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Chemistry, a vital tool for sustainable development, faces a challenge due to the lack of clear guidance on actionable steps, hindering the optimal adoption of sustainability practices across its diverse facets from discovery to implementation. This Scientific Perspective explores established frameworks and principles, proposing a conciliated set of triple E priorities anchored on Environmental, Economic, and Equity pillars for research and decision making. We outline associated metrics, crucial for quantifying impacts, classifying them according to their focus areas and scales tackled. Emphasizing catalysis as a key driver of sustainable synthesis of chemicals and materials, we exemplify how triple E priorities can practically guide the development and implementation of processes from renewables conversions to complex customized products. We summarize by proposing a roadmap for the community aimed at raising awareness, fostering academia–industry collaboration, and stimulating further advances in sustainable chemical technologies across their broad scope. [ABSTRACT FROM AUTHOR]

Chemistry, a vital tool for sustainable development, faces a challenge due to the lack of clear guidance on actionable steps, hindering the optimal adoption of sustainability practices across its diverse facets from discovery to implementation. This Scientific Perspective explores established frameworks and principles, proposing a conciliated set of triple E priorities anchored on Environmental, Economic, and Equity pillars for research and decision making. We outline associated metrics, crucial for quantifying impacts, classifying them according to their focus areas and scales tackled. Emphasizing catalysis as a key driver of sustainable synthesis of chemicals and materials, we exemplify how triple E priorities can practically guide the development and implementation of processes from renewables conversions to complex customized products. We summarize by proposing a roadmap for the community aimed at raising awareness, fostering academia–industry collaboration, and stimulating further advances in sustainable chemical technologies across their broad scope. [ABSTRACT FROM AUTHOR]

Background: Double crush syndrome refers to a nerve in the proximal region being compressed, affecting its proximal segment. Instances of this syndrome involving ulnar and cubital canals during ulnar neuropathy are rare. Diagnosis solely through clinical examination is challenging. Although electromyography (EMG) and nerve conduction studies (NCS) can confirm neuropathy, they do not incorporate inching tests at the wrist, hindering diagnosis confirmation. We recently encountered eight cases of suspected double compression of ulnar nerve, reporting these cases along with a literature review. Methods: The study included 5 males and 2 females, averaging 45.6 years old. Among them, 4 had trauma history, and preoperative McGowan stages varied. Ulnar neuropathy was confirmed in 7 cases at both cubital and ulnar canal locations. Surgery was performed for 4 cases, while conservative treatment continued for 3 cases. Results: In 4 cases with wrist involvement, 2 showed ulnar nerve compression by a fibrous band, and 1 had nodular hyperplasia. Another case displayed ulnar nerve swelling with muscle covering. Among the 4 surgery cases, 2 improved from preoperative McGowan stage IIB to postoperative stage 0, with significant improvement in subjective satisfaction. The remaining 2 cases improved from stage IIB to IIA, respectively, with moderate improvement in subjective satisfaction. In the 3 cases receiving conservative treatment, satisfaction was significant in 1 case and moderate in 2 cases. Overall, there was improvement in hand function across all 7 cases. Conclusion: Typical outpatient examinations make it difficult to clearly differentiate the two sites, and EMG tests may not confirm diagnosis. Therefore, if a surgeon lacks suspicion of this condition, diagnosis becomes even more challenging. In cases with less than expected postoperative improvement in clinical symptoms of cubital tunnel syndrome, consideration of double crush syndrome is warranted. Additional tests and detailed EMG tests, including inching tests at the wrist, may be necessary. We aim to raise awareness double crush syndrome with ulnar nerve, reporting a total of 7 cases to support this concept. [ABSTRACT FROM AUTHOR]

Background: In 2023, Burkina Faso experienced the largest dengue epidemic ever in Africa. This study aimed to estimate the prevalence of symptomatic, subclinical, and asymptomatic dengue and determine the associated factors among adult contacts of dengue in the Central Region, Burkina Faso. Methods: This cross-sectional study included contacts of dengue probable cases through cluster sampling in 2022–2023. These suspected cases that tested positive were identified from the five health facilities (Pissy CMA, Saaba CM, Kossodo CMA, Samandin CM, and Marcoussis CSPS) that reported the highest number of cases in 2021 per district. All participants underwent dengue and malaria rapid diagnostic tests (RDT). Samples positive for non-structural 1 protein antigen (AgNS1) and/or immunoglobulin M (IgM) were tested for serotype detection by reverse transcription polymerase chain reaction (RT-PCR). Binary logistic regression was done to identify the determinants of asymptomatic, subclinical, and symptomatic dengue among contacts of probable dengue cases. Results: A total of 484 contacts were included, mostly in 2023 (75.2%). Most participants were females (58.6%), residing (24.3%) and passing their daytime (23.1%) in Saaba. The overall prevalence of dengue was estimated at 15.1% [95% confidence interval (CI): 12.0–18.6%], representing cases not seeking care in hospitals. Asymptomatic cases represented 2.9% (95% CI: 1.6–4.8%). Subclinical and symptomatic cases accounted for 6.0% (95% CI: 4.1–8.5%) and 6.2% (95% CI: 4.2–8.7%), respectively. Of the 58 samples tested by RT-PCR, 10 were confirmed for serotype 3 in 2023. Malaria cases were estimated at 5.6% (95% CI: 3.7–8.0%). After adjustment, participants claiming that a virus transmits dengue were likelier to have asymptomatic dengue [adjusted odds ratio (aOR) = 7.1, 95% CI: 2.4–21.0]. From the multivariable analysis, subclinical dengue was statistically associated with being included in the study in 2023 (aOR = 30.2, 95% CI: 2.0–455.5) and spending the daytime at Arrondissement 4 (aOR = 11.5, 95% CI: 1.0–131.0). After adjustment, symptomatic dengue was associated with living less than 50 m away from cultivated land (aOR = 2.8, 95% CI: 1.1–6.9) and living less than 50 m from a stretch of water (aOR = 0.1, 95% CI: 0.0–0.6). Conclusions: The overall burden of dengue among populations not seeking care in hospitals was quite high, with few asymptomatic cases. Efforts to manage dengue cases should also target non-hospital cases and raise population awareness. The 2023 epidemic could be due to dengue virus (DENV)-3. [ABSTRACT FROM AUTHOR]

Background: Urban poor women face dual challenges regarding gender inequalities and urban poverty, which make them more likely to have health problems and affect their health-seeking behaviour. This study aimed to determine the prevalence of health-seeking behaviour during times of illness and predictors of sought care among urban poor women in Kuala Lumpur, Malaysia. Methods: This cross-sectional study was performed among 340 randomly selected women residents from April to May 2023. Data was collected using a validated and reliable self-administered questionnaire and analysed using SPSS version 28.0 software. The dependent variable in this study was health-seeking behaviour during times of illness, while the independent variables were sociodemographic characteristics, socioeconomic characteristics, medical conditions, women's autonomy in decision-making, social support, perceived stigma, and attitude towards health. Multiple logistic regression was used to identify the predictors of sought care during times of illness. Results: Study response rate was 100%, where 72.4% sought care during times of illness. Being non-Malay (AOR = 4.33, 95% CI: 1.847, 10.161), having healthcare coverage (AOR = 2.60, 95% CI: 1.466, 4.612), rating their health as good (AOR = 1.87, 95% CI: 1.119, 3.118), and having pre-existing chronic diseases (AOR = 1.92, 95% CI: 1.130, 3.271) were identified as predictors of sought care during times of illness. Conclusion: The present study showed that health-seeking behaviour during times of illness among the participants was appropriate. Health promotion and education, with a focus on educating and raising awareness about the importance of seeking timely healthcare, are crucial to improving health-seeking behaviour among urban poor women. Collaboration with relevant stakeholders is needed to develop comprehensive strategies to improve access to healthcare facilities for these women. [ABSTRACT FROM AUTHOR]

Background: Chikungunya is a viral disease caused by a mosquito-borne alphavirus. The acute phase of the disease includes symptoms such as fever and arthralgia and lasts 7–10 days. However, debilitating symptoms can persist for months or years. Despite the substantial impact of this disease, a comprehensive assessment of its clinical picture is currently lacking. Methods: We conducted a systematic literature review on the clinical manifestations of chikungunya, their prevalence and duration, and related hospitalization. Embase and MEDLINE were searched with no time restrictions. Subsequently, meta-analyses were conducted to quantify pooled estimates on clinical outcomes, the symptomatic rate, the mortality rate, and the hospitalization rate. The pooling of effects was conducted using the inverse-variance weighting methods and generalized linear mixed effects models, with measures of heterogeneity reported. Results: The systematic literature review identified 316 articles. Out of the 28 outcomes of interest, we were able to conduct 11 meta-analyses. The most prevalent symptoms during the acute phase included arthralgia in 90% of cases (95% CI: 83–94%), and fever in 88% of cases (95% CI: 85–90%). Upon employing broader inclusion criteria, the overall symptomatic rate was 75% (95% CI: 63–84%), the chronicity rate was 44% (95% CI: 31–57%), and the mortality rate was 0.3% (95% CI: 0.1–0.7%). The heterogeneity between subpopulations was more than 92% for most outcomes. We were not able to estimate all predefined outcomes, highlighting the existing data gap. Conclusion: Chikungunya is an emerging public health concern. Consequently, a thorough understanding of the clinical burden of this disease is necessary. Our study highlighted the substantial clinical burden of chikungunya in the acute phase and a potentially long-lasting chronic phase. Understanding this enables health authorities and healthcare professionals to effectively recognize and address the associated symptoms and raise awareness in society. Author summary: Chikungunya disease is an emerging public health concern. The disease is transmitted by mosquitoes and characterized by arthralgia and fever in the acute phase, lasting 7–10 days. Additionally, some individuals experience chronic symptoms such as arthralgia and tiredness that can last from months to years. Chikungunya is mainly present in the Americas and Asian countries, but the mosquitoes transmitting the disease are spreading to other regions due to climate change, amongst others. This increased disease threat highlights the importance of understanding chikungunya symptoms. However, there are currently no precise estimates on the prevalence of chikungunya symptoms. Therefore, we analysed the available literature on the clinical manifestations of chikungunya. We found that 75% of infected people develop symptoms, primarily characterized by arthralgia in 90% and fever in 88% of cases. Chronic symptoms affect 44% of symptomatic people, and 0.3% of patients with chikungunya die. Unfortunately, we were not able to estimate all predefined outcomes of interest because we did not find enough studies publishing on some of these, demonstrating that there is still much unknown around the clinical manifestations of chikungunya. However, the results can help healthcare workers early identifying chikungunya and raise awareness of this debilitating disease. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Anatomy education plays a critical role in medical practice, and the level of anatomical knowledge among students and physicians significantly impacts patient care. This article presents a pilot project aimed at exploring the effectiveness of the Area9's Rhapsode platform, an intelligent tutoring system that uses artificial intelligence (AI) to personalize learning and collect data on mastery acquisition. METHODS: The study focused on liver anatomy (microscopic and macroscopic anatomy, embryology, clinical anatomy) and employed a flipped classroom approach, incorporating adaptive learning modules and an interactive in-class session. A total of 123 first-year medicine students (55 M/68F) participated to the study. Content and resources of the module were adaptable to various digital devices. Statistics were compiled based, on the one hand, on the measurement of mastery for every single learning objective provided automatically by the platform via the student interactions with the system probes (questions); on the other hand, metacognition data were worked out by crossing mastery data with the self-awareness declared in every question and learning resource by each learner. RESULTS AND CONCLUSIONS: At the outset of the study, students displayed a 18.11% level of conscious incompetence and a 19.43% level of unconscious incompetence. Additionally, 50.86% of students demonstrated conscious competence. By the conclusion of the learning module, the level of conscious incompetence had decreased to 1.87%, and 98.73% of students exhibited conscious mastery of the materials. The results demonstrated improved learning quality, positive repurposing of study time, enhanced metacognitive awareness among students, with most students demonstrating conscious mastery of the materials and a clear understanding of their level of competence. This approach, by providing valuable insights into the potential of AI-based adaptive learning systems in anatomy education, could address the challenges posed by limited teaching hours, shortage of anatomist, and the need for individualized instruction. [ABSTRACT FROM AUTHOR]

The South East Asian region has the world's second highest fatal drowning burden. This study reports analysis of survey data from representatives from nations within the Association of South East Asian Nations regarding current efforts, challenges and future opportunities for drowning prevention. Twenty-two responses were received from respondents from all ASEAN nations excepting Cambodia and Myanmar. Drowning prevention initiatives varied across ASEAN nations, with most efforts focused on public education and raising awareness, including the provision of drowning data to the media. The lack of comprehensive, national level data collection was identified as a challenge, necessitating strengthened data collection capacity. Governmental involvement spanned one to six different ministries, highlighting the multi-sectoral nature of drowning prevention. However, a lead ministry could be identified in only two countries. Despite the challenges identified, there remain many opportunities to strengthen drowning prevention across ASEAN nations, addressing a significant regional public health threat. [ABSTRACT FROM AUTHOR]

Background: Primary osteoporosis (POP) is recognized as a "silent disease" and often ignored. This meta-analysis aimed to determine the prevalence of POP in the Chinese population over the past 20 years to raise awareness of the disease's epidemiology, which is hoped to help prevent and treat the condition better. Methods: Eight English and three Chinese language databases were searched systematically from January 2002 to December 2023. Relevant data were analysed using Stata 16.0. Meta-regression and subgroup analyses were performed to explore causes of heterogeneity. A funnel plot was further drawn in combination with Egger and Begg tests to determine publication bias. Results: A total of 45 studies (241,813 participants) were included. The meta-analysis revealed that the overall prevalence of POP in the Chinese population was 18.2% (95% CI: 14.7–21.7%), showing a positive correlation with age. Specifically, prevalence rates were 23.4% (18.3–28.5%) in women and 11.5% (9.1–13.9%) in men. A notable increase was observed within the span of 20 years (16.9% before 2010 and 20.3% in 2011–2020). Notably, regional variations were observed, with southern China reporting a lower prevalence of 16.4% compared to 20.2% in northern China. Meta-regression suggested that sample size significantly influenced the estimation of point prevalence (P = 0.037). Conclusions: Over the past two decades, there has been an increase in the prevalence of POP within the Chinese population. The growing prevalence of older individuals and women further highlights the urgency for tailored disease prevention and control measures. [ABSTRACT FROM AUTHOR]

Introduction: Systemic racism and tobacco-industry targeting contribute to disparities in communities of color. However, understanding tobacco as a social justice issue and the industry's role in perpetuating inequities remains limited. This study explored youth and young adult awareness of tobacco marketing and perceptions of tobacco marketing as a social justice issue. Aims and Methods: Focus groups were conducted with youth and young adults in 2020 and 2021, including individuals who used tobacco and e-cigarettes and those who did not use either. Online surveys were conducted in 2021 with youth (n = 1227) and young adults (n = 2643) using AmeriSpeak's nationally representative panel, oversampling for black and Hispanic Americans and people who smoke. Perceptions of flavor bans, social justice, and industry marketing were assessed. Results: Most (>80%) survey respondents agreed that tobacco companies target youth. However, only 20% saw tobacco as a social justice issue. Focus group participants regardless of their tobacco or e-cigarette use, reported higher prevalence of tobacco advertising in their communities relative to survey respondents but did not view it as targeting communities of color. Black non-Hispanic (20.9%) and Hispanic (21.4%) survey respondents perceived tobacco as a social justice issue more than white non-Hispanic (16.1%) respondents. The majority (>60%) of survey respondents supported bans on menthol and flavored tobacco, regardless of race or ethnicity. Conclusions: Respondents broadly supported menthol and flavored tobacco bans and recognized tobacco-industry influence on youth. Low awareness of tobacco as a social justice issue highlights the need to raise awareness of the underlying factors driving tobacco-related disparities. Implications: The majority of young people see the tobacco industry as targeting them. Most young people support bans on menthol and flavored tobacco bans, with support across racial and ethnic groups. While few young respondents perceived tobacco as a social justice issue, some perceived tobacco companies as targeting low-income and communities of color. Black non-Hispanic and Hispanic respondents were more likely to perceive tobacco as a social justice issue than white non-Hispanic respondents. Efforts to raise awareness among young people of tobacco as a social justice issue may be key in addressing tobacco disparities and advancing support for flavor tobacco bans. [ABSTRACT FROM AUTHOR]

Patients from equity-deserving populations, such as those who are from racialized communities, the 2SLGBTQI+ community, who are refugees or immigrants, and/or who have a disability, may experience a unique set of challenges accessing virtual models of care. The objective of this qualitative study was to describe the experiences of patients from equity-deserving communities and their family members who received care from a Virtual Emergency Department (ED) in Toronto, Canada. Forty-three participants (36 patients and 7 family caregivers) with different and intersecting identities who used the Virtual ED participated in the study. Semi-structured interviews were conducted to explore reasons for accessing the Virtual ED, barriers to access, and how the Virtual ED met their care needs and expectations, including ways their experience could have been improved. Thematic analysis was used to identify themes from the data. Patients from equity-deserving populations described negative past experiences with ED in-person care, which included recounts of discrimination or culturally insensitive care while waiting to see the ED physician or nurse. Conversely, participants found the Virtual ED to be a socially and culturally safe space since they could now by-pass the waiting room experience. However, virtual care could not replace in-person care for certain issues (e.g., physical exam), and there was a need for greater promotion of the service to specific communities that might benefit from having access to the Virtual ED. Targeted outreach to help raise awareness of the service to equity-deserving communities is an important future direction. [ABSTRACT FROM AUTHOR]

The purpose of developing the colour coding system is to create better awareness and help consumers monitor and understand the sugar content of foods. Our research focused on food products (dairy products and cereal products on the Slovenian market) that contain so-called hidden sugars, as these can cause many health risks. The aim of the study was to raise awareness of the sugar content in dairy products and cereals through a packaging design with a uniform labelling and coding system. During the process of this research, few answers were provided to the following questions: How can a labelling system be designed to be clear and impartial, what is the hierarchy and layout of food information on packaging, and how can the system be coherently integrated with existing packaging? The impact of the information design on the consumer in the food packaging industry, which helps in further execution, was analysed. Based on the research, variants of a multi-colour labelling system were created, differing in primary information graphics, colour, placement and formats. The packaging for an imaginary brand and the placement of the code system were designed. Finally, the packaging design was implemented in the 3D models for each food group. The result of this research is a collection of packaging models with a labelling system that informs consumers about sugar content, facilitates decision-making and helps them control their food intake. The colour-coded labels were applied to the packaging in a uniform and coherent manner, which can provide sufficient attention and information. [ABSTRACT FROM AUTHOR]

Cybersecurity awareness has a huge impact on individuals and an even bigger impact on firms, universities, and institutes to those individuals belong. Consequently, it is essential to explore and asses the factors affecting the awareness level of cybersecurity. More specifically this research study examines the impact of demographic features of individuals on cybersecurity awareness. The Studied literature's limitations have been addressed and overcome in our research from the variability, and ambiguity aspects. A questionnaire was developed and responses were collected from 613 participants. Reliability and validity tests as well as correlations have been applied for the instruments and data employed in this study. Coefficients were calculated via multiple linear regression for the weights of each of the cybersecurity components. Data reliability test showed that Cronbach's Alpha value of 0.707 for the used data which is acceptable for research purposes. Results analysis showed r-value for each of the questions is greater than the r table which was 0.07992. Examining the proposed hypotheses showed that there is a difference as the null hypothesis is rejected for one of the demographic features being tested namely, gender. While there is no significant difference when it comes to the other two factors, education level, and age. Using the weight for each of the components, password security, technical behavior, and social influence could provide a solid base for decision-makers to focus on and implement the available resources for gender-specific developments to raise the cybersecurity awareness level. [ABSTRACT FROM AUTHOR]

Peripheral neuropathy (PN) is one of the most common diseases of the peripheral nervous system. Symptoms range from mild sensory signs to severe neuropathic pain. Untreated PN is progressive and can lead to complications and impair quality of life (QoL). However, PN prevalence is underestimated in the general population and affected individuals often remain undiagnosed. This study aimed to contribute to the global generation of prevalence data and determine sociodemographic and disease-related characteristics of PN sufferers. This cross-sectional study collected information on PN prevalence and associated factors in the adult population (40–65 years) of the Mexico City area. Participants were recruited in public places and screened for PN using the Michigan Neuropathy Screening Instrument (MNSI). Subjects with PN answered the Neuropathy Total Symptom Score-6 (NTSS-6), the Short Form-36 Health Survey (SF-36), and the QoL Pharmacoeconomic Questionnaire. Statistical analysis included descriptive methods and calculation of PN prevalence with 95% confidence intervals. Of 3066 participants, 448 had PN based on the MNSI physical examination. The overall PN prevalence was 14.6%, with the highest (18.9%) seen in subjects aged 61–65 years. PN was undiagnosed in 82.6%, and 62.9% had never heard of PN. Although half of all subjects had only mild PN symptoms, QoL was impacted in 91.8%. The results confirm that PN prevalence in the general population is high. Despite the disease burden, most affected persons are undiagnosed and unaware of the disease. Almost all felt their QoL was impacted. The data highlight the need to raise awareness and identify undiagnosed individuals to prevent complications. [ABSTRACT FROM AUTHOR]

Patrolling represents a potential application area for multi-robot systems, as it can enable efficient surveillance. A key aspect in facilitating the real-world applications of such missions is the enhancement of situation awareness of the base station (BS), in addition to ensuring well-coordinated patrol behavior. This paper addresses this requirement by proposing a layered patrol algorithm designed to maintain network connectivity with the BS. The novelty of this research lies in the distributed nature of the algorithm, despite the presence of the BS. Each robot independently determines its behavior based on local information while concurrently preserving connectivity to the BS. Additionally, this study introduces a novel performance metric to assess the situation awareness of the BS, focusing on the algorithm's ability to provide prompt information about mission progress. Simulated missions revealed that the proposed algorithm outperformed existing algorithms, visited locations of interest more frequently and comprehensively, and provided the BS with improved situation awareness. Enhancing situation awareness may enable human operators to quickly gain insights into the system's behavior based on mission progress, allowing for timely interventions if necessary. This capability contributes to improving human trust in autonomous systems. [ABSTRACT FROM AUTHOR]

The plan of the paper is to study autism spectrum disorder (ASD) in children as complex conditions that affect cognitive, emotional, social, and physical health. Broadly tracing the medical journey of the condition, it addresses the challenges faced by parents as they make sense of, and navigate their way through the appearance of early symptoms, impediments in correct diagnosis, acceptance, and adapt to live with the condition. The paper attempts to understand autism in medical and neurological terms, as well as the challenges faced by children and parents through the case study of Kyari (meaning a flower bed), a lone centre providing accessible autism care in about 150 km around Moradabad (west UP, India), which has been instrumental in raising an awareness of autism and has a reach that is unprecedented in the city in bringing sensitive autism intervention. It further comprehensively studies the symptoms of ASD, and the role of augmentative and alternative communication, behaviour modification, and the work of organisations like the Centre for Autism, CBSE mandate for inclusive education as applied in the case and Indian government policy for autism. [ABSTRACT FROM AUTHOR]

Background: Climate change is the greatest threat to human health. Cardiothoracic patients suffer direct consequences from poor environmental health and we have a vested interest to address this in our practice. As leaders of complex high‐end surgery, we are uniquely positioned to effect practical and immediate changes to significantly pare down emissions within the operating theatre, outside the operating theatre and beyond the confines of the hospital. Methods: We aim to spotlight this pressing issue, take stock of our current efforts, and encourage fellow specialists to drive this agenda. Results: Sustainability in healthcare needs to be formalized as part of the core curriculum in surgical training and awareness generated via carbon audits and life cycle analyses. Practical actions such as reducing unnecessary equipment usage, choosing reusable equipment over single use disposables, judicious use of investigations rooted in clinical reasoning and sharing of resources across services and health systems help reduce the carbon output of our specialty. Conclusion: The 'Triple Bottom Line' serves as a good template to calibrate efforts that balance quality against environmental costs. More can be done to advocate for and find solutions for sustainable healthcare with cardiothoracic surgery. [ABSTRACT FROM AUTHOR]

Background: According to the studies, more than 80% of pediatric patients with cancer can achieve a survival rate greater than 5 years; however, long‐term chemotherapy and/or radiation therapy may seriously affect their reproductive ability. Fertility preservation in adolescents with cancer in China was initiated late, and related research is lacking. Analyze data to understand the current situation and implement measures to improve current practices. Methods: From 2011 to 2020, data on 275 male adolescents with cancer whose age ranged from 0 to 19 years old were collected from 16 human sperm banks for this retrospective study. Methods include comparing the basic situation of male adolescents with cancer, the distribution of cancer types, and semen quality to analyze the status of fertility preservation. Results: The mean age was 17.39 ± 1.46 years, with 13 cases (4.7%) aged 13–14 years and 262 cases (95.3%) aged 15–19 years. Basic diagnoses included leukemia (55 patients), lymphomas (76), germ cell and gonadal tumors (65), epithelial tumors (37), soft tissue sarcomas (14), osteosarcoma (7), brain tumors (5), and other cancers (16). There are differences in tumor types in different age stages and regions. The tumor type often affects semen quality, while age affects semen volume. Significant differences were found in sperm concentration and progressive motility before and after treatment (p < 0.001). Moreover, 90.5% of patients had sperm in their semen and sperm were frozen successfully in 244 patients (88.7%). Conclusions: The aim of this study is to raise awareness of fertility preservation in male adolescents with cancer, to advocate for fertility preservation prior to gonadotoxic therapy or other procedures that may impair future fertility, and to improve the fertility status of future patients. [ABSTRACT FROM AUTHOR]

We propose an interactive web‐based application to inform the general public about personal flood risks. Flooding is the natural hazard affecting most people worldwide. Protection against flooding is not limited to mitigation measures, but also includes communicating its risks to affected individuals to raise awareness and preparedness for its adverse effects. Until now, this is mostly done with static and indiscriminate 2D maps of the water depth. These flood hazard maps can be difficult to interpret and the user has to derive a personal flood risk based on prior knowledge. In addition to the hazard, the flood risk has to consider the exposure of the own house and premises to high water depths and flow velocities as well as the vulnerability of particular parts. Our application is centered around an interactive personalized visualization to raise awareness of these risk factors for an object of interest. We carefully extract and show only the relevant information from large precomputed flood simulation and geospatial data to keep the visualization simple and comprehensible. To achieve this goal, we extend various existing approaches and combine them with new real‐time visualization and interaction techniques in 3D. A new view‐dependent focus+context design guides user attention and supports an intuitive interpretation of the visualization to perform predefined exploration tasks. HORA 3D enables users to individually inform themselves about their flood risks. We evaluated the user experience through a broad online survey with 87 participants of different levels of expertise, who rated the helpfulness of the application with 4.7 out of 5 on average. [ABSTRACT FROM AUTHOR]

Considering the complex structure of Chinese characters, particularly the connections and intersections between strokes, there are challenges in low accuracy of Chinese character stroke extraction and recognition, as well as unclear segmentation. This study builds upon the YOLOv8n-seg model to propose the YOLOv8n-seg-CAA-BiFPN Chinese character stroke fine segmentation model. The proposed Coordinate-Aware Attention mechanism (CAA) divides the backbone network input feature map into four parts, applying different weights for horizontal, vertical, and channel attention to compute and fuse key information, thus capturing the contextual regularity of closely arranged stroke positions. The network's neck integrates an enhanced weighted bi-directional feature pyramid network (BiFPN), enhancing the fusion effect for features of strokes of various sizes. The Shape-IoU loss function is adopted in place of the traditional CIoU loss function, focusing on the shape and scale of stroke bounding boxes to optimize the bounding box regression process. Finally, the Grad-CAM++ technique is used to generate heatmaps of segmentation predictions, facilitating the visualization of effective features and a deeper understanding of the model's focus areas. Trained and tested on the public Chinese character stroke datasets CCSE-Kai and CCSE-HW, the model achieves an average accuracy of 84.71%, an average recall rate of 83.65%, and a mean average precision of 80.11%. Compared to the original YOLOv8n-seg and existing mainstream segmentation models like SegFormer, BiSeNetV2, and Mask R-CNN, the average accuracy improved by 3.50%, 4.35%, 10.56%, and 22.05%, respectively; the average recall rates improved by 4.42%, 9.32%, 15.64%, and 24.92%, respectively; and the mean average precision improved by 3.11%, 4.15%, 8.02%, and 19.33%, respectively. The results demonstrate that the YOLOv8n-seg-CAA-BiFPN network can accurately achieve Chinese character stroke segmentation. [ABSTRACT FROM AUTHOR]

Tinea incognito is a dermatophyte infection with atypical features, due to the use of topical or systemic steroids or other immunosuppressive medications. Delayed diagnosis, spread of the infection to critical body surfaces, resistance to antifungal drugs, and increased costs due to prolonged hospitalization and multiple treatment regimens often complicate tinea incognito. It can affect individuals of all ages and genders, but it is more common in children. Atypical clinical appearance often necessitates differentiation from other diseases such as eczema, seborrheic dermatitis, lupus erythematosus, psoriasis, or other non-fungal skin conditions. The treatment of tinea incognito usually involves discontinuation of topical steroids or other immunosuppressive medications. Preventive measures and management of the underlying fungal infection are necessary and can be achieved with antifungal drugs. Patients should wear loose cotton clothes, use boiling water for laundry, and iron their clothing before wearing them. Additionally, they should avoid sharing bed linens, towels, clothes, and shoes. This review aims to raise awareness of tinea incognito among health practitioners, provide tips for detecting the disorder, include it in the differentials, and evaluate the available diagnostic procedures. [ABSTRACT FROM AUTHOR]

Introduction: Cardiac arrest results in a high death rate if cardiopulmonary resuscitation and early defibrillation are not performed. Mortality is strongly linked to regulations, in terms of prevention and emergency–urgency system organization. In Italy, training of lay rescuers and the presence of defibrillators were recently made mandatory in schools. Our analysis aims to analyze Out-of-Hospital Cardiac Arrest (OHCA) events in pediatric patients (under 18 years old), to understand the epidemiology of this phenomenon and provide helpful evidence for policy-making. Methods: A retrospective observational analysis was conducted on the emergency databases of Lombardy Region, considering all pediatric OHCAs managed between 1 January 2016, and 31 December 2019. The demographics of the patients and the logistics of the events were statistically analyzed. Results: The incidence in pediatric subjects is 4.5 (95% CI 3.6–5.6) per 100,000 of the population. School buildings and sports facilities have relatively few events (1.9% and 4.4%, respectively), while 39.4% of OHCAs are preventable, being due to violent accidents or trauma, mainly occurring on the streets (23.2%). Conclusions: Limiting violent events is necessary to reduce OHCA mortality in children. Raising awareness and giving practical training to citizens is a priority in general but specifically in schools. [ABSTRACT FROM AUTHOR]

Sustainable access to effective antibiotics is a foundational need for functioning health care that is increasingly threatened by antibiotic resistance. Although resistance has been known as long as antibiotics have been in clinical use, there are still multiple gaps in the global and local responses. One often cited cause for this complacency is the language that is used to describe the problem and its consequences. In this paper, we survey some examples of the current discussions around antibiotic resistance and seek to offer a path towards unified and understandable messaging that is relevant both to the public and policymakers by using narratives that highlight the individual and societal consequences of antibiotic resistance. Major shortcomings in the current language that hamper both the understanding of antibiotic resistance and needed behaviour change have been identified in scientific papers and special reports. These shortcomings range from terminology that is difficult to understand, through a lack of personal relevance, to a fragmented response in the policy field. We propose that scientists, including behaviour change experts, and other key stakeholders that are engaged in the issue take lead to agreement on the core scientific facts and to formulate a vision that can be a foundation for creation of consistent global narratives. These narratives must in turn be adapted to local contexts. Development of such narratives should be viewed as an essential component in national action plans on AMR to raise awareness, empower citizens and incentivise societal behaviour change, policy development and implementation of governance structures. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the prevalence of anterior extensions of the parotid gland (AEPG), namely the accessory parotid gland (APG) and the facial process of the parotid gland (FP), using ultrasonography. Study design: A total of 338 parotid glands were scanned bilaterally. APG was defined as a soft tissue mass with the same echogenic features as the main parotid gland (MPG) and not in contact with it, while FP was defined as an extension that exceeded the anterior border of the mandibular ramus and was continuous with the MPG. The anteroposterior, mediolateral, superoinferior dimensions and the mean distance from the MPG to the APG were measured. Results: The prevalence of APG and FP were 19.5% and 36%, respectively, resulting in an AEPG prevalence of 55.6%. The presence of APG was statistically higher in females than in males (p = 0.039). The mean anteroposterior, mediolateral, and superoinferior dimensions of the APG were 18.1 ± 0.57 mm, 0.35 ± 0.17 mm, and 12.3 ± 0.36 mm, respectively, and the mean distance from the MPG was measured as 12.1 ± 0.87 mm. Conclusion: This study can raise awareness among clinicians about the presence of AEPG in the differential diagnosis of mid-cheek masses. [ABSTRACT FROM AUTHOR]

Health education is an essential topic for contemporary society because it focuses on providing information to improve and sustain the health of the community. This type of education covers issues of broad interest, such as disease prevention, promoting a healthy lifestyle, the importance of nutrition and exercise, and stress reduction. Health education aims to raise awareness and build skills for healthy behaviour. This article aims to cover topics of interest to society such as a literature review to emphasize the importance of the concept of health education, a theoretical approach to the factors that influence health, in the idea of the possibility to act on them. The specialized literature shows a connection between education for health, health and economy, a connection that the authors proposed to highlight also by referring to the social determinants of health that we believe start, on the one hand, from children's education and, on the other on the other hand, from the economy. Health and education can be considered determinants of the economy and, implicitly, health education contributes to the balanced development of society. Most of the time, an educated child will be a healthy, employable adult; there is a possibility that not every healthy child will be educated, but will be able to work. Society is interested in people's labor force, without considering that a low standard of living and lack of health care will exhaust the labor force sooner. [ABSTRACT FROM AUTHOR]

Background: Patients with diabetes often have coexisting chronic health conditions such as hypertension, dyslipidemia, coronary artery disease, depression, and chronic kidney disease. Drug interactions are a daily challenge for physicians and screening all drug interactions in the prescriptions has become very cumbersome and virtually impossible. The aim and objective of our study is to estimate the prevalence of Drug-Drug Interactions (DDIs) in diabetic patients and raise awareness among physicians to prevent the occurrence of some clinical adverse events. Method: This is a cross-sectional observational retrospective study design conducted on diabetic patients admitted to Seiyun Hospital over 2 months from December 2023 to Feburary 2024. Results: This study found that approximately two-thirds of patients were prescribed more than six medications. Most prescriptions that were prescribed for diabetic patients have at least one or more Drug-Drug Interactions per prescription. We note that most of the antidiabetic agents that cause drug interactions with other medications were moderate and minor interactions; only six interactions of major type were observed with quinolone antibiotics. Conclusions: This study found that the incidence of drug interactions in diabetic patients was very high. Therefore, the best way to avoid the occurrence of such drug interactions is to have a specialized pharmacist examine the total medication chart for each patient individually. [ABSTRACT FROM AUTHOR]

People with disabilities (PwD) are frequently excluded from certain activities due to the lack of accessible information. In this area, information systems can help PwD by allowing access to a range of information about the accessibility of spaces, facilities, and products. There has been an increase in technologies that promote accessibility, but there are few literature studies which analyse how these technologies were developed to ensure access for all. To address this gap, this study aims to explore the integration of accessibility requirements in the processes of developing information systems. To achieve this aim, a systematic literature review was conducted using the PRISMA reporting guidelines. To conduct the review, a search was carried out for primary studies in four well-established databases—SCOPUS, Web of Science, IEEE, and ACM. A snowball search to find additional studies was also performed. Based on this, 34 papers were obtained to conduct the study. In general, the studies published on this topic are relatively recent, with healthcare and education being the two major areas where accessibility in information systems is most addressed. The integration of accessibility seems to be primarily applied during the requirement assessment and testing phases, involving potential users in the process. The results obtained within this systematic literature review raise awareness about the integration of accessibility for the success of solutions, which are oriented towards the accessible market. Additionally, the different practical and theoretical contributions can help future practitioners and technology developers establish guidelines that promote the integration of accessibility, thus achieving a more accessible and inclusive society. [ABSTRACT FROM AUTHOR]

A noteworthy feature of entomology is the opportunity for it to be practically integrated into our lives. It stretches out over a wide spectrum of useful applications across many scientific fields. Several challenges to fully understanding the complexity of entomology are presented, such as considering its vast research paradigm and raising awareness as to the importance of insects on a global scale. The current study offers an interdisciplinary outlook on insects regarding their potential role in human surgical interventions. This is achieved through the description of anatomical features and their biomechanical manifestations, observed in rare neuropteran and dipteran insect species from the European fauna, documented by the author. Empirically justified parallels between insect anatomy and advancement in surgery are exemplified through analysis of evident mechanical properties of legs in Mantispa aphavexelte (U. Aspöck & H. Aspöck, 1994) and Rainieria calceata (Fallén, 1820). In addition, suggestions on implementing specific examples of insect biomechanical design in robot-assisted surgery setups are made. [ABSTRACT FROM AUTHOR]

Objective: This is a retrospective analysis of clinical data from individuals diagnosed with neurosyphilis, aiming to enhance healthcare professionals' understanding of the disease and expedite early diagnosis and intervention. Methods: A retrospective analysis was conducted on the clinical records of 50 patients who received a diagnosis of symptomatic neurosyphilis and were admitted to the Neurology Department during the period spanning January 2012 to December 2022. Results: Clinical manifestations encompassed diverse phenotypes, with syphilitic meningitis accounting for 16% of cases, characterized by symptoms such as headache, blepharoptosis, paralysis, blurred vision, and tinnitus. Meningovascular syphilis presented in 36% of cases, exhibiting episodic loss of consciousness, limb numbness, and limb convulsion. Paralytic dementia manifested in 36% of cases, featuring symptoms such as memory loss, sluggish response, and slow movement. Tabes dorsalis was observed in 12% of cases, presenting with weakness, numbness, and staggering. Routine cerebrospinal fluid (CSF) analysis indicated abnormal white blood cell counts in 60% of patients, while biochemical testing revealed abnormal protein content in 52% of patients. Notably, statistically significant differences were observed between patients with interstitial and parenchymatous neurosyphilis (Z = 2.023, P = 0.044) in terms of CSF protein content. Electroencephalogram (EEG) results were abnormal in six patients, and imaging studies unveiled diverse findings in 46 patients. Conclusion: The study highlights the importance of neurological and/or ocular symptoms in diagnosing symptomatic neurosyphilis. Individuals with hypomnesia should be closely monitored for potential neurosyphilis. Integrating clinical manifestations, laboratory tests, EEG, and imaging can reduce misdiagnosis. This comprehensive approach shows promise in improving early identification and management of neurosyphilis. [ABSTRACT FROM AUTHOR]

Background: Stroke is a second leading cause of death globally, with an estimated one in four adults suffering a stroke in their lifetime. We aimed to describe the clinical characteristics, quality of care, and outcomes in adults with stroke in urban Northwestern Tanzania. Methods: We analyzed de-identified data from a prospective stroke registry from Bugando Medical Centre in Mwanza, the second largest city in Tanzania, between March 2020 and October 2022. This registry included all adults ⩾18 years admitted to our hospital who met the World Health Organization clinical definition of stroke. Information collected included demographics, risk factors, stroke severity using the National Institutes of Health Stroke Scale, brain imaging, indicators for quality of care, discharge modified Rankin Scale, and in-hospital mortality. We examined independent factors associated with mortality using logistic regression. Results: The cohort included 566 adults, of which 52% (294) were female with a mean age of 65 ± 15 years. The majority had a first-ever stroke 88% (498). Premorbid hypertension was present in 86% (488) but only 41% (200) were taking antihypertensive medications before hospital admission; 6% (32) had HIV infection. Ischemic strokes accounted for 66% (371) but only 6% (22) arriving within 4.5 h of symptom onset. In-hospital mortality was 29% (127). Independent factors associated with mortality were severe stroke (adjusted odds ratio (aOR) = 1.81, 95% confidence interval (CI) = 1.47–2.24, p < 0.001), moderate to severe stroke (aOR = 1.49, 95% CI = 1.22–1.84, p < 0.001), moderate stroke (aOR = 1.80, 95% CI = 1.52–2.14, p < 0.001), leukocytosis (aOR = 1.19, 95% CI = 1.03–1.38, p = 0.022), lack of health insurance coverage (aOR = 1.15, 95% CI = 1.02–1.29, p = 0.025), and not receiving any form of venous thromboembolism prophylaxis (aOR = 1.18, 95% CI = 1.02–1.37, p = 0.027). Conclusion: We report a stroke cohort with poor in-hospital outcomes in urban Northwestern Tanzania. Early diagnosis and treatment of hypertension could prevent stroke in this region. More work is needed to raise awareness about stroke symptoms and to ensure that people with stroke receive guidelines-directed therapy. [ABSTRACT FROM AUTHOR]

Social leaders and human rights defenders (SLHRD) in Colombia have been under increasing attack for defending the rights of communities affected by violence. From 2016 to 2022, over 600 SLHRD were assassinated, resulting in a serious violation of both individual and community human rights. The media's portrayal of these attacks can shape public perceptions and influence efforts towards peacebuilding and promoting human rights. This study examines the media's framing of violence against SLHRD in Colombia between 2016 and 2020, a period marked by an escalation of violence after the signing of the 2016 peace accord between the Colombian government and the Revolutionary Armed Forces of Colombia (FARC). We analysed 1506 textual publications from seven media outlets using a lexicometric approach and identified two frames of news articles: episodic and thematic. Our findings suggest that the episodic media framing may present a simplistic and non‐political perspective of the issue, which can impede peacebuilding efforts, while the thematic frame can raise awareness of violence against SLHRD and promote human rights defence. Our study highlights the media's significant role in shaping public opinion on violence against SLHRD, offering practical implications for advocacy and activism. [ABSTRACT FROM AUTHOR]

Objective: Although teletherapy is increasingly common, very little is known about its impact on therapeutic relationships. We aimed to examine differences between therapists' experiences of teletherapy and in-person therapy post-pandemic with regard to three variables pertinent to the therapeutic relationship: working alliance, real relationship, and therapeutic presence. Methods: In a sample of 826 practicing therapists, we examined these relationship variables, as well as potential moderators of these perceived differences including professional and patient characteristics and covid-related variables. Results: Therapists reported feeling significantly less present in teletherapy and their perceptions of the real relationship were somewhat impacted, but there were no average effects on their perceived quality of the working alliance. Perceived differences in the real relationship did not persist with clinical experience controlled. The relative reduction in therapeutic presence in teletherapy was driven by the ratings of process-oriented therapists and therapists conducting mostly individual therapy. Evidence for moderation by covid-related issues was also found, with larger perceived differences in the working alliance reported by therapists who used teletherapy because it was mandated and/or not by choice. Conclusion: Our findings might have important implications for generating awareness around the therapists' lowered sense of presence in teletherapy compared to in-person teletherapy. [ABSTRACT FROM AUTHOR]

Immersive global learning experiences like Collaborative Online International Learning (COIL) offer students cross-cultural knowledge, awareness, and language fluency, fostering critical analysis, and problem-solving. This paper focuses on U.S. and Dutch students' perceptions of personal growth as future health education specialists regarding cultural sensitivity and competence within a COIL course. The study explores valuable skills for professionals engaging with diverse populations, contributing to the literature on faculty-led internationalization initiatives. Both the COIL research model and the cultural intelligence (CQ) framework guided the design and implementation of the COIL course. A thematic analysis of self-reflection narratives from N = 49 undergraduate students from the U.S. and the Netherlands revealed categories and themes related to cultural perspectives in health promotion, cultural sensitivity and competence, and essential skills for health education specialists. The findings demonstrate the impact of COIL on students' cultural perspectives and knowledge, their awareness of cultural norms, and the importance of diverse strategies and approaches in health promotion. The study highlights the value of COIL courses in developing cultural understanding within educational settings and provides insights for educators and students interested in engaging with diverse populations. [ABSTRACT FROM AUTHOR]

Unfortunately, eleven of our provinces were severely affected due to two severe earthquakes that occurred in our country, the Republic of Turkey, on February 6, 2023. As a result, thousands of buildings were destroyed and tens of thousands of our citizens lost their lives. From past to present, such disasters have occurred in many parts of our world and will continue to happen. In order to raise awareness for researchers and academicians reading our article, we will give a new definition of convexity in this article, and we will call it "earthquake convexity". In this paper, we study some algebraic properties of the earthquake convexity. Then we compare the results obtained with both Hölder, Hölder–İşcan inequalities and power-mean, improved power-mean integral inequalities and show that the results obtained with Hölder–İşcan and improved power-mean inequalities are better than the others. Some applications to special means of real numbers are also given. [ABSTRACT FROM AUTHOR]

Distant pet owners suffer from negative feelings such as distress or anxiety when separating from their pet dogs. Informed by prior work on facilitating intimacy between distant couples and among distant family members, we present the design and evaluation of the cAMpanion ambient display to enhance distant owner's sense of connectedness with their pet dogs. cAMpanion shows three statuses of pet dogs via different light colors in real-time enabled by sensor modules installed in pet dog's living environment. We examined the impact and effectiveness of cAMpanion via a 14-day field study using mixed methods research. Our qualitative data suggested that cAMpanion helped raise awareness, while quantitative results indicated statistically significant decrease in owners' negative emotions and increase in their perceived closeness. We discussed both advantages and limitations of cAMpanion from distant owners' perspective, and provided implications for future researchers who would like to design similar display to enhance human-animal connectedness. [ABSTRACT FROM AUTHOR]

Promoting human contact with wildlife can be harmful to animal conservation and welfare by exposing animals to unsafe situations and driving demand for wildlife tourism and exotic pets. Conservationists and researchers justifiably use social media to raise awareness, but professionals posting pictures of themselves with animals can have unintended negative consequences for conservation. Though the International Union for Conservation of Nature Best Practice Guidelines for Responsible Images of Non‐Human Primates suggests researchers and animal professionals provide context in captions of images of humans interacting with primates, there is little research investigating whether this approach is effective. We investigated whether informative captions affect viewers' desires to have primates as pets and attitudes toward wildlife conservation. Using 4 mock Instagram posts depicting human−gorilla and human−slender loris interactions, we surveyed 2977 respondents to assess the effect of captions on viewers' perceptions of the images and primate conservation. Likert scale response data were analyzed with ordered probit regression models. Captions clearly contextualizing an image as research resulted in a significantly higher agreement that posts depicted wildlife research (gorilla β = 0.28 [SE 0.06], p < 0.001; loris β = 0.18 [0.06], p = 0.002), but such captions resulted in no significant difference in responses regarding viewers' desires to own primates as pets or questions regarding the primates' conservation statuses. Although most participants agreed the primates were endangered, more than 56% and 59%, respectively, stated they would have a gorilla or loris as a pet, that they would make good pets, or both, further supporting the conclusion that captions do not minimize harmful impacts of images of human−primate interactions. [ABSTRACT FROM AUTHOR]

Following recommendations for replacing center pivots and center-pivot sprinkler packages can help farmers improve water application efficiency and optimize crop production. Little information exists on the frequency with which farmers are replacing center pivots and sprinkler packages. To help address this issue, this study evaluated an industry database of center pivot (n=654) and sprinkler package (n=5,131) replacements in the western United States. On average, pivot systems were oldest in Montana, Idaho, and Utah, with an average age of 18, 16, and 16 years, respectively. Oregon had the lowest average pivot age (9 years). Average pivot age also varied by brand: Reinke systems were the oldest (16 years) and Valley were the youngest (11 years), on average. Across the database, 92% of the pivots were 25 years old or younger. Utah also had the oldest average sprinkler package age (10 years). Oregon and California changed sprinkler packages most frequently (≤4 years). Sprinkler package replacement frequency varied among center-pivot manufacturers, with Valley pivots having the highest frequency of sprinkler package changes (5 years) and Zimmatic pivots having the lowest frequency (8 years). Across the database, 50% of the sprinkler packages were replaced within 2 to 5 years, and 81% were replaced within 10 years. Most farmers in the region generally follow recommendations on replacing pivots and pivot sprinkler packages, but a sizeable number of farmers do not. Therefore, an opportunity exists to improve center-pivot and sprinkler package maintenance, thereby helping to make center-pivot irrigation more water efficient and crop production more sustainable. This study contributes to industry knowledge and awareness by providing data and insights on center-pivot and sprinkler package replacement trends. The authors evaluated an industry database of center-pivot (n=654) and sprinkler package (n=5,131) replacements in the western United States. Insights on the frequency of replacement can help farmers make informed decisions about when to replace their equipment, and can raise awareness on the importance of equipment maintenance. Farmers may therefore be encouraged to follow equipment maintenance recommendations and replace outdated or inefficient equipment. By so doing, farmers can irrigate more efficiently and optimize crop production, leading to improved yields and more sustainable crop production. The study revealed that equipment replacement trends vary by manufacturer. This reinforces the need for irrigators to consult with irrigation experts, manufacturers, or equipment dealers to obtain specific recommendations tailored to their specific circumstances and equipment. Irrigation equipment manufacturers and distributors can also use the study findings to improve their equipment and farmer support systems. Policy makers may use the findings in structuring and implementing farmer support programs and related policies and laws. The study, therefore, can provide insights that contribute to the nation's goals of sustainable agricultural water use and crop production. [ABSTRACT FROM AUTHOR]

High incidences of haemorrhagic fever with renal syndrome (HFRS) have been reported in the southern Republic of Korea (ROK). A distinct southern genotype of Orthohantavirus hantanense (HTNV) was identified in Apodemus agrarius chejuensis on Jeju Island. However, its association with HFRS cases in southern ROK remains elusive. We investigated the potential of the southern HTNV genotype as an etiological agent of HFRS. Samples from 22 patients with HFRS and 193 small mammals were collected in the southern ROK. The clinical characteristics of patients infected with the southern HTNV genotype were analysed. Amplicon-based MinION sequencing was employed for southern HTNV from patients and rodents, facilitating subsequent analyses involving phylogenetics and genetic reassortment. High-throughput sequencing of HTNV exhibited higher coverage with a cycle of threshold value below 32, acquiring nearly whole-genome sequences from six patients with HFRS and seven A. agrarius samples. The phylogenetic pattern of patient-derived HTNV demonstrated genetic clustering with HTNV from Apodemus species on Jeju Island and the southern Korean peninsula, revealing genetic reassortment in a single clinical sample between the M and S segments. These findings imply that the southern HTNV genotype has the potential to induce HFRS in humans. The phylogenetic inference demonstrates the diverse and dynamic characteristics of the southern HTNV tripartite genomes. Therefore, this study highlights the significance of active surveillance and amplicon sequencing for detecting orthohantavirus infections. It also raises awareness and caution for physicians regarding the emergence of a southern HTNV genotype as a cause of HFRS in the ROK. [ABSTRACT FROM AUTHOR]

• Vitamin D is one of the most widely used drugs. • Large use of vitamin D in prevention leads to therapeutic inappropriateness. • Governments must adopt policies without wasting public resources. At the Asl Napoli 3 SUD a local, regional and national level analysis of prescription and spending related to the prescription and dispensing of drugs intended to increase vitamin D levels in the human body was carried out. The Italian Pharmacy Regulatory Agency (AIFA) in late 2019 introduced a prescriptive note of appropriateness (note 96) to regulate the prescribing activity of a drug that is widely used on the Italian national population, significantly affecting spending by the National Health System (NHS). Despite this action there has been an increase in prescription and expenditure of calcifediol at all levels of analysis (national, regional and local) while regarding the remaining Anatomical Therapeutic Chemical (ATC) referring to drugs used as vitamin D supplement in the Campania Region and at the Asl Napoli 3 SUD there is a slower decrease in expenditure and prescription, sometimes even increasing and in countertendency to the Italian national average. For these reasons, the Campania Region instituted two executive decrees (DD 405/2021 and 91/2022) that led to a marked reduction in spending and prescription in 2022 even higher than in other Italian regional realities. This analysis aims to show how vitamin D prescription is widespread and often inappropriate, attested by wide regional variability. In addition, the main recommendations for the use of these drugs are highlighted in order to raise awareness among all healthcare professionals of the informed use of these molecules ensuring sustainability and governance. [ABSTRACT FROM AUTHOR]

It is widely acknowledged that patients with cancer commonly experience malnutrition, and some individuals may adopt specific dietary trends. This study investigated the prevalence of malnutrition and dietary trends among Algerian cancer outpatients undergoing chemotherapy. This cross-sectional, descriptive study was conducted from January to October 2023 with 71 cancer outpatients undergoing chemotherapy. Malnutrition risk was evaluated using the Malnutrition Screening Tool (MST). The questionnaire also collected the occurrence of nutrition impact symptoms, the avoidance of specific food groups, and the use of oral nutritional supplements and dietary supplements. Malnutrition risk was identified in 57.7% (41 cases) of participants. Nutrition impact symptoms were reported by 59.2% (42 cases) of patients. A total of 36 of the patients (50.7%) altered their eating habits by avoiding at least one food group. Among malnourished cancer outpatients, only five used oral nutritional supplements. Dietary supplements were used by 23.9% (27/71) of the patients after cancer diagnosis. Our findings underscore the necessity for a systematic malnutrition assessment in cancer patients. Qualified clinicians should provide nutritional awareness to enhance the quality of life for these patients. [ABSTRACT FROM AUTHOR]

Pediatric and adolescent gynecology (PAG) is a unique subspecialty for which accessible educational resources and clinical exposure have historically been limited; surveys show that trainees in both obstetrics and gynecology and pediatrics agree. In 2014, the North American Society for Pediatric and Adolescent Gynecology (NASPAG) introduced PAG WebEd, an original and interactive online case-based curriculum designed to bridge this learning gap. As of 2023, there are 35 published PAG WebEd clinical cases with key learning points that present, test, and discuss a variety of current PAG topics. The NASPAG Resident Education Committee (REC) compiled and reviewed administrative data from the module platform to investigate trainee utilization and performance. The activity data and assessment scores for 161 registered users are included and reported in this article. This brief report highlights that a relatively small number of medical trainees use PAG WebEd and aims to raise awareness of this resource through publication. There is potential for many more users to benefit from this resource; its efficacy as an examination and clinical practice tool could also be measured. The NASPAG REC hopes to ultimately show, with increased utilization, that PAG WebEd deserves to be a key piece of PAG-focused medical education. For PAG WebEd information and faculty registration, as well as a link that allows faculty to submit new learners, please visit https://www.naspag.org/pagwebed-information. [ABSTRACT FROM AUTHOR]

Plenty of studies demonstrate that hospital-acquired anemia (HAA) can increase transfusion rates, mortality, morbidity and cause unnecessary patient burden, including additional length of hospital stay, sleep disruption and venipuncture harms resulting from blood samples unlikely to change clinical management. Beyond patient costs, community costs should also be considered, such as laboratory time and resources waste, environmental impact, increasing pressure on labs and fewer tests available on time for patients who can benefit from them most. Blood over-testing does not support the principles of non-maleficence, justice and respect for patient autonomy, at the expense dubious beneficence. Reducing the number and frequency of orders is possible, to a certain extent, by adopting nudge strategies and raising awareness among prescribing doctors. However, reducing the orders may appear unsafe to doctors and patients. Therefore, reducing blood volume from each order is a better alternative, which is worth implementing through technological, purchasing and organizational arrangements, possibly combined according to need (smaller tubes, adequate analytic platforms, blind dilution, blood conservative devices, aggregating tests and laboratory units). [ABSTRACT FROM AUTHOR]

Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease caused by the SFTS virus (SFTSV). The Miyazaki Prefecture has the highest number of SFTS cases in Japan and requires countermeasures for prevention. In this study, we aimed to conduct an epidemiological survey in Miyazaki Prefecture to determine the exposure conditions of SFTSV by measuring the seroprevalence among residents of Miyazaki and to evaluate the factors that influence the endemicity of SFTS. The survey was conducted between June 2014 and April 2019 in all 26 municipalities in Miyazaki Prefecture. SFTSV antibodies were detected using an enzyme-linked immunosorbent assay in the blood samples of 6013 residents (3184 men and 2829 women). A questionnaire-based survey of the living environment was also conducted. Multiple logistic regression analysis revealed that age and occupation were significant factors related to the proportion of participants with an optical density (OD) value > 0.2 and a seroprevalence of 0.9 % (54/6013). Seven seropositive individuals (0.1 %) with an OD value of >0.4 were identified (three men and four women, aged 54–69 years), and all were asymptomatic. One participant had a higher OD than the positive control. Although SFTS is endemic in Miyazaki Prefecture, Japan, its seroprevalence is relatively low. Since some risk areas in Miyazaki prefecture have been identified, it is important to enhance awareness of SFTS in residences and reduce contact with ticks, especially in high-risk areas. [ABSTRACT FROM AUTHOR]

Spinal cord malignant melanotic schwannoma (MMNST) is a rare central nervous system tumor that originates from the spinal cord or spinal myelin sheath cells and can produce melanin. This type of tumor is usually highly aggressive and malignant, with a poor prognosis. The clinical manifestations of spinal cord MMNST are mainly pain, paresthesia, muscle weakness, muscle atrophy, etc., and symptoms of spinal cord compression, such as intestinal and bladder dysfunction, paraplegia, etc. Early detection of tumor lesions can facilitate tumor removal, improve patients' quality of life, and prolong patients' survival. In this case report, a 27-year-old young woman was diagnosed with MMNST of the cervical spinal cord due to weakness of her limbs in our hospital, and underwent surgical resection. The patient's limbs returned to normal after surgery. It is worth mentioning that the patient visited our hospital 7 months ago for "right upper limb pain for 3 days" and was diagnosed with a cervical spine space-occupying lesion at the same position this time, but the pathology report was "hemosiderosis". This case report aims to raise awareness of the problem of spinal cord MMNST and contribute to greater knowledge of this rare tumor. [ABSTRACT FROM AUTHOR]

Background: The effects of household air pollution on urinary incontinence (UI) symptoms and stress urinary incontinence (SUI) symptoms have not been studied. This study seeks to investigate the correlation between household air pollution and UI/SUI symptoms among middle-aged and elderly adults in India. Methods: We employed data derived from individuals aged 45 years and older who participated in the inaugural wave (2017–2018) of the Longitudinal Aging Study in India (LASI). The assessment of household air pollution exposure and the occurrence of UI/SUI symptoms relied on self-reported data. The analytical approach adopted was cross-sectional in nature and encompassed a cohort of 64,398 participants. To explore relationships, we utilized multivariate logistic regression analysis, incorporating subgroup analysis and interaction tests. Results: 1,671 (2.59%) participants reported UI symptoms and 4,862 (7.55%) participants reported SUI symptoms. Also, the prevalence of UI/SUI symptoms is much higher among middle-aged and elderly adults who use solid polluting fuels (UI: 51.23% vs. 48.77%; SUI: 54.50% vs. 45.50%). The results revealed a noteworthy correlation between household air pollution and the probability of experiencing UI/SUI symptoms, persisting even after adjusting for all conceivable confounding variables (UI: OR = 1.552, 95% CI: 1.377–1.749, p < 0.00001; SUI: OR: 1.459, 95% CI: 1.357–1.568, p < 0.00001). Moreover, significant interaction effects were discerned for age, education level, tobacco consumption, alcohol consumption, and physical activity (p for interaction < 0.05). Conclusions: The results of our study indicate that the utilization of solid fuels in the home increases the likelihood of developing urinary incontinence and stress urinary incontinence. As a result, we argue that there is an immediate need to reform the composition of cooking fuel and raise public awareness about the adverse effects of air pollution in the home. [ABSTRACT FROM AUTHOR]

Introduction: Plague continues to be a major public health concern in African countries. Several social practices and environmental conditions have been associated with the reoccurrence of bubonic plague, especially in places where the disease is prevalent. Therefore, it remains important to understand people knowledge, behavior and practices related to disease risks in order to identify factors that may hinder prevention and control strategies in the foci. Methods and results: A study survey of 100 households was conducted in Mbulu district to assess plague knowledge, factors that influence flea bite and measures used for rodent and flea control. Majority of participants (86%) were familiar with the plague disease and about (50%) mentioned swelling lymph nodes as a common symptom. Most of the participants (62%) claimed to observe human plague cases during the long rain season. The majority of participants (97%) reported to experience flea bite in their domestic settings, with most stating that they experienced more flea bites during the dry season. Houses with livestock had a greater likelihood of flea bite (OR = 2.7; 95% CI: 0.36–18.80, p = 0.267) compared to houses with no livestock. Furthermore, residents reported using both local and chemical methods to control rodents and flea inside houses. Most respondents preferred using local methods in flea control. Respondents stated that the efficacy of flea control methods being applied ranged from few days to several months. There was limited knowledge of the residual effects of the agricultural chemicals being used to control fleas among the surveyed community. Conclusion: Our study highlights the importance of raising awareness and adopting effective control methods for controlling fleas and lower the risk of plague transmission and other flea borne diseases in the local communities. Sensitization of the local community on the use of appropriate chemicals for flea control is urgent to avoid any potential long-term impacts of the residual effects on the health of the local communities. Author summary: Plague is a significant health challenge in Africa due to environmental conditions, lifestyle, and behaviors of the people living mostly in persistent areas. Understanding people's knowledge on the environmental conditions and lifestyle practices related to plague transmissions is essential to preventing the disease spread. We assessed community understanding on plague, factors influencing flea bites, and methods used to control rodents and fleas in the plague foci to inform the development of the potential mitigation strategies for the disease. Majority of respondents were familiar with the disease; however, few were aware of its symptoms. They reported that human cases occurred during the rainy season, with frequent flea bites experienced during the dry season. Also, households keeping livestock inside sleeping houses had a higher likelihood of flea bites compared to those without livestock. Furthermore, residents reported using both local and chemical methods to control rodents and fleas with the majority preferring local methods for flea control. Respondents stated the efficacy of the flea control methods used ranged from days to months, although there was limited understanding of the long-term health effects of the chemical residuals used among the surveyed community. The study findings emphasize the importance of understanding community awareness and preventive measures in controlling the spread of plague and call for greater community awareness raising on using appropriate flea control methods. Understanding local practices and preventive methods aids the development of interventions that are safer and more acceptable to the community, ultimately leading to more effective control strategies in these rural settings. [ABSTRACT FROM AUTHOR]