrus and left inferior parietal lobule. SDM revealed increased brain functional activity in the left striatum and right central posterior gyrus and decreased activity in the right cerebellar gyrus, left middle frontal gyrus, corpus callosum, and right cuneus. This meta-analysis consistently identified brain regions affected by sleep deprivation, notably the left medial frontal gyrus and corpus callosum, shedding light on the neuropathology of sleep deprivation and offering insights into its neurological impact.

The Effects of Fiscal Policy and Monetary Policy on Borrowing Costs and Credit Access for SMEs: An Empirical Study

The objective of this study is to investigate the impact of fiscal policies (FP) on borrowing costs and credit access (BCAC) for SMEs, considering the role of monetary policy (MP) as a the second independent factor. This research aims to understand more deeply how fiscal and monetary policies can be utilized to support growth and access to finance for SMEs, as well as identify remaining barriers to access to finance. Through comprehensive analysis, this study is expected to provide effective policy recommendations to improve access to credit for SMEs, which in turn can support economic growth and job creation. This study adopts a quantitative research design using statistical analysis to examine the impact of fiscal policies on borrowing costs and credit access for Small and Medium Enterprises (SMEs). The analysis will be conducted using the SMARTPLS 3.0. Sample size based on valuable samples are 120 of SME. The sampling technique used in this study will be purposive sampling. This approach will involve selecting SMEs that meet specific criteria, such as size, sector, and eligibility for relevant government programs or incentives. Result of this study state Fiscal Policy (FP) and Monetary Policy (MP) have a significant effect on Borrowing Costs and Access to Credit (BCAC).

The Effect of Fiscal Decentralization, Balanced Budget, Provincial Financial Aid, and Public Investment on Human Development Index with Population as a Moderation Variable in Regency/City Regional Government in North Sumatra Province

This research aims to analyze the influence of Fiscal Decentralization, Balancing Funds, Provincial Financial Assistance, and Public Investment on the Human Development Index partially and simultaneously. This research also analyzes the influence of Fiscal Decentralization, Balancing Funds, Provincial Financial Assistance, and Public Investment on the Human Development Index with Population as a moderating variable. The population of this research is the Regency/City Government in North Sumatra Province, totaling 33 Regency/Cities. Data collection methods were carried out using documentation techniques using secondary data, namely APBD Realization Reports, Population Data, and Human Development Index data for 2017-2021. The sampling technique used was purposive sampling based on specific criteria. Based on these criteria, a total of 145 analysis units were obtained. The data analysis methods used in this research are descriptive statistical analysis methods, classical assumption tests, multiple linear regression analysis, sensitivity test analysis, hypothesis testing, and residual tests using SPSS version 25. This research shows that Fiscal Decentralization, Balancing Funds, Provincial Financial Assistance, and Public Investment affect the Human Development Index. Partially, fiscal decentralization and provincial financial assistance have positively affected the human development index. The Balancing Fund has a negative effect on the Human Development Index, and Public Investment does not affect the Human Development Index. This research also concludes that population is a moderating variable in strengthening and weakening the relationship between Fiscal Decentralization, Balancing Funds, Provincial Financial Assistance, and Public Investment on the Human Development Index. Keywords: fiscal decentralization, balancing funds, provincial financial assistance, public investment, human development index, population.

Assessment of rehabilitation effectiveness in patients with COPD as part of the project "PulmoRehab – Access to healthcare services through a personalized care system for patients with COPD, including remote monitoring and tele-rehabilitation based on Artificial Intelligence methods"

Introduction. In the project “PulmoRehab – Access to Healthcare Services through a Personalized Patient Care System for COPD including Remote Monitoring and Tele-rehabilitation Based on Artificial Intelligence Methods,” SP ZOZ Specialized Hospital Ministry of Internal Affairs and Administration in Głuchołazy and 10 partners conducted research on tele-rehabilitation for people suffering from Chronic Obstructive Pulmonary Disease (COPD). The tele-rehabilitation program, based on personalized approach and technology, allowed patients to use therapy at home or a convenient location. The project aimed to reduce social inequalities in healthcare by providing remote access to health services for COPD patients. Materials and Methods. The study involved 80 patients aged 50 to 76 years, hospitalized at Ministry of Internal Affairs and Administration’s Specialist Hospital of St. John Paul II, meeting specific criteria. Qualification for the tele-rehabilitation program took into account the assessment of exercise tolerance, dyspnea, fatigue, lung ventilatory function, and saturation. The program included exercises adapted to the individual needs of the patients. Results. Analysis of the results conducted using XLSTAT software 2021.2.2 showed statistically significant differences between spirometric values before and after rehabilitation. Similarly, significant improvement was observed in the results of the 6MWT test and blood saturation. The tele-rehabilitation program proved effective in improving respiratory health parameters in COPD patients. Conclusions. 1. The tele-rehabilitation program improves lung ventilatory function in people with COPD. It reduces the feeling of dyspnea, decreases fatigue, improves SpO2, and increases exercise tolerance, demonstrating the beneficial effects of the rehabilitation applied. 2. The obtained results encourage further research on a representative group with the use of randomization.

Association between variants in TCF7L2, CTRB1/2, and GLP-1R genes and response to therapy with glucagon-like peptide-1 receptor agonists

ABSTRACT Objectives The factors determining the response to treatment with glucagon-like peptide-1 receptor agonists (GLP-1- RAs) have not been clarified. The present study investigated the association between polymorphisms in TCF7L2, CTRB1/2, and GLP-1 R genes and response to GLP-1 RAs regarding glycemic control and weight loss among Greek patients with type 2 diabetes mellitus (T2DM). Methods Patients (n = 191) treated with GLP-1 RAs for at least 6 months were included. Participants were genotyped for TCF7L2 rs7903146 (C>T), CTRB1/2 rs7202877 (T>G) and GLP-1 R rs367543060 (C>T) polymorphisms. Clinical and laboratory parameters were measured before, 3, and 6 months after treatment initiation. The patients were classified into responders and non-responders according to specific criteria. Results Carriers of at least one rs7903146 ‘T’ allele and rs7202877 ‘G’ allele presented similar glucose control and weight loss response to GLP-1 RAs with the respective homozygous wild-type genotypes [odds ratio (OR): 1.08, 95% confidence interval (CI): 0.5, 2.31, p = 0.85 and OR: 1.35, 95% CI: 0.66, 2.76, p = 0.42; OR: 1.4, 95% CI: 0.56, 3.47, p = 0.47 and OR: 1.28, 95% CI: 0.55, 2.98, p = 0.57, respectively]. Regarding the GLP-1 R polymorphism, all participants were homozygous for the wild-type allele; thus, no comparisons were feasible. Female sex (p = 0.03) and lower baseline weight (p = 0.024) were associated with an improved glycemic and weight loss response, respectively. Conclusion There is no evidence suggesting a role for the variants studied in response to GLP-1 RA therapy in people with T2DM. However, specific demographic and clinical factors may be related to a better response to treatment with these agents.

Effectiveness of IT-supported patient recruitment: study protocol for an interrupted time series study at ten German university hospitals

BackgroundAs part of the German Medical Informatics Initiative, the MIRACUM project establishes data integration centers across ten German university hospitals. The embedded MIRACUM Use Case “Alerting in Care - IT Support for Patient Recruitment”, aims to support the recruitment into clinical trials by automatically querying the repositories for patients satisfying eligibility criteria and presenting them as screening candidates. The objective of this study is to investigate whether the developed recruitment tool has a positive effect on study recruitment within a multi-center environment by increasing the number of participants. Its secondary objective is the measurement of organizational burden and user satisfaction of the provided IT solution.MethodsThe study uses an Interrupted Time Series Design with a duration of 15 months. All trials start in the control phase of randomized length with regular recruitment and change to the intervention phase with additional IT support. The intervention consists of the application of a recruitment-support system which uses patient data collected in general care for screening according to specific criteria. The inclusion and exclusion criteria of all selected trials are translated into a machine-readable format using the OHDSI ATLAS tool. All patient data from the data integration centers is regularly checked against these criteria. The primary outcome is the number of participants recruited per trial and week standardized by the targeted number of participants per week and the expected recruitment duration of the specific trial. Secondary outcomes are usability, usefulness, and efficacy of the recruitment support. Sample size calculation based on simple parallel group assumption can demonstrate an effect size of d=0.57 on a significance level of 5% and a power of 80% with a total number of 100 trials (10 per site). Data describing the included trials and the recruitment process is collected at each site. The primary analysis will be conducted using linear mixed models with the actual recruitment number per week and trial standardized by the expected recruitment number per week and trial as the dependent variable.DiscussionThe application of an IT-supported recruitment solution developed in the MIRACUM consortium leads to an increased number of recruited participants in studies at German university hospitals. It supports employees engaged in the recruitment of trial participants and is easy to integrate in their daily work.

IMPACT OF TECHNOLOGY DURING COVID-19 PANDEMIC ON ADOLESCENTS’ IDENTITY DEVELOPMENT

Identity development is significant during adolescence, which requires strong peer relationships through social interactions. The recent COVID-19 pandemic has created havoc in human life, where people distanced from each other to save themselves. To overcome this situation, adolescents already born into a digital era who used technology for fun previously increased their dependency on it to learn and develop.This literature review study was conducted using specific criteria that included literature before and after the pandemic and addressed the problem of how adolescents could develop their identity while shifting from face-to-face to virtual platforms during the COVID-19 pandemic. So, this study aimed to observe the adolescent’s identity development before and after the pandemic while considering Erikson’s theory of eight psychosocial stages and Marcia’s identity statuses.Research findings revealed complex positive outcomes and significant negative consequences. The authors argued that whether positive or negative, adolescents’ identity development became weak and pushed them to a new social and historical context that impaired their ability to develop their identity.

Anticancer and chemopreventive potential of Morinda citrifolia L. bioactive compounds: A comprehensive update.

Morinda citrifolia L., commonly known as Noni, has a longstanding history in traditional medicine for treating various diseases. Recently, there has been an increased focus on exploring Noni extracts and phytoconstituents, particularly for their effectiveness against cancers such as lung, esophageal, liver, and breast cancer, and their potential in cancer chemoprevention. This study aims to provide a comprehensive review of in vitro and in vivo studies assessing Noni's impact on cancer, alongside an exploration of its bioactive compounds. A systematic review was conducted, encompassing a wide range of scientific databases to gather pertinent literature. This review focused on in vitro and in vivo studies, as well as clinical trials that explore the effects of Noni fruit and its phytoconstituents-including anthraquinones, flavonoids, sugar derivatives, and neolignans-on cancer. The search was meticulously structured around specific keywords and criteria to ensure a thorough analysis. The compiled studies highlight Noni's multifaceted role in cancer therapy, showcasing its various bioactive components and their modes of action. This includes mechanisms such as apoptosis induction, cell cycle arrest, antiangiogenesis, and immune system modulation, demonstrating significant anticancer and chemopreventive potential. The findings reinforce Noni's potential as a safe and effective option in cancer prevention and treatment. This review underscores the need for further research into Noni's anticancer properties, with the hope of stimulating additional studies and clinical trials to validate and expand upon these promising findings.

From Posts to Knowledge: Annotating a Pandemic-Era Reddit Dataset to Navigate Mental Health Narratives

Mental illness is increasingly recognized as a substantial public health challenge worldwide. With the advent of social media, these platforms have become pivotal for individuals to express their emotions, thoughts, and experiences, thereby serving as a rich resource for mental health research. This paper is devoted to the creation of a comprehensive dataset and an innovative data annotation methodology to explore the underlying causes of these mental health issues. Our approach included the extraction of over one million Reddit posts from five different subreddits, spanning the pre-pandemic, during-pandemic, and post-pandemic periods. These posts were methodically annotated using a set of specific criteria, aimed at identifying various root causes. This rigorous process produced a richly categorized dataset, invaluable for detailed analysis. The complete unlabelled dataset, along with a subset that has been expertly annotated, is prepared for public release, as outlined in the data availability section. This dataset is a critical resource for training and fine-tuning machine learning models to identify the foundational triggers of individual mental health issues, offering valuable insights for practical interventions and future research in this domain.

Longitudinal assessment of psychological distress and its determinants in a sample of firefighters based in Montreal, Canada.

Firefighters face elevated risks of common mental health issues, with distress rates estimated at around 30%, surpassing those of many other occupational groups. While exposure to potentially traumatic events (PTEs) is a well-recognized risk factor, existing research acknowledges the need for a broader perspective encompassing multidimensional factors within the realm of occupational stress. Furthermore, this body of evidence heavily relies on cross-sectional studies. This study adopts an intensive longitudinal approach to assess psychological distress and its determinants among firefighters. Participants were recruited from 67 fire stations in Montreal, Canada, meeting specific criteria: full-time employment, smartphone ownership, and recent exposure to at least one PTE, or first responder status. Subjects underwent a telephone interview and were directed to use an app to report depressive, post-traumatic, and generalized anxiety symptoms every 2 weeks, along with work-related stressors, social support, and coping styles. Analyses involved 274 participants, distinguishing between those exceeding clinical thresholds in at least one distress measure (the "distressed" subgroup) and those deemed "resilient." The duration and onset of distress were computed for the distressed group, and linear mixed models were employed to evaluate determinants for each psychological distress variable. Clinical psychological distress was observed in 20.7% of participants, marked by depressive, post-traumatic, and anxiety symptoms, often within the first 4-week reference period. Contextual factors (operational climate, social support, solitude) and individual factors (coping style, solitude and lifetime traumatic events in private life) exhibited more significant impacts on psychological distress than professional pressures within the firefighters' work environment. This study reports lower rates of psychological distress than previous research, possibly attributable to sample differences. It highlights that reported symptoms often represent a combined and transient layer of distress rather than diagnosable mental disorders. Additionally, determinants analysis underscores the importance of interpersonal relationships and coping mechanisms for mental health prevention interventions within this worker group. The findings carry implications for the development of prevention and support programs for firefighters and similar emergency workers.

Consumer and provider perceptions of the specialist unit model of care: A qualitative study.

Specialist care units cater to targeted cohorts of patients, applying evidence-based practice to people with a specific condition (e.g., dementia) or meeting other specific criteria (e.g., children). This paper aimed to collate perceptions of local consumers and health providers around specialist care units, as a model of care that may be considered for a new local healthcare facility. This was a qualitative study using two-hour workshops and interviews to collect data. Participants were consumers and health providers in the planned facility's catchment: 49 suburbs in metropolitan Australia. Consumers and health providers were recruited through advertisements and emails. An initial survey collected demographic details. Consumers and health providers participated in separate two-hour workshops in which a scenario around the specialist unit model was presented and discussion on benefits, barriers and enablers of the model was led by researchers. Detailed notes were taken for analysis. Five consumer workshops (n = 22 participants) and five health provider workshops (n = 42) were conducted. Participants were representative of this culturally diverse region. Factors identified by participants as relevant to the specialist unit model of care included: accessibility; a perceived narrow scope of practice; coordination with other services; resources and infrastructure; and awareness and expectations of the units. Some factors identified as risks or barriers when absent were identified as strengths and enablers when present by both groups of participants. Positive views of the model centred on the higher perceived quality of care received in the units. Negative views centred on a perceived narrow scope of care and lack of flexibility. Consumers hinted, and providers stated explicitly, that the model needed to be complemented by an integrated model of care model to enable continuity of care and easy transfer of patients into and out of the specialist unit.

Correlation between Hearing Thresholds and Habitual use of Headphones/Earphones among Students of Tertiary Institutions in Northwestern Nigeria

Background: There has been ongoing concern that prolonged use of headphones/earphones that amplify the sound intensity can lead to noise induced hearing loss. This study therefore aimed at determining the correlation between hearing thresholds and habitual usage of headphones/earphones among undergraduates of tertiary institutions in Northwestern Nigeria.&#x0D; Method: A cross-sectional study was conducted on young adults, who are undergraduate students of tertiary institutions, to assess the hearing thresholds of individuals who frequently use headphones or earphones. Ethical clearance was obtained, and participants who met specific criteria were selected. Amultistage sampling technique was used, and 272 participants (representing 544 ears) with equal number of controls were recruited. They completed questionnaires and underwent otoscopic examination and pure tone audiometry (PTA). Those having wax or foreign bodies in the ears had it removed before performing PTA. The data was recorded and analyzed using SPSS version 20. Frequency tables and variable relationships were examined to determine significance, which was set at a p-value of &lt;0.05.&#x0D; Result: The study involved 272 users of headphones/earphones (representing 544 ears) and an equal number of age- and sex-matched controls. The participants' ages ranged between 18 and 33, with 50.4% being male. The pure tone average among the headphones/earphones users and the controls ranged from 11.0 – 43.8dB, with a mean of 20.2±6.0 and 10.6 – 43.2dB, with a mean of 19.6 ± 4.5, respectively. More than half, 280/544 ears (51.5%) of the participants used headphones/earphones for over 4 years, and of these, 222/280 ears (79.3%) used them for 1 – 4 hours daily. Moderate volume was the preferred listening mode for 63.2% of the users. A moderate positive correlation was observed between hearing thresholds and hours of headphone/earphone use, and a weak positive correlation between hearing thresholds and preferred level of loudness (r = 0.290, p &lt; 0.0001) while no correlation was found between hearing threshold and long-term use (r = 0.003, p = 0.937).&#x0D; Conclusion: This study suggests that individuals who use headphones or earphones for prolonged periods of listening hours daily or at higher listening levels tend to have poorer hearing thresholds.

Effects of Circuit Class Training Versus Individual, Task Specific Training on Upper Extremity Function in Chronic Stroke Patients

Background: Stroke is a leading contributor to disability globally, emphasizing the need for effective rehabilitation techniques. Circuit class training (CCT) and individual, task-specific training (ITST) have emerged as potential approaches for enhancing upper extremity function in stroke survivors. Comparative analyses of their efficacy, especially among chronic stroke patients, are scant. Objective: This study aimed to evaluate and compare the impacts of CCT and ITST on upper extremity spasticity, motor function, and quality of life in individuals with chronic stroke. Methods: In a randomized controlled trial, 36 chronic stroke patients were allocated to either CCT or ITST groups. Participants were aged 45-70 years, had experienced a single stroke episode, and were at least 6 months post-stroke, with specific inclusion criteria regarding spasticity and motor function levels. The interventions were delivered for 1.5 hours daily, five days a week, over eight weeks. Outcomes were measured using the Modified Ashworth Scale (MAS) for spasticity, Functional Independence Measure for Upper Extremity (FMA-UE) for motor function, and Stroke-Specific Quality of Life (SS-QOL) scale for quality of life, analyzed using SPSS version 25. Results: Post-intervention, both CCT and ITST participants exhibited significant improvements in their outcomes. MAS scores showed a reduction in spasticity, with average improvements not significantly differing between the groups. FMA-UE scores increased by an average of 10 points in both groups, indicating enhanced motor function without a significant difference between the groups (p &gt; 0.05). SS-QOL scores improved by an average of 20 points in each group, reflecting better quality of life, with no significant intergroup difference observed. Conclusion: The study concludes that CCT and ITST are equally effective in ameliorating upper extremity spasticity, motor function, and quality of life among chronic stroke patients. The selection between CCT and ITST can thus be personalized based on patient preferences, available resources, and logistical considerations, maintaining rehabilitation efficacy.

Acanthamoeba Keratitis in China: Genotypic and Clinical Correlations.

To investigate the relationship between Acanthamoeba genotypes, clinical manifestations, and outcomes in Acanthamoeba keratitis (AK) patients. This retrospective study included 159 culture-confirmed AK patients. Patients' data were collected, including demographics, initial diagnosis, treatments, and clinical features. The genotype of Acanthamoeba was identified through sequencing the Diagnostic Fragment 3 (DF3) region in the small ribosomal subunit RNA genes. The phylogenetic tree was constructed using the ClustalW model and maximum likelihood method. Cases with "poor outcome" were defined based on specific clinical criteria, including corneal perforation, keratoplasty, other eye surgery, duration of anti-amoebic therapy ≥8.0months, and final visual acuity ≤20/80. "Better outcome" cases were the remainder. The correlation between T4 subtypes, clinical phenotypes, and clinical prognosis were further analyzed. In this study, AK was primarily attributed to the T4A genotype, with a positive correlation between geographical and genetic distances. The primary clinical associated with T4 subtypes was deep stromal infiltration. Results was also showed a significant association between T4 subtypes and clinical outcomes (P = 0.021). Further analysis revealed that T4C was closely associated with a better prognosis (P = 0.040) and T4D with worse outcomes (P = 0.013). In China, AK was predominantly caused by the T4A subtype. Geographical distance positively correlated with genetic distance. Clinical prognosis varied among different subtypes, notably in T4C and T4D. This study demonstrated the association between T4 subtypes and clinical phenotypes, as well as the effects of T4 subtypes on clinical prognosis.

Seismic behavior of reduced beam section joints considering concrete floor effect

SummaryThis study investigates the seismic impact of concrete floors on reduced beam section beam‐to‐column joints through four quasi‐static cyclic tests. We examine mechanical properties, failure modes, and processes against specific criteria. Additionally, we analyze hysteretic response, energy dissipation, stiffness, capacity, and stress–strain mechanisms. Moreover, the ABAQUS platform was used to reproduce the specimen nonlinear finite element model to compare and analyze the test results. The results showed that the specimens exhibit excellent energy dissipation capacity and ductility (with a coefficient of 5.00); the column‐bar connection characteristics affect the maximum capacity and plastic hinge behavior in the reduced beam area. The reduced section of beam's upper flange could not improve the overall seismic performance of the joint. The observed failure sequence is as follows: concrete floor cracking, beam flange yielding, reinforcement fracture, lower flange yielding in the reduced beam area, and overall joint failure. This sequence confirms that the joint fulfills the design criteria of a “strong column‐weak beam” by achieving the target of plastic hinge outward movement.

Musculoskeletal disorders and discomfort for female surgeons or surgeons with small hand size when using hand-held surgical instruments: a systematic review

BackgroundWork-related musculoskeletal disorders (WMSDs), also referred to as work-related musculoskeletal injuries (MSKIs), cause surgeons pain and discomfort. Implementing ergonomics in the operating room has helped reduce such symptoms. However, there are still many issues that surgeons face when dealing with medical instruments, especially among female surgeons or surgeons with smaller hands.MethodsThe Cochrane methodology for performing a systematic review was utilized to search five databases for pertinent literature based on the study question “Do female surgeons or surgeons with smaller hand size, who use surgical instruments have an increased risk of musculoskeletal disorders and discomfort compared to male or larger handed surgeons?”. The literature search strategy was designed around the three conceptual domains of surgeons/surgery, smaller hand size, and instrumentation. We searched PubMed, Embase.com, CINAHL Plus with Full Text (EBSCOhost), Scopus, and Web of Science Core Collection. This exploration identified 2165 research publications, and after specific inclusion and exclusion criteria, 19 studies were included in the systematic review. Risk of bias analysis was conducted to assess the quality of the included studies. After conducting a heterogeneity test, a meta-analysis was not performed due to high heterogeneity.ResultsUsing certain surgical instruments presents challenges in the form of MSKIs for female and smaller-handed surgeons. Studies showed that 77% of females and 73% of surgeons who wear < 6.5 glove size report musculoskeletal issues ranging from difficulty of use to pain. Difficulties using surgical instruments and reported injuries have a greater impact on surgical trainees which might deter interest in surgical fields for future proceduralists. Recommendations for improved ergonomic tool design are suggested by some of the included studies to help tackle the MSKIs that surgeons face when performing operations.ConclusionsThe number of female surgeons has increased substantially in the last decade. Hence, there exists an urgent need to address the major challenges they encounter by focusing on this specific aspect of workplace safety and health to mitigate injury. Doing so will yield a productive environment while simultaneously protecting the health and safety of both surgeons and patients.Systematic review registrationThe study protocol was registered on PROSPERO (ID: CRD42022283378).

Metastatic Granular Cell Tumor: A Rare Entity.

Granular cell tumor, which is thought to recapitulate a Schwann cell phenotype, is a very rare neoplasm that belongs to soft tissue tumors. It can be classified as benign, atypical or malignant, based on specific histological criteria, with the majority of cases exhibiting an indolent behavior. Its biology and clinical course are poorly understood and its optimal management is yet to be defined, given the rarity of cases. Here we describe an atypical granular cell tumor in the upper middle back skin that evolved after a thirty-year indolent period. Despite complete surgical removal, the patient experienced a recurrence, both local and in the lungs, following an aggressive clinical course. Data on management of metastatic disease are extremely scarce, comprised exclusively of case reports. Therefore, we administered to the patient systemic therapy according to soft tissue sarcoma guidelines, which led to disease progression, with fatal outcome. In conclusion, recurrent and/or metastatic granular cell tumor is a rare disease that can be life-threatening, for which response to different therapies is unknown. The biologic behavior of atypical and malignant granular cell tumor is quite different from its benign counterpart, evoking soft tissue sarcomas, and its diagnosis should alert clinicians. The role of adjuvant chemotherapy and radiation therapy in this setting should be explored, to limit disease recurrence.