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Abstract Hepatocellular carcinoma (HCC) stands as the most prevalent form of primary liver cancer, predominantly affecting patients with chronic liver diseases such as hepatitis B or C-induced cirrhosis. Diagnosis typically involves blood tests (assessing liver functions and HCC biomarkers), imaging procedures such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), and liver biopsies requiring the removal of liver tissue for laboratory analysis. However, these diagnostic methods either entail lengthy lab processes, require expensive imaging equipment, or involve invasive techniques like liver biopsies. Hence, there exists a crucial need for rapid, cost-effective, and noninvasive techniques to characterize HCC, whether in serum or tissue samples. In this study, we developed a spiral sensor implemented on a printed circuit board (PCB) technology that utilizes impedance spectroscopy and applied it to 24 tissues and sera samples as proof of concept. This newly devised circuit has successfully characterized HCC and normal tissue and serum samples. Utilizing the distinct dielectric properties between HCC cells and serum samples versus the normal samples across a specific frequency range, the differentiation between normal and HCC samples is achieved. Moreover, the sensor effectively characterizes two HCC grades and distinguishes cirrhotic/non-cirrhotic samples from tissue specimens. In addition, the sensor distinguishes cirrhotic/non-cirrhotic samples from serum specimens. This pioneering study introduces Electrical Impedance Spectroscopy (EIS) spiral sensor for diagnosing HCC and liver cirrhosis in clinical serum—an innovative, low-cost, rapid (

Objectives: As the world transitions to COVID-19 endemicity, studies focusing on aerosol shedding of highly transmissible SARS-CoV-2 variants of concern (VOCs) are vital for the calibration of infection control measures against VOCs that are likely to circulate seasonally. This follow-up Gesundheit-II aerosol sampling study aims to compare the aerosol shedding patterns of Omicron VOC samples with pre-Omicron variants analyzed in our previous study. Design: Coarse and fine aerosol samples from 47 patients infected with SARS-CoV-2 were collected during various respiratory activities (passive breathing, talking, and singing) and analyzed using reverse transcription-quantitative polymerase chain reaction and virus culture. Results: Compared with patients infected with pre-Omicron variants, comparable SARS-CoV-2 RNA copy numbers were detectable in aerosol samples of patients infected with Omicron despite being fully vaccinated. Patients infected with Omicron also showed a slight increase in viral aerosol shedding during breathing activities and were more likely to have persistent aerosol shedding beyond 7 days after disease onset. Conclusion: This follow-up study reaffirms the aerosol shedding properties of Omicron and should guide continued layering of public health interventions even in highly vaccinated populations.

The emergence of new SARS-CoV-2 variants, such as the more transmissible Delta and Omicron variants, has raised concerns on efficacy of the COVID-19 vaccines. Here, we examined the waning of antibody responses against different variants following primary and booster vaccination. We found that antibody responses against variants were low following primary vaccination. The antibody response against Omicron was almost non-existent. Efficient boosting of antibody response against all variants, including Omicron, was observed following a third dose. The antibody response against the variants tested was significantly higher at one month following booster vaccination, compared with two months following primary vaccination, for all individuals, including the low antibody responders identified at two months following primary vaccination. The antibody response, for all variants tested, was significantly higher at four months post booster than at five months post primary vaccination, and the proportion of low responders remained low (6-11%). However, there was significant waning of antibody response in more than 95% of individuals at four months, compared to one month following booster. We also observed a robust memory B cell response following booster, which remained higher at four months post booster than prior to booster. However, the memory B cell responses were on the decline for 50% of individuals at four months following booster. Similarly, while the T cell response is sustained, at cohort level, at four months post booster, a substantial proportion of individuals (18.8 – 53.8%) exhibited T cell response at four months post booster that has waned to levels below their corresponding levels before booster. The findings show an efficient induction of immune response against SARS-CoV-2 variants following booster vaccination. However, the induced immunity by the third BNT162b2 vaccine dose was transient. The findings suggest that elderly individuals may require a fourth dose to provide protection against SARS-CoV-2.

Open educational resource (OER) initiatives have opened new avenues for educational opportunities, yet OER adoption levels globally remain low. Two significant obstacles to more widespread adoption of OER are the challenge of internet connectivity that nearly half the world's population still faces, and the lack of locally-relevant (e.g. in terms of language and curricula) OER resources. This article's contribution is twofold. First, it presents a qualitative landscape analysis of existing primary- and secondary-level Arabic-language digital OERs and of the initiatives that provide these resources. Second, it details applied research via a case study, wherein appropriate resources identified in the analysis were subsequently curated for inclusion in an offline digital library currently being used in schools in Northeast Syria that offers all Open resources. Results from the landscape analysis indicate a limited quantity of Arabic-language OER content available for primary and secondary education. Furthermore, multiple challenges hinder the adoption of OER in resource-constrained settings. Accordingly, recommendations are made that could help to improve these resources' ability to be used, particularly drawing from the article's applied case study for examples. Given the case study's application of providing locally-relevant OER resources in an offline setting, this article provides a real-world example of furthering open e-learning, despite infrastructural, linguistic, and socio-political challenges. As such, it advances research supporting innovative e-learning practice, and should be of interest for scholars and practitioners interested in furthering the adoption of open e-learning in low-resource settings globally. [ABSTRACT FROM AUTHOR]

Abstract An accurate tumour segmentation in brain images is a complicated task due to the complext structure and irregular shape of the tumour. In this letter, our contribution is twofold: (1) a lightweight brain tumour segmentation network (LBTS‐Net) is proposed for a fast yet accurate brain tumour segmentation; (2) transfer learning is integrated within the LBTS‐Net to fine‐tune the network and achieve a robust tumour segmentation. To the best of knowledge, this work is amongst the first in the literature which proposes a lightweight and tailored convolution neural network for brain tumour segmentation. The proposed model is based on the VGG architecture in which the number of convolution filters is cut to half in the first layer and the depth‐wise convolution is employed to lighten the VGG‐16 and VGG‐19 networks. Also, the original pixel‐labels in the LBTS‐Net are replaced by the new tumour labels in order to form the classification layer. Experimental results on the BRATS2015 database and comparisons with the state‐of‐the‐art methods confirmed the robustness of the proposed method achieving a global accuracy and a Dice score of 98.11% and 91%, respectively, while being much more computationally efficient due to containing almost half the number of parameters as in the standard VGG network.

This study investigates the quality of groundwater sources in the rural areas of Duhok City, Iraq, with a particular focus on heavy metal contamination, chemical composition, and properties of water. Water samples from 14 wells, serving as the main water source for the surrounding areas, were collected and analyzed. Water quality parameters including calcium (Ca²⁺), magnesium (Mg²⁺), chloride (Cl⁻), potassium (K⁺), and sulfate (SO₄²⁻) values ranged from 24 to 105.6 mg/L, 6.832 to 50.752 mg/L, 18 to 34 mg/L, 1 to 7 mg/L, and 3.4 to 38 mg/L respectively. Common heavy metals like manganese (Mn), lead (Pb), copper (Cu), and cobalt (Co) exhibited varying concentrations. Most parameters meet the WHO standards, except for the elevated potassium in one sample, requiring attention. Additionally, 50% of the sampled wells showed elevated cadmium (Cd) levels. Possible sources of contamination include industrial activities, agricultural runoff, and geological factors, highlighting the importance of ongoing monitoring and targeted interventions to ensure access to clean and safe water. [ABSTRACT FROM AUTHOR]

Background: A stroke, sometimes referred to as a brain attack, happens when a blood vessel in the brain breaks or when something stops the blood flow to a portion of the brain. Either way, the brain suffers damage or dies. Strokes can result in death, permanent brain damage, or long-term disability. A stroke is characterized by an abrupt stoppage of the blood flow to the brain. In order to help and improve the quality of life for senior stroke patients, care for stroke patients requires a thorough grasp of the many aspects involved in stroke management and the provision of interventions such as social, emotional, and psychological support. Aim of the study:To assess Competence of physiotherapist and nurses in stroke care pathways at Saudia Arabia based on their self-evaluation and identify the factors associated with competence. Research design: descriptive cross sectional research design was utilized to conduct this study. An electronic survey was sent to physiotherapists and nurses (n = 300) treating persons with stroke in Saudi Arabia between May and September 2024 in order to get the results. The RN-STROKE, PT-STROKE, and OT-STROKE instruments, which are based on a four-factor model, were used to assess competency in stroke care pathways. Exploratory factor analysis and Cronbach's alpha were used to verify the validity and reliability of the instruments. The data was analyzed using Kruskal-Wallis, Chi Square, Mann Whitney U, oneway ANOVA, and K-means clustering. The findings were presented as means, standard deviations, percentages, and frequencies. Finding: Results: There are four primary areas in which healthcare providers are proficient in stroke care pathways: (1) The ability to counsel and interact (2) proficiency with evidence-based knowledge; (3) proficiency with self-management and development; and (4) proficiency with multiprofessional collaboration. Three competency profiles of medical professionals involved in the stroke care pathway were then found by the study. Competence was rated at the highest level by professionals in Nurses a, average by those in Physotherpist, and lowest by those in Profile C. Competency profiles were shown to be related to the occupation of nurses and physotherabiest and their involvement in the expert network of their organization. Conclusion: Although healthcare workers' overall proficiency in the stroke care pathway was deemed good, there is room for improvement, particularly in their ability to apply evidence-based knowledge in clinical practice. Therefore, in order to facilitate the use of evidence-based information in clinical work, organizations should expand education and training in this area and provide sufficient resources. [ABSTRACT FROM AUTHOR]

HAIs are among the top-priority challenges to healthcare, expected to boost the associated morbidity, mortality, and costs of care. Active prevention and control of HAIs depend upon interoperable application of disciplines of radiology, nursing, anesthesia, surgery, and sterilization. Each of these has contributions to make towards the infection prevention initiative through evidence-based practice, routine sterilization of equipment, and environmental cleaning relating to the needs of the patient. It discusses the two specialties' roles in HAI prevention by emphasizing the importance of collaboration, adherence to infection control guidelines, and building safety culture. It further discusses a variety of strategies that would decrease infection transmission and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Resilience is crucial for healthcare teams to navigate the demanding nature of medicine effectively. Implementations that encourage collaboration, among healthcare professionals are key, in promoting team resilience. This study delves into the ways interdisciplinary methods boost communication efficiency reducing burnout and enhancing team dynamics. By utilizing decision making, strong leadership and professional growth strategies can be developed to help healthcare teams build resilience and respond to changing requirements effectively. Discussing obstacles, like resources and cultural differences and how to encourage collaboration across disciplines is important, in healthcare settings.A strong healthcare team not helps its members. Also leads to better patient results and a sustainable healthcare system. [ABSTRACT FROM AUTHOR]

Objective: This qualitative study aimed to explore the experiences of nursing technicians and midwives in Saudi Arabia in promoting healthy lifestyle behaviors among patients. Methods: Semi-structured interviews were conducted with 24 nursing technicians and midwives working in various healthcare settings across Saudi Arabia. Thematic analysis was used to identify key themes and subthemes from the interview data. Results: Four main themes emerged: 1) The role of nursing technicians and midwives in promoting healthy lifestyles, 2) Strategies used to encourage healthy behaviors, 3) Barriers and challenges faced in promoting lifestyle changes, and 4) Recommendations for enhancing the effectiveness of lifestyle promotion interventions. Participants recognized the importance of their role in promoting healthy living and utilized various strategies such as patient education, goal-setting, and motivational interviewing. However, they also encountered barriers including time constraints, cultural factors, and lack of patient readiness for change. Conclusion: Nursing technicians and midwives in Saudi Arabia play a crucial role in promoting healthy lifestyle behaviors among patients. Providing additional training, resources, and support for nursing staff can enhance their capacity to effectively facilitate lifestyle modifications and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Biomarker testing has become a pivotal element in the management of cancer, facilitating the transition towards personalized medicine and improving patient outcomes. This comprehensive review examines the latest advancements in biomarker testing technologies and their clinical implications for cancer patients. We explore the classification of biomarkers into diagnostic, prognostic, and predictive categories, emphasizing their roles in early detection, treatment decision-making, monitoring response, and assessing prognosis. Recent innovations in genomic testing, including next-generation sequencing (NGS) and liquid biopsy, have revolutionized the landscape of cancer diagnostics by enabling the identification of genetic mutations and circulating tumor DNA (ctDNA) with minimal invasiveness. Additionally, advancements in proteomics and metabolomics have expanded the scope of biomarker discovery beyond genomics, revealing unique tumor signatures that can guide therapeutic strategies. The integration of artificial intelligence (AI) and machine learning in biomarker analysis is transforming data interpretation, allowing for more accurate predictions of treatment responses and outcomes. Despite these advancements, challenges remain, including the need for standardization, validation of tests across diverse clinical settings, and addressing issues of cost and accessibility. The review highlights the importance of multi-omics approaches that combine genomics, proteomics, and metabolomics to provide a holistic view of tumor biology, paving the way for more effective personalized therapies. Furthermore, the future of biomarker testing is expected to focus on patient-centric approaches, emphasizing patient engagement and education regarding the significance of biomarker testing in cancer care. In conclusion, ongoing advancements in biomarker testing hold great promise for improving the diagnosis, treatment, and management of cancer, ultimately leading to better outcomes for patients and a more tailored approach to cancer therapy. [ABSTRACT FROM AUTHOR]

Antibiotic resistance has also become the biggest threat to global health, in which it resists five decades of medical care and advances in public health. Resistance is a result of the capabilities of microorganisms such as bacteria, viruses, and fungi to develop strategies that enable their survival even when exposed to antibiotics which normally would kill them. These infections are tougher to handle, and the resultant effects of such resistance are increased length of sickness, higher treatment costs, and an appreciable increase in mortality rates. Thus, nurses being primary caregivers in these situations are bound to participate actively in the infection management and prevention of the spread of antibiotic-resistant infections. It ranges from infection control to patient education, surveillance, and early detection of resistance patterns. The nurses are very much in the lead when it comes to the application of infection control protocols, hygiene, and education on the responsible use of antibiotics by the patients. They also play a very significant role in the early detection of the signs of infection for appropriate adoption of early interventions that prevent further spread. More so, in collaboration with multidisciplinary health teams, the nurses provide valuable insights into treatment and assist in the implementation of antibiotic stewardship programs to minimize the use of antibiotics. Despite their essential role in the current increase in antimicrobial resistance, it has always been the case for nurses to face challenges based on deficient resources, absence of periodic training, and even resistance to change in behavior practices among both patients and health professional environments. Considering this fact, continuous professional development, improvement in strategies related to infection control, and investment in more technology and tools become highly critical needs. Such strengthening of support to the nursing staff becomes very critical considering the current fight against antibiotic resistance in many parts of the world, implying thereby that health systems would be better positioned to handle and prevent life-threatening infections. [ABSTRACT FROM AUTHOR]

We have chosen to address in this research the subject of pre-contractual commitment to inform consumers, which is one of the most prominent legal mechanisms in the field of consumer protection in general. In order to give a clear picture of this commitment and the importance of the role it plays in the field of consumer protection, we have divided it into two sections, in the first part, what is the obligation before the contract in the media, and in the second part, the penalty for breach of obligation before contractual information.Our study has led to a number of basic results. The most important of these is that the rapid developments in the various fields revealed the inadequacy of these general rules to ensure the desired protection of the consumer.Moreover, by reference to the Iraqi consumer protection law, we have not seen any indication of the exclusion or modification of the unfair conditions against the consumer, the frequency of which is to be included in the contracts, especially those exempt from the guarantee or the scope of liability, even if he is aware of the Declares it is a cheat of it, According to the general rules of civil law, a debtor may require exemption from liability except in case of serious error or fraud, and here the advertiser has committed fraud, so he may not require that he be relieved of liability by special provision in the law governing the commercial declaration. We also point out that we have reached through the research to many points that we recommend the Iraqi legislator to take them, which were mentioned in the research.

Ensuring regular physical exercise is crucial for managing blood glucose levels and promoting overall health in those with diabetes and prediabetes. Recommendations and precautions differ based on individual attributes and health conditions. This article aimed to provide a comprehensive assessment and evidence-based guidelines on physical activity and exercise for diabetic patients. An electronic literature search was conducted in the MEDLINE database using the specified search keywords: Physical, Activity, Exercise, Diabetes, Statement, and American Diabetes Association. The search was limited to publications between 2014 and 2024 to identify relevant material. Relevant search terms were utilized on Google Scholar to locate and explore relevant scholarly articles. The selection of papers was guided by certain inclusion criteria. The study was organized into several sections with particular headers in the discussion. It is advisable to suggest and prescribe physical activity and exercise to all patients with diabetes as a means of managing glucose control and promoting overall health. The advice and precautions for managing diabetes depend on factors such as the specific type of diabetes, age, level of physical activity, and any existing diabetes-related health issues. Recommendations should be customized to address the unique requirements of each individual. All adults should be encouraged to not only participate in regular physical exercise but also to reduce the overall amount of time spent being sedentary each day. It is important to interrupt prolonged periods of sitting with frequent intervals of physical activity. Ultimately, behavior-change tactics might be employed to encourage the acceptance and continuation of lifelong physical exercise. [ABSTRACT FROM AUTHOR]