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This study investigates the impact of public borrowing and total capital formation on Nepal’s economic growth. The analysis relies on secondary data from publications from the Nepal Rastra Bank and economic surveys conducted in Nepal. The dataset has 34 consecutive yearly data points from 1988/89 to 2021/22. A causal correlational research design is used. It is guided by positivist research philosophy and deductive reasoning. The robust least square method is employed to explore the impact of independent variables. Research indicates that public debt and capital formation favourably and significantly affect Nepal’s economic growth. The study demonstrates that a one-unit rise in public debt and capital formation leads to 0.2881 and 0.6205 unit increases in Nepal’s economic growth, respectively. The positive impact of capital formation is more effective than public borrowing in promoting the economic growth of Nepal. Policymakers should focus on creating a business-friendly environment, enacting growth-oriented fiscal and monetary policies, efficiently allocating resources for infrastructure and technology, and managing public debt prudently to ensure sustainable and equitable economic development.

This study investigates the impact of public borrowing and total capital formation on Nepal's economic growth. The analysis relies on secondary data from publications from the Nepal Rastra Bank and economic surveys conducted in Nepal. The dataset has 34 consecutive yearly data points from 1988/89 to 2021/22. A causal correlational research design is used. It is guided by positivist research philosophy and deductive reasoning. The robust least square method is employed to explore the impact of independent variables. Research indicates that public debt and capital formation favourably and significantly affect Nepal's economic growth. The study demonstrates that a one-unit rise in public debt and capital formation leads to 0.2881 and 0.6205 unit increases in Nepal's economic growth, respectively. The positive impact of capital formation is more effective than public borrowing in promoting the economic growth of Nepal. Policymakers should focus on creating a business-friendly environment, enacting growth-oriented fiscal and monetary policies, efficiently allocating resources for infrastructure and technology, and managing public debt prudently to ensure sustainable and equitable economic development. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension is a known perioperative risk factor that carries a high morbidity and mortality rate. Severe pulmonary hypertension is related to high morbidity after general anaesthesia. We are reporting three patients with underlying severe pulmonary hypertension, who presented with intestinal obstruction managed with different perioperative approaches. In case 1, a 38-year-old man with Eisenmenger syndrome and severe pulmonary hypertension underwent exploratory laparotomy, right hemicolectomy, and double barrel stoma for obstructed right-sided colonic tumour. He passed away on Day 6 post-operation. In case 2, a 52-year-old man with Eisenmenger syndrome and severe pulmonary hypertension presented with obstructed rectosigmoid tumour and jejunojejunal intussusception and underwent exploratory laparotomy and Hartmann's procedure. He succumbed after 33 days of fighting with cardiovascular and respiratory complications. In case 3, a 65-year-old woman, with strangulated paraumbilical hernia, underwent mini laparotomy, small bowel resection, primary anastomosis, and paraumbilical hernia repair under monitored sedation and local anaesthesia. She was discharged home after 7 days of hospitalization. [ABSTRACT FROM AUTHOR]

Low-grade appendiceal mucinous neoplasm (LAMN) is a rare entity identified in ~1% of patients undergoing appendectomy. The presentation often varies, making diagnosis challenging. Timely identification and treatment are critical to prevent rupture, which may lead to pseudomyxoma peritonei. We describe the case of a 41-year-old male who presented for evaluation of acute right lower quadrant abdominal pain. The clinical impression was consistent with appendicitis with a clinical suspicion for underlying malignancy. The patient was brought to the operating room for an exploratory laparotomy and right hemicolectomy, revealing low-grade appendiceal mucinous neoplasm. The diagnosis of low-grade appendiceal mucinous neoplasm can be challenging given the variable presentation and imaging findings. Early recognition and treatment are imperative to prevent progression to pseudomyxoma peritonei. Our case report seeks to contribute to the ongoing literature and provide a review of the current knowledge. [ABSTRACT FROM AUTHOR]

In Canada, formal structures for advancing engineering education research (EER), including graduate programmes, funding, and career pathways, are uncommon. However, an active informal EER community exists. Using the Identity Trajectory Framework, we designed an exploratory basic interpretive qualitative study to learn how 21 graduate students experienced EER in Canada. EER's dualist internal identity and lack of external identity, credibility, and structural support create a feedback loop of uncertainties for graduate students trying to navigate EER. This inhibits the healthy development of EER as an academic discipline, and thereby, the healthy development of EER graduate students. If we want to successfully support graduate students in developing their identity as EER researchers, we need institutional structures. Understanding how graduate students experience EER in Canada is important to understand how to build capacity here and in other locales where the field is newly developing. [ABSTRACT FROM AUTHOR]

Objective: Technique description and verification of L5 pars interarticularis (L5PI) using diagnostic ultrasound (DUS). Methods: Asymptomatic 10-year-old male subject was scanned with diagnostic ultrasound applying a linear array transducer (8-13 MHz) over L5/S1 facets; longaxis slide cephalad to capture both superior (SAP) and inferior articulating process (IAP) of L5. Contiguous hyperechoic cortex with deep acoustic shadowing between the SAP and IAP was assumed to be L5PI. To confirm in vivo technique representing L5PI, two spine models (plastic, human spine) were scanned to verify authors' assumption. Metallic paperclip was placed over L5PI then DUS image captured. Lastly, a subject with known spondylolysis was imaged and sonographic appearance of L5PI compared. Results: The structures localized with the metal paperclip on L5PI models were equivalent to the in vivo DUS image. Spondylolysis demonstrates an abrupt stepoff defect at L5PI. Conclusion: We report the first technique description and verification of the L5PI using DUS. [ABSTRACT FROM AUTHOR]

Maternal substance use and unpredictable maternal sensory signals may affect child development, but no studies have examined them together. We explored the unpredictability, frequency and duration of maternal sensory signals in 52 Caucasian mother–child dyads, 27 with and 25 without maternal substance use. We also examined the association between unpredictable maternal signals and children's cognitive development. Maternal sensory signals were evaluated with video‐recorded dyadic free‐play interactions at child age of 24 months. Children's cognitive development was evaluated with Bayley‐III at 24 months and with WPPSI‐III at 48 months. We found similar unpredictability, frequency and duration of sensory signals between substance‐using and non‐using mothers. Higher unpredictability of maternal sensory signals was robustly linked with poorer child cognitive development at 24 months. The link persisted, although weakened to 48 months. Unpredictability of maternal sensory signals may be a vital parenting aspect shaping children's development, but more research is needed in high‐risk groups. Highlights: We examined unpredictability, frequency and duration of maternal sensory signals among substance‐using and non‐using mothers, and the associations between unpredictability and children's cognitive development.We assessed sensory signals with dyadic free‐play interaction and children's cognitive development with standardized tests. Groups showed similar sensory signal unpredictability, frequency and duration. Unpredictable sensory signals were linked with poorer child cognitive development at 24 and 48 months.Unpredictability of maternal sensory signals is a potentially vital aspect of parental care in shaping children's development. More research is needed especially including high‐risk mothers. [ABSTRACT FROM AUTHOR]

The Yellow River Basin of China is a key region that contains myriad interactions between human activities and natural environment. Industrialization and urbanization promote social-economic development, but they also have generated a series of environmental and ecological issues in this basin. Previous researches have evaluated urban resilience at the national, regional, urban agglomeration, city, and prefecture levels, but not at the watershed level. To address this research gap and elevate the Yellow River Basin's urban resilience level, we constructed an urban resilience evaluation index system from five dimensions: industrial resilience, social resilience, environmental resilience, technological resilience, and organizational resilience. The entropy weight method was used to comprehensively evaluate urban resilience in the Yellow River Basin. The exploratory spatial data analysis method was employed to study the spatiotemporal differences in urban resilience in the Yellow River Basin in 2010, 2015, and 2020. Furthermore, the grey correlation analysis method was utilized to explore the influencing factors of these differences. The results of this study are as follows: (1) the overall level of urban resilience in the Yellow River Basin was relatively low but showed an increasing trend during 2010-2015, and significant spatial distribution differences were observed, with a higher resilience level in the eastern region and a low-medium resilience level in the western region; (2) the differences in urban resilience were noticeable, with industrial resilience and social resilience being relatively highly developed, whereas organizational resilience and environmental resilience were relatively weak; and (3) the correlation ranking of resilience influencing factors was as follows: science and technology level>administrative power>openness>market forces. This research can provide a basis for improving the resilience level of cities in the Yellow River Basin and contribute to the high-quality development of the region. [ABSTRACT FROM AUTHOR]

Background: There are 1.2 billion adolescents in the world today, more than ever before, making up 16% of the world's population and nearly one-fourth of the total population in Sub-Saharan Africa. Adolescents are facing life-threatening health challenges attributed to sexual and reproductive health issues such as unwanted pregnancies, unsafe abortions, and sexually transmitted infections, including the human immunodeficiency virus, and acquired immunodeficiency syndrome. The aim of this research is to explore the individual and relational levels of factors that drive adolescents to engage in risky sexual behaviour. Methods: A qualitative phenomenological study design was used from February to June 2020. Adolescents and health professionals were selected purposefully. A total of 12 individual in-depth interviews, five focus group discussions with adolescents, and eight key informant interviews with health professionals were conducted using a semi-structured guide. Data analysis was performed using thematic analysis with ATLAS Ti version 7 software. Credibility, dependability, transferability, and confirmability were used to ensure the trustworthiness of the data. Results: In this study, two themes were identified; individual level factors such as sexual desire and emotion driven sex, limited knowledge of sexual and reproductive health, and a permissive attitude towards sexual activities drive adolescents to engage in risky sexual behaviour; and relational level factors such as, limited family support and involvement, negative peer pressure and influence, male partner dominance during the partnership, and pressuring females to engage in sexual intercourse were perceived factors influencing adolescents to engage in risky sexual behaviour. Conclusion: Various individual-level and relational-level factors are influencing adolescents to engage in risky sexual behaviour. Socially and culturally acceptable, comprehensive sexual education should be provided for in-school and out-school adolescents to enhance their knowledge, attitude, and skill about sexual and reproductive health. Interventions at the peer and partner level should be considered to enhance the life skills that enable them to resist pressure from peers and their partners. Child-parent communication on sexual and reproductive health matters should be promoted. [ABSTRACT FROM AUTHOR]

Introduction and importance: Spontaneous hemoperitoneum (SH) is a rare, life-threatening condition characterized by nontraumatic and non-iatrogenic intraperitoneal bleeding. This article explores three unique cases of SH, shedding light on unusual causes and emphasizing the critical role of diagnostic imaging and exploratory laparotomy in management. Methods: The study was a retrospective single-center non-consecutive case series. Results: We report three distinct cases of SH, each originating from uncommon sources: rupture of greater omentum arterio-venous malformation, a branch of the left gastric artery, and pathological splenic rupture. Clinical evaluation, diagnostic imaging, and surgical interventions are detailed for each case. Conclusion: These rare cases underscore the diverse etiologies of SH, including idiopathic omental bleeding, gastric intramural hematoma, and atraumatic splenic rupture. Enhanced CT imaging plays a crucial role in diagnosis, enabling the characterization of underlying pathologies. Exploratory laparotomy proves to be an essential treatment option for unstable patients with suspected or confirmed diagnoses of SH. [ABSTRACT FROM AUTHOR]

Comprehensively defining end-of-life healthcare is a challenge due to the diverse areas of healthcare involved, the various stakeholders, and the range of patient options. This qualitative study examined many areas of end-of-life healthcare including quality, areas for improvement, and healthcare policy in Tennessee, in which the definition of end-of-life healthcare was a focus. Data were collected using semi-structured interviews with 19 participants who included end-of-life healthcare experts and Tennessee legislators. Through this research an operational definition of end-of-life healthcare, encompassing five concepts, was developed. Concepts include: a diagnosis, a timeframe, type of care, location of care, and planning for the future. When considered together, they are the embodiment of what end-of-life healthcare encompasses. Not in a one-fits-all definition, but individually tailored. An understanding of what end-of-life healthcare denotes is essential to maintaining open communication, high quality standards of care, and the protection of patient autonomy. [ABSTRACT FROM AUTHOR]

Introduction: Drugs in the family of non-steroidal anti-inflammatory analgesics (NSAIDs) can cause adverse drug reactions (ADRs) and drug-drug interactions, hence the importance for the stomatologist to know how to prescribe and use each drug rationally. Currently, there is no information on the pharmacovigilance actions of analgesics that are the responsibility of the stomatologist, so the objective of this research was to explore the pharmacovigilance actions carried out by clinical teachers in stomatology. Materials and methods: For the purposes of this study, a 23-question questionnaire derived from the Mexican Official Standard NOM-220-SSA1-2016 on pharmacovigilance actions of analgesics was constructed. Google forms were used in a self-administered manner. Results: 67.56% of the participants (n=37) were female. Regarding years of experience they have a minimum of 5 years and a maximum of 42 (M=13.36, SD=8.2). Most of the teachers (64.86%) monitor the analgesics they prescribe; however, 86.66% of the participants have never detected an Adverse Drug Reaction (ADR) and 70% do not monitor the possible pharmacological interactions of the prescribed analgesics. Conclusion: There is a need for updating and educational initiatives in pharmacovigilance in stomatology, monitoring analgesic prescription patterns, developing prescription guidelines to ensure that patients receive the most effective treatment for their oral pain, and structuring a protocol in accordance with current standards for the reporting of ADRs and the recording of drug interactions. [ABSTRACT FROM AUTHOR]

Anecdotal evidence, commentary in the media, and research conducted by intergovernmental organizations in Vietnam indicate that sexism is commonly experienced by women in the Vietnamese workplace. However, few systematic studies to date have been conducted on the prevalence and types of sexism that Vietnamese women experience. This cross-sectional exploratory study seeks to inquire into women's experiences of sexism in the STEM field and its potential associations with mental health outcomes through the lens of ambivalent sexism theory, which categorizes sexism as benevolent and hostile. Vietnamese women employed in STEM (N = 148) completed online questionnaires assessing experiences of ambivalent sexism, perceived stress and perceived sexism, stress symptoms, depression, and anxiety. The results indicate that benevolent sexism is more common than hostile sexism and that younger women are more frequently targeted. Correlation and regression analyses indicate that benevolent and hostile sexism are positively correlated with women's mental health problems. The findings highlight that despite the gains made in workplace gender equality in Vietnam, sexism continues to pose a problem for women's career development in STEM as well as potential health and safety issues. The study concludes with measures that organizations can undertake to tackle the problem and recommendations for future research in Vietnam to build on this exploratory inquiry.

Congenital colonic stenosis (CCS) is a rare cause of intestinal obstruction, most commonly presenting in the neonatal period. We present a case of delayed CCS and describe the diagnostic challenges experienced. A 16-week-old female patient presented with persistent failure to thrive associated with signs of intestinal obstruction. Prior encounters included investigation for pyloric stenosis, gastrointestinal pathogens, acid reflux, and cow milk allergy, with no to little improvement in symptoms. Abdominal imaging showed bowel dilation with possible colonic obstruction while excluding malrotation. Exploratory laparotomy revealed abrupt reduction in caliber of the mid/distal transverse colon and extreme luminal narrowing, consistent with colonic stenosis. Extended right hemicolectomy and anastomosis resulted in returned bowel function and appropriate weight gain in follow-up. Though rare, CCS should be considered in cases of partial or subacute intestinal obstruction throughout the first year of life. Inconclusive clinical and imaging results may support exploratory laparotomy after excluding differential diagnoses. [ABSTRACT FROM AUTHOR]

The overarching purpose of this study is to examine the current status of academic public engagement in Vietnam. Data were obtained from a survey with 245 university lecturers, and descriptive statistics were used jointly with Bayesian statistics as tools for analysis. This study reveals that a significant proportion of university lecturers are not involved in public engagement, neither through the public press (66.5%) nor social media (49%). Those who have been active in public engagement use the public press and social networks to communicate science, with the latter being more used than the former. In addition, this study also pointed out that experienced scientists tend to engage with the public press, while early-career researchers often choose social networks. The findings of this study provide implications for higher education policymakers and administrators. [ABSTRACT FROM AUTHOR]

Menarche can be a difficult transition for young people. With appropriate education, youth can feel more positively about the menstrual experience. Since many elementary teachers are not equipped with menstrual health knowledge, the education falls to the school nurse. However, it is unknown if school nurses feel comfortable communicating about menstruation with young people. The purpose of this study was to explore school nurses' perceptions regarding menstrual health education in elementary schools (grades K-5). An online mixed-methods survey was established using Qualtrics. Through snowball sampling, 30 elementary school nurses responded. Using the Integrated Behavioral Model (IBM) as a framework, a deductive semantic thematic analysis was used to identify themes for each question. Data suggested that elementary school nurses would participate in professional development regarding menstrual health and hygiene. School health nurses are receiving limited knowledge/skills surrounding pedagogy and are not familiar with cultural differences when it comes to menstrual health. [ABSTRACT FROM AUTHOR]

Breeding is a pivotal aspect of crop production, and Horticultural Crop Breeding, a compulsory course for undergraduate horticulture students, often faces challenges in traditional teaching. These challenges include students' limited active learning, inadequate knowledge acquisition, monotonous teaching approach, and simplistic evaluation methods, which hinder optimal enthusiasm and learning outcomes. To address these issues, the author's teaching team has implemented innovative teaching strategies. By refining course objectives, incorporating ideological and political elements, broadening the curriculum, diversifying teaching methodologies, and enhancing assessment frameworks, they have significantly enhanced the effectiveness of the Horticultural Crop Breeding (Bilingual) course. This, in turn, has led to improved overall teaching quality, higher student satisfaction, and greater professional recognition. The successful practices serve as a valuable reference for the development of bilingual courses. [ABSTRACT FROM AUTHOR]

Manufacturing enterprises continue to grapple with transforming from their existing business model, which revolves around designing and selling tangible products, to business models centered on providing a blend of products and services. Product-as-a-Service (PaaS) emerges as a business strategy capable of catalyzing the shift toward higher levels of circularity. However, effecting changes in operational methodologies and value delivery mechanisms is imperative, consequently prompting modifications in the core business strategies of these companies. The objective of this study is to discern and categorize prevailing PaaS business models for electrical and electronic equipment (EEE). The Business Model Canvas (BMC) is introduced as a foundational tool to facilitate this transition, emphasizing the central role of the value proposition within the business model. Additionally, the study underscores the importance of robust take-back systems and repairability in PaaS implementation, particularly within the EEE sector. It highlights the need for novel partnerships, redesigned reverse logistics networks, and efficient product assessment methods to facilitate environmentally responsible decisions. Furthermore, the research evaluates the financial implications of PaaS adoption through Life Cycle Costing (LCC), emphasizing its value in predicting and addressing temporary financial complications, thereby ensuring a smoother transition to service-oriented business models. [ABSTRACT FROM AUTHOR]

BackgroundThere are 1.2 billion adolescents in the world today, more than ever before, making up 16% of the world's population and nearly one-fourth of the total population in Sub-Saharan Africa. Adolescents are facing life-threatening health challenges attributed to sexual and reproductive health issues such as unwanted pregnancies, unsafe abortions, and sexually transmitted infections, including the human immunodeficiency virus, and acquired immunodeficiency syndrome. The aim of this research is to explore the individual and relational levels of factors that drive adolescents to engage in risky sexual behaviour.MethodsA qualitative phenomenological study design was used from February to June 2020. Adolescents and health professionals were selected purposefully. A total of 12 individual in-depth interviews, five focus group discussions with adolescents, and eight key informant interviews with health professionals were conducted using a semi-structured guide. Data analysis was performed using thematic analysis with ATLAS Ti version 7 software. Credibility, dependability, transferability, and confirmability were used to ensure the trustworthiness of the data.ResultsIn this study, two themes were identified; individual level factors such as sexual desire and emotion driven sex, limited knowledge of sexual and reproductive health, and a permissive attitude towards sexual activities drive adolescents to engage in risky sexual behaviour; and relational level factors such as, limited family support and involvement, negative peer pressure and influence, male partner dominance during the partnership, and pressuring females to engage in sexual intercourse were perceived factors influencing adolescents to engage in risky sexual behaviour.ConclusionVarious individual-level and relational-level factors are influencing adolescents to engage in risky sexual behaviour. Socially and culturally acceptable, comprehensive sexual education should be provided for in-school and out-school adolescents to enhance their knowledge, attitude, and skill about sexual and reproductive health. Interventions at the peer and partner level should be considered to enhance the life skills that enable them to resist pressure from peers and their partners. Child-parent communication on sexual and reproductive health matters should be promoted.

A medical condition called hematosalpinx causes an accumulation of blood within the fallopian tube. It is usually seen in patients with ectopic pregnancy. Inflammatory disease of the pelvis, tubal cancer, pelvic trauma, and endometriosis are further causes. Here, we report a unique case of hematosalpinx with associated tubal torsion in a 13-year-old female lacking any previously reported contributing causes. She is celibate and presented with abdominal pain and fever. Beta-hcg was not present, and her menstrual cycle was regular. Pelvic ultrasound sonography revealed a large cyst and was suggestive of a right paraovarian cyst. An exploratory laparotomy was performed and a giant hematosalpinx was observed in an otherwise normal ovary. In conclusion, although very rare in adolescence, hematosalpinx must be considered in the differential diagnosis. This unusual instance highlights new concerns regarding the pathogenesis of hematosalpinx. [ABSTRACT FROM AUTHOR]

Meckel's diverticulum (MD), a rare congenital abnormality, can lead to issues like diverticulitis and bleeding. Foreign bodies in MD are even rarer, causing vague symptoms and perforation, requiring urgent surgery. This case report highlights a patient with a foreign body in MD, focusing on clinical presentation and management. A 55-year-old male presented with abdominal pain, nausea, and vomiting. Computed tomography scan revealed a foreign body perforating the small bowel. Exploratory laparotomy found a partially perforated MD with a foreign body. Diverticulectomy was performed, and the patient recovered, discharged the next day. Foreign bodies in MD are exceedingly rare and can cause inflammation, infection, and perforation, mimicking appendicitis. Diagnosis is challenging due to nonspecific symptoms, with imaging and clinical evaluation crucial. Surgical intervention, like diverticulectomy, is primary. Early diagnosis and prompt surgery are critical in managing MD complicated by foreign bodies, ensuring favorable outcomes. This report underscores symptom recognition and effective management strategies. [ABSTRACT FROM AUTHOR]

During the preclinical research process, multiple factors can be difficult to implement without the careful consideration and planning of each step. As research has become more advanced with the use of increasingly complex technology, animal models have also become essential for understanding the potential impact of devices, drug therapies, and surgical techniques on humans before clinical trials are conducted. The use of an in vivo animal model is a key and necessary step in the progression of preclinical research studies that will lead to future medical inventions and innovation. Here, we describe the three phases of effectively designing a preclinical research protocol: the research, preprocedural planning, and experimental phases. Furthermore, we provide researchers with guidance through these phases and discuss important considerations.

Background: Autism spectrum disorders (ASDs) encompass a broad range of phenotypes characterized by diverse neurological alterations. Genomic studies have revealed considerable overlap between the molecular mechanisms implicated in the etiology of ASD and genes involved in the pharmacokinetic (PK) and pharmacodynamic (PD) pathways of antipsychotic drugs employed in ASD management. Given the conflicting data originating from candidate PK or PD gene association studies in diverse ethnogeographic ASD populations, dosage individualization based on "actionable" pharmacogenetic (PGx) markers has limited application in clinical practice. Additionally, off-label use of different antipsychotics is an ongoing practice, which is justified given the shortage of approved cures, despite the lack of satisfactory evidence for its safety according to precision medicine. This exploratory study aimed to identify PGx markers predictive of risperidone (RIS) exposure in autistic Saudi children. Methods: This prospective cohort study enrolled 89 Saudi children with ASD treated with RIS-based antipsychotic therapy. Plasma levels of RIS and 9-OH-RIS were measured using a liquid chromatography--tandem mass spectrometry system. To enable focused exploratory testing, genotyping was performed with the Axiom PharmacoFocus Array, which included a collection of probe sets targeting PK/PD genes. A total of 720 PGx markers were included in the association analysis.Results: A total of 27 PGx variants were found to have a prominent impact on various RIS PK parameters; most were not located within the genes involved in the classical RIS PK pathway. Specifically, 8 markers in 7 genes were identified as the PGx markers with the strongest impact on RIS levels (p < 0.01). Four PGx variants in 3 genes were strongly associated with 9-OH-RIS levels, while 5 markers in 5 different genes explained the interindividual variability in the total active moiety. Notably, 6 CYP2D6 variants exhibited strong linkage disequilibrium; however, they significantly influenced only the metabolic ratio and had no considerable effects on the individual estimates of RIS, 9-OH-RIS, or the total active moiety. After correction for multiple testing, rs78998153 in UGT2B17 (which is highly expressed in the brain) remained the most significant PGx marker positively adjusting the metabolic ratio. For the first time, certain human leukocyte antigen (HLA) markers were found to enhance various RIS exposure parameters, which reinforces the gut--brain axis theory of ASD etiology and its suggested inflammatory impacts on drug bioavailability through modulation of the brain, gastrointestinal tract and/or hepatic expression of metabolizing enzymes and transporters. Conclusion: Our hypothesis-generating approach identified a broad spectrum of PGx markers that interactively influence RIS exposure in ASD children, which indicated the need for further validation in population PK modeling studies to define polygenic scores for antipsychotic efficacy and safety, which could facilitate personalized therapeutic decision-making in this complex neurodevelopmental condition. [ABSTRACT FROM AUTHOR]

Background: The digital transformation in health care requires training nursing and health professionals in the digitally competent use of digital assistive technologies (DAT). The continuing education training "Beratende für digitale Gesundheitsversorgung" ("Consultant for Digital Healthcare") was developed to fill this gap. The effectiveness of the training program will be assessed in this study. Objective: The primary objective is to record and measure the participants' learning success. We will assess whether the previously defined teaching intentions, learning objectives, competencies, and participants' expectations have been achieved and whether a transfer of learning occurred. The secondary objective is participant satisfaction and feasibility of the training. The tertiary objective is the successful transfer of DAT by participants in their institutions. Methods: Approximately 65 nursing and health care professionals will participate in the pilot phase of the further training and evaluation process, which is planned in a mixed methods design in a nonsequential manner. The different methods will be combined in the interpretation of the results to achieve a synaptic view of the training program. We plan to conduct pre-post surveys in the form of participant self-assessments about dealing with DAT and content-related knowledge levels. Exploratory individual interviews will also be conducted to build theory, to examine whether and to what extent competence (cognition) has increased, and whether dealing (affect) with DAT has changed. Furthermore, an interim evaluation within the framework of the Teaching Analysis Poll (TAP) will occur. The knowledge thereby gained will be used to revise and adapt the modules for future courses. To assess the transfer success, the participants create a practical project, which is carried out within the training framework, observed by the lecturers, and subsequently evaluated and adapted. Results: We expect that the learning objectives for the continuing education training will be met. The attendees are expected to increase their level of digital competence in different skills areas: (1) theoretical knowledge, (2) hands-on skills for planning the application and practical use of DAT, (3) reflective skills and applying ethical and legal considerations in their use, (4) applying all that in a structured process of technology implementation within their practical sphere of work. Conclusions: The aim of this study and appropriate further training program are to educate nursing and health care professionals in the use of DAT, thereby empowering them for a structured change process toward digitally aided care. This focus gives rise to the following research questions: First, how should further training programs be developed, and which focus is appropriate for addressee-appropriate learning goals, course structure, and general curriculum? Second, how should a training program with this specific content and area be evaluated? Third, what are the conditions to offer a continued program? International Registered Report Identifier (IRRID): PRR1-10.2196/57860 [ABSTRACT FROM AUTHOR]

Research is a form of knowledge whose content is given by the "creation" resulting from human curiosity, or better said, research activity. Scientific research is based on scientific knowledge and is a continuous search carried out within a complex process, the content of which is given by "scientific creation". The researcher's opinion is actually his answer, written in the form of a narrative, the content of which presents, in a logical and fluent structure, the staged development of the research activity, as well as the conclusions and results obtained as a result. When we discuss about types of research we are actually discussing different approaches that researchers can use to research a problem, a phenomenon or even a process. The methodology used in a research activity is often determined by the type of research being addressed. Therefore, there are different types of research, and each of them is conducted for a specific purpose, scope and type of data. [ABSTRACT FROM AUTHOR]

Abstract Defining spaces and places in retrojective Geographical Information Systems (GIS) of land use and occupancy is not an easy task. Research into the areas described as suitable for land use and occupancy need to incorporate multiple perspectives of what makes a land use patch useful or salient ecologically. The effect of the concept of 'Terra Nullius' and European colonisation is deeply apparent in the current GIS models of historical land use and occupancy of Aboriginal communities within arid zones in Australia. Biocultural zones of land use and occupancy zones omit spaces and places of habitation due to European bias of what a suitable ecological or hydrological land use zone should look like. This article employs Exploratory GIS methods to interrogate the data layers within the Willandra Lakes Region World Heritage Area, NSW, Australia. This work conclusively demonstrates that there are ranges of areas and land suitability zones prior to colonisation in the nineteenth century. In turn, these Exploratory GIS models of an active Country comprehensively address the question of why visually salient areas of hydrological and ecological Indigenous land use and occupancy continue to be ignored, destroyed, and damaged by settlements in semi-arid regions. Biocultural GIS mapping unpacks the myth that areas were empty or uninhabited by Aboriginal communities and underlines the need for biocultural GIS mapping tools to understand the habitable spaces and places of the arid zone.

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs’ perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2–3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech’s content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study’s findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Background: Autism spectrum disorders (ASDs) encompass a broad range of phenotypes characterized by diverse neurological alterations. Genomic studies have revealed considerable overlap between the molecular mechanisms implicated in the etiology of ASD and genes involved in the pharmacokinetic (PK) and pharmacodynamic (PD) pathways of antipsychotic drugs employed in ASD management. Given the conflicting data originating from candidate PK or PD gene association studies in diverse ethnogeographic ASD populations, dosage individualization based on “actionable” pharmacogenetic (PGx) markers has limited application in clinical practice. Additionally, off-label use of different antipsychotics is an ongoing practice, which is justified given the shortage of approved cures, despite the lack of satisfactory evidence for its safety according to precision medicine. This exploratory study aimed to identify PGx markers predictive of risperidone (RIS) exposure in autistic Saudi children.Methods: This prospective cohort study enrolled 89 Saudi children with ASD treated with RIS-based antipsychotic therapy. Plasma levels of RIS and 9-OH-RIS were measured using a liquid chromatography–tandem mass spectrometry system. To enable focused exploratory testing, genotyping was performed with the Axiom PharmacoFocus Array, which included a collection of probe sets targeting PK/PD genes. A total of 720 PGx markers were included in the association analysis.Results: A total of 27 PGx variants were found to have a prominent impact on various RIS PK parameters; most were not located within the genes involved in the classical RIS PK pathway. Specifically, 8 markers in 7 genes were identified as the PGx markers with the strongest impact on RIS levels (p < 0.01). Four PGx variants in 3 genes were strongly associated with 9-OH-RIS levels, while 5 markers in 5 different genes explained the interindividual variability in the total active moiety. Notably, 6 CYP2D6 variants exhibited strong linkage disequilibrium; however, they significantly influenced only the metabolic ratio and had no considerable effects on the individual estimates of RIS, 9-OH-RIS, or the total active moiety. After correction for multiple testing, rs78998153 in UGT2B17 (which is highly expressed in the brain) remained the most significant PGx marker positively adjusting the metabolic ratio. For the first time, certain human leukocyte antigen (HLA) markers were found to enhance various RIS exposure parameters, which reinforces the gut–brain axis theory of ASD etiology and its suggested inflammatory impacts on drug bioavailability through modulation of the brain, gastrointestinal tract and/or hepatic expression of metabolizing enzymes and transporters.Conclusion: Our hypothesis-generating approach identified a broad spectrum of PGx markers that interactively influence RIS exposure in ASD children, which indicated the need for further validation in population PK modeling studies to define polygenic scores for antipsychotic efficacy and safety, which could facilitate personalized therapeutic decision-making in this complex neurodevelopmental condition.

We present a case of spontaneous abdominal hemoperitoneum secondary to ruptured splenosis in a 35-year-old patient with a history of splenectomy secondary to trauma 23 years prior. Computed tomography imaging demonstrated a large amorphous mass-like structure in the mesentery of the left hemiabdomen with active extravasation and hemoperitoneum. The patient also had a separate focus of hyper-enhancing mass adjacent to the bladder representing a mass versus splenule. The patient's radiographic and clinical presentation prompted management with exploratory laparotomy, hematoma evacuation, and resection of two splenules. With only a few cases of spontaneous abdominal hemoperitoneum from splenosis reported, this case describes successful management with surgical intervention. [ABSTRACT FROM AUTHOR]

During the preclinical research process, multiple factors can be difficult to implement without the careful consideration and planning of each step. As research has become more advanced with the use of increasingly complex technology, animal models have also become essential for understanding the potential impact of devices, drug therapies, and surgical techniques on humans before clinical trials are conducted. The use of an in vivo animal model is a key and necessary step in the progression of preclinical research studies that will lead to future medical inventions and innovation. Here, we describe the three phases of effectively designing a preclinical research protocol: the research, preprocedural planning, and experimental phases. Furthermore, we provide researchers with guidance through these phases and discuss important considerations. [ABSTRACT FROM AUTHOR]

Evaluating reintroduction success is fundamental to wildlife management and conservation. Movement affects animal fitness and survival and is the first response of reintroduced animals, making it an excellent indicator of reintroduction success. However, there is limited information on the early post-release movement of reintroduced animals. Here, we addressed this important issue by studying the post-release behaviour of the critically endangered black rhinoceros, Diceros bicornis minor, reintroduced to the Gonarezhou National Park, Zimbabwe, in 2021. We used daytime sighting data collected from 21 rhinoceros for 1.5 years to investigate survival and reproduction, movement patterns and habitat selection after release. We examine how sex, age and different release sites affect the short-term movement behaviour and habitat selection of black rhinos. Rhinos showed progressive and consistent changes in movement patterns and habitat selection, shifting from large-scale movements during the early stages of release to smaller-scale movements after home ranges were established. We found that rhinos released in the large area had larger activity areas with less overlap between individuals and moved further away from the release site (less fidelity to the release site) than the individuals released in the smaller area. These findings confirm the great capacity of black rhinos to adapt to the environment, occupying large ranges when given the opportunity, but populations with smaller ranges can also be viable. Based on our study and a literature review, we stress the importance of long-term monitoring and believe that reserve size, rhino density, fencing, food and water availability, familiarity between conspecifics and human disturbance are key factors in the successful establishment of a rhino population that should be considered in future reintroductions. Finally, the high survival and birth rates in the first 1.5 years after reintroduction, together with most rhinos having established their home range, suggest a successful reintroduction in the short term.

Defining spaces and places in retrojective Geographical Information Systems (GIS) of land use and occupancy is not an easy task. Research into the areas described as suitable for land use and occupancy need to incorporate multiple perspectives of what makes a land use patch useful or salient ecologically. The effect of the concept of 'Terra Nullius' and European colonisation is deeply apparent in the current GIS models of historical land use and occupancy of Aboriginal communities within arid zones in Australia. Biocultural zones of land use and occupancy zones omit spaces and places of habitation due to European bias of what a suitable ecological or hydrological land use zone should look like. This article employs Exploratory GIS methods to interrogate the data layers within the Willandra Lakes Region World Heritage Area, NSW, Australia. This work conclusively demonstrates that there are ranges of areas and land suitability zones prior to colonisation in the nineteenth century. In turn, these Exploratory GIS models of an active Country comprehensively address the question of why visually salient areas of hydrological and ecological Indigenous land use and occupancy continue to be ignored, destroyed, and damaged by settlements in semi-arid regions. Biocultural GIS mapping unpacks the myth that areas were empty or uninhabited by Aboriginal communities and underlines the need for biocultural GIS mapping tools to understand the habitable spaces and places of the arid zone. [ABSTRACT FROM AUTHOR]

Advising programs for undecided/exploratory students risk reinvention of the wheel through lack of familiarity with existing literature. This lack can also leave the scholar and the practitioner unable to identify potential gaps within the research. Applying the methodological approach of qualitative historiography to literature from 1950 to 2022, our findings clarify the need for a nuanced and clear understanding of undecided/exploratory students. Observed throughout the literature is an awareness that exploration and decision-making skills are valuable to all students. Additionally, cultural context--examining the various models, programs, and interventions through a lens of equity and inclusion--and a more global perspective are critical for future research. [ABSTRACT FROM AUTHOR]