Search Results (192)

A wide variety of requirements can be placed on tasks that deal with education for sustainable development in mathematics lessons. They should be as authentic as possible, use real problems as the mathematical learning material, and stimulate action, among other qualities. This article discusses the role of self-efficacy and the experience of self-efficacy when working on modelling tasks that are geared towards a sustainable future. High school students in Germany worked in a STEM learning environment on different aspects of climate change and species extinction, including plastic waste, recycling, rainforests, and their deforestation. These aspects were analysed from a geographical, biological, physical, and mathematical perspective. In mathematics, specifically, tasks were used to address the learners’ self-efficacy. After completing the tasks, a questionnaire was distributed to assess the interest and motivation of the learners. The results show that even a slightly different use of self-efficacy, whether by focusing on what has already been achieved (sustainable successes that promote positive emotions) or on what can still be achieved, can influence the learners’ interest in completing the tasks. The learners’ experience of self-efficacy seems to have a positive influence on their willingness to solve tasks. Additionally, the results indicate a complex relationship between motivation and interest on the one hand and self-efficacy on the other. Full article

Anal squamous cell carcinoma (ASCC) is a rare malignancy with an increasing incidence despite advancements in treatment. The primary treatment for localized ASCC is radiochemotherapy (RCT), which achieves high rates of tumor regression in most cases, but up to 30% of patients experience recurrence or persistent disease. Salvage surgery, such as an abdominoperineal resection (APR), is often used for recurrent disease but is associated with significant morbidity and limited oncological outcomes. Patients with small T1 tumors may also benefit from primary local excision. For patients with metastatic or unresectable recurrent ASCC, chemotherapy, particularly carboplatin and paclitaxel, remains the standard treatment. New therapeutic strategies, including immune checkpoint inhibitors like pembrolizumab, are showing promise, particularly in PD-L1-positive tumors. Clinical trials have suggested that immunotherapy offers a potential alternative for patients for whom conventional treatments have failed, though the overall response rates remain modest. Re-radiation and intraoperative radiotherapy combined with salvage surgery may improve the outcomes for select patients, though the data are still limited. The management of recurrent or persistent ASCC requires a personalized approach, incorporating both established and emerging therapies to optimize patient outcomes. Further research is needed to refine these treatment strategies. Full article

Background/Objectives: Helminth infections, particularly prevalent in low- and middle-income countries, have been extensively studied for their effects on human health. With the emergence of new infectious diseases like SARS-CoV-2 and Ebola, their impact on disease outcomes become more apparent. While individual studies have explored the impact of helminth co-infections on disease severity and vaccine efficacy, the findings are often inconsistent and context-dependent. Furthermore, the long-term effects of helminth-mediated immunosuppression on vaccine efficacy and its broader implications for co-infections in endemic regions remain not fully understood. Methods: This systematic review conducted in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines synthesizes the current evidence, identifies patterns, and highlights areas needing further research, offering a cohesive understanding of the topic. PubMed, Scopus, Google Scholar, and Cochrane Library were searched to include studies published from 2003 to February 2025. Results: Co-infection reveals a dual role of helminths in modulating immune responses, with both beneficial and detrimental interactions reported across studies. It may confer benefits against respiratory viral infections by muting hyper-inflammation associated with the severity of conditions like COVID-19, Influenza, and RSV. However, they can exacerbate disease outcomes in most bacteria and blood-borne viral conditions by impairing immune functions, such as neutrophil recruitment and antibody response, leading to more severe infections and higher viral loads. The stage of helminth infection also appears critical, with early-stage infections sometimes offering protection, while late-stage infections may worsen disease outcomes. Helminth infection can also negatively impact vaccine efficacy by suppressing B cell activity, reducing antibody levels, and decreasing vaccine effectiveness against infectious diseases. This immunosuppressive effect may persist after deworming, complicating efforts to restore vaccine efficacy. Maternal helminth infections also significantly influence neonatal immunity, affecting newborn vaccine responses. Conclusions: There is a need for targeted interventions and further research in helminth-endemic regions to mitigate the adverse effects on vaccine efficacy and improve public health outcomes. Full article

Both commercial and research applications of wire arc additive manufacturing (WAAM) have seen considerable growth in the additive manufacturing of metallic components. However, there remains a clear lack of a unified paradigm for toolpath generation when slicing parts for WAAM deposition. Existing toolpath generation options typically lack the appropriate features to account for all complexities of the WAAM process. This manuscript explores the key slicing challenges specific to toolpaths for WAAM geometry and pairs each consideration with multiple solutions to mitigate most negative effects on completed components. These challenges must be addressed to minimize voids, prevent bead collapse, and ensure deposited components accurately approximate the desired geometry. Slicing considerations are grouped into four general categories: geometric, process, thermal, and productivity. Geometric considerations are addressed with overhang compensation, corner-sharpening, and toolpath-smoothing features. Process considerations are addressed with start point configuration and controls for the bead lengths and end points. Thermal and productivity considerations are addressed with island optimization, multi-material printing, and connected insets. Finally, tools for the post-processing of generated G-code are explored. Overall, these solutions represent a critical set of slicing features used to improve generated toolpaths and the quality of the components deposited with those toolpaths. Full article

In December 2021, an outbreak of the SARS-CoV-2 B.1.640.2 variant, potentially originating from Cameroon, was investigated among schoolchildren in Germany. The index case, an adult who had recently returned from a three-week stay in the Republic of Congo, introduced the variant into a school setting via their children, resulting in subsequent transmission within the school and ultimately to a hospital ward. Whole-genome sequencing of viral samples identified both B.1.640.1 and B.1.640.2 lineages. This outbreak highlights the unpredictable nature of emerging SARS-CoV-2 variants and emphasizes the importance of early detection and containment to mitigate transmission to high-risk populations. Notably, wastewater surveillance detected the variant during the study peri-od, reinforcing the utility of wastewater-based epidemiology as a complementary tool for the early warning and containment of novel variants. These findings underline the critical need for timely research and adherence to quarantine measures to enhance outbreak control efforts. Full article

Polyurethane (PUR)-based artificial leathers are often used as interior materials in public area, making flame retardants (FRs) necessary. The mode of action of different FRs varies depending on the chemical class and the structure of the supplied material. Usually, FRs are designed for bulk materials like foams, e.g., for upholstery, the main application of PUR. However, in thin materials, FRs act differently, thus leaving the PUR without sufficient flame resistance. In this study, PUR films and artificial leathers were equipped with twelve commercially available, halogen-free FRs in various concentrations and combinations. Fire resistance was tested with LOI measurements, cone calorimetry, horizontal burning behavior, and thermogravimetric analyses. An organophosphorus FR proved to be the most suited for flame-resistant artificial leather. The LOI was increased from 20 to 24.2%, the peak heat release rate was reduced by about 30%, and the sample was self-extinguishing in horizontal burning behavior. Phosphinates and aluminum trihydroxide were the least efficient FRs. Combinations of bentonite with phosphorus-based FRs showed synergistic effects in reducing the probability of igniting the material. The results demonstrate that sufficient flame retardancy for PUR-based thin materials can be achieved with commercially available halogen-free FRs, paving the way for more sustainable and greener materials by substituting ecologically harmful and health-damaging FRs. Full article

Background/Objectives: The COVID-19 pandemic has significantly impacted global health. However, Africa has reported relatively low numbers of cases and fatalities. Although the pandemic has largely receded, the reasons for its milder course on the African continent have not yet been fully clarified. This study explored the hypothesis that helminth co-infections may have contributed to these observations. Methods: A retrospective cohort study was conducted using 104 plasma samples collected during the third wave of the pandemic in the Ashanti Region of Ghana. Luminex assays were used to measure SARS-CoV-2-specific IgA and IgG, neutralizing antibodies, systemic cytokines and helminth-specific IgG. Results: The results indicated that the highest cumulative seroprevalence of helminths (61.5%) was observed in asymptomatic COVID-19 patients. In comparison, mild and moderate patients had helminth seropositivity rates of 43.8% and 34.5%, respectively, which were 1.4 and 1.8 times lower than those of the asymptomatic group, respectively. Notably, the two severe COVID-19 cases investigated were seronegative for all three of the helminths tested. Strikingly, co-exposure resulted in lower SARS-CoV-2-specific IgA/IgG expression and reduced neutralization potential. However, co-seropositive individuals for helminths and SARS-CoV-2 exhibited a higher expression of Th2 cytokines and IL-10 over Th1 cytokines compared to SARS-CoV-2-positive individuals alone. Conclusion: These data suggest that co-exposure to helminths could mitigate the severity of COVID-19 outcomes by reducing the Th1 and Th17 responses; this highlights the potential protective role of helminthiasis against severe COVID-19. These findings provide valuable insights for the development of public health policies in helminth-endemic regions and underscore the importance of considering helminth co-infections in managing viral infections. It also offers a plausible explanation for the milder disease severity observed in helminth-endemic regions while raising critical considerations regarding vaccine efficacy, as helminth-induced immune modulation may influence the magnitude and quality of vaccine-induced immune responses. Full article

Background: Intravenous protamine administration for heparin reversal after percutaneous hepatic chemosaturation intervention is generally recommended, but its effectiveness on coagulation parameters remains unclear. Methods: In a single-center retrospective observational study, the effects of different postinterventional protamine doses on the activated partial thromboplastin time (aPTT), international normalized ratio (INR), prothrombin time (PT), fibrinogen, platelet count (PLT), and hemoglobin (Hb) were analyzed in consecutive patients who underwent high-dose heparin administration (>300 U/kg body weight) and extracorporeal circulation for chemosaturation treatment. Due to the multiple treatments of individual patients, linear mixed-effects models were applied. Results: Thirty-one patients underwent 90 chemosaturation interventions, 68 (75.6%) of which involved heparin reversal with protamine. All investigated variables showed significant postinterventional alterations, while protamine use was associated with significantly lower aPTT, lower INR, higher PT, and higher fibrinogen levels, whereas PLT and Hb levels were comparable to those in procedures without protamine use. After adjustment for aPTT, significant independent effects of protamine remained for the INR and PT. Dose-dependent effects of protamine were observed for reductions in aPTT and an increase in fibrinogen levels, which were confirmed after adjustment for the heparin dose. A 10% higher protamine dose resulted in a 3% decrease in aPTT and a 4% increase in fibrinogen. An increase of 0.1 in the protamine-to-heparin ratio was associated with an increase of 9% in fibrinogen. Conclusions: The present results suggest that protamine contributes to the normalization of the aPTT, INR, PT, and fibrinogen levels. Further prospective studies should be conducted to determine optimal dosing ratios. Full article

In this study, thin mouse kidney sections from healthy mice and those infected leading to acute and chronic sepsis were examined with two-photon excited fluorescence lifetime imaging (2P-FLIM) using the endogenous fluorescent coenzymes nicotinamide adenine dinucleotide (NADH) and flavin adenine dinucleotide (FAD). The results presented show that this approach is a powerful tool for investigating cell metabolism in thin tissue sections. An adapted measurement routine was established for these samples by performing a spectral scan, identifying a combination of two excitation wavelengths and two detection ranges suitable for detailed scan images of NADH and FAD. Selected positions in thin slices of the renal cortex of nine mice (three healthy, three with chronic sepsis, and three with acute sepsis) were studied using 2P-FLIM. In addition, overview images were obtained using two-photon excited fluorescence (2PEF) intensity. This study shows that healthy kidney slices differ considerably from those with acute sepsis with regard to their fluorescence lifetime signatures. The latter shows a difference in metabolism between the inner and outer cortex, indicating that outer cortical tubular cells switch their metabolism from oxidative phosphorylation to glycolysis in kidneys from mice with acute sepsis and back in later stages, as seen for mice with chronic infections. These findings suggest that 2P-FLIM could serve as a powerful tool for early-stage sepsis diagnosis and monitoring metabolic recovery during treatment. Full article

Sirtuins (SIRTs), nicotine adenine dinucleotide (+)-dependent histone deacetylases, have emerged as critical regulators in many signalling pathways involved in a wide range of biological processes. Currently, seven mammalian SIRTs have been characterized and are found across a number of cellular compartments. There has been considerable interest in the role of SIRTs in the brain due to their role in a plethora of metabolic- and age-related diseases, including their involvement in learning and memory function in physiological and pathophysiological conditions. Although cognitive function declines over the course of healthy ageing, neurological disorders including Alzheimer’s disease (AD) can be associated with progressive cognitive impairments. This review aimed to report and integrate recent advances in the understanding of the role of SIRTs in cognitive function and dysfunction in the context of AD. We have also reviewed the use of selective and/or natural SIRT activators as potential therapeutic agents and/or adjuvants for AD. Full article

The objectives of the study were to examine the effect of an antibiotic solution applied in the Streptomyces griseus protease method (SGPM) and the effect of carbohydrases in SGPM on the effective crude protein (CP) degradation (ED) with reference to in sacco ED. For this purpose, the ruminal CP degradation of rapeseed meal, dried distillers’ grains with solubles, wheat grain, corn grain, corn silage, grass silage and partial crop field pea silage was determined in sacco using three rumen-fistulated dairy cows and in vitro using SGPM. The impact of the antibiotic solution on CP degradation by S. griseus protease was investigated by supplementing SGPM with Penicillin–Streptomycin solution to reduce microbial mass proliferation during incubation. The carbohydrase α-amylase or Viscozym^® L (cell wall-degrading enzyme mixture) was added to the SGPM at four different doses simultaneously as a co-incubation to improve feed protein accessibility. For most feedstuffs, ED was lower when the antibiotic solution was used in SGPM (p < 0.05). The use of an antibiotic solution in the SGPM is recommended to standardize the SGPM. The in sacco ED values were significantly underestimated by the SGPM and by the SGPM with co-incubated carbohydrase (p < 0.05). Co-incubation of S. griseus protease and carbohydrase was not successful in reducing the differences to the in sacco CP degradation. Full article

Introduction: In South Africa over the past 20 years, immunisation has saved countless lives as well as prevented illnesses and disabilities. Despite this, vaccine-preventable illnesses remain a danger. The demand for and uptake of immunisation services are shaped by a variety of factors that can either act as barriers or facilitators to immunisation uptake. The aim of this project was to identify the supply and demand barriers and develop local strategies to improve childhood immunisation in four zero-dose districts in South Africa. Materials and Methods: This study used a mixed-method approach. In each of these four districts, 15 in-depth key informant interviews with health workers and local health managers and four focus group discussions (10 participants per focus group discussion) with community members and caregivers were held over a three-month period. Transcribed interviews were thematically analysed using qualitative analysis software (Nvivo^®) into 10 factors as identified as important in influencing immunisation demand and uptake in previous studies. A further four were identified during the data analysis process. Results: Despite the varying role of factors affecting demand and uptake of immunisation services, three consistent findings stand out as major barriers across all districts. The first is interaction with healthcare staff. This clearly highlights the crucial role that the interactions between patients and staff play in shaping perceptions and behaviours related to immunisation services. The second is the overall experience of care at healthcare facilities. This emphasises the role that patient experience of services plays in perceptions and behaviours related to immunisation services. The third is family dynamics. This highlights the important role family dynamics play in shaping individuals’ decisions regarding immunisation uptake as well as the impact it has on the ability of people to access health services. Discussion: The role played by the different factors in the demand and uptake of immunisation services varied across the four districts examined in this study. Each of the districts presents a unique landscape where different factors have varying degrees of importance in affecting the utilisation of immunisation services. In some districts, certain factors are major barriers, clearly hindering the demand and uptake of immunisation services, while in others, these same factors might be a relatively minor barrier. This discrepancy highlights the unique nature of healthcare challenges across the districts and the need for tailored strategy recommendations to address them effectively. Full article

GBM WHO CNS Grade 4 represents a major challenge for oncology due to its aggressive behavior. Conventional imaging has restrictions in detecting tumor recurrence. This prospective study aims to identify gene-based biomarkers in whole blood instead of isolating exosomes for the early detection of tumor recurrence. Blood samples (n = 33) were collected from seven GBM patients at time points before and after surgery as well as upon tumor recurrence. Four tumor tissue samples were assessed in parallel. Next-generation sequencing (NGS), including mRNA-seq and small RNA-seq, was used to analyze gene expression profiles in blood samples and tumor tissues. A novel filtering pipeline was invented to narrow down potential candidate genes. In total, between 6–93 mRNA and 1–19 small RNA candidates could be identified among the seven patients. The overlap of genes between the patients was minimal, indicating significant inter-individual variance among GBM patients. In summary, this prospective study supports the applicability of gene expression measurements in whole blood for the detection of tumor recurrence. It might provide an alternative to the challenging workflow of liquid biopsy after laborious exosome isolation from whole blood. Full article

Rectal cancer typically necessitates a combination of radiotherapy (RT), chemotherapy, and surgery. The associated functional disorders and reduction in quality of life have led to an increasing interest in organ preservation strategies. Response strongly correlates with RT dose, but dose escalation with external beam remains limited even with modern external beam RT techniques because of toxicity of the surrounding tissues. This study reports on the use of Papillon, an endocavitary Radiotherapy device, in the treatment of rectal cancer. The device delivers low energy X-rays, allowing for safe dose escalation and better complete response rate. Between January 2015 and February 2024, 24 rectal cancer patients were treated with the addition of a boost delivered by Papillon to standard RT, with or without chemotherapy, in an upfront organ preservation strategy. After a median follow-up (FU) of 43 months, the organ preservation rate was 96% (23/24), and the local relapse rate was 8% (2/24). None of our patients developed grade 3 or more toxicities. Our results demonstrate that the addition of Papillon contact RT provides a high rate of local remission with sustained long-term organ preservation, offering a promising alternative to traditional surgical approaches in patients with rectal cancer. Full article

So far, the cellular origin of glioblastoma (GBM) needs to be determined, with prevalent theories suggesting emergence from transformed endogenous stem cells. Adult neurogenesis primarily occurs in two brain regions: the subventricular zone (SVZ) and the subgranular zone (SGZ) of the hippocampal dentate gyrus. Whether the proximity of GBM to these neurogenic niches affects patient outcome remains uncertain. Previous studies often rely on subjective assessments, limiting the reliability of those results. In this study, we assessed the impact of GBM’s relationship with the cortex, SVZ and SGZ on clinical variables using fully automated segmentation methods. In 177 glioblastoma patients, we calculated optimal cutpoints of minimal distances to the SVZ and SGZ to distinguish poor from favorable survival. The impact of tumor contact with neurogenic zones on clinical parameters, such as overall survival, multifocality, MGMT promotor methylation, Ki-67 and KPS score was also examined by multivariable regression analysis, chi-square test and Mann–Whitney-U. The analysis confirmed shorter survival in tumors contacting the SVZ with an optimal cutpoint of 14 mm distance to the SVZ, separating poor from more favorable survival. In contrast, tumor contact with the SGZ did not negatively affect survival. We did not find significant correlations with multifocality or MGMT promotor methylation in tumors contacting the SVZ, as previous studies discussed. These findings suggest that the spatial relationship between GBM and neurogenic niches needs to be assessed differently. Objective measurements disprove prior assumptions, warranting further research on this topic. Full article