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Objective Since the emergence of COVID-19, university education has drastically transformed into digital-based learning (DBL). Online education has been well recognised as a promising mode of teaching; however, only a limited number of studies have reported the students’ preferred format for academic learning.Design Cross-sectional.Setting The study was conducted in a university setting in Japan. A Google Forms online questionnaire was distributed to the participants between April and May 2022.Participants A total of 939 undergraduate medical, nursing and pharmaceutical students in the pre-clinical grade were recruited, and 344 were included in the final analysis.Primary and secondary outcome The questionnaire assessed students’ format preferences between paper-based learning (PBL) and DBL as it pertained to academic performance and eyestrain. In terms of academic performance, comprehension, memory retention and absorption (concentration) were assessed. We also explored the association between students’ daily time spent using DBL and their digital preference by the Cochran-Armitage trend test and logistic regression analysis.Results A total of 344 (191 medical, 73 nursing and 80 pharmaceutical) university students completed the questionnaire (response rate 36.6%). An even distribution was observed in the preferred learning format for comprehension: PBL (32.0%), both formats equivalent (32.8%) and DBL (35.2%; digital preference). Only few students preferred DBL for memory retention (6.1%), absorption (6.7%) and eyestrain (1.2%). Although a positive association was observed between daily time spent using DBL and digital preference for comprehension, there was no association for memory retention, absorption and eyestrain.Conclusion Among university students, DBL was just as preferred as PBL for comprehension; however, only a few students reported that DBL was better in terms of memory retention, absorption and eyestrain. A learning environment where students can study using PBL should be continued.

Zabihollah Yousefi1, Reza-Ali Mohmadpour 2, Ebrahim Zarei3, Mansour Barafrashtehpour 4 1 PhD, Department of Environmental Health Engineering, School of Health and Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran 2 PhD, Professor, Department of Statistics, School of Health, Mazandaran University of Medical Sciences, Sari, Iran 3 Lecturer, Department of Analytical Chemistry, University of Mazandaran, Sari, Iran 4 MSc, Department of Environmental Health Engineering, Student Research Committee, School of Health, Mazandaran University of Medical Sciences, Sari, Iran In the article published in volume 23, issue Suppl 2, 2014, the first author’s name was incorrect. It should have been Zabihollah Yousefi, which is now corrected.

Abstract The surface modification of filters with large pore sizes for the development of low-cost gravity-driven point-of-use (POU) technologies for water disinfection can be an effective strategy to empower people to access safe water instantly, especially in low- and middle-income countries. In this study, the surface of commercial cellulose filter papers, as cheap and bio-based filters, was modified with polydopamine (PDA), polyethyleneimine (PEI) and ZnO/Ag/GO nanocomposite (ZnO/Ag/GO@PDA/PEI papers) for bacterial removal from water. PDA/PEI incorporation introduced a cationic functional layer, which can entrap negative bacteria and make a stable chemical bond with the nanocomposite. ZnO/Ag/GO exhibited promising synergistic antibacterial activities (30 times stronger than ZnO). As a result, 3 sheets of ZnO/Ag/GO@PDA/PEI papers showed a 99.98% bacterial reduction (E. coli), which met the WHO standards. Moreover, the leached zinc and silver in the filtrate were far below the WHO’s limits (380 and 10 ppb, respectively). The results showed that the modified papers could be reused multiple times. After six times of reuse, the flow rate dropped slightly (below 20%) and the bacterial removal efficiency was more than 99.9%. This study is valuable for developing filters for treating bacterial-contaminated water on-site with no need for energy, which is a demand in many countries.

Abstract Trimethylsilyl cellulose (TMSC) was employed as the coating matrix for the application of zinc oxide nanoparticles (ZnO) onto paper surfaces and the protections of ZnO/TMSC coating against UV-induced damages and fungal spoilage were evaluated. Filter papers were immersed in 2% w/v TMSC solution loaded with ZnO and air-dried. Three ZnO/TMSC suspensions were prepared with 0.1, 0.5, and 1% w/v ZnO NPs. The presences of ZnO/TMSC protective layers were confirmed with ATR-IR spectroscopy. The coated papers exhibited high surface hydrophobicities. After the coated papers were subject to 365-nm UV irradiation at 400 W for 3 h, the contact angles dramatically dropped. The trimethylsilyl (TMS) groups exposed on the surface formed a moisture barrier and were partially removed on UV exposure. ATR-IR revealed that more TMS groups were removed in the protective layer with no ZnO. UV-irradiated papers turned yellow and papers protected with 1% ZnO/TMSC exhibited significantly lower color changes than that of the uncoated one. Compared to the TMSC-coated paper, the addition of ZnO resulted in a significant reduction in tensile strength at maximum. However, after UV irradiation, significant increases in both the strain at break and strength at maximum were only observed in 1% ZnO/TMSC-protected papers. Regarding their anti-fungal properties, the 1% ZnO/TMSC films were effective in growth inhibitions of Aspergillus sp. and Penicillium sp. on the nonirradiated papers. Despite being hydrophilic after UV-irradiation, growths of the molds were severely suppressed on the UV-irradiated paper.

Besluit European Summit, Wroclaw, september 2008

The objective of academic training is to prepare midwives as independent healthcare professionals to make a substantial contribution to the healthcare of women in their reproductive years as well as to the health of their children and families. This article therefore describes the professional and educational requirements derived from the legal midwifery competencies within the new midwifery act. Furthermore, it identifies the conditions that need to be established to enable midwives in Germany to practise to their full scope in compliance with statutory responsibilities. Educational science, academic efforts, policymaking and accompanying research should work in synergy. This in turn enables midwives to achieve the maximum scope of their skills, with the objective of promoting physiological pregnancies and births. Consequently, it can strengthen early parenthood in alignment with the national health objectives of “health around childbirth”.The academisation of the midwifery profession presents a profound opportunity for professional development in Germany. It is essential that midwives receive training based on the principles of educational science and care structures that are yet to be developed. This can enable them to perform within the wide range of their professional tasks to the highest standards, thereby ensuring the optimal care of their clients. Moreover, there is a chance to implement sustainable improvements in healthcare provision for women and their families during the reproductive phase and the period of parenthood in Germany.

The current situation in Germany is characterised by significant differences between the two types of higher education institutions offering bachelor's degree programmes in midwifery at both universities of applied sciences and universities. These differences are noticeable in admission procedures, resource allocation, content focus and competence assessment at the respective institutions, which in turn result in heterogeneous study experiences. This article highlights the challenges currently facing bachelor degree programmes and the academic qualification of midwives, and identifies future requirements for the development of degree programmes in theory and practice as well as theory-practice transfer, and assessment formats. Furthermore, this article covers the content-related and structural-organisational requirements to develop in-depth academic skills grounded in theory teaching, the facilitation of clinical placements at an academic level, the training of qualified practical instructors and the development of applicable competence-based assessment formats, especially for the state exam.The development of a standardised, high-quality academic education for midwives in Germany requires networking of the different academic sites/locations to exchange experiences in teaching/learning and assessment formats. Furthermore, it can facilitate the development of a standardised competence-oriented model and core curriculum as well as the definition of quality criteria and standards for study programmes of midwifery science. The Midwifery Science Committee (AHW) in the DACH Assoviation for Medical Education (GMA) offers an optimal platform for cooperation between the different universities. The existing challenges for the further professional development of midwives can only be overcome by collaboration and pooled expertise.

Introduction Paediatric concussion is a common injury. Approximately 30% of youth with concussion will experience persisting postconcussion symptoms (PPCS) extending at least 1 month following injury. Recently, studies have shown the benefit of early, active, targeted therapeutic strategies. However, these are primarily prescribed from the specialty setting. Early access to concussion specialty care has been shown to improve recovery times for those at risk for persisting symptoms, but there are disparities in which youth are able to access such care. Mobile health (mHealth) technology has the potential to improve access to concussion specialists. This trial will evaluate the feasibility of a mHealth remote patient monitoring (RPM)-based care handoff model to facilitate access to specialty care, and the effectiveness of the handoff model in reducing the incidence of PPCS.Methods and analysis This study is a non-randomised type I, hybrid implementation-effectiveness trial. Youth with concussion ages 13–18 will be enrolled from the emergency department of a large paediatric healthcare network. Patients deemed a moderate-to-high risk for PPCS using the predicting and preventing postconcussive problems in paediatrics (5P) stratification tool will be registered for a web-based chat platform that uses RPM to collect information on symptoms and activity. Those patients with escalating or plateauing symptoms will be contacted for a specialty visit using data collected from RPM to guide management. The primary effectiveness outcome will be the incidence of PPCS, defined as at least three concussion-related symptoms above baseline at 28 days following injury. Secondary effectiveness outcomes will include the number of days until return to preinjury symptom score, clearance for full activity and return to school without accommodations. The primary implementation outcome will be fidelity, defined as the per cent of patients meeting specialty care referral criteria who are ultimately seen in concussion specialty care. Secondary implementation outcomes will include patient-defined and clinician-defined appropriateness and acceptability.Ethics and dissemination This study was approved by the Institutional Review Board of the Children’s Hospital of Philadelphia (IRB 22-019755). Study findings will be published in peer-reviewed journals and disseminated at national and international meetings.Trial registration number NCT05741411.

Introduction While research into adolescent mental health has developed a considerable understanding of environmental and psychosocial risk factors, equivalent biological evidence is lacking and is not representative of economic, social and ethnic diversity in the adolescent population. It is important to understand the possible barriers and facilitators to conduct this research. This will then allow us to improve our understanding of how biology interacts with environmental and psychosocial risk factors during adolescence. The objective of this scoping review is to identify and understand the needs, barriers and facilitators related to the collection of biological data in adolescent mental health research.Methods and analysis Reviewers will conduct a systematic search of PubMed, Medline, Scopus, Cochrane, ERIC, EMBASE, ProQuest, EBSCO Global Health electronic databases, relevant publications and reference lists to identify studies published in the English language at any time. This scoping review will identify published studies exploring mental health/psychopathology outcomes, with biological measures, in participants between the ages of 11 and 18 and examine the reported methodology used for data collection. Data will be summarised in tabular form with narrative synthesis and will use the methodology of Levac et al, supplemented by subsequent recommendations from the Joanna Briggs Institute Scoping Review Methodology.Ethics and dissemination Ethical approval is not required for this scoping review. The scoping review will be conducted with input from patient and public involvement, specifically including young people involved in our study (‘Co-producing a framework of guiding principles for Engaging representative and diverse cohorts of young peopLE in Biological ReseArch in menTal hEalth’—www.celebrateproject.co.uk) Youth Expert Working Group. Dissemination will include publication in peer-reviewed journals, academic presentations and on the project website.

The AUD2IT-algorithm is a tool to structure the data, which is collected during an emergency treatment. The goal is on the one hand to structure the documentation of the data and on the other hand to give a standardised data structure for the report during handover of an emergency patient. AUD2IT-algorithm was developed to provide residents a documentation aid, which helps to structure the medical reports without getting lost in unimportant details or forgetting important information. The sequence of anamnesis, clinical examination, considering a differential diagnosis, technical diagnostics, interpretation and therapy is rather an academic classification than a description of the real workflow. In a real setting, most of these steps take place simultaneously. Therefore, the application of the AUD2IT-algorithm should also be carried out according to the real processes. A big advantage of the AUD2IT-algorithm is that it can be used as a structure for the entire treatment process and also is entirely usable as a handover protocol within this process to make sure, that the existing state of knowledge is ensured at each point of a team-timeout. PR-E-(AUD2IT)-algorithm makes it possible to document a treatment process that, in principle, does not have to be limited to the field of emergency medicine. Also, in the outpatient treatment the PR-E-(AUD2IT)-algorithm could be used and further developed. One example could be the preparation and allocation of needed resources at the general practitioner. The algorithm is a standardised tool that can be used by healthcare professionals of any level of training. It gives the user a sense of security in their daily work.

Lipid disorders, primarily hypercholesterolemia, are the most common cardiovascular (CV) risk factor in Poland (this applies even 3/4 of people). The low-density lipoprotein cholesterol (LDL-C) serum level is the basic lipid parameter that should be measured to determine CV risk and determines the aim and target of lipid-lowering treatment (LLT). Lipid-lowering treatment improves cardiovascular prognosis and prolongs life in both primary and secondary cardiovascular prevention. Despite the availability of effective lipid-lowering drugs and solid data on their beneficial effects, the level of LDL-C control is highly insufficient. This is related, among other things, to physician inertia and patients’ fear of side effects. The development of lipidology has made drugs available with a good safety profile and enabling personalisation of therapy. Pitavastatin, the third most potent lipid-lowering statin, is characterised by a lower risk of muscle complications and new cases of diabetes due to its being metabolised differently. Thus, pitavastatin is a very good therapeutic option in patients at high risk of diabetes or with existing diabetes, and in patients at cardiovascular risk. This expert opinion paper attempts at recommendation on the place and possibility of using pitavastatin in the treatment of lipid disorders.

Abstract Uropathogenic Escherichia coli (UPEC) causes up to 90% of urinary tract infections (UTI) which is more prevalent among females than males. In urine, patients with symptomatic UTI usually have a high concentration of bacterial infection, ≥ 105 colony-forming units (CFU) per mL, in which the culture method is regularly the gold standard diagnosis. In this study, a simple and inexpensive distance-based paper device (dPAD) combined with the fluorescent closed tube LAMP assay was validated for simultaneously screening and semi-quantifying the infection level of E. coli in 440 urine samples of patients with UTI. The dPAD could measure the LAMP amplicons and semi-quantify the levels of E. coli infection in heavy (≥ 104 CFU/mL), light (≤ 103 CFU/mL) and no infection. The sensitivity and specificity had reliable performances, achieving as high as 100 and 92.7%, respectively. The one step LAMP assay could be performed within 3 h, which was 7.5 times faster than the culture method. To empower early UTI diagnosis and fast treatment, this inexpensive dPAD tool combined with the fluorescent closed tube LAMP assay is simple, reliably fast and practically portable for point-of-care settings, particularly in resource-limited areas, which can be set up in all levels of healthcare facilities.

Background: Some sputum smear microscopy protocols recommend placing filter paper over sputum smears during staining for Mycobacterium tuberculosis (TB). We found no published evidence assessing whether this is beneficial. We aimed to evaluate the effect of filter paper on sputum smear microscopy results. Methods: Sputum samples were collected from 30 patients with confirmed pulmonary TB and 4 healthy control participants. From each sputum sample, six smears (204 smears in total) were prepared for staining with Ziehl-Neelsen (ZN), auramine or viability staining with fluorescein diacetate (FDA). Half of the slides subjected to each staining protocol were randomly selected to have Whatman grade 3 filter paper placed over the dried smears prior to stain application and removed prior to stain washing. The counts of acid-fast bacilli (AFB) and precipitates per 100 high-power microscopy fields of view, and the proportion of smear that appeared to have been washed away were recorded. Statistical analysis used a linear regression model adjusted by staining technique with a random effects term to correct for between-sample variability. Results: The inclusion of filter paper in the staining protocol significantly decreased microscopy positivity independent of staining with ZN, auramine or FDA (p=0.01). Consistent with this finding, there were lower smear grades in slides stained using filter paper versus without (p=0.04), and filter paper use reduced AFB counts by 0.28 logarithms (95% confidence intervals, CI=0.018, 0.54, p=0.04) independent of staining technique. In all analyses, auramine was consistently more sensitive with higher AFB counts versus ZN (p=0.001), whereas FDA had lower sensitivity and lower AFB counts (p

How do author perceptions match up to the outcomes of the peer-review process and perceptions of others? In a top-tier computer science conference (NeurIPS 2021) with more than 23,000 submitting authors and 9,000 submitted papers, we surveyed the authors on three questions: (i) their predicted probability of acceptance for each of their papers, (ii) their perceived ranking of their own papers based on scientific contribution, and (iii) the change in their perception about their own papers after seeing the reviews. The salient results are: (1) Authors had roughly a three-fold overestimate of the acceptance probability of their papers: The median prediction was 70% for an approximately 25% acceptance rate. (2) Female authors exhibited a marginally higher (statistically significant) miscalibration than male authors; predictions of authors invited to serve as meta-reviewers or reviewers were similarly calibrated, but better than authors who were not invited to review. (3) Authors' relative ranking of scientific contribution of two submissions they made generally agreed with their predicted acceptance probabilities (93% agreement), but there was a notable 7% responses where authors predicted a worse outcome for their better paper. (4) The author-provided rankings disagreed with the peer-review decisions about a third of the time; when co-authors ranked their jointly authored papers, co-authors disagreed at a similar rate-about a third of the time. (5) At least 30% of respondents of both accepted and rejected papers said that their perception of their own paper improved after the review process. The stakeholders in peer review should take these findings into account in setting their expectations from peer review.

Paper mulberry pollen, declared a pest in several countries including Pakistan, can trigger severe allergies and cause asthma attacks. We aimed to develop an algorithm that could accurately predict high pollen days to underpin an alert system that would allow patients to take timely precautionary measures. We developed and validated two prediction models that take historical pollen and weather data as their input to predict the start date and peak date of the pollen season in Islamabad, the capital city of Pakistan. The first model is based on linear regression and the second one is based on phenological modelling. We tested our models on an original and comprehensive dataset from Islamabad. The mean absolute errors (MAEs) for the start day are 2.3 and 3.7 days for the linear and phenological models, respectively, while for the peak day, the MAEs are 3.3 and 4.0 days, respectively. These encouraging results could be used in a website or app to notify patients and healthcare providers to start preparing for the paper mulberry pollen season. Timely action could reduce the burden of symptoms, mitigate the risk of acute attacks and potentially prevent deaths due to acute pollen-induced allergy.

We conducted a systematic review of conference papers in social psychology at two large psychology conferences in Japan: the Japanese Psychological Association and the Japanese Society for Social Psychology. The conference papers were effectively not subjected to peer review; hence, they were suitable for testing if psychologists selectively reported statistically significant findings without pressure from journal editors and reviewers. We investigated the distributions of z-values converted from the p-values reported in the articles presented at the 2013 and 2018 conferences. The z-curve analyses suggest the existence of selective reporting by the authors in 2013. The expected discovery rate (EDR) was much lower than the observed discovery rate (ODR; 7% vs. 76%, respectively), and the 95% confidence interval (CI) did not include the ODR. However, this does not mean that the set of studies completely lacked evidential value. The expected replication rate (ERR) was 31%; this is significantly higher than 5%, which was expected under the null hypothesis of no effect. Changes were observed between 2013 and 2018. The ERR increased (31% to 44%), and the EDR almost doubled (7% to 13%). However, the estimation of the maximum false discovery rate (FDR; 68% in 2013 and 35% in 2018) suggested that a substantial proportion of the reported findings were false positives. Overall, while social psychologists in Japan engaged in selective reporting, this does not mean that the entire field was covered with false positives. In addition, slight signs of improvement were observed in how they reported their findings. Still, the evidential value of the target studies was weak, even in 2018, allowing for no optimism.

Abstract The valorization of paper mill sludge (PMS) is the main goal of this study. The emissions of PMS continue to increase at global scale, especially from packaging paper and board sectors. The raw sludge was used to prepare an adsorbent to remove toxic pollutants from wastewater, the methylene blue (MB), an organic dye. Firstly, the physico-chemical characterization of PMS was done determining the crystalline phases of PMS fibers, the content of main elements, and the pH zero point charge, which was determined at around pH 7. The adsorption of MB on PMS powder was studied at 18 °C with an agitation of 200 rpm, being the best operating conditions 30 min of contact time, 250 mg L−1 of initial MB concentration and 0.05 g in 25 mL of adsorbent dose. Experimental data of MB adsorption was fitted to Langmuir and Freundlich isotherm equations. The Langmuir model was more accurate for the equilibrium data of MB adsorption at pH 5.1. The PFOM and PSOM were adjusted to experimental adsorption kinetics data, being PSOM, which describes better the MB adsorption by PMS powder. This was confirmed by calculating the maximum adsorption capacity with PSOM, which was 42.7 mg g−1, being nearly similar of the experimental value of 43.5 mg g−1. The analysis of adsorption thermodynamics showed that the MB was adsorbed exothermically with a ΔH0 = − 20.78 kJ mol−1, and spontaneously with ΔG0 from − 0.99 to − 6.38 kJ mol−1 in the range of temperature from 291 to 363 K, respectively. These results confirm that the sludge from paper industry can be used as biosorbent with remarkable adsorption capacity and low cost for the treatment of wastewater. PMS can be applied in the future for the depollution of the effluents from the textile industry, which are highly charged with dyes.

Abstract Laserjet printing is a kind of facile and digital do-it-yourself strategies, which is of importance to fabricate inexpensive paper-based microfluidic devices. However, the printed hydrophobic barrier is not hydrophobic enough due to the weak hydrophobicity and requires subsequent heating, which can lead to the pyrolysis of cellulose in the paper and influence the detection results. Here, for the first time, we report a kind of functional toner including toner and polydopamine (PDA) nanocapsules which contains oleic acid modified ferric tetroxide (OA-Fe3O4) and octadecylamine (ODA), which is suitable for printing with desired shapes and sizes to lead to formation of superhydrophobic barriers. Moreover, patterns printed with functional toner have good stability, including resistance to moisture, ultraviolet (UV) and bending. Finally, a proof-of-concept of metal and nitrite ions testing is demonstrated using colorimetric analysis, and the results show that the printed devices successfully perform instant detection of ions. The developed functional toner offers easy fabrication, cost-effectiveness and mass production of paper-based devices. In general, this strategy provides a new idea and technical support for the rapid prototyping of microfluidic paper-based analytical devices (μPADs) using laserjet printing.

Abstract In this paper, three kinds of micro-nano bamboo powder (MBP) and alkyl ketene dimer (AKD) were added to the polyvinyl alcohol/cellulose nanofiber (PVA/CNF) coating to prepare PVA/CNF/MBP coated paper and PVA/CNF/M-MBP/AKD coated paper. The results showed that MBP improved the oleophobicity of PVA/CNF coating, and the grease resistance grade of PVA/CNF/B-MBP and PVA/CNF/M-MBP coated papers reached the highest level, with a kit number of 12. Among the PVA/CNF/MBP coated papers, the PVA/CNF/M-MBP coated paper has the best hydrophobic properties, with the water contact angle and Cobb value of 74° and 21.3 g/m2, respectively. In addition, when the AKD dosage was 0.2% in the PVA/CNF/M-MBP/AKD coating, the kit number of the coated paper was 11, the Cobb value was 15.2 g/m2, the water contact angle was 103°, and the tensile strength was found to increase slightly. Therefore, compared with PVA/CNF coated paper, PVA/CNF/M-MBP/AKD coated paper has good strength and excellent hydrophobic and oleophobic properties.

Abstract Paper coating plays an important role in the paper properties, printability and application. The nanocoating is a multifunction layer that provides the paper with unique features. In this work, nanocoating formulas were prepared using a green method and component. The nanocoating formulas were based on biopolymers nanostarch NSt and nanochitosan NCh (NCS) decorated with Egyptian kaolinite Ka doped with zinc nanoparticles NCS@xka/ZnONPs (x represents different ratios) support for multifunctional uses. The nanocoating formulas were characterized using a physiochemical analysis as well as a topographical study. FTIR, XRD, SEM and TEM techniques were used. Additionally, the antimicrobial activity of the tested samples was assessed against six microorganisms including Gram-negative and Gram-positive bacteria. The prepared nanocoating formulas affirmed excellent antimicrobial activity as a broad-spectrum antimicrobial active agent with excellent activity against all representative microbial communities. The nanocoating with the highest ratio of Ka/ZnONPs (NCS@40 ka/ZnONPs) showed excellent antimicrobial activity with an inhibition percentage of more than 70% versus all microorganisms presented. The paper was coated with the prepared suspensions and characterized concerning optical, mechanical and physical properties. When Ka/ZnONPs were loaded into NCS in a variety of ratios, the characteristics of coated paper were enhanced compared to blank paper. The sample NCS@40 ka/ZnONPs increased tensile strength by 11%, reduced light scattering by 12%, and improved brightness and whiteness by 1%. Paper coated with NCh suspension had 35.32% less roughness and 188.6% less porosity. When coated with the sample NCS@10 ka/ZnONPs, the coated paper's porosity was reduced by 94% and its roughness was reduced by 10.85%. The greatest reduction in water absorptivity was attained by coating with the same sample, with a reduction percentage of 132%.

Scientific manuscripts are the basis for the transmission of scientific data among physicians in all fields of medicine. To teach young oncologists the skills needed to author a paper, we decided to emulate how experienced clinicians perform this task. The first step is to create a spreadsheet with all the clinical data gathered and submit it to a statistical analysis using a statistical software package. The most important results are presented in the graphs and tables. The results should be explained in a logical and understandable manner. Writing the “Materials and Methods” section follows, with all the technical information that any other researcher may need to reproduce elsewhere the study in question. A critical-thinking stage, in which a review of the pertinent literature is conducted with the use of a reference management software, should provide all the knowledge and questions to write the “Introduction” and “Discussion” sections. The “Abstract” and “Title” are the final sections to be created. Following these steps, the author can correct the first draft of the manuscript for submission to a specific journal. Choosing the right journal and answering the reviewers' comments are also important steps in this process. Even if a young oncologist does not embark on an academic career, learning how to write a scientific manuscript is believed to be the best way to teach them how to read such manuscripts during their lifelong continuous self-education.

This study presents a comprehensive exploration of topic modeling methods tailored for large language model (LLM) using data obtained from Web of Science and LexisNexis from June 1, 2020, to December 31, 2023. The data collection process involved queries focusing on LLMs, including "Large language model," "LLM," and "ChatGPT." Various topic modeling approaches were evaluated based on performance metrics, including diversity and coherence. latent Dirichlet allocation (LDA), nonnegative matrix factorization (NMF), combined topic models (CTM), and bidirectional encoder representations from Transformers topic (BERTopic) were employed for performance evaluation. Evaluation metrics were computed across platforms, with BERTopic demonstrating superior performance in diversity and coherence across both LexisNexis and Web of Science. The experiment result reveals that news articles maintain a balanced coverage across various topics and mainly focus on efforts to utilize LLM in specialized domains. Conversely, research papers are more concise and concentrated on the technology itself, emphasizing technical aspects. Through the insights gained in this study, it becomes possible to investigate the future path and the challenges that LLMs should tackle. Additionally, they could offer considerable value to enterprises that utilize LLMs to deliver services.

Threatened shark species are caught in large numbers by artisanal and commercial fisheries and traded globally. Monitoring both which shark species are caught and sold in fisheries, and the export of CITES-restricted products, are essential in reducing illegal fishing. Current methods for species identification rely on visual examination by experts or DNA barcoding techniques requiring specialist laboratory facilities and trained personnel. The need for specialist equipment and/or input from experts means many markets are currently not monitored. We have developed a paper-based Lab-on-a-Chip (LOC) to facilitate identification of three threatened and CITES-listed sharks, bigeye thresher (Alopias superciliosus), pelagic thresher (A. pelagicus) and shortfin mako shark (Isurus oxyrinchus) at market source. DNA was successfully extracted from shark meat and fin samples and combined with DNA amplification and visualisation using Loop Mediated Isothermal Amplification (LAMP) on the LOC. This resulted in the successful identification of the target species of sharks in under an hour, with a working positive and negative control. The LOC provided a simple "yes" or "no" result via a colour change from pink to yellow when one of the target species was present. The LOC serves as proof-of-concept (PoC) for field-based species identification as it does not require specialist facilities. It can be used by non-scientifically trained personnel, especially in areas where there are suspected high frequencies of mislabelling or for the identification of dried shark fins in seizures.

Introduction Long-term follow-up after an acute coronary syndrome (ACS) presents a crucial challenge due to the high residual cardiovascular risk and the potential for major bleeding events. Although several treatment strategies are available, this article focuses on patients who have undergone percutaneous coronary intervention (PCI) for ACS, which represent a frequent clinical situation. This position paper aims to support physicians in daily practice to improve the management of ACS patients. Material and methods A group of recognized international and French experts in the field, provides an overview of current evidence-based recommendations − supplemented by expert opinion where such evidence is lacking − and a practical guide for the management of patients with ACS after hospital discharge. Results The International Collaborative Group underlines the need of a shared collaborative approach, and a care plan individualized to the patient’s risk profile for both ischemia and bleeding. Each follow-up appointment should be viewed as an opportunity to optimize the personalized approach, to reduce adverse clinical outcomes and improve quality of life. As risks – both ischaemic and haemorrhagic – evolve over time, the risk–benefit balance should be assessed in an ongoing dynamic process to ensure that patients are given the most suitable treatment at each time point. Conclusions This Expert Opinion aims to help clinicians with a practical guide underlying the proven strategies and the remaining gaps of evidence to optimize the management of coronary patients.

The objective of this study was the presentation of quantitative characteristics regarding the scientific content and bibliometric details of the relevant publications. In total, 156 papers were considered. Most papers presented original studies (n = 135), and fewer were reviews (n = 21). Most original articles (n = 101) referred to work involving cattle. Most original articles described work related to the diagnosis (n = 72) or pathogenesis (n = 62) of mastitis. Most original articles included field work (n = 75), whilst fewer included experimental (n = 31) or laboratory (n = 30) work. The tissue assessed most frequently in the studies was milk (n = 59). Milk was assessed more frequently in studies on the diagnosis (61.1% of relevant studies) or pathogenesis (30.6%) of the infection, but mammary tissue was assessed more frequently in studies on the treatment (31.0%). In total, 47 pathogens were included in the studies described; most were Gram-positive bacteria (n = 34). The three bacteria most frequently included in the studies were Staphylococcus aureus (n = 55 articles), Escherichia coli (n = 31) and Streptococcus uberis (n = 19). The proteomics technology employed more often in the respective studies was liquid chromatography-tandem mass spectrometry (LC-MS/MS), either on its own (n = 56) or in combination with other technologies (n = 40). The median year of publication of articles involving bioinformatics or LC-MS/MS and bioinformatics was the most recent: 2022. The 156 papers were published in 78 different journals, most frequently in the Journal of Proteomics (n = 16 papers) and the Journal of Dairy Science (n = 12). The median number of cited references in the papers was 48. In the papers, there were 1143 co-authors (mean: 7.3 ± 0.3 co-authors per paper, median: 7, min.–max.: 1–19) and 742 individual authors. Among them, 15 authors had published at least seven papers (max.: 10). Further, there were 218 individual authors who were the first or last authors in the papers. Most papers were submitted for open access (n = 79). The median number of citations received by the 156 papers was 12 (min.–max.: 0–339), and the median yearly number of citations was 2.0 (min.–max.: 0.0–29.5). The h-index of the papers was 33, and the m-index was 2. The increased number of cited references in papers and international collaboration in the respective study were the variables associated with most citations to published papers. This is the first ever scientometrics evaluation of proteomics studies, the results of which highlighted the characteristics of published papers on mastitis and proteomics. The use of proteomics in mastitis research has focused on the elucidation of pathogenesis and diagnosis of the infection; LC-MS/MS has been established as the most frequently used proteomics technology, although the use of bioinformatics has also emerged recently as a useful tool.

Oxidative stress participates in the occurrence of diabetic nephropathy（DN）. Abnormal glucose metabolism will lead to the production of oxygen free radicals, damaging the intrinsic cells of the kidney, affecting the structure and function of renal tissue. Meanwhile, the high glucose-induced oxidative stress inhibits the expression of the antioxidant factor Nrf2, which activation has a protective effect on the kidney of diabetic mice, and can improve the kidney injury at the cellular level. However, the antioxidant mechanism of Nrf2 involved in DN remains unclear. This paper will introduce the role of Nrf2 in regulating oxidative stress at the cellular level to improve renal injury caused by high glucose.

Objective: To assess the current trends in the field of artificial intelligence in medicine by analysing 100 most cited original articles relevant to the field. Methods: The systematic review was conducted in September 2022, and comprised literature search on Scopus database for original articles only. Google and Medical Subject Headings databases were used as resources to extract key words. In order to cover a broad range of articles, original studies comprising human as well as non-human subjects, studies without abstract and studies in languages other than English were part of the inclusion criteria. There was no specific time period applied to the search and no specific selection was done regarding the journals in the database. The screening was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to extract the top 100 most cited articles in the field of artificial intelligence usage in medicine. Data was analysed using SPSS 23. Results: Of the 11,571 studies identified, 100(0.86%) were analysed in detail. The studies were published between 1986 and 2021, with a median of 43 citations (IQR 53) per article. The journal ‘Artificial Intelligence in Medicine’ accounted for the highest number 9(9%)) of articles, and the United States was the country of origin for most of the articles 36(36%). Conclusion: The trends, development and shortcomings in field of artificial intelligence usage in medicine need to be understood to conduct an effective research in areas that still need attention, and to guide the authorities to direct their funding accordingly.

Objectives Current mental health practices for people living in residential aged care (RAC) facilities are poor. In Australia, there are no mechanisms to monitor and promote mental health for people living in RAC, including those who experience changed behaviours and psychological symptoms. The aim of this study is to improve current practices and mental health outcomes for people living in RAC facilities by codesigning a Mental Health benchmarking Industry Tool for residential aged Care (MHICare Tool).Methods A two-stage sequential and mixed methods codesign methodology will be used. Stage 1 will include qualitative interviews and focus groups to engage with residents, family/care partners and RAC staff to ascertain mental healthcare practices and outcomes of greatest significance to them. Adapted concept mapping methods will be used to rank identified issues of concern in order of importance and changeability, and to generate draft quality indicators. Stage 2 will comprise a Delphi procedure to gain the wider consensus of expert panel views (aged care industry, academic, clinical) on the performance indicators to be included, resulting in the codesigned MHICare Tool.Ethics and dissemination This study has been reviewed and approved by the University of Queensland Human Research Ethics Committee (HREC/2019002096). This project will be carried out according to the National Statement on Ethical Conduct in Human Research (2007). The study’s findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media.Conclusion This protocol reports structured methods to codesign and develop a mental health performance indicator tool for use in Australian RAC.

Introduzione La medicina interna e la cardiologia riabilitativa Il referral in cardiologia riabilitativa Lo scenario attuale Il paziente cardiovascolare in medicina interna L’organizzazione della rete assistenziale dopo sindrome coronarica acuta La moderna epidemiologia degli eventi cardiovascolari in Italia Moderne prove di efficacia dell’intervento di cardiologia riabilitativa Gruppi di accesso alla cardiologia riabilitativa nell’evoluzione delle raccomandazioni Modificazioni della rete dei centri di cardiologia riabilitativa Evoluzione della normativa nazionale Raccomandazioni operative per il referral del paziente internistico in cardiologia riabilitativa Conclusioni Bibliografia

Introduction Air pollution is a global issue that poses a significant threat to public health. Children, due to their developing physiology, are particularly susceptible to the inhalation of environmental pollutants. Exposure can trigger immune modulation and organ damage, increasing susceptibility to respiratory diseases. Therefore, we aim to examine the association between heavy metal and particulate matter exposure with tuberculosis in children.Methods and analysis As a case–control study, we will include children diagnosed with pulmonary tuberculosis (n=60) and matched healthy controls (n=80) recruited from the same communities in Dhaka, Bangladesh. Exposure data for both cases and controls will be collected by a trained field team conducting home visits. They will administer an exposure questionnaire, measure child anthropometry, collect blood and household dust samples and instal 48-hour air quality monitors. The blood samples will be analysed by inductively coupled plasma mass spectrometry for serum heavy metal concentrations (lead, cadmium, arsenic, mercury and chromium), as a representative marker of exposure, and the presence of inflammatory biomarkers. Descriptive and inferential statistics, including independent samples t-tests, analysis of variance and conditional regression analysis, will be used to quantify heavy metal and particulate matter exposure status in tuberculosis cases compared with healthy controls, while accounting for potential confounders. Dust samples and air quality results will be analysed to understand household sources of heavy metal and particulate matter exposure. To test the study hypothesis, there is a positive association between exposure and tuberculosis diseases, we will also measure the accumulated effect of simultaneous exposures using Bayesian statistical modelling.Ethics and dissemination This study has been approved by International Centre for Diarrhoeal Disease Research, Bangladesh’s Institutional Review Board (PR-22030). The study findings will be disseminated at conferences and published in peer-reviewed journals.

[This corrects the article DOI: 10.1371/journal.pone.0292261.].

BackgroundGlobal evidence on psychosis is dominated by studies conducted in Western, high-income countries. The objectives of the Study of Context Of Psychoses to improve outcomes in Ethiopia (SCOPE) are (1) to generate rigorous evidence of psychosis experience, epidemiology and impacts in Ethiopia that will illuminate aetiological understanding and (2) inform development and testing of interventions for earlier identification and improved first contact care that are scalable, inclusive of difficult-to-reach populations and optimise recovery.MethodsThe setting is sub-cities of Addis Ababa and rural districts in south-central Ethiopia covering 1.1 million people and including rural, urban and homeless populations. SCOPE comprises (1) formative work to understand care pathways and community resources (resource mapping); examine family context and communication (ethnography); develop valid measures of family communication and personal recovery; and establish platforms for community engagement and involvement of people with lived experience; (2a) a population-based incidence study, (2b) a case-control study and (2c) a cohort study with 12 months follow-up involving 440 people with psychosis (390 rural/Addis Ababa; 50 who are homeless), 390 relatives and 390 controls. We will test hypotheses about incidence rates in rural vs. urban populations and men vs. women; potential aetiological role of khat (a commonly chewed plant with amphetamine-like properties) and traumatic exposures in psychosis; determine profiles of needs at first contact and predictors of outcome; (3) participatory workshops to develop programme theory and inform co-development of interventions, and (4) evaluation of the impact of early identification strategies on engagement with care (interrupted time series study). Findings will inform development of (5) a protocol for (5a) a feasibility cluster randomised controlled trial of interventions for people with recent-onset psychosis in rural settings and (5b) two uncontrolled pilot studies to test acceptability, feasibility of co-developed interventions in urban and homeless populations.

Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is a chronic, relapsing-remitting condition associated with increased morbidity. Previous research has shown patients with AAV report high levels of fatigue, pain, depression and anxiety. Over recent years successful work has been carried out to improve clinical outcomes, resulting in reduced mortality and end stage kidney disease (ESKD). Despite this, little work has been done to better understand the role of the patient within this condition. The prevalence of AAV is increasing and to date, there is a shortage of specific tools that assess and measure key features relating to patient reported outcomes (PROs). This protocol details how we can better understand the lived experiences of those with AAV through the development of a disease specific, patient reported outcome measure (PROM), to be used in clinic practice. This will allow us to recognise and validate PROs and the impact the disease and its treatment has on patients' health related quality of life (HRQoL). In addition, we aim to identify potential differences in PRO's between demographics, organ involvement and treatment subgroups in AAV as well as outcomes relating to the patient experience. Patients from a single centre in the UK will be recruited to take part in the exploratory qualitative study which will include focus groups and semi-structured interviews. The inclusion criteria comprise anyone with a diagnosis of AAV and willing to participate, including those who have active or relapsing disease, those are economically active, unemployed, retired and patients receiving renal replacement therapy. The aim of the project is to identify key issues patients experience in relation to their disease and its management and how these can be better assessed in a new PROM developed for use in the clinic setting. This will enable better delivery of individualised care and inform shared decision making, while also serving as a platform for future research looking at PROs in other glomerulonephritides.

Introduction The outbreak of COVID-19 has produced an unprecedented number of trials and articles.

This study evaluated the effectiveness of an electronic system for managing individuals with drug-sensitive pulmonary tuberculosis in the Kyrgyz Republic. This cohort study used programmatic data. The study included people registered on the paper-based system in 2019 and 302 people registered on both the electronic and the paper-based systems between June 2021 and May 2022. The data from the 302 individuals were used to assess the completeness of each form of record and the concordance of the electronic record with the paper-based system. This study showed that for most variables, the completeness and concordance were 85.3–93.0% and were lowest for nonmandatory fields such as medication side effects (26.8% vs. 13.6%). No significant difference was observed in the time taken from symptom onset to diagnosis and treatment initiation between the two systems. However, the electronic system had a significantly higher percentage of subjects who initiated treatment on the day of diagnosis (80.3% vs. 57.1%). The proportion with successful outcomes was similar in both groups, but the electronic system had a significantly lower proportion of individuals with outcomes that were not evaluated or recorded (4.8% vs. 14.3%, p < 0.001). This study highlights the potential advantages and gaps associated with implementing an electronic TB register system for improving records.

Objective: This bibliographic analysis was designed to review all dental publications in the Kingdom of Saudi Arabia (KSA) and evaluate the effect of international collaboration on the impact of published articles. Methods: The Web of Science (WOS) database was used to extract all related published articles in the KSA from 1982 to 2021. The keywords were connected using Boolean Operators to download related articles. Downloaded articles were screened according to the following inclusion criteria: collaboration journal category, journal discipline, number of citations, number of authors, and impact factor. After applying the inclusion criteria and excluding single-author articles, 5,689 documents were included in the final analysis. The chi-square test and two-independent samples t-test were used to determine the statistical significance between the variables. Results: A significantly higher proportion of articles with international collaboration (51.4%) were published in dental journals than those published nationally (43.3%) or within the institutional level (41.8%) (P

Abstract Background Misinformation regarding COVID-19 pandemic and vaccination is damaging COVID-19 vaccine trust and acceptance in Low- and Middle-Income Countries (LMIC). Identification of misinformation and designing locally acceptable solutions are needed to improve COVID-19 vaccine acceptance. This study aimed to utilize community-led co-design methodology to evaluate misinformation regarding COVID-19 and develop contextual interventions to address misinformation in a marginalized peri urban slum communities of Landhi town Karachi, Pakistan. Methods This study was conducted between January and December 2021, in marginalized peri-urban slum dwellers of Muslimabad Colony, Landhi Town Karachi, Pakistan. We used a community-centred co-design methodology embedded within mixed study design to identify misinformation, co-design, test and implement locally acceptable solutions. The co-design methodology involved five stages of the design thinking model: (1) Empathize, (2) Define, (3) Ideate, (4) Prototype, and (5) Test. The project involved active engagement and participation of wide range of stakeholders and community beneficiaries (end users) including local EPI vaccinators, informal healthcare workers, religious leaders (male and female), schoolteachers (male and female), local government representatives, community leaders, housewives, youth, and general population. To develop a trusting relationship, and understand local culture, values, practices, and traditions, we allowed one month of observation period (observe, engage, watch, and listen) in the beginning, followed by door-to-door survey along with focus group discussions (FGD) and in-depth interviews (IDI) at baseline. Co-design workshops (separate for male and female) were conducted at each stage of co-design methodology to design and test locally acceptable solutions. Conclusion Community-centred co-design methodology was not only successful in designing, testing, and evaluating locally acceptable solutions but it also actively engaged and empowered the marginalized population living in peri urban slum communities of Karachi, Pakistan.

Abstract Background Problem-based learning (PBL) remains a valid and effective tool for small-group medical education. Using Virtual patients (VP) case simulation in PBL is a recognizable educational method that has successfully prepared students to focus learning on core information that uses realistic patient-based cases relating to everyday clinical scenarios. Using other modalities as the virtual patient in PBL instead of the paper-based methods remains debatable. This study aimed to evaluate the effectiveness of using VP case simulation mannequin in PBL versus the PBL in paper-based cases in improving the cognitive skills by comparing the grades of a multiple-choice question test and assess its ability to reach students' satisfaction using questionnaire with Likert survey instrument. Methods The study was conducted on 459 fourth-year medical students studying in the pulmonology module of the internal medicine course, Faculty of Medicine, October 6 University. All students were divided into 16 PBL classes and randomly divided into groups A and B by simple manual randomization. The groups were parallel with a controlled cross-over study between paper-based and virtual patient PBL. Results The pre-test showed no significant difference between both, while post-test scores were significantly higher in both VP PBL cases 1 discussing COPD (6.25 ± 0.875) and case 2 discussing pneumonia (6.56 ± 1.396) compared to paper-based PBL (5.29 ± 1.166, 5.57 ± SD1.388, respectively) at p

Abstract In this work heat transfer papers were loaded with a new core–shell pigment based on precipitating thin shell of titanium dioxide on a core of rice husk silica ash TiO2/RHSA to be applied in dye sublimation printing of textile fabrics. Besides, 0.1% (w/w) cationic polyacrylamide (CPAM) and 1% (w/w) bentonite (Bt) were also added sequentially to improve drainage and filler retention of the paper hand-sheets made from bleached kraft bagasse pulps. The effect of the new core–shell pigment on the mechanical and barrier properties, thermal stability and surface morphology of modified paper sheets were investigated. In addition, the study of transfer printability and ease of dye release from paper to fabric in this heat transfer printing of polyester fabrics using silk-screen printing under different transfer parameters were studied. Also, fastness measurements including washing, light and perspiration of printing polyester fabric were also estimated.

Abstract Paper and packaging materials a lignocellulose-based natural biodegradable polymer that spontaneously releases acetic acid, aldehydes, alcohol, and ester-based volatile organic compounds (VOCs) upon ageing and these VOCs start degrading the paper products and decline their mechanical strength properties. The reactivity of the paper of unbleached wheat straw pulp towards acetic acid and hexanal, which has been proven to have more degrading effects on paper than other VOCs, was considered in this work. The papers were exposed to these volatile compounds for 90 days in an air-tight vessel under ambient environmental conditions. The results showed that hexanal was more destructive than acetic acid with regards to cellulose degradation and depletion in the mechanical strength properties. The paper properties like, tensile, tear and burst index, viscosity, pH and carbonyl group content was measured. The growth of the carbonyl group, evidence of the ageing effects in the paper, detected more in the paper exposed to acetic acid. However, the strength of paper properties declined more with hexanal. FE-SEM analysis of the sample showed the development of pores and damage of cellulose fibre upon ageing. Similarly, the damaging effects of VOCs on cellulose, hemicelluloses and lignin were confirmed by significantly reduced peak detection through FT-IR \analysis. The high crystallinity index of the paper products due to exposure to VOCs was detected by XRD analysis, which confirmed the degradation of the low molecular weight cellulose molecule. Thus, the results are strongly recommended that VOCs that generates due to natural or artificial ageing could be the leading cause of paper degradation.

Abstract Polymers are often combined with magnetostrictive materials to enhance their toughness. This study reports a cellulose nanofibril (CNF)-based composite paper containing dispersed CoFe2O4 particles (CNF–CoFe2O4). Besides imparting magnetization and magnetostriction, the incorporation of CoFe2O4 particles decreased the ultimate tensile strength and increased the fracture elongation of the CNF–CoFe2O4 composite paper. CNF was responsible for the tensile properties of CNF–CoFe2O4 composite paper. Consequently, the magnetic and magnetostrictive properties and tensile properties of CNF–CoFe2O4 composite paper can be controlled by changing the mixture ratio of CNF and CoFe2O4 particles.

Patients with cancer can be immunocompromised because of their disease and/or due to anticancer therapy. In this population, severe influenza virus infections are associated with an elevated risk of morbidity and mortality. Influenza vaccination is therefore highly recommended in cancer patients, including those receiving anticancer therapy. However, vaccination coverage remains far below the recommended target for vulnerable subjects. Six specialists in oncology, hematology, immunology, and public health/vaccinology convened with the objective of developing strategies, based on evidence and clinical experience, for improving influenza vaccination coverage in cancer patients. This viewpoint provides an overview of current influenza vaccination recommendations in cancer patients, discusses barriers to vaccination coverage, and presents strategies for overcoming said barriers. New immunization issues raised by the COVID-19 pandemic are also addressed. Future directions include improving public education on influenza vaccination, providing the media with accurate information, improving knowledge among healthcare professionals, improving access to vaccines for cancer patients, co-administration of the influenza and COVID-19 vaccines, increased collaboration between oncologists and other health professionals, increased accessibility of digital vaccination registries to specialists, shared information platforms, and promoting immunization campaigns by healthcare systems with the support of scientific societies.

Abstract We aimed to investigate differences in patients’ anxiety and satisfaction between patients undergoing paper-based patient decision aid (PDA) for shared decision-making (SDM) and those receiving computer-based PDA. We retrospectively collected questionnaires before and after SDM. Basic demographic data as well as anxiety, satisfaction, knowledge acquisition, and participation in SDM were recorded. We divided our population into subgroups according to use of paper-based or computer-based PDA. In addition, Pearson correlation analysis was applied to assess the relationships among variables. In total, 304 patients who visited our Division of Nephrology were included in the final analysis. Overall, over half of the patients felt anxiety (n = 217, 71.4%). Near half of the patients felt a reduction in anxiety after SDM (n = 143, 47.0%) and 281 patients (92.4%) were satisfied with the whole process of SDM. When we divided all the patients based on use of paper-based or computer-based PDA, the reduction of anxiety level was greater in the patients who underwent paper-based PDA when compared with that of those who underwent computer-based PDA. However, there was no significant difference in satisfaction between the two groups. Paper-based PDA was as effective as computer-based PDA. Further studies comparing different types of PDA are warranted to fill the knowledge gaps in the literature.

Abstract Although often regarded a childhood toy, the design of paper airplanes is subtly complex. The design space and mapping from geometry to distance flown is highly nonlinear and probabilistic where a single airplane design exhibits a multitude of trajectory forms and flight distances. This makes optimization and understanding of their behavior challenging for humans. By understanding the behavior of paper airplanes and predicting flight behavior, there is a potential to improve the design of aerial vehicles that operate at low Reynolds numbers. By developing a robotic system that can fabricate, test, analyze, and model the flight behavior in an unsupervised fashion, a wide design space can be reliably characterized. We find there are discrete behavioral groups that result in different trajectories: nose dive, glide, and recovery glide. Informed by this characterization we propose a method of using Gaussian mixture models to extract the clusters of the design space that map to these different behaviors. This allows us to solve both the forward and reverse design problem for paper airplanes, and also to perform efficient optimization of the geometry for a given target flight distance.