Systematic Testing Research Articles

Challenges in the Treatment of Coinfection of Visceral Leishmaniosis and Hepatitis B/C Viruses

There is a significant research gap in India due to incomplete investigation of seroprevalence of co-infection with visceral leishmaniasis (VL), hepatitis B (HBV) and hepatitis C (HCV). This study attempts to fill this gap by providing an in-depth analysis of the prevalence and consequences of these co-infections. The study of 32 VL patients revealed that 28 (8.88%) tested positive for HBV, 1 (0.317%) for HCV and 3 (0.95%) for both HBV and HCV. These results highlight how difficult it is to treat people with two diseases at the same time. An example of how co-infection makes treatment much more difficult is the fact that a patient with both VL and HBV required six courses of anti-leishmaniasis medication. The study shows how important it is for VL patients to be tested regularly for HBV and HCV to improve treatment response and support India's plan to get rid of kala-azar. Accurate identification of co-infections is necessary to reduce the overall burden of the disease and develop effective treatment regimens. Systematic testing of VL patients for HBV and HCV not only helps in controlling and perhaps even eliminating kala-azar, but also makes it easier to treat each patient as an individual, improving their health. In areas where viral hepatitis is prevalent, this strategy is particularly important as these diseases represent a double burden on public health. Implementing integrated treatment regimens and routine screening can reduce the impact of co-infection and advance the public health goal of kala-azar elimination. To improve patient outcomes and advance public health goals, the results of this study strongly support the integration of comprehensive screening programs into existing healthcare systems to improve the treatment of VL patients.

A polyester- stainless steel based smart wristband sensor for skin temperature monitoring

This study presents the development and characterization of a novel textile-based wristband sensor for continuous temperature monitoring. The sensor, woven with a blend of polyester-stainless steel and polyester-cotton yarns, exhibited high sensitivity (0.0315/°C) and a rapid response time (∼35 sec). Stainless steel was selected for its excellent electrical conductivity and biocompatibility, crucial for accurate and safe skin contact applications, while polyester and cotton contribute its lightweight, breathable, and durable properties, ensuring prolonged comfort and wearability. Through systematic testing and optimization, the sensor’s sensitivity was fine-tuned by adjusting the number and length of conductive yarns. The study also introduced a theoretical resistance equivalent model, comparing its theoretical sensitivity with experimental findings. The sensor, lightweight and cost-effective, proved comfortable during 8–10 h of continuous wear. This study addresses challenges faced by existing textile temperature sensors and offers a reliable alternative with high linearity, repeatability, and suitability for individuals with sensitive skin.

Sulfur-Phosphorus Doped Metal Composites As Superior Catalyst for Electrolytic Hydrogen Production in Real Seawater

In the face of the increasingly severe global energy crisis and challenges posed by climate change, promoting energy transition has become an international consensus. Among various renewable energy sources, hydrogen is considered an ideal energy carrier due to its clean and efficient characteristics. The electrolysis of seawater for hydrogen production has garnered widespread attention for its ability to fully utilize abundant seawater resources and the advantage of zero carbon dioxide emissions. However, achieving efficient, stable, and economically viable hydrogen production in seawater still faces many challenges, with catalyst design and optimization being recognized as key issues.Firstly, NiFe-LDH was synthesized using a simple one-pot solvothermal method. Subsequently, phosphorization, sulfurization, and sulfur-phosphorus co-doping were conducted to obtain samples namely NiFe-P, NiFe-S and NiFe-SP, respectively. Various electrochemical tests, including hydrogen evolution reaction (HER), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were firstly performed in simulated seawater to evaluate the electrochemical performance of the synthesized catalysts. The overall seawater splitting reaction was conducted with the same catalysts for both anode and cathode sides.After comparing the electrochemical activity of four different catalysts, it was found that NiFe-SP performs superior HER activity in alkaline simulated seawater. NiFe-SP required merely -0.143 V to deliver 100 mA cm-2 current density, which was 95 mV lower than NiFe-LDH to achieve the same current density. In EIS tests, NiFe-SP exhibited a smaller charge transfer resistance than NiFe-LDH, and NiFe-SP had the largest double-layer capacitance (Cdl) value in ECSA measurements, indicating that NiFe-SP possessed and lowest reaction resistance and the maximum electrochemically active surface area.X-ray Diffraction (XRD) and Raman spectroscopy analyses indicate that the catalyst, after sulfur-phosphorus doping, does not exhibit a pure-phase LDH structure but transforms into a heterogeneous structure of Ni3S2 and FeS2. Scanning Electron Microscopy (SEM) observations suggest that sulfur-phosphorus co-doping causes the original spherical structure of NiFe-LDH to aggregate, with the appearance of some lamellar structures on the surface. Energy Dispersive Spectroscopy (EDS) also confirms the successful doping of sulfur and phosphorus elements into NiFe-LDH, with uniform distribution on the material's surface.Finally, the catalyst underwent a 2000-hours continuous stability test at a constant current of 100 mA cm-² in real seawater. The results indicate that the potential of NiFe-SP increased by only 5%, demonstrating that the doping of sulfur and phosphorus not only reduces the catalytic overpotential but also significantly sustains potential retention. This suggests that the metal composite structure obtained after sulfur-phosphorus co-doping is well-formed and stable. The systematic electrochemical tests and stability evaluation in this study highlights the potential of sulfur-phosphorus co-doped metal composite NiFe-SP as an efficient and stable catalyst for real seawater electrolysis. This not only contributes to a deeper understanding of the fundamental principles governing catalyst behavior but also opens new possibilities for the practical application of hydrogen production technology. Figure 1

Seroprevalence and risk factors for SARS-CoV-2 infection in middle-sized cities of Burkina Faso: A descriptive cross-sectional study.

Since March 2020, COVID-19 has evolved from a localized outbreak to a global pandemic. We assessed the seroprevalence of COVID-19 in three towns in the Centre Sud region of Burkina Faso. A population-based cross-sectional survey was conducted in three middle-sized cities in Burkina Faso's Centre Sud region, from June to July 2021. Subjects aged 16 or over at the time of the survey were considered for this seroprevalence study. The Biosynex COVID-19 BSS rapid test was used to detect immunoglobulin G (IgG) and immunoglobulin M (IgM) against SARS-CoV-2. A standardized questionnaire was also administered to collect additional information. A total of 2449 eligible participants (age ≥ 16 years) were identified. Serological tests for COVID-19 were performed in 2155 individuals, of which 2143 valid tests were retained and analyzed. Out of the entire sample, 246 positive tests were observed, corresponding to a prevalence of 11.48%. Prevalence was 9.35% (58 cases) in Kombissiri, 12.86% (80 cases) in Manga and 11.99% (108 cases) in Pô. By gender, 13.37% of women (164 cases) tested positive, and 8.95% of men (82 cases). Women accounted for 66.67% of all positive test subjects. The results from the multivariate analysis show a significantly higher seroprevalence in women (p = 0.007), people over 55 years old (p = 0.004), overweight people (p = 0.026) and those with drinking water sources at home (p = 0.013). The results of this study show that the COVID-19 virus also circulates in the population of middle-sized cities in Burkina Faso, far more than officially reported by the information service of the government of Burkina Faso, given the lack of systematic testing in the general population in the country. The study also highlighted the greater vulnerability of women, older and overweight individuals to the epidemic. The preventive measures put in place to fight the pandemic must take these different factors into account.

Application of coalbed methane assisted iron ore sintering: Injection effect, pollutant abatement and economic evaluation

Hydrogen-rich gas injection, which has garnered widespread attention from academia and industry, is an effective method for reducing CO2 emissions during the sintering process and for improving sinter quality. Coalbed methane (CBM) is a cost-effective and reliable hydrogen-rich gas resource in China. In this study, we investigated the injection effect of CBM in assisting iron ore sintering. Additionally, we determined the appropriate injection parameters by systematic sintering pot tests and compared it with coke oven gas (COG). The impacts of CBM injection on pollutant abatement and combustion efficiency were analyzed based on the variations in the sintering flue gas composition, and a comprehensive economic evaluation was conducted. The results showed that injecting 0.51 vol% CBM between 5 and 13 min after ignition with 0.3 wt% coke breeze ratio reduction could significantly improve the sintering index and the uniformity of heat distribution within the sinter bed. Excessive injection would affect the bed permeability. CBM took advantage over COG at a gas–solid heat transfer ratio of 1:1.28. The four-stage cascade mode with a gradient of 0.18 vol% and the intermittent mode with an intermittent time of 0.5 min could optimize the injection effect. However, the cascade mode performed better. Besides, injecting CBM increased the emission reduction rates of CO and NOx and improved combustion efficiency by 5.72%, 4.47%, and 1.46%, respectively. Overall, the cost-savings were CNY 2.19 per ton sinter, and the annual production cost could be reduced by approximately CNY 6.71 million for a 265 m2 sintering machine. The profits achieved because of CBM injection can be further improved by increasing the bed permeability and mixed injecting with other gas media. This study provides an effective path for green transformation of sintering production.

Systematic Testing of Road Markings’ Retroreflectivity to Increase Their Sustainability through Improvement of Properties: Croatia Case Study

Road markings are important elements of road infrastructure, influencing traffic safety. Since they are deteriorating systems, their upkeep through renewals is important. To assure the quality of the renewal jobs, the systematic testing of retroreflectivity, which is the key performance parameter of road markings, was imposed in Croatia. Results from two decades of annual measurements of renewal jobs are provided. For the first decade, the measurements were taken statically, at spot locations, and later dynamically, across the entire road segments. When the evaluation started, only 1 out of 18 tested job sites was exceeding the minimum requirements; only after 8 years of measurements, 100% of the jobs exceeded the minimum demands. A subsequent switch to dynamic testing revealed that, on average, only 71% of the renewed road markings were in satisfactory condition and approximately 1.22% of the analysed line lengths had grossly substandard retroreflectivity. These results demonstrated that the field verification of jobs quality is necessary and simultaneously showed that static localised testing was not adequate. The outcome underlines the need for the strict supervision of road maintenance contracts to maximise the benefits for the society: through the better visibility of road markings, road safety should also improve, and the entire system will become more sustainable.

An all-digital low-complexity blind background calibration of timing mismatch in time-interleaved ADCs

This paper proposed a novel all-digital blind background calibration to mitigate timing mismatch in time-interleaved analog-to-digital converter (TIADC). In estimation module, the adoption of a subtraction-based error extraction function and the design of Variable-Step-Size Least Mean Squares algorithm contribute to reducing the computational complexity and enhancing the convergence speed with optimal output accuracy respectively. In compensation module, a dual-stage Taylor series expansion structure has been introduced to effectively maintain the overall output performance. The proposed architecture is applied to a 12-bit 3 GS/s four-channel TIADC model. Its effectiveness for single-tone and multi-tone signals is proven through systematical testing and analysis. The simulation results exhibit that the Spurious Free Dynamic Range is significantly improved by 54.53 dB in the single-tone signal case, and the timing mismatch is converged after 1000 samples. The proposed calibration circuit has been synthesized utilizing a 28 nm standard cell library for assessing its hardware consumption, area (0.051 mm2) and average power dissipation (67.5 mW) within the integrated chip architecture. Our technology provides a viable optimization solution to improve efficiency of TIADC in high-speed systems.

Sensitivity and specificity of strategies to identify patients with hemostasis abnormalities leading to an increased risk of bleeding before scheduled intervention: the Hemorisk study

BackgroundPreoperative identification of patients with hemostasis abnormalities leading to an increased bleeding risk is based on routine hemostasis tests: prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet count. Because of their low predictive performance, guidelines recommend replacing them with structured bleeding risk questionnaires, but none is validated in this population. ObjectivesTo assess the diagnostic accuracy of 3 strategies, performed at the preanesthesia visit before scheduled interventions, and to identify patients with hemostasis abnormalities leading to an increased bleeding risk MethodsA multicenter study was performed in 7 French academic hospitals, involving patients scheduled for surgical intervention, without antiplatelet/anticoagulant treatment. The 3 strategies consisted of 1-a structured screening questionnaire; 2-PT, APTT, and platelet count ordered in selected patients; and 3-systematic PT, APTT, and platelet count. The reference standard comprised von Willebrand factor activity/antigen, factor (F)VIII, FIX, FXI, platelet function analyzer, and, when required, FII, FV, FX, and FVII and hemostasis consultation. ResultsEighteen (1.2%) of 1484 patients had a hemostasis abnormality leading to an increased bleeding risk according to reference standard. In the overall cohort, sensitivity of the questionnaire-based strategy was 50% (95% CI, 26%-74%; specificity, 87% [95% CI, 85%-88%]); sensitivity was 0% (95% CI, 0%-41%) in men vs 82% (95% CI, 48%-98%) in women. For selective routine tests, sensitivity was 33% (95% CI, 13%-59%) and specificity 97% (95% CI, 96%-98%). Corresponding values for systematic routine tests were 44% (95% CI, 22%-69%) and 93% (95% CI, 91%-94%). ConclusionSensitivity was low for all 3 strategies investigated. The structured screening questionnaire had clinically acceptable diagnostic accuracy only in women.

Efficiently assessing the early-age cracking risk of cementitious materials with a mini temperature stress testing machine

Temperature Stress Testing Machine (TSTM) is a universal testing tool for many properties relevant to early-age cracking of cementitious materials. However, the complexity of TSTMs require heavy lab work and thus hinders a more thorough parametric study on a range of cementitious materials. This study presents the development and validation of a Mini-TSTM for efficiently testing the autogenous deformation (AD), viscoelastic properties, and their combined results, the early-age stress (EAS). The setup was validated through systematic tests of EAS, AD, elastic modulus, and creep. Besides, the heating/cooling capability of the setup was examined by tests of coefficient of thermal expansion by temperature cycles. The results of EAS correspond well to that of AD, which qualitatively validates the developed setup. To quantitatively validate the setup, a classical viscoelastic model was built, based on the scenario of a 1-D uniaxial restraint test, to predict the EAS results with the tested AD, elastic modulus, and creep of the same cementitious material as the input. The predicted EAS matched the testing results of Mini-TSTM with good accuracy in 6 different cases. The viscoelastic model also provided quantitative explanations for why variations in early AD do not influence the EAS results. The testing and modelling results together validate the developed Mini-TSTM setup as an efficient tool for studying early-age cracking of cementitious materials. At the end, the potential limitations of the Mini-TSTM are discussed and its applicability for concrete with aggregate size up to 22 mm is demonstrated.

Real-world biomarker testing patterns: clinical-pathological portrait of early and late non-small cell lung cancer in hub and spoke North Italian centers.

Lung cancer is still the main cause of cancer death. In the last decades, significant innovations were introduced in non-small cell lung cancer (NSCLC) treatment and management improving patient outcomes. The discovery of immune checkpoint inhibitors and the detection of an increasing list of actionable genetic alterations are enabling a tailored approach. Herein, we assessed in a pragmatic retrospective study the rate of biomarker tests within a large pulmonary pathology-based unit (PPU) network of the Veneto region (Northern Italy). Each PPU of 7 hubs and spoke centers implemented a biomarker database with pathologic and clinical data of patients with NSCLC diagnosis over 24 months. Out of 1,817 NSCLC cases, 51% were advanced and 49% early stage, with 72% being adenocarcinomas. Programmed death ligand 1 expression and epidermal growth factor receptor mutations were available in most samples, 91% and 78%, respectively. Only 36% of advanced stages received all 5 biomarker tests with an increased rate over time. Co-occurring molecular alterations were detected in 42 cases (2%): the prevalence was (n=17) 41% and (n=25) 59% in early and late-stage adenocarcinomas, respectively. In this real-world study, while most patients received at least one biomarker test, less than 50% had all 5 biomarkers. The screening appeared to increase over time especially with the progressive use of next generation sequencing. Our results confirm the importance of systematic biomarker testing including all NSCLCs based on the evidence of several genomic alterations also in early-stage disease whose analysis may become relevant as neo-adjuvant targeted therapies are available. Non-small cell lung cancer (NSCLC); biomarkers; actionable targets; lung cancer.

Systematic and quantitative testing simulations and theories on phase coarsening by experiments

Microgravity experiments on phase coarsening in solid-liquid mixtures provided an ideal tool to closely and accurately explore the kinetics of phase coarsening because the sedimentation and convective melt flow are eliminated in the International Space Station. In this study, we employed phase-field simulations to systematically investigate the microstructure evolution during phase coarsening at various volume fractions. Simulated microstructure evolution during phase coarsening are compared quantitatively with the microstructure evolution archived from microgravity experiments. Furthermore, kinetics of phase coarsening in Pb-Sn solid-liquid mixtures at various volume fractions is studied theoretically and numerically, which is compared with microgravity experiments. In particular, particle size distribution, relative coarsening rate constants, and scaled maximum particle radii, are predicted from theories, and deduced from microgravity experiments, then calculated from phase-field simulations. This systematic and quantitative study of phase coarsening confirms the consistency to the results from phase-field simulation, microgravity experiments and theories at lower volume fractions, and stimulates more careful microgravity experiments at higher volume fractions (≥0.7).

The impact of population influx on infectious diseases - from the mediating effect of polluted air transmission.

The global population influx during the COVID-19 pandemic poses significant challenges to public health, making the prevention and control of infectious diseases a pressing concern. This paper aims to examine the impact of population influx on the spread of infectious diseases, with a specific emphasis on the mediating role of air pollution in this process. A theoretical analysis is conducted to explore the relationship between population influx, air pollution, and infectious diseases. Additionally, we establish a series of econometric models and employ various empirical tests and analytical techniques, including mediation effect test, threshold effect test, and systematic GMM test, to evaluate our hypotheses. The results indicate that: (1) Population influx directly and indirectly impacts infectious diseases. Specifically, population influx not only directly elevates the risk of infectious diseases, but also indirectly increases the incidence rate of infectious diseases by intensifying air pollution. (2) The impact of population inflow on infectious diseases exhibits regional heterogeneity. Compared to central and western China, the eastern regions exhibit a significantly higher risk of infectious diseases, exceeding the national average. (3) External factors influence the relationship between population influx and infectious diseases differently. Personal income and medical resources both help mitigate the risk of infectious diseases due to population influx, with medical resources having a more substantial effect. Contrary to expectations, abundant educational resources have not reduced the risk, instead, they have exacerbated the risk associated with population influx. This paper provides a scientific basis for formulating effective strategies for the prevention and control of infectious diseases.

Acute and sub-acute Toxicity Profiles of Anchusa strigosa and Zataria Multiflora: Insights from wistar albino rats

The present study aims to assess the acute and subacute toxicity of the hydro-alcoholic extracts of Anchusa strigosa (leaves) and the aerial parts of Zataria multiflora Boiss in Wistar albino rats. The crude extracts of Anchusa strigosa (leaves) and the aerial parts of Zataria multiflora Boiss were prepared in 70% ethanol. Systematic tests for acute toxicity were performed at varying dosages of 100, 250, and 500 mg/kg, while for subacute toxicity, a dose of 600 mg/kg was orally given to Wistar albino rats. At the end of acute and sub-acute toxicity studies, biochemical parameters, hematological analysis, and histopathological analysis showed no significant difference in the body weight, abnormalities, or organ damage of the rats compared to the untreated rats (control). Also, there were no results of death recorded in rats. These findings indicated that the medium-term oral administration of Anchusa strigosa (leaves) and the aerial parts of Zataria multiflora Boiss after the treatment does not cause toxicity and provides assurance regarding their suitability for potential therapeutic applications in both acute and subacute forms.

Evaluating phasic transcutaneous vagus nerve stimulation (taVNS) with pupil dilation: the importance of stimulation intensity and sensory perception.

The efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) as a non-invasive method to modulate physiological markers of noradrenergic activity of the Locus Coeruleus (LC), such as pupil dilation, is increasingly more discussed. However, taVNS studies show high heterogeneity of stimulation effects. Therefore, a taVNS setup was established here to test different frequencies (10 Hz and 25 Hz) and intensities (3 mA and 5 mA) during phasic stimulation (3 s) with time-synchronous recording of pupil dilation in younger adults. Specifically, phasic real taVNS and higher intensity led to increased pupil dilation, which is consistent with phasic invasive VNS studies in animals. The results also suggest that the influence of intensity on pupil dilation may be stronger than that of frequency. However, there was an attenuation of taVNS-induced pupil dilation when differences in perception of sensations were considered. Specifically, pupil dilation during phasic stimulation increased with perceived stimulation intensity. The extent to which the effect of taVNS induces pupil dilation and the involvement of sensory perception in the stimulation process are discussed here and require more extensive research. Additionally, it is crucial to strive for comparable stimulation sensations during systematic parameter testing in order to investigate possible effects of phasic taVNS on pupil dilation in more detail.

Robust bioprocess design and evaluation of commercial media for the serial expansion of human induced pluripotent stem cell aggregate cultures in vertical-wheel bioreactors

BackgroundWhile pluripotent stem cell (PSC) therapies move toward clinical and commercial applications at a rapid rate, manufacturing reproducibility and robustness are notable bottlenecks in regulatory approval. Therapeutic applications of PSCs require large cell quantities to be generated under highly robust, well-defined, and economically viable conditions. Small-scale and short-term process optimization, however, is often performed in a linear fashion that does not account for time needed to verify the bioprocess protocols and analysis methods used. Design of a reproducible and robust bioprocess should be dynamic and include a continuous effort to understand how the process will respond over time and to different stresses before transitioning into large-scale production where stresses will be amplified.MethodsThis study utilizes a baseline protocol, developed for the short-term culture of PSC aggregates in Vertical-Wheel® bioreactors, to evaluate key process attributes through long-term (serial passage) suspension culture. This was done to access overall process robustness when performed with various commercially available media and cell lines. Process output variables including growth kinetics, aggregate morphology, harvest efficiency, genomic stability, and functional pluripotency were assessed through short and long-term culture.ResultsThe robust nature of the expansion protocol was demonstrated over a six-day culture period where spherical aggregate formation and expansion were observed with high-fold expansions for all five commercial media tested. Profound differences in cell growth and quality were revealed only through long-term serial expansion and in-vessel dissociation operations. Some commercial media formulations tested demonstrated maintenance of cell growth rates, aggregate morphology, and high harvest recovery efficiencies through three bioreactor serial passages using multiple PSC lines. Exceptional bioprocess robustness was even demonstrated with sustained growth and quality maintenance over 10 serial bioreactor passages. However, some commercial media tested proved less equipped for serial passage cultures in bioreactors as cultures led to cell lysis during dissociation, reduction in growth rates, and a loss of aggregate morphology.ConclusionsThis study demonstrates the importance of systematic selection and testing of bioprocess input variables, with multiple bioprocess output variables through serial passages to create a truly reproducible and robust protocol for clinical and commercial PSC production using scalable bioreactor systems.

Evaluating the Usefulness of Population-Wide COVID-19 Testing in the Omicron Era: Insights from a German Model.

The Omicron variant of SARS-CoV-2, which has become dominant worldwide since late 2021, presents a unique challenge due to its high rate of asymptomatic transmission. This study evaluates the efficacy and value of population-wide testing, including self-testing, in the context of COVID-19, particularly under the Omicron variant, using data from Germany. A decision-analytical model and secondary data was used for assessing the impact of systematic screening and testing for COVID-19. Various scenarios were taken into consideration including seasonal patterns of COVID-19 transmission and the potential for annual waves. The model assessed the clinical benefits of testing against the backdrop of vaccine effectiveness, transmission rates, and the potential to prevent severe clinical events, including death, ICU admission, and long COVID syndrome. The study found that the value of mass testing and self-testing for private use was highly contingent on the transmission rate and the scenario of COVID-19 waves (seasonal vs. continuous). For winter waves, a very high incidence rate was required to justify testing, while for continuous waves, testing could be valuable for those in contact with individuals in their last decade of life. The analysis highlighted the limitations of mass testing when community transmission rates were low and the potential value of testing in high-risk contacts or amidst new outbreaks. The findings suggest that the resumption of testing during winter waves is unlikely to provide significant clinical benefits given the current understanding of Omicron's transmission and immunity waning. This study underscores the need for a nuanced approach to COVID-19 testing policies, considering both the epidemiological context and the practical implications of testing strategies.

Faculty standardized patients versus traditional teaching method to improve clinical competence among traditional Chinese medicine students: a prospective randomized controlled trial

BackgroundStandardized patients (SPs) simulation training models have been widely used in various fields, the study of using SPs in Traditional Chinese medicine (TCM) is still a new filed. Previous studies have demonstrated the effectiveness of occupational SP for TCM (OSP-TCM), which has an increasingly problem of high time and financial costs. The faculty SPs for TCM (FSP-TCM) simulation training model may provide a better alternative. This study aims to test and determine whether FSP-TCM simulations are more cost-effective than OSP-TCM and traditional educational models to improve the clinical competence of TCM students.MethodsThis study was a single-blind, prospective, randomized controlled trial conducted between February 2023 and October 2023. The participants were randomized into FSP-TCM group, OSP-TCM group and traditionally taught group (TT group) in the ratio of 1:1:1. The duration of this training program was 12 weeks (36 credit hours). Formative and summative assessments were integrated to evaluate the effectiveness of teaching and learning. Three distinct questionnaires were utilized to collect feedback from students, SPs, and teachers at the conclusion of the course. Additionally, analysis of cost comparisons between OSP-TCM and FSP-TCM were performed in the study.ResultsThe study comprised a total of 90 students, with no dropouts during the research. In the formative evaluation, students assigned to both the FSP-TCM and OSP-TCM groups demonstrated higher overall scores compared to those in the TT group. Notably, their performance in “physical examination” (Pa = 0.01, Pb = 0.04, Pc = 0.93) and “comprehensive ability” (Pa = 0.01, Pb = 0.006, Pc = 0.96) significantly exceeded that of the TT group. In the summary evaluation, both SP-TCM groups students outperforms TT group in the online systematic knowledge test (Pa = 0.019, Pb = 0.04, Pc = 0.97), the application of TCM technology (Pa = 0.01, Pb = 0.03, Pc = 0.93) and real-time assessment (Pa= 0.003, Pb = 0.01, Pc = 0.93). The feedback questionnaire demonstrated that both SP-TCM groups showed higher levels of agreement for this course in “satisfaction with the course” (Pa = 0.03; Pb = 0.02) and “enhanced TCM clinical skills” (Pa = 0.02; Pb = 0.03) than TT group. The SP questionnaire showed that more FSPs than OSPs in “provided professional feedback” (FSPs: strongly agree 30%, agree 50% vs. OSPs: strongly agree 20%, agree 40%. P = 0.69), and in “gave hints” during the course (FSPs: strongly agree 10%, agree 30% vs. OSPs: strongly agree 0%, agree 10%. P = 0.42). It is noteworthy that FSP-TCM was significantly lower than the OSP-TCM in overall expense (FSP-TCM $7590.00 vs. OSP-TCM $17415.60), and teachers have a positive attitude towards the FSP-TCM.ConclusionFSP-TCM training mode showed greater effectiveness than traditional teaching method in improving clinical competence among TCM students. It was feasible, practical, and cost-effective, and may serve as an alternative method to OSP-TCM simulation.

Subnational Investments in Mitigation and Adaptation to Climate Change: Some Financing and Governance Issues

Meeting climate change goals requires steadfast action at all levels of government in terms of both mitigation (measures to reduce greenhouse gas emissions) and adaptation (measures to reduce the impacts of climate change on economies and societies). Against this background, this paper discusses the role of subnational investment, including funding and financing options, as well as governance arrangements. It fills a gap in scholarly work on the principles guiding subnational investment in climate change mitigation and adaptation, identifies areas for future work, and underscores the need for cross-country comparable information on policy instruments and outcomes at the subnational levels of administration that could be used in more systematic hypothesis testing in this area. JEL classification codes: H11, H70, Q54.

Impact of gain-loss framing on online scam susceptibility: the role of scam frames, warning frames, and risk perception

ABSTRACT In the digital era, technological advancements have enabled greater convenience, economic growth, and productivity, but also caused a significant increase in online scams, leading to both financial loss and emotional distress to individuals. It becomes critical to understand why individuals fall for these scams and identify effective protective measures. Central to the tactics used by scammers and security experts is gain-loss framing, a persuasive technique in communication that influences decision-making by altering how information is presented; it emphasises potation benefits (gain-framed) or losses (loss-framed) associated with the same core content. This study conducts a systematic test of how gain-loss framing is employed in scam tactics and warning messages and examines the role of risk perception in these processes. Results suggest that loss-based (versus reward-based) scams increase individuals’ perceived risk of not responding to scams, making them more susceptible to scams. Loss-framed (versus gain-framed) warnings are more effective in preventing people from responding to scams, particularly when individuals perceive moderate to high risks of responding to scams. These findings not only bridge a gap in our theoretical understanding of how gain-loss framing influences scam compliance and intervention processes but also inform the design of more targeted and effective anti-scam interventions.

Model independent refusal trace testing

Software Testing is normally one of the main forms of verification and validation used in software development but it is often manual and so expensive and error prone. One of the proposed solutions to this is to use model-based testing, in which testing is based on a model of how the system should behave. If the model has a formal semantics, then there is potential to automate systematic test generation. In this paper we consider the case where the semantics of the model is a set of refusal traces, also called failure traces. We show how the notions of fundamental refusal and fundamental refusal trace can be used to derive a normalised transition system, which we call an observation transition system (OTS), from the semantics. We then show how, if this OTS has finitely many states, and we are given a bound m, one can produce a corresponding complete test suite: one that is guaranteed to determine correctness as long as the number of states of the OTS defined by the semantics of the system under test has no more than m states. In practice, the choice of value for m might be based on domain knowledge or a cost-benefit analysis. As far as we are aware, this is the first work to show how a finite complete test suite can be derived when the semantics under consideration is a set of refusal traces.