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Lizy Sonia Benjamin,1 Eddieson Pasay-an,2 Petelyne Pangket,3 Aidah Sanad Alqarni,4 Ferdinand Gonzales,4 Lailani Sacgaca,5 Dawlat Ahmed Mahmoud,1 Maysa M Mohsen,4 Yahya Showkan Ali Hamdi,6 Sumathi Robert Shanmugam7 1Department of Medical-Surgical Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 2Department of Nursing Administration, College of Nursing, King Khalid University, Abha, Saudi Arabia; 3Department of Medical Surgical Nursing, University of Hail, Hail City, Saudi Arabia; 4Department of Fundamental of Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 5Department of Nursing, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia; 6Nursing Service, Aseer Central Hospital, Aseer, Saudi Arabia; 7Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Sumathi Robert Shanmugam, Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia, Email srshanmugm@pnu.edu.saIntroduction: Nursing students frequently encounter the challenge of balancing their studies with the demanding requirements of hands-on practice and this can greatly affect their mental wellbeing. This study aimed to investigate the impact of sleep and psychological well-being on the academic and clinical performance of nursing students in Saudi Arabia.Methods: This study used a cross-sectional approach with 218 student nurses selected through convenience sampling from King Khalid University, Abha, Saudi Arabia. The sleep quality, psychological wellbeing, academic performance and clinical performance questionnaires were adopted to measure the variables. The Google Forms survey was used to gather the data, which were collected in August through October 2023. t-test and chi-square were used to analyze the data.Results: The sleep quality was higher with good/very good performers (p < 0.001). There was a significant difference with academic performance on positive relations (p < 0.007) and purpose in life (p < 0.004). Additionally, there was a significant difference in autonomy (p < 0.01), environmental mastery (p < 0.026), positive relations (p < 0.001), and purpose in life (p < 0.001) with clinical performance. Among students with good academic performance, those who were older than 25 years of age (p < 0.043) and level 3 students (p < 0.001) were found to have a significant correlation. Furthermore, those who were 25 years of age (p < 0.012) and level 3 students (p < 0.001) were also found to have a significant correlation with clinical performance.Conclusion: The sleep quality, positive relations, purpose in life, autonomy, and environmental mastery are all important factors for academic and clinical success. Moreover, older students and level 3 students may be more likely to have the skills and knowledge necessary to succeed in these areas. Further research exploring factors influencing academic and clinical success must be conducted.Keywords: sleep quality, psychological well-being, academic performance, clinical performance, nursing students, Saudi Arabia

Abstract Background Reflection is a core competency in geriatric nursing, and reflective learning is an effective approach in nursing education and pracice. An internship program is a transition course that enhances the knowledge, skills, and attitudes of aspiring nursing students in real clinical work. In geriatric clinical setting, nursing internship students require a broad understanding of professional competency that integrates reflective learning with clinical practice to deal with geriatric patient problems and equip them with the knowledge, attitudes, and skills needed to provide quality of care. However, there is a lack of studies examining the effect of holistic reflective learning on professional competency development among nursing internship students in geriatric settings. Aim This study aimed to investigate the effect of professional holistic reflective learning on professional competency development among nursing internship students caring for hospitalized older adults in medical-surgica wards. Design This study employed a quasi-experimental pretest–posttest design, where 160 participants were grouped into control and intervention groups. This study was conducted at two nursing schools under the Mashhad University of Medical Sciences in Iran in 2020. Baseline information was collected from both groups, followed by a pretest and follow-up assessment. The intervention group received a Blended Professional Holistic Reflective learning program, while the control group received conventional learning(undertaking professional clinical practice as a usual treatment and submitted reflective logbooks),, which included standard lectures and group discussions. Methods Participants were selected based on specific inclusion and exclusion criteria. The selection process was non-randomized and unblinded. The participants were equally divided, with 80 in the control group and 80 in the intervention group. Baseline data, including demographic characteristics, were collected. Pretest data were collected for both groups using the Geriatric Nursing-Specific Mini-CEX (GN-Specific Mini-Clinical Evaluation Exercise), an instrument designed to assess nursing students' professional competency in geriatric nursing practice. The intervention was delivered through a combination of in-person and online sessions over four mounts. Posttest data and follow-up, were collected similarly to the pretest. Data were analyzed using SPSS version 22, and potential confounding variables were controlled for in the analysis. Results The study included a total of 160 nursing internship students, with no exclusions. At baseline, no significant differences were observed between the intervention and control groups in terms of professional competency (PC) and its dimensions, except for age, which was adjusted as a covariate in the analyses. The intervention group showed a significant improvement in PC and its various domains (communication skills, physical examination, clinical judgment, health education, professionalism, and organizational efficacy) over time. The Generalized Estimating Equation (GEE) analysis confirmed significant interaction effects between time and group for all PC dimensions (p

Abstract Background Malaysian preschool children continue to exhibit a high prevalence of dental caries and poor oral hygiene. There is a need to gain an in-depth understanding of oral hygiene habits and design suitable interventions to improve oral hygiene in early childhood. Objective To cross-culturally adapt and determine the psychometric properties of the Malay-translated Parenting and Child Tooth Brushing Assessment questionnaire (M-PACTA). Methodology This cross-sectional study involved face and content validation, and forward and back-translation of PACTA. The M-PACTA was then tested for reliability and construct validity on 150 Malaysian parents of children aged 5 to 6 years old. Results Face validity indicated that the M-PACTA items were clear and easy to understand. For content validity, some words had to be modified in accordance with the recommendations of the expert committees to make it more coherent to Malaysians. Some statements in the parental knowledge scales were modified according to the guidelines applicable in Malaysia. The content comparison of the back translation with the adapted PACTA revealed that all items were semantic and linguistically equivalent. Exploratory factor analyses of M-PACTA suggested a two-factor structure for three scales including child behaviour scale (‘non-compliance’ and ‘avoidance behaviour’), parental attitudes (‘lack of concern’ and ‘attitude of care’), and parental knowledge (‘general tooth brushing knowledge’ and ‘awareness of tooth brushing care’) while for the parental strategy scale, three-factor structure was extracted including ‘routine positive methods’, ‘uncommon positive methods’, and ‘negative methods’. Internal consistencies for all scales were good (α > 0.9). Conclusion M-PACTA did not replicate the construct of the original PACTA. Nonetheless, M-PACTA demonstrated good construct validity, internal consistency reliability, and test-retest reliability within Malaysian context.

Zinc finger CCCH containing 11A (ZC3H11A) is a stress-induced protein that is upregulated in various conditions such as heat shock and virus infection. It has also been reported to be upregulated in certain cancers. The aim of this study was to evaluate the feasibility of targeting ZC3H11A as a therapeutic approach for cancer treatment, using nuclease-resistant, affinity-enhanced antisense oligonucleotide (ASO). An ASO targeting ZC3H11A was validated and evaluated in vitro and in the B16 melanoma model in vivo. Antigen presentation, interferon response, cell proliferation, and apoptosis were transcriptionally affected. These findings were validated on the protein level by the upregulation of major histocompatibility complex class I (MHC class I), an increased secretion of interferon-β (IFN-β), and induction of apoptosis observed as upregulation of caspases and annexin V. Immunogenic features of the induced apoptosis were evidenced by the surface exposure of calreticulin (CRT) and the secretion of ATP leading to enhanced dendritic cell (DC) phagocytosis, maturation, and activation. Treatment with the ZC3H11A-targeted ASO had limited efficacy in vivo, while constitutive lentiviral shRNA knockdown of ZC3H11A in murine B16 melanoma cells and human HeLa cells led to reduced tumor growth with prolonged survival of mice, validating ZC3H11A as a relevant target for cancer therapy.

PURPOSEBeliefs on causes of cancer, although sometimes aligned with known risk factors, may be influenced by personal experiences, cultural narratives, and misinformation. We investigated the prevalence of beliefs on causes of cancer and their association with cancer risk perception and lifestyle in a multiethnic Asian population.METHODSIn total, 2,008 Malaysian adults with no previous cancer were surveyed using a 42-item questionnaire adapted from the Awareness Measure and the Cancer Awareness Measure–Mythical Causes Scale. Partial least squares structural equation modeling was used to evaluate measurement models.RESULTSDespite high educational attainment, only about half of the respondents believed that 7 of the 21 listed established risk factors caused cancer. Factors associated with accurate beliefs included higher socioeconomic status (SES) and having family or friends with cancer. However, 14 of the 21 listed mythical/unproven factors were correctly believed as not cancer-causing by the majority. Women and those with lower SES were more likely to hold misconceptions. Beliefs on established risk factors were significantly associated with perceived risk of cancer. Individuals with stronger beliefs in established risk factors were less likely to be associated with healthy behaviors. Conversely, stronger beliefs in mythical or unproven factors were more likely to be associated with healthy lifestyles.CONCLUSIONFindings highlight the importance of prioritizing cancer literacy as a key action area in national cancer control plans. The counterintuitive associations between cancer beliefs and lifestyle emphasize the complexity of this relationship, necessitating nuanced approaches to promote cancer literacy and preventive behaviors.

Purpose: The aim of this research was to analyze the spatial distribution of current libraries and the optimal distribution of libraries in the future in Rasht city. Methodology: In this research, the data of Rasht's existing libraries, statistical blocks of the 2015 census of the Rasht, and Rasht's spatial data were used in shape file format. This research was conducted based on the instructions of the Iran Public Libraries Foundation, 2017. Spatial statistics analysis has been used to investigate the spatial distribution of existing libraries and network analysis has also been used to determine the service range of libraries. Finally, VIKOR decision-making model was used to prioritize future service areas. Findings: The values ​​of the tests show the significance of cluster distribution of libraries in Rasht city, which indicates heterogeneous distribution based on population or distance from population centers. In fact, the distribution of libraries in Rasht is not suitable and they are mostly concentrated in the city center. There are few libraries in the south, west and north of Rasht city. Based on the criteria of distance and population for existing libraries, 4 service areas were determined (due to the proximity of some libraries to each other, their service areas were merged with each other). Considering the population of Rasht city, there is 14,991 square meters lack of library infrastructure to reach the access standard in this city. The existing libraries cover only 163,633 people (equivalent to 24.2%) of Rasht’s population, and with the development of about 3500 square meters of library space at the available libraries, 32.4% of Rasht's population will be covered by library services. By conducting network analysis and applying distance and population filters, twenty future service areas in Rasht city were proposed to cover the population of Rasht city in the most equitable way. These twenty areas will cover 442,575 people of the population of Rasht city, which includes 65.3% of the population of Rasht, and if they are realized and the infrastructure level of the current libraries is increased, a total of 661,943 people (97.7%) of the population of Rasht city will be covered by public libraries services. In determining the priority of the future service areas, the population is more important than the distance, and respectively, the areas with the largest population in the south, west, north and northeast of Rasht city are in the first six priorities for the construction of new libraries, and marginal areas in the north of Rasht is the last priority due to its lower population and proximity to existing libraries. 2.3% of the population of Rasht, including 15,322 people do not have the necessary population and distance criteria, and currently it is not possible to propose the establishment of a new library for them, who are mainly located in the south of Rasht city. Originality/value: Conducting land use planning researches is the basis of future planning. Lack of this type of studies and lack of foresight will lead to waste of resources and duplication in different projects. According to the basic criteria, this research has determined the amount of library infrastructure based on the population, the amount needed to increase the infrastructure of existing libraries and also the number and area of ​​new libraries in order to cover the needs of the population of Rasht city. By doing it, libraries can be expanded in principle in Rasht and new libraries can be established at the right areas of the city.

Abstract Background Professionalism is a dynamic construct that requires constant revision based on contemporary practices and attitudes. Objectives The purpose of this study was to cross-culturally adapt an already validated English questionnaire assessing patient perceptions of professionalism among dentists, into the Malay language. Methods An original 24-item questionnaire was cross-cultural adapted in the Malaysian context through two phases. Phase I included content and face validity from experts’ evaluation which was followed by translation into the Malay language. Phase II involved psychometric assessment including construct validity and reliability analysis. Results Expert evaluation indicated that all items demonstrated excellent content validity for the characteristics of relevance (CVI = 0.75–1.00 Kappa = 0.72–1.00) and clarity (CVI = 0.75–1.00 and Kappa= 0.72–1.00). A total of 300 dental patients completed the questionnaire. EFA was done on the first dataset and the second dataset was subjected to CFA which showed composite reliability (CR) ranging between 0.741 and 0.897 indicating acceptable reliability among items. The final questionnaire had 20 items with 3 domains; Patient expectation of a dental care provider, Ethics and Dentist’s professional responsibilities, Patient communication and confidentiality. Conclusion This study has successfully validated the questionnaire for patient perception of professionalism in the Malaysian context.

Background: Considering the development of a knowledge-based economy in the world and Iran, identifying the effective components in the development of knowledge-based companies in the medical field is essential in line with the policy and economic development of the country. Methods: In this qualitative research, data was collected through in-depth and semi-structured interviews from faculty members, specialists and managers of organizations in charge of the country's knowledge-based ecosystem. The statistical population was selected by snowball sampling, and the scientific interviews continued until the theoretical saturation stage, and finally 19 interviews were conducted. All data were analyzed based on Brovan and Clark's six-step theme analysis method. Results: From data analysis, three main themes including the factors of " revision of the general policies of the country", "creating a suitable economic platform" and "revision of the performance of institutions in charge of knowledge-based economy" and 37 subthemes were extracted which were regarded as effective factors in the development of knowledge-based companies in the medical field. Conclusion: It is necessary to review the general and executive policies of the country for the development of knowledge-based companies, and the government must provide the basis for the development of knowledge-based companies by creating a suitable economic context, fighting economic rents, creating economic stability and reforming the banking network. It is also necessary to review the processes in the Deputy of Science, Technology and Knowledge-Based Economy and the Ministry of Health, Treatment and Medical Education.

Automatic indexing plays a crucial role in bridging the gap between the creators and publishers of intellectual content and the researchers who seek to access it. By offering an objective analysis and detailed description of intellectual works, automatic indexing enables quick, accurate, and efficient retrieval of information. This process has become increasingly vital due to the exponential growth in intellectual production, the diversity of its fields, and the continuous influx of new content. Periodicals, particularly specialized ones, are a critical source of information on intellectual and cognitive advancements. They serve as a cornerstone of scientific research, offering researchers timely insights and updates across various fields. Due to their large volume, continuous publication, and ability to keep pace with current developments, periodicals have become indispensable to researchers seeking to achieve their academic and professional goals. With the widespread adoption of databases, particularly in the Arab world—such as Dar Al-Manzomah’s information databases, which encompass a broad spectrum of Arab scientific periodicals—the role of automatic indexing has become even more significant. These databases rely heavily on automatic indexing to make vast amounts of information accessible to researchers. The indexing services provided for articles within these periodicals are now the cornerstone for ensuring that researchers can effectively navigate the extensive body of knowledge contained within intellectual production journals. Through efficient indexing, these databases facilitate the discovery and utilization of relevant information, thereby maximizing the value and impact of intellectual production.

Memory loss is becoming an increasingly significant health problem, largely due to Alzheimer's disease (AD), which disrupts the brain in several ways, including causing inflammation and weakening the body's defenses. This study explores the potential of medicinal plants as a source of novel therapeutic agents for AD.First, we tested various plant extracts against acetylcholinesterase (AChE) in vitro, following molecular docking simulations with key AD-related protein targets such as MAO-B, P-gp, GSK-3β, and CD14. Rosemary extract was found to be the most inhibitory towards AChE. The compounds found in rosemary (oleanolic acid), sage (pinocembrin), and cinnamon (italicene) showed promise in potentially binding to MAO-B. These chemicals may interact with a key protein in the brain and alter the production and removal of amyloid-β. Luteolin (from rosemary), myricetin (from sage), chamigrene, and italicene (from cinnamon) exhibited potential for inhibiting tau aggregation. Additionally, ursolic acid found in rosemary, sage, and chamigrene from cinnamon could modulate CD14 activity.For the first time, our findings shed light on the intricate interplay between neuroinflammation, neuroprotective mechanisms, and the immune system's role in AD. Further research is needed to validate the in vivo efficacy and safety of these plant-derived compounds, as well as their interactions with key protein targets, which could lead to the development of novel AD therapeutics.

Kafrelsheikh, situated in the middle of the Nile Delta, significantly contributes to Egypt's aquaculture and agriculture sectors. However, the local use of organochlorine pesticides (OCPs) in agriculture is often a source of OCP residues in associated drainage waters, which may threaten aquatic ecosystems. These pesticides persist in local water bodies, jeopardizing aquatic ecosystems and potentially impacting human health. This comprehensive study assessed the seasonal variations of 17 OCPs in both water sources and Nile tilapia across eight fish farming locations in Kafrelsheikh. Using gas chromatography coupled with mass spectrometry (GC-MS), we detected OCP concentrations in water that varied seasonally where winter recorded the highest levels at 22.5 ng/mL and, summer showed the lowest levels at 6.2 ng/mL. Despite water samples occasionally showing risk quotients (RQs) greater than 1, indicating a potential threat to aquatic life, the OCP levels in Nile tilapia were sufficiently low, with target hazard quotients (THQ) below 1, suggesting no significant risk for human consumption. The research highlights a pressing need for regular environmental monitoring and stricter regulatory control over pesticide use to protect aquatic life and ensure the safety of aquaculture products. These findings provide a critical basis for policy-making, aimed at balancing agricultural productivity with environmental sustainability in regions heavily dependent on both.

Abstract Background The existing respiratory fit test panels (RFTPs) are based on Bivariate and Principal Component Analysis (PCA) which utilise American and Chinese head and facial dimensions. As RFTPs based on local facial anthropometric data for Malaysia are not available, this study was conducted with the aim to develop new RFTPs using Malaysian data. Methodology A cross-sectional study was conducted across Malaysia among 3,324 participants of the study of National Health and Morbidity Survey 2020 aged 18 and above. Ten head and facial dimensions were measured. Face length and face width were used to construct bivariate facial panel, whereas the scores from the first two PCA were used to develop the PCA panel. Results This study showed that Malaysians have the widest upper limit for facial width. It also found that three factors could be reduced from the PCA analysis. However only 2 factors were selected with PCA 1 representing head and facial size and PCA 2 representing facial shape. Our bivariate panel could accommodate 95.0% of population, while our PCA panel accommodated 95.6%. Conclusion This was the first study to use Malaysian head and facial anthropometry data to create bivariate and PCA panels. Respirators constructed using these panels are likely to fit ≥ 95.0% of Malaysia’s population.

This article investigates resistive random access memory (ReRAM) crossbar memory arrays, which is a notable development in non-volatile memory technology. We highlight ReRAM’s competitive edge over NAND, NOR Flash, and phase-change memory (PCM), particularly in terms of endurance, speed, and energy efficiency. This paper focuses on the architecture of crossbar arrays, where memristive devices are positioned at intersecting metal wires. We emphasize the unique resistive switching mechanisms of memristors and the challenges of sneak path currents and delve into the roles and configurations of selectors, particularly focusing on the one-selector one-resistor (1S1R) architecture with an insulator–metal transition (IMT) based selector. We use SPICE simulations based on defined models to examine a 3 × 3 1S1R ReRAM array with vanadium dioxide selectors and titanium dioxide film memristors, assessing the impact of ambient temperature and critical IMT temperatures on array performance. We highlight the operational regions of low resistive state (LRS) and high resistive state (HRS), providing insights into the electrical behavior of these components under various conditions. Lastly, we demonstrate the impact of selector presence on sneak path currents. This research contributes to the overall understanding of ReRAM crossbar arrays integrated with IMT material-based selectors.

Diversity and homeostasis of gut bacterial composition is highly associated with the pathogenesis of insulin dysfunction and type 1 diabetes melittus (T1D), hence emerged in parallel with the activation of autoimmunity. We aimed to study the bioactive potential of essential oil from Zanthoxylum myriacanthum var. pubescens Huang (Maqian) through computational approaches. Twelve chemical constituents derived from Maqian essential oil were docked with selected proteins (i.e., 3pig, 1kho, 7dmq, 4m4d, 2z65, 4glp, and 3fxi) in which are involved in gut microbiota modulation in T1D. Subsequently, the prediction of bioavailability properties of the small molecules were evaluated. Among all chemical constituents, the post-docking interaction analysis demonstrated that α-phellandrene exhibits the strongest binding affinity and induces gut microbiota modulation with β-fructofuranosidase from Bifidobacterium longum. The current result revealed the potential of 3-Carene and α-Pinene in inducing specific changes in gut microbiota downregulating Clostridium perfringens and quenching Leptotrichia shahii respectively. β-Pinene possess exceptionally strong binding affinity that effectively disrupt the interaction between lipopolysaccharide and its cognate receptors, while α-Phellandrene was exhibited the uppermost binding affinity with TLR4/MD2 and could likely target TLR4 stimulating lipopolysaccharide. Our results are the first to report on the gut microbiota modulation effects of α-Phellandrene and β-Phellandrene via actions on LPS binding to CD14 and the TLR4 co-receptor signaling. In conclusion, our findings based on computational approaches, small molecules from Maqian present as promising agents which could regulate inflammatory response and modulate gut microbiota in type 1 diabetes mellitus.

Abstract Background Teenage pregnancies continue to disrupt teenage girls’ academic development. As a result, teenage mothers are at risk of unemployment, maternal death, and poverty. Previous research, however, has shown that both individual and environmental factors can have a significant impact on the prevalence of adolescent pregnancy. However, there has been little rigorous research on the impact of these factors on pregnant students’ academic performance. Objectives The purpose of this study was to determine the relationship between environmental (neighbourhood) and individuals (sexual attitudes, peer attachment) factors. It also examined the influence of individual factors on the academic performance of pregnant teens. Methods The study included a cross-sectional study of 400 pregnant adolescent students aged 15–19 years. The target groups were drawn from three major cities in Nigeria. Respondents were identified through targeted snowballing. Pregnant participants were a combination of married and unmarried girls attending school from home. Data were collected using a structured and self-completed questionnaire. Thus, frequency, mean and standard deviation were used for descriptive analysis. Pearson correlation analysis was applied to show the relationship between variables. Results The study found that neighbourhood (r=-.125, p = .12) had a negative and significant relationship with peer attachment. However, there was no significant evidence of a relationship between sexual attitudes and neighbourhood (r=-.040, p = .422). There was, however, a significant relationship between sexual attitudes and academic performance (r = .236, p = .000). There was also a relationship between peer attachment and academic performance (r=-.401, p =

Objective Statins are effective for preventing cardiovascular disease. However, many patients decide not to take statins because of negative influences, such as online misinformation. Online health information may affect decisions on medication adherence, but measuring it is challenging. This study aimed to examine the associations between online health information behaviour and statin adherence in patients with high cardiovascular risk. Methods A prospective cohort study involving 233 patients with high cardiovascular risk was conducted at a primary care clinic in Malaysia. Participants used a digital information diary tool to record online health information they encountered for 2 months and completed a questionnaire about statin necessity, concerns and adherence at the end of the observation period. Data were analysed using structural equation modelling. Results The results showed that 55.8% (130 of 233 patients) encountered online health information. Patients who actively sought online health information (91 of 233 patients) had higher concerns about statin use ( β = 0.323, p = 0.023). Participants with higher concern about statin use were also more likely to be non-adherent ( β = -0.337, p

Breast cancer is a prevalent disease that has a potential influence on the lives of countless women globally. Early diagnosis and intervention are crucial for successful treatment and better patient outcomes. Machine learning algorithms have shown promising results in developing accurate and dependable prediction models for breast cancer. In this research, we conduct an extensive overview of various machine learning (ML) techniques employed to develop breast cancer prediction models using diverse datasets. Our study explores the literature on several ML algorithms utilized for breast cancer prediction. We also examine the types of datasets used for training and testing these models, including clinical data, mammography images, and genetic data. Additionally, we evaluate the benefits and limitations of each machine learning algorithm and dataset and offer recommendations for future research. Our aim is to provide a comprehensive understanding of the current state-of-the-art in breast cancer prediction models using ML and to promote the development of precise and effective models to detect breast cancer at an early stage.

Study Design Validation of a novel retrospective comparative questionnaire to obtain post-intervention outcome data in patients with lumbar degenerative spinal disease. Purpose Acquiring prospective outcome data for spinal intervention is not frequently feasible in resource-depleted units in certain developing countries. Therefore, a novel retrospective instrument is being validated for clinical use, which can act as a standard method to describe outcomes when data are retrospectively collected. Overview of Literature The standard method of collecting outcome data after a spinal intervention has been prospective, including the Oswestry Disability Index, Roland-Morris Questionnaire, and Short Form-36. The process of content validation and reliability of the novel retrospective spinal questionnaires is highlighted. Methods Questionnaire items were created based on a literature review, followed by a process of content validation by experts and modification based on expert opinions to achieve an acceptable content validity index (CVI, 0.70–1.00). To calculate factor loadings for each question, a pilot test was subsequently conducted from a pool of patients who underwent lumbar spine surgeries for degenerative spine diseases. Results All items achieved a CVI of >0.85 for both relevancy and clarity and were successfully validated after appropriate corrections were made before the second validation phase. Except for Q9 and Q10, which showed low-loading factors in the pooled sample, the remainder of the items had acceptable loading factors across different subgroups, indicating that the passage of time did not affect the results of the exploratory factor analysis. Conclusions The retrospective questionnaire that encompasses the general well-being and lumbar-specific symptoms is a valid and reliable instrument to provide an impression of the outcome after intervention in a patient with a degenerative lumbar spinal disease. A summative score will indicate the overall outcome.

Abstract Background Inflammatory bowel disease is an uncommon disease in developing nations whereby patient’s knowledge on the disease may be limited. The CCKNOW questionnaire, a widely known questionnaire to assess patient’s knowledge on the disease, may be too complex to comprehend for patients in developing countries. The aim of this study is to develop a new tool known as AIBDKQ questionnaire to evaluate the local inflammatory bowel disease patient’s knowledge. Methods This was a prospective study carried out in four phases. In phase 1, three gastroenterologists with expertise in IBD generated a total of 21 questions related to the general knowledge of the disease in the English language. Phase 2 involved content and face validity whereby the questions were further validated by other gastroenterologists. In phase 3, the validated questions were translated into three languages namely Malay, Mandarin and Tamil which are commonly used in Malaysia. In phase 4 (statistical validity), administration of the questionnaires to patients and hospital staff were conducted to assess the construct validity, discriminative ability, predictive validity and reliability of the questionnaires. Results A total of 21 questions were generated initially. Further evaluation indicated that 20 items had adequate kappa and content validity index for relevance (CVI: 0.714 to 1, Kapp: 0.645 to 1) and clarity (CVI: 0.714 to 1, Kapp: 0.645 to 1). The questionnaires in four languages were administered to 213 patients to assess the construct validity. Six items were removed (three for low communality, one for small loading factors, two for cross loading), resulting in 16 final questions. Assessment with 34 hospital staff involving nurses, doctors and clerks showed significant differences in knowledge between the groups (F = 14.007, p

Objective:Coronavirus disease-2019 (COVID-19) has caused hospitals to suspend routine procedures. As the world recovers, there is concern that the outcome of many diseases has been impaired. This study aimed to assess the impact of the pandemic on breast cancer demography, clinicopathological characteristics and patient management at a teaching hospital in Kuala Lumpur, Malaysia.Materials and Methods:Pre-COVID data were collected between January 1, 2019, to March 18, 2020, when a national lockdown was implemented, which caused the suspension of services at the breast clinic of University Malaya Medical Centre (UMMC). COVID data was obtained from March 2020 until June 2021.Results:This study compared 374 breast cancer patients in the COVID-19 period with 382 patients in the pre-COVID period. There was no significant difference in the median (range) time to surgery between pre-COVID [45 (26.50–153.50) days] and COVID [44 (24.75–156.25) days] periods. The clinicopathological features of breast cancer showed reduction in in situ carcinoma and increase in Stage 4 diagnoses during the COVID period. There was a reduction in screening-detected carcinoma (9% vs. 12.3%), mastectomy followed by immediate reconstruction (5.6% vs. 14.5%) and adjuvant chemotherapy (25.8% vs. 32.9%) in the COVID period.Conclusion:In this center COVID-19 caused operational changes in breast cancer management, including a reduction in reconstructive procedures and adjuvant treatment. Healthcare disruption and fear of COVID may have caused delayed diagnosis, resulting in a higher frequency of Stage 4 disease and lower proportion of in situ carcinoma during the pandemic. However, there was no delay in the time to surgery, reduction in surgical volume, or change in surgery types.

The Athletic Religious Faith Scale (ARFS) is an instrument measuring religious faith in a sporting context. This study validated the ARFS using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to reach a final version of the scale. Using the EFA, seven domains were classified: religious coping (9 items), religious psychological effects (5 items), dependence on faith (5 items), religious mental healing (6 items), flow (4 items), athletic identity (4 items), and religious dietary practices (7 items). Using CFA, all construct factor loadings were over 0.5. Composite reliability and Cronbach’s alpha values indicated adequate reliability (0.81–0.94) for all ARFS domains. The convergent validity and discriminant validity of all constructs were also established. Overall, the ARFS is a reliable and valid assessment tool for measuring religious faith in athletes. The ARFS could potentially be used with athletes of various religious affiliations in different countries, cultures, and sporting contexts.

Abstract Background Northwest Syria (NWS) is a complex and extremely fragile operating environment, with more than 2.8 million people needing humanitarian assistance. To support a common standard of care delivery and enable coordination among the multiple providers in NWS, WHO developed an Essential Health Services package (EHSP) in 2016-17 and subsequently supported a facility network model to deliver the EHSP. This article provides an evaluation of the network to date, aiming to inform further development of the network and draw wider lessons for application of similar approaches in complex emergency settings. Methods This mixed method study included document review, participatory, qualitative and quantitative data, gathered in the first half of 2021. Participatory data came from two group model building workshops with 21 funders and implementers. Semi-structured interviews with 81 funders, health professionals and community members were also conducted. Analyses of the workshops and interviews was inductive, however a deductive approach was used for synthesising insights across this and the document review. The final component was a survey of health providers (59 health care professionals) and service users (233 pregnant women and 214 persons living with NCDs) across network and other comparable facilities, analysed using routine descriptive and inferential statistics. Findings across all methods were triangulated. Results The study finds that the network and its accompanying essential service package were relevant to the dynamic and challenging context, with high but shifting population needs and multiple uncoordinated providers. Judged in relation to its original goals of comprehensive, coordinated services, equitable access and efficient service delivery, the data indicate that gains have been made in all three areas through the network, although attribution is challenging, given the complex environment. The context remains challenging, with shifting boundaries and populations displaced by conflict, difficulties in retaining staff, the need to import medicines and supplies across borders, and governance gaps. Conclusion This study adds to a very limited literature on coordinated network approaches used to raise care quality and improve referrals and efficiency in a complex emergency setting. Although areas of ongoing challenge, including for sustainability, are noted, the network demonstrated some resilience strategies and can provide lessons for other similar contexts.

Abstract Background Professional self-concept is one of the important outcomes of nursing professionalism. There is a lack of adequately planned curriculum may limit nursing students’ practical knowledge, skills and professional self-concept in providing comprehensive geriatric-adult care and promoting nursing professionalism. Professional portfolio learning strategy has allowed nursing students to continue professional development and enhance nursing professionalism in professional clinical practice. However, there is little empirical evidence in nursing education to support the use of professional portfolios in blended learning modality among internship nursing students. Therefore, this study aims to examine the effect of the blended professional portfolio learning on professional self-concept among undergraduate nursing students during Geriatric-Adult internship. Methods A quasi-experimental study two-group pre-test post-test design. A total of 153 eligible senior undergraduate students completed the study (76 in the intervention group and 77 in the control group). They were recruited from two Bachelor of Sciences in Nursing (BSN) cohorts from nursing schools at Mashhad University of Medical Sciences (MUMS), in Iran, in January 2020. Randomization was undertaken at the level of school via a simple lottery method. The intervention group received the professional portfolio learning program as a holistic blended learning modality, though the control group received conventional learning during professional clinical practice. A demographic questionnaire and the Nurse Professional Self-concept questionnaire were used for data collection. Results The findings imply the effectiveness of the blended PPL program. Results of Generalized Estimating Equation (GEE) analysis was indicated significantly improved professional self-concept development and its dimensions (self-esteem, caring, staff relation, communication, knowledge, leadership) with high effect size. The results of the between-group comparison for professional self-concept and its dimensions at different time points (pre, post and follow up test) showed a significant difference between groups at post-test and follow up test (p 0.05).The results of within-group comparison for both control and intervention showed that there were significant differences in professional self-concept and for all its dimensions across the time from pre-test to post-test and follow-up (p

Abstract Salinity and freshwater scarcity are significant challenges affecting agriculture production worldwide. Sustaining food production in arid and semi-arid regions requires innovative, efficient, and low-cost technologies. Integrated aqua-vegeculture systems (IAVS) are promising technologies for cultivating vegetable crops and rearing fish and in a closed-loop system. The system utilizes fish effluents as crop fertilizers and recycles water for increased productivity. Hence, the current study aimed to investigate the response and productivity of kale (Brassica oleracea L.) grown at different brackish water salinities in an IAVS. The greenhouse experiment followed a completely randomized design with three salinity variants (i.e., 3000, 6000, and 9000 ppm) and control (freshwater, 400 ppm) with four replicates per treatment. The study results indicated that kale grown in a greenhouse could tolerate salinity levels of up to 6000 ppm without significantly compromising the plants’ growth, yield, and nutritional composition of leaves. Likewise, rearing Oreochromis niloticus at high water salinities did not negatively impact the water quality and the growth performance, survival, and feed utilization of fish. Overall, cultivating kale and rearing O. niloticus in IAVS in water salinities reaching up to 6000 ppm could be a sustainable agricultural strategy to increase food production in regions affected by freshwater scarcity.

Introduction: Ventricular remodeling is a mal-adaptive process. Both angiotensin-converting enzyme inhibitors and sacubitril/valsartan have been shown to reverse remodeling in mostly uncontrolled observational studies. There is a lack of head-to-head studies. Methods: This cohort study compares the remodeling effects of angiotensin receptor blockers combined with a neprilysin inhibitor (ARNI) and perindopril in heart failure with reduced ejection fraction (HFrEF) patients between January 2017 and December 2020. Inclusion criteria: (i) age > 18 years, (ii) recent diagnosis of de-novo HFrEF (EF

The primary objective of this research was to investigate the potential moderating role of audit fees in the relationship between audit committee characteristics and earnings management. Specifically, this study aimed to establish connections between audit committee features, such as committee size, member independence, and financial expertise, and the practice of earnings management. To address these research questions, a convenient sample of 46 service providers listed on the Amman Stock Exchange between 2016 and the subsequent year was employed. Descriptive statistical methods were applied to characterize the variables under investigation, while a multiple regression model was utilized to assess the study’s hypotheses. The findings of the study revealed that there was no significant correlation between the size of the audit committee and earnings management. However, a negative correlation was observed between the audit committee’s independence and the financial expertise of its members. Importantly, when audit fees were introduced as a moderating variable, the relationships between committee member independence and earnings management, as well as between committee member financial expertise and earnings management, were found to be weakened. These results have potential implications for policymakers and regulators in Jordan. They may offer valuable insights into corporate governance reforms that could assist Jordanian businesses in enhancing their earnings management practices.

Vanadium dioxide (VO2) stands out for its versatility in numerous applications, thanks to its unique reversible insulator-to-metal phase transition. This transition can be initiated by various stimuli, leading to significant alterations in the material’s characteristics, including its resistivity and optical properties. As the interest in the material is growing year by year, the purpose of this review is to explore the trends and current state of progress on some of the applications proposed for VO2 in the field of sensors and actuators using literature review methods. Some key applications identified are resistive sensors such as strain, temperature, light, gas concentration, and thermal fluid flow sensors for microfluidics and mechanical microactuators. Several critical challenges have been recognized in the field, including the expanded investigation of VO2-based applications across multiple domains, exploring various methods to enhance device performance such as modifying the phase transition temperature, advancing the fabrication techniques for VO2 structures, and developing innovative modelling approaches. Current research in the field shows a variety of different sensors, actuators, and material combinations, leading to different sensor and actuator performance input ranges and output sensitivities.

Relatively little is known about the first hematopoietic stem and progenitor cells to arrive in the fetal bone marrow. Here they characterize the frequency, function, and molecular identity of fetal BM HSPCs and their bone marrow niche, and show that most BM HSPCs have little hematopoietic function until birth.

Abstract Pathogenic bacteria cause disease outbreaks and threaten human health, prompting the research on advanced detection assays. Herein, we developed a selective molecular imprinted aptasensor for sensitive and prompt quantitation of Staphylococcus aureus (S. aureus) bacteria. The aptasensor was constructed by immobilization of aptamer on gold nanoparticles modified magnetic nanoparticles (apt-AuNPs@ Fe3O4). A functional monomer (o-phenylenediamine, o-phen) was electro-polymerized on the surface of the as-synthesized nanocomposite in the presence of a template (S. aureus). After removing S. aureus, the formed imprinted sites were available to extract pathogenic bacteria from complicated matrices. The surface morphology of the as-fabricated nanocomposites was characterized using different spectroscopic and electrochemical methods. Moreover, we thoroughly evaluated factors affecting the synthesis and determination procedures. The molecular imprinted aptasensor exhibited a wide linear range of 101–107 CFU mL−1 with a Limit of Detection, LOD (signal to noise = 3) of 1 CFU mL−1. The aptasensor detected S. aureus in milk, conduit water, and apple juice samples with good recoveries % and satisfactory relative standard deviations (RSDs %) values.

This study addressed the definition of the thesaurus, its purpose, purpose, function, and the obstacles facing the process of building an Arabic thesaurus in the web environment. The study reviewed the need and goal of creating an electronic thesaurus for library and information science terms. A thesaurus of library and information science terms was also built as a sample of a proposed project to build a general thesaurus in various branches. Promised knowledge for use in the process of automated indexing of scientific materials, as well as to assist researchers in the process of searching and retrieving the materials to be accessed. The study reviewed in an applied manner the stages of establishing the thesaurus for library and information sciences, the stages of its preparation and organization, and the database that was built specifically for this purpose, as well as the thesaurus’ website on the Internet.

Abstract This study investigated the utilization of fish effluents as irrigation water and nutrient sources to close the crop yield gap and increase Swiss chard productivity in a closed-loop sandponics system. The experiment was operated using desalinated water from a Reverse Osmosis plant. The study followed a completely randomized design with four variants, i.e., an aquaponic system (T1) and three sandponics systems; October (T2), Benu Suef (T3) and Fayoum (T4). Results indicated that T2 and T4 significantly recorded the highest plant heights in all cuts. The number of leaves per plant decreased with the increase in cut number. Leaf area and chlorophyll was significantly different between the treatments. T1 significantly had low biomass yields in cuts one and two, almost 40% less than T3 and T4. The various systems efficiently minimized water consumption ranging from 1.5 to 1.96 L/m2/day. The crop protein content ranged from 11.84 to 18.72 mg/100 g dry weight. Mineral composition in cut one was significantly higher compared to cuts two and three. The study recommends a novel technique for increasing crop production using fish effluents under sandponics systems while increasing water and fertilizer efficiency to close the crop yield gap.

Abstract Background To evaluate an experimental T-shaped toothbrush for plaque removal and gingival health when compared to a conventional toothbrush among children. Methods This single blind parallel randomized controlled trial was conducted on 8–10-year-old healthy schoolchildren with no history of recent antibiotic intake, proximal caries or more than 3 missing teeth per quadrant. A computer-generated randomization list allocated child to the 2 groups. Each child received detailed instructions for tooth brushing. Gingival health and plaque scores were recorded in school at baseline, 2 weeks, 1 month and 3 months in a portable dental chair by an examiner who was blind to the allocated toothbrush. A general feedback on the use of the T-shaped toothbrush was obtained at 3 months. Data was analyzed using two-way repeated measure ANOVA, Generalized estimating equation and Bonferroni test. Results A total of 195 eligible children were invited, 110 parents gave consent and 100 children completed the study; 50 in each group. There were statistically significant reductions in mean gingival and plaque scores at each visit when compared to baseline for both toothbrushes (p 0.05). Majority of participants gave positive feedback regarding the T-shaped toothbrush. Conclusions Both toothbrushes had similar efficacy in removing plaque and improving gingival health among children. The T-shaped toothbrush is an alternative to the conventional toothbrush for oral hygiene in children. Trial registration Retrospectively registered at ClinicalTrials.gov Registry—NCT03989479 18/06/2019.

Cholera is an exceptionally aggressive infectious disease characterized by the potential to induce acute, copious, watery diarrhea of considerable severity and renal inflammation. Diabetic nephropathy is a serious complication of diabetes mellitus that can lead to kidney failure through inflammation; thus, anti-inflammatory agents are promising therapies for diabetic nephropathy. Previous studies have shown that the essential oil of Zanthoxylum myriacanthum var. pubescens Huang, Maqian essential oil (MQEO), exhibits potent antibacterial, anti-inflammatory, and renoprotective activities in diabetic mice and has emerged as a potential therapeutic drug for the treatment of diabetic nephropathy complications. Therefore, the present study was carried out to screen the potential inhibition of cholera toxin and the diabetic renoprotective activity of MQEO through computational approaches. Twelve chemical constituents derived from MQEO were docked with cholera toxin and the target proteins involved in diabetic nephropathy, namely, TXNIP, Nrf2, and DPP IV, and, subsequently, the predictions of molecular dynamic simulations, the drug-likeness properties, and the ADMET properties were performed. α-terpineol showed high binding affinities toward the cholera toxin protein. For TXNIP, among all the chemical constituents, α-phellandrene and p-cymene showed strong binding affinities with the TXNIP protein and displayed relatively stable flexibility at the hinge regions of the protein, favorable physicochemical properties in the absence of hepatotoxicity, and low cytotoxicity. For Nrf2, α-terpineol exhibited the highest binding affinity and formed a very stable complex with Nrf2, which displayed high pharmacokinetic properties. All compounds had low free-binding energies when docked with the DPP IV protein, which suggests potent biological activity. In conclusion, based on a computational approach, our findings reveal that MQEO constituents have inhibitory activity against cholera toxin and are promising therapeutic agents for suppressing diabetic inflammation and for the treatment of diabetic nephropathy complications.

The ITC Malaysia Project is part of the 31-country ITC Project, of which the central objective is to evaluate the impact of tobacco control policies of the WHO Framework Convention on Tobacco Control (FCTC). This article describes the methods used in the 2020 International Tobacco Control (ITC) Malaysia (MYS1) Survey. Adult smokers and non-smokers aged ≥18 years in Malaysia were recruited by a commercial survey firm from its online panel. Survey weights, accounting for smoking status, sex, age, education, and region of residence, were calibrated to the Malaysian 2019 National Health and Morbidity Survey. The survey questions were identical or functionally similar to those used in other ITC countries. Questions included demographic measures, patterns of use, quit history, intentions to quit, risk perceptions, beliefs and attitudes about cigarettes, e-cigarettes, and heated tobacco products. Questions also assessed measures assessing the impact of tobacco demand-reduction domains of the FCTC: price/tax (Article 6), smokefree laws (Article 8), health warnings (Article 11), education, communication and public awareness (Article 12), advertising, promotion, and sponsorship restrictions (Article 13), and support for cessation (Article 14). The total sample size was 1253 (1047 cigarette smokers and 206 non-smokers). Response rate was 11.3%, but importantly, the cooperation rate was 95.3%. The 2020 ITC MYS1 Survey findings will provide evidence on current tobacco control policies and evidence needed by Malaysian government regulatory agencies to develop new or strengthen existing tobacco control efforts that could help achieve Malaysia’s endgame, i.e. a tobaccofree nation by 2040.

Introduction Malaysia has the largest e-cigarette (EC) market in Southeast Asia, and it has been estimated that 17% of adult daily cigarette smokers also used ECs on a daily basis in 2020. However, few studies have examined the reasons people use ECs in Malaysia. This cross-sectional study of adult cigarette smokers from Malaysia assessed reasons for EC use and their support for key proposed EC regulations. Material and Methods Data are from the 2020 International Tobacco Control (ITC) Malaysia Wave 1 Survey of adult (aged ≥18 years) smokers who reported that they used ECs at least monthly (N=459 out of 1047 smokers). Weighted analyses were conducted on EC users’ reasons for using ECs and their support for various EC regulations. Results Smokers who used ECs at least monthly were more likely to be male, aged 25–39 years, of Malay ethnicity, married, more highly educated, and living in Peninsular Malaysia. Smokers who used ECs daily reported using ECs to reduce the number of cigarettes smoked (91.3%), pleasant taste (90.1%), to quit smoking (87.9%), and enjoyment (87.5%). Smokers who used ECs less than daily reported using ECs for their pleasant taste (weekly 89.4%, monthly 87.5%), curiosity (weekly 79.5%, monthly 88.8%), being offered EC by someone (weekly 76.3%, monthly 81.6%), and to reduce the number of cigarettes smoked (weekly 76.2%, monthly 77.6%). Smokers who also used ECs were most likely to support EC regulations requiring a minimum purchasing age (88.3%) and limiting nicotine concentration (79.6%), and least likely to support regulations banning EC fruit and candy flavors (27.1%). Conclusions The most prevalent reasons for using ECs in Malaysia are comparable to those of other ITC countries, including Canada, US, England, and Australia. An understanding of use patterns of ECs, especially their interaction with cigarettes, are important in developing evidence-based regulations in Malaysia.

Introduction E-cigarettes (ECs) have become increasingly common in many countries, including Malaysia. The prevalence of EC use increased in Malaysia from 0.8% in 2011 to 4.9% in 2019. Three quarters of Malaysian EC users also smoke combustible cigarettes, and the prevalence of EC use among Malaysian smokers in 2014 was consistent with the prevalence of use among smokers from Canada and the US in 2016. The purpose of this study was to estimate the prevalence of EC use among Malaysian adults aged ≥18 years in 2020 and the types of EC products and flavors used by cigarette smokers who also used ECs at least monthly. Methods Data came from 1253 adults aged ≥18 years who participated in the 2020 International Tobacco Control Malaysia Wave 1 Survey. Weighted descriptive statistics were used to estimate the prevalence of adults who reported ever using ECs and the prevalence who used ECs either monthly, weekly, or daily. The types of EC products and flavors used were compared by frequency of EC use among current smokers who used ECs at least monthly (n=459). Results Overall, 5.4% (95% CI: 3.7–7.5) of Malaysian adults reported using ECs on a daily basis in 2020. Among current cigarette smokers who used ECs daily, 81.0% (95% CI: 72.5–87.7) used nicotine in their ECs, 46.2% (95% CI: 37.8–54.7) used pre-filled ECs, and 60.4% (95% CI: 51.9–68.6) reported being somewhat/very addicted to ECs. The most common EC flavors were fruit, coffee, and menthol/ mint. Conclusions Continued surveillance of EC use is necessary to monitor EC use in non-tobacco using populations while longitudinal research is needed to determine the extent to which ECs are, or are not, related to quitting smoking.

The present study estimates households' resilience against food insecurity in a selected village of Qalandar Abad district in Iran. The Resilience Index Measurement and Analysis (RIMA) of the Food and Agriculture Organization of the United Nations (FAO) was used for the first time in Iran, to achieve this goal. The samples included 149 farmers randomly selected and the Data were collected through interviews. The factor analysis method was used to estimate the components of resilience, and the MIMIC method was used to estimate the latent variable of resilience. The results showed that the components of asset and adaptive capacity had a significant role in increasing the resilience of rural households in the study area. Variables such as the land area, water availability, and the yield of crops had a significant positive role in improving the asset pillar. The households head and other members' education also had a significant positive effect in improving the adaptive capacity pillar. Therefore, due to time and budget constraints in the execution of macro-policies, adopting and implementing policies that increase the above components will improve the resilience of rural households

CCCH-type zinc figure proteins (ZFP) are small cellular proteins that are structurally maintained by zinc ions. Zinc ions coordinate the protein structure in a tetrahedral geometry by binding to cystine-cystine or cysteines-histidine amino acids. ZFP’s unique structure enables it to interact with a wide variety of molecules including RNA; thus, ZFP modulates several cellular processes including the host immune response and virus replication. CCCH-type ZFPs have shown their antiviral efficacy against several DNA and RNA viruses. However, their role in the human coronavirus is little explored. We hypothesized that ZFP36L1 also suppresses the human coronavirus. To test our hypothesis, we used OC43 human coronavirus (HCoV) strain in our study. We overexpressed and knockdown ZFP36L1 in HCT-8 cells using lentivirus transduction. Wild type, ZFP36L1 overexpressed, and ZFP36L1 knockdown cells were each infected with HCoV-OC43, and the virus titer in each cell line was measured over 96 hours post-infection (p.i.). Our results show that HCoV-OC43 replication was significantly reduced with ZFP36L1 overexpression while ZFP36L1 knockdown significantly enhanced virus replication. ZFP36L1 knockdown HCT-8 cells started producing infectious virus at 48 hours p.i. which was an earlier timepoint as compared to wild -type and ZFP36L1 overexpressed cells. Wild-type and ZFP36L1 overexpressed HCT-8 cells started producing infectious virus at 72 hours p.i. Overall, the current study showed that overexpression of ZFP36L1 suppressed human coronavirus (OC43) production.

ObjectiveRoad traffic accident (RTA) is the major cause of traumatic brain injury (TBI) in developing countries and affects mostly young adult population. This research aimed to describe the factors predicting functional outcome after TBI caused by RTA in a Malaysian setting.MethodsThis was a retrospective cross-sectional study conducted on specialist medical reports written from 2009 to 2019, involving patients who survived after TBI from RTA. The functional outcome was assessed using the Glasgow Outcome Scale-Extended (GOSE). Factors associated with good outcome were analysed via logistic regression analysis. Multivariate logistic regression analysis was used to derive the best fitting Prediction Model and split-sample cross-validation was performed to develop a prediction model.ResultsA total of 1939 reports were evaluated. The mean age of the study participants was 32.4 ± 13.7 years. Most patients were male, less than 40, and with average post RTA of two years. Good outcome (GOSE score 7 & 8) was reported in 30.3% of the patients. Factors significantly affecting functional outcome include age, gender, ethnicity, marital status, education level, severity of brain injury, neurosurgical intervention, ICU admission, presence of inpatient complications, cognitive impairment, post-traumatic headache, post traumatic seizures, presence of significant behavioural issue; and residence post discharge (pConclusionGood functional outcome following TBI due to RTA in this study population is comparable to other low to middle income countries but lower than high income countries. Factors influencing outcome such as seizure, cognitive and behavioural issues, and independent living post injury should be addressed early to achieve favourable long-term outcomes.

The validity and reliability of the Lafayette stability platform are well-established for double leg testing. However, no evaluation of single leg (SL) stance on the platform was discovered yet. Therefore, this study aimed to investigate the reliability of conducting the SL stance on the Lafayette platform. Thirty-six healthy and active university students (age 23.2 ± 3.2 years; BMI 21.1 ± 3.1 kg/m2) were tested twice, one week apart (week 1; W1, week 2; W2). They stood on their dominant leg with eyes-open (EO) and eyes-closed (EC) in random order. Three successful trials of 20 seconds each were recorded. The duration during which the platform was maintained within 0° of tilt was referred to as time in balance (TIB). At all-time points, TIB was consistently longer in EO (EOW1: 17.02 ± 1.04s; EOW2: 17.32 ± 1.03s) compared to EC (ECW1: 11.55 ± 1.73s; ECW2: 13.08 ± 1.82s). A ±10 seconds difference was demonstrated in the Bland-Altman analysis in both EO and EC. Lower standard error of measurement (SEM) and coefficient of variation (CV) indicated consistent output. High intraclass correlation coefficient (ICC) values were seen between weeks (EO = 0.74; EC = 0.76) and within weeks (EOW1 = 0.79; EOW2 = 0.86; ECW1 = 0.71; ECW2 = 0.71). Although statistical measures (i.e., SEM, CV, and ICC) indicated good reliability of Lafayette for SL tasks, the wide agreement interval is yet to be clinically meaningful. Factors underlying the wide variation need to be identified before Lafayette is used for TIB assessment.

This study aims to determine the intention of Chinese parents to vaccinate their children against SARS-CoV-2. Secondly, preferences for foreign- or domestically made COVID-19 vaccines were also explored. A nationwide, cross-sectional, self-administered online survey based on the Health Belief Model (HBM) and new vaccine concerns was used. Participants were eligible if they were residents of China with children aged 12 years old or younger. A total of 2,026 parents responded to the survey. Half reported a probable intent (50.7%) and 26.9% reported a definite intent. The results of the data analysis of partial least squares structural equation modeling (PLS-SEM) found that perceived cost barriers (B = −0.210, p

Abstract Background Prior research has shown that around 5%–7% of patients in breast cancer centers in Germany participate in the discussion of their own case within a multidisciplinary tumor conference (MTC). The PINTU study is one of the first to research this practice. The objective is to describe (a) how patient participation in MTCs is implemented, (b) what is the role of patients, and (c) how patients experience MTCs. Methods MTCs in six breast and gynecological cancer centers in North Rhine‐Westphalia, Germany, with and without patient participation, are studied prospectively by (non)participatory, structured observation. Breast and gynecological cancer patients completed surveys before, directly after, and 4 weeks after MTC participation. Data are analyzed descriptively. Results Case discussions of a sample of n = 317 patients (n = 95 with MTC participation and n = 222 without) were observed. Survey data were obtained from n = 242 patients (n = 87 and n = 155). Observational data showed heterogeneity in the ways MTC participation was practiced. Among participating patients, 89% had the opportunity to express their opinion and 61% were involved in decision‐making. Whereas most patients reported positive experiences and would recommend participation, some had negative experiences and regretted participating. Conclusions Due to a lack of recommendations, hospitals implement patient participation in MTCs in many different ways. So far, it is unknown which setting and procedures of MTC participation are beneficial for patients. However, existing evidence on communication in cancer care together with this exploratory study's findings can build the basis for developing recommendations for hospitals that invite their patients to MTCs. Clinical trial registration number German Clinical Trials Register Nr. DRKS00012552.

Abstract Background The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. Methods An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. Results Of the 19,714 responses received, 90.4% (95% CI 81.8–95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4–61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4–75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0–22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3–53.1) reported that they would only accept a COVID-19 vaccine from a specific country‐of‐origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3–41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9–36.4). Conclusions The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population. Graphic Abstract

Abstract Background Smokeless tobacco is a part of social and cultural life in Sudan. The affordability and availability of this kind of tobacco make it a fundamental issue in adolescents. The aim of this study is to investigate the extent of the use of smokeless tobacco in adolescents and its determinants. Methods A school-based cross-sectional study was conducted in Khartoum state in Sudan. The study targeted male and female adolescents in secondary schools. A total of 3387 students from public and private schools participated in the study. Multistage random sampling was used to select the participants. The Arabic version questionnaire from the Global Youth Tobacco Survey (GYTS) was utilised to collect the data from the participants. Results Among the participants, 57.3% were females and 42.7% were males. Students from private and public schools were 48.4 and 51.6%, respectively. The overall prevalence of those who had ever used smokeless tobacco was 7.6%, in which the prevalence among male students was 11.0% while among females was 5.0%. The determinant factors were male gender (OR 1.53 CI 95% 1.03–2.28), family structure (OR 1.52 CI 95% 1.03–2.23), exposure to second-hand smoke at home (OR 1.60 CI 95% 1.11–2.31), friends smoking cigarettes (OR 1.78 CI 95% 1.22–2.60), lack of restriction of selling tobacco to minors (OR 1.73 CI 95% 1.25–2.39), promotion of smokeless tobacco (OR 2.12 CI 95% 1.20–3.72) and low self-efficacy (OR 7.47 CI 95% 4.45–12.52). Conclusion A comprehensive prevention programme that enforces the prohibition of the promotion of smokeless tobacco and the selling of smokeless tobacco to minors is crucial. Moreover, the prevention programme should enhance adolescents’ self-efficacy.

The global dynamics of a discrete SEIR epidemic model with treatment has been considered. A unique positive solution for the proposed model with the positive initial conditions is obtained. The stability analysis of the disease-free equilibrium and endemic equilibrium have been investigated. It has been proved that the DFE is globally asymptotically stable when the basic reproduction number $\mathcal{R}_0\leq1$. The proposed model has a unique endemic equilibrium that is globally asymptotically stable whenever $\tilde{\mathcal{R}}_0>1$. The theoretical results are illustrated by a numerical simulation.

ZC3H11A is a cellular protein associated with the transcription export (TREX) complex that is induced during heat-shock. Several nuclear-replicating viruses exploit the mRNA export mechanism of ZC3H11A protein for their efficient replication. Here we show that ZC3H11A protein plays a role in regulation of NF-κB signal transduction. Depletion of ZC3H11A resulted in enhanced NF-κB mediated signaling, with upregulation of numerous innate immune related mRNAs, including IL-6 and a large group of interferon-stimulated genes. IL-6 upregulation in the absence of the ZC3H11A protein correlated with an increased NF-κB transcription factor binding to the IL-6 promoter and decreased IL-6 mRNA decay. The enhanced NF-κB signaling pathway in ZC3H11A deficient cells correlated with a defect in IκBα inhibitory mRNA and protein accumulation. Upon ZC3H11A depletion The IκBα mRNA was retained in the cell nucleus resulting in failure to maintain normal levels of the cytoplasmic IκBα mRNA and protein that is essential for its inhibitory feedback loop on NF-κB activity. These findings indicate towards a previously unknown mechanism of ZC3H11A in regulating the NF-κB pathway at the level of IkBα mRNA export.

Copper (Cu) could be seriously hazardous when present at excessive levels, despite its vital contribution to various cellular processes. Selenium-enriched yeast (SeY) was reported to improve the health and metabolic status in broiler chicken. Hence, our study was endeavored to illustrate the mitigating efficacy of SeY on Cu-induced hepatic and renal damage. Cobb chicks aged 1 day were allocated into four experimental groups and offered a basal diet, SeY (0.5 mg/kg), CuSO4 (300 mg/kg), or SeY plus CuSO4 in their diets for 42 days. Our results revealed that SeY supplement antagonized significantly the Cu accumulation in livers and kidneys of exposed birds. Marked declines were also detected in the AST, ALT, urea, and creatinine levels, besides marked increases in total protein, glycerides, and cholesterol in the SeY-supplemented group. Moreover, enhancement of cellular antioxidant biomarkers (superoxide dismutase, CAT, GPx, and GSH) along with lowered MDA contents were achieved by SeY in hepatic and renal tissues. Further, SeY exerted a noteworthy anti-inflammatory action as indicated by decreased inflammatory biomarkers (IL-1β and TNF-α) and NO levels in both organs. Noticeable histopathological alterations of both organs further validated the changes in the markers mentioned above. To sum up, our findings indicate that SeY can be considered a potential feed supplement for alleviating Cu-induced hepatic and renal damage in broilers, possibly via activation of antioxidant molecules and lessening the inflammatory stress.

Abstract In the contemporary video surveillance system, there have been many efforts made to maintain high security and extend the coverage areas in most of the countries around the world. The deployment of many surveillance cameras and sensors capable of detecting abnormal and meaningful events on the territories' streets and airports is an aspect of internal security. There are two main problems that affect the homeland security system, and the security cameras and sensors are not enough to cover all areas in the country. This is because of the high cost of the video surveillance cameras and the sensor installations, and the non‐standardisation of security cameras and sensors manufacturing, which is due to the differentiated infrastructure of companies or organizations that provide home security. The authors introduce a design and hardware implementation of a motion estimation (ME) co‐processor that can be used for video surveillance cameras in homeland security. The proposed ME co‐processor, if adopted in video surveillance cameras, can be connected utilising an internet of video things infrastructure (IoVT). The proposed co‐processor is suited for high‐efficiency encoding video surveillance systems (H.265/HEVC). Furthermore, to reduce the memory I/O, data reuse Level A and Level B have been used in the proposed architecture while taking full advantage of the hardware resources. Moreover, an effective local memory has been used to reuse the data during the process of loading both the search area and the current block into the processing element array (PE array). The performance of the proposed architecture has been calculated using subjective and quantitative measures techniques and compared to the full search block‐based motion estimation (FSBB‐ME) algorithm. Moreover, the proposed architecture achieves a very high video resolution accuracy that is similar to the accuracy of the FSBB‐ME algorithm. Modelism‐version10.4a has been used for simulation and time verification testing proposes. The proposed ME co‐processor can be embedded in the compressing decompressing and high definition broadcast for video surveillance systems.

Determining how climate change affects aquatic organisms, such as fish is vital, since this could directly or indirectly impact food and protein sources that are important for human nutrition. Thus, identifying suitable organisms for studying the impacts of climate change on aquatic species is essential. It is most effective to select model organisms for climate change study and determine how each organism might adapt within the diversity of organisms present. This study aimed to review the current development and frontiers of climate change’s model organism based on the literature. We conducted a scientometric analysis by differentiating between publications on different model species, the number and origin of authors and affiliations involved, the citation analysis, and the most common keywords used. Increased publication numbers for Zebrafish and Medaka were detected during the analysis of the networks. Our results showed that both species are among the most important aquatic model organisms for climate change related research. Furthermore, we found that these model organisms, especially the Zebrafish are becoming increasingly important towards climate change related studies, because of their simple anatomy and established biological studies. Our analysis could be on the forefront for disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, policymakers, and to the public worldwide for future contribution to the community resources preservation.

BackgroundExisting anthropometric studies for respirator designs are based on the head and facial dimensions of Americans and Chinese nationals, with no studies for multi-ethnic countries like Malaysia. This study aimed to create head and facial morphological database for Malaysia, specifically to identify morphological differences between genders, ethnicities, and birthplaces, as well as predictors of the dimensions.DesignA cross-sectional study.SettingMalaysia.ParticipantsA nation-wide cross-sectional study using a complex survey design with two stage-stratified random sampling was conducted among 3,324 participants, aged 18 years and above who were also participants of the National Health and Morbidity Survey 2020.Primary and secondary outcomesThe study collected data on sociodemographic, measurement of Body Mass Index (BMI) and 10 head and facial dimensions (3 dimensions were measured using direct measurement, and 7 others using Digimizer software for 2-dimension images). Linear regression was performed to determine the association between gender, ethnicity, birthplace, age and BMI and the dimensions.ResultsThere were significant differences in all the dimensions between sex, birthplace and ethnicity (p < 0.005). Further analysis using linear regression showed sex, ethnicity, birthplace, age and BMI were significant predictors of the dimensions. In comparison to studies from the United States and China, our study population had a wider interpupillary distance and nose breadth for both male and female participants, but smaller bigonial breadth and smaller minimal frontal breadth.ConclusionThese findings could assist in the design and sizing of respirators that will fit Malaysians and possibly other Southeast Asian population.