Search Results (1,038)

Antibiotics play a crucial role in the treatment of many complicated problems in clinical medicine, but antimicrobial resistance (AMR) has emerged as a serious concern threatening to undermine its effectiveness. Precision medicine (PM) which tailors treatment to individual and genetic and lifestyle factors, may offer a novel approach to combat AMR. Yet, little is known about how healthcare providers in Pakistan understand and integrate the concept of precision medicine within their knowledge, attitudes, and practices (KAP) towards AMR. This study aims to investigate the knowledge, attitude, and practices of healthcare professionals towards AMR and to explore their perception about precision medicine as a strategy to reduce AMR. A mixed method approach was employed for the study. The knowledge, attitude, and practices (KAP) of healthcare professionals (N = 326) were assessed through a validated questionnaire. SPSS version 26 (Statistical Package for the Social Sciences) was employed for descriptive and bivariate analyses to determine KAP score and its association with demographics. Qualitative data were gathered through a focus group discussion and thematic analysis was performed to explore the perception about PM. Results showed that healthcare professionals demonstrate poor knowledge (55.5%), relatively positive attitudes (54.6%), and that nearly half had unfavorable practices (48.3%). Significant associations (p < 0.05) were found between KAP scores and factors such as location, healthcare setting, educational level, professional designation, and prior infectious disease training. During focus group discussion (FGD), HCPs emphasized the cautious use of PM, particularly in the management of resistant infections. However, limitations in resources, poor governance, poverty, and access to data and testing facilities were highlighted as barriers in the implementation of PM into practice. This study highlights critical gaps in knowledge and practices towards AMR among HCPs. While PM is viewed as a potential tool against AMR, systemic support, resource allocation, and targeted awareness programs are essential to integrate PM into clinical practice. Full article

Background/Objectives: Metabolic syndrome (MetS) and even closely related metabolic and anthropometric alterations require timely intervention to reduce associated risks. Neo-Policaptil^® Gel Retard has shown potential in managing both established MetS and early imbalances. To further characterize its real-world impact, a large post-marketing survey was conducted to assess perceived effectiveness, safety, quality of life (QoL), and patterns of use. Methods: Between December 2021 and May 2025, patients/child caregivers, pharmacists, and physicians completed online questionnaires via a dedicated web platform. Patients reported their direct experience, while healthcare professionals (HCPs) provided observations on patient use. Results: The survey included 2204 patients, 57 child caregivers, 455 physicians, and 387 pharmacists. Overall, 97.7% of patients reported an improvement in their condition. Most physicians (94.3%) and pharmacists (89.1%) rated the overall effectiveness of the product as “good” or “excellent”. The safety profile was judged “good” or “excellent” by 84.4% of patients and by over 93% of HCPs. The product was mainly used as monotherapy or in combination with dietary measures and/or physical exercise. Conclusions: These findings underscore the product’s effectiveness, safety, tolerability, and positive influence on QoL in both adults and children affected by MetS or by related metabolic and anthropometric imbalances. Full article

This study examines the relationship between bond strength degradation in corroded reinforced concrete and Half-Cell Potential (HCP) measurements through a combined experimental and numerical approach. Fifty-four concrete specimens reinforced with D19 and D22 rebars underwent impressed-current corrosion to induce specific levels of mass loss. The experimental results showed a progressive reduction in bond strength with increasing corrosion; at approximately 20% mass loss, D19 specimens exhibited up to ~45% reduction, while D22 specimens showed a reduction in ~30%. Correspondingly, HCP values became more negative as corrosion intensified, shifting from around −200 mV at 0% corrosion to values below −900 mV at higher corrosion levels. Although HCP effectively reflected corrosion severity, it did not correlate linearly with bond strength degradation. Numerical simulations performed using COMSOL Multiphysics reproduced the observed electrochemical trends, demonstrating increasingly negative potential distributions with higher corrosion current densities. The findings confirm that HCP is a reliable indicator of corrosion activity but has limited predictive capacity for bond strength loss. This work contributes quantitative insight into the electrochemical–mechanical relationship in corroded reinforced concrete and supports the development of improved assessment frameworks for early maintenance and structural integrity evaluation. Full article

Ti-6Al-4V (TC4) alloy is widely used in aerospace and biomedical applications due to its excellent strength-to-weight ratio and corrosion resistance. Its plastic deformation behavior is strongly influenced by its microstructural characteristics, particularly grain size. In this study, a crystal plasticity model incorporating a Hall–Petch relationship was developed to simulate the plastic deformation of TC4, with explicit consideration of the effect of grain size on slip resistance. The model employs a thermally activated flow rule to describe the kinetics of slip systems, enabling accurate prediction of flow stress and strain hardening across different microstructural conditions. The model is calibrated and validated using experimental stress–strain data from uniaxial tensile tests on specimens with varying grain sizes. Simulation results demonstrate that the model successfully captures the grain-size-strengthening effect and predicts the corresponding evolution of local strain heterogeneity. Furthermore, a critical local equivalent plastic strain criterion was established, which effectively predicts the dependence of macroscopic failure strain on grain size. This work provides a physically based computational tool for optimizing TC4 processing parameters and predicting deformation under service conditions. Full article

Alpha-gal syndrome (AGS) is an emerging, relatively newly recognized allergic disorder with clinical manifestations that occur as a result of hypersensitivity reactions to oligosaccharide galactose-α-1,3-galactose (α-gal), a carbohydrate present in lower-mammalian meat, dairy products, and some biopharmaceutical products. These reactions are delayed with oral ingestion of the antigen but can be immediate with intravascular or other parenteral antigenic exposure. Over the past 15 years, many revelations have occurred in the realm of AGS. However, there is still a huge unmet need related to its pathophysiology, diagnostics, timely recognition, and management. This article is geared towards providing a review of AGS for healthcare providers (HCPs) from all realms of medicine. It is a universal challenge, with cases being recognized from various parts of the world. Hence, it is critically important for HCPs planet-wide to pay heed to the prompt recognition of AGS and educate their patients. This can prevent morbidity as well as potentially fatal complications like severe anaphylaxis. It is a narrative clinical review. The PubMed database was searched from 2009 to 2025. Alpha-gal syndrome and related topics were included in the search engine. Full article

Background: Vaccination remains one of the most effective public health interventions, yet hesitancy persists even among healthcare students who aid in promoting immunization. Understanding students’ perspective plays a crucial role in designing targeted educational interventions. The purpose of this study was to evaluate knowledge, attitude, and practices of healthcare students (HSCs) in Kuwait about vaccines. Methods: A quantitative, cross-sectional study was conducted between August and October 2024. A validated 21-item questionnaire was used to assess vaccine-related knowledge, attitude, and practices, along with demographic data. Descriptive statistics and binary logistic regression were used to identify predictors of higher knowledge and positive attitude. Results: A total of 351 students participated (mean age 23.0 ± 2.4 years; 90.6% female). The mean knowledge score was 3.9/7 (55.7%), indicating moderate knowledge, with misconceptions noted regarding benefits of post-infection vaccination and extra vaccine doses. The mean attitude score was 3.6/6 (60%), indicating moderately positive attitude, yet safety concerns, particularly about long-term effect, were common (59.3%). Nearly half (45.9%) delayed vaccination until mandatory. Vaccine uptake was highest for COVID-19 (92.3%), followed by hepatitis B (73.8%). Older age, male gender, and being a medical student predicted higher knowledge (p = 0.011), while older age and being in later study years predicted more positive attitude (p = 0.032). Conclusions: HSCs demonstrated moderate knowledge and attitude toward vaccines, with significant hesitancy driven by safety concerns despite high eventual uptake. Early targeted curricular interventions addressing vaccine safety evidence, benefits of timely immunization, and professional responsibility are warranted to improve confidence and proactive vaccine acceptance among future healthcare professionals (HCPs). Full article

Half-cell potential (HCP) measurement is widely applied as a non-destructive technique for assessing corrosion probability, yet its diagnostic capacity remains limited to probabilistic interpretations rather than quantifying the extent of steel mass loss. Conventional HCP measurements can indicate corrosion probability, but not the actual extent of deterioration. The objective of this study is to examine the potential of HCP measurements to indicate actual corrosion severity by numerically simulating HCP values and correlating them with steel mass loss data. Using published experimental datasets, relationships among corrosion current density (J₍corr₎), electrical resistivity (ER), HCP, and steel mass loss (m_L) were established through regression analysis, while COMSOL Multiphysics v6.2 was employed to simulate HCP responses. The simulations revealed increasingly negative HCP values with higher J₍corr₎ and conductivity. A second-order polynomial correlation (R² = 0.9999) was obtained between simulated HCP and measured mass loss (0–20%), enabling quantitative interpretation of corrosion severity, demonstrating that HCP can serve as a predictive indicator of corrosion severity. It is demonstrated that the interpretative value of HCP has potential for quantifying corrosion severity to improve monitoring and maintenance strategies. Full article

Metals with a hexagonal close-packed (HCP) structure such as magnesium, titanium and zirconium constitute key structural materials in the aerospace, automotive, biomedical and nuclear energy industries. Their welding and regeneration by conventional methods is hindered due to the limited number of slip systems, high reactivity and susceptibility to the formation of defects. Laser technologies offer precise energy control, minimization of the heat-affected zone and the possibility of producing joints and coatings of high quality. This article constitutes a comprehensive review of the state of knowledge concerning laser welding, cladding and regeneration of HCP metals. The physical mechanisms of laser beam interactions are discussed including the dynamics of the keyhole channel, Marangoni flows and the formation of gas defects. The characteristics of the microstructure of joints are presented including the formation of α′ martensite in titanium, phase segregation in magnesium and hydride formation in zirconium. Particular attention is devoted to residual stresses, techniques of cladding protective coatings for nuclear energy with Accident Tolerant Fuel (ATF) and advanced numerical modeling using artificial intelligence. The perspectives for the development of technology are indicated including the concept of the digital twin and intelligent real-time process control systems. Full article

Background/Objectives: This randomized, single-blinded trial compared the effects of Kinesio taping (KT) and rigid taping (RT) on gross motor function, balance, and functional capacity in children with hemiplegic cerebral palsy (HCP). Methods: Fifty-two children (aged 7–16) were assessed using the Gross Motor Function Measure (GMFM), Pediatric Berg Balance Scale (PBBS), Time-Up-and-Go (TUG), and 2-Minute Walk Test (2-MWT). Results: Both KT and RT produced significant intra-group improvements in GMFM, PBBS, TUG, and 2-MWT scores (p ≤ 0.001). Although nonparametric analysis suggested greater changes for KT in TUG and 2-MWT (p < 0.001; p = 0.036), no significant inter-group differences were found when baseline scores were adjusted using the General Linear Model (GLM) (2-MWT: p = 0.29; TUG: p = 0.087). Conclusions: KT and RT are similarly effective adjuncts to physiotherapy, improving gross motor function, balance, and functional capacity in children with HCP. Therefore, the choice between KT and RT may be guided by clinical preference, child tolerance, and therapeutic goals rather than superiority of effect. Full article

Background/Objectives: COPD is a leading cause of death in the US, with higher morbidity and mortality in rural areas that lack specialized pulmonary care. Mobile health (mHealth) tools, including remote spirometry, may fill this gap, yet healthcare provider (HCP) perspectives on utility and implementation of remote spirometry and mHealth for COPD management in these settings remain unexplored. This study aimed to examine HCPs’ perspectives of mHealth with remote spirometry to inform future implementation in rural and low medical access settings. Methods: Five HCPs working in rural or medically limited settings in South Carolina participated in a deliberative discussion focus group. A semi-structured interview guide was used to explore insights into feasibility, clinical utility, and implementation needs. Transcripts were analyzed using thematic analysis to identify facilitators, barriers, and implementation considerations. Results: Participants reported that remote spirometry and mHealth had potential to support COPD treatment, increase healthcare access, and support self-management. Key facilitators identified were access to smartphones, potential for individualized COPD care, and visual tools for patient engagement. Barriers included risk of time and workload burden, data information overload, and technological limitations. Participants emphasized the need for team training, thoughtful integration into existing workflows, customizable data displays, and robust support for patient onboarding. Conclusions: Providers viewed mHealth applications with remote spirometry as a valuable tool with potential to improve COPD care but identified critical implementation needs. Participants emphasized that successful integration would require structured support, user-centered design, and attention to reimbursement and workflow alignment to enhance sustainability and patient/provider engagement. Full article

This study aimed to assess the prevalence and reporting rate of adverse events following immunization (AEFIs) among healthcare professionals (HCPs) and students of health-related disciplines after COVID-19 vaccination. It was conducted at the beginning of the vaccination campaign in Poland (February 2021), when vaccines were only available to limited groups of recipients, mainly those related to healthcare. Questionnaires were distributed among HCPs in the Pomeranian voivodeship (N = 1063) and students at the Medical University of Gdańsk (N = 1506). The primary objective was to compare respondents’ self-reported AEFI notifications with official reports published by the National Sanitary Inspectorate. A total of 240 participants declared having reported at least one AEFI, whereas official reports from the same period indicated that only 194 individuals had reported AEFIs in the entire voivodeship. This translates into significant differences in notification rates (14.9% and 0.09%, respectively). A detailed breakdown into local and systemic AEFIs also revealed significant discrepancies with official reports (850 vs. 329 and 1137 vs. 46, respectively). The most common reasons for not reporting were managing the symptoms on one’s own and perceiving the symptoms as not severe enough to report. Underreporting of AEFIs is an issue that requires attention from both the scientific community and public health authorities, as it may hinder reliable vaccine safety assessment and contribute to increased vaccine hesitancy. Full article

Aiming at the drawbacks of the classic CoCrFeNi high-entropy alloy (HEA)—low room-temperature strength and softening above 600 °C, which fail to meet strict material requirements in high-end fields like aerospace—this study used the vacuum hot-pressing sintering process to prepare CoCrFeNiTa_x HEAs (x = 0, 0.5, 1.0, 1.5, 2.0 atom, designated as H4, Ta_0.5, Ta_1.0, Ta_1.5, Ta_2.0, respectively). This process effectively inhibits Ta segregation (a key issue in casting) and facilitates the presence uniform microstructures with relative density ≥ 96%, while this study systematically investigates a broader Ta content range (x = 0–2.0 atom) to quantify phase–property evolution, differing from prior works focusing on limited Ta content or casting/spark plasma sintering (SPS). Via X-ray diffraction (XRD), scanning electron microscopy–energy-dispersive spectroscopy (SEM-EDS), microhardness testing, and room-temperature compression experiments, Ta’s regulatory effect on the alloy’s microstructure and mechanical properties was systematically explored. Results show all alloys have a relative density ≥ 96%, verifying the preparation process’s effectiveness. H4 exhibits a single face-centered cubic (FCC) phase. Ta addition transforms it into a “FCC + hexagonal close-packed (HCP) Laves phase” dual-phase system. Mechanically, the alloy’s inner hardness (reflecting the intrinsic property of the material) increases from 280 HV to 1080 HV, the yield strength from 760 MPa to 1750 MPa, and maximum fracture strength reaches 2280 MPa, while plasticity drops to 12%. Its strengthening mainly comes from the combined action of Ta’s solid-solution strengthening (via lattice distortion hindering dislocation motion) and the Laves phase’s second-phase strengthening (further inhibiting dislocation slip). Full article

Metaverse safety training (MST) is popular in highway construction projects (HCPs). While researchers have statically examined the influence of MST, one of the essential gaps is that the interaction among stakeholders on how to improve MST effect is neglected. This paper adopts a game theory approach to illustrate the dynamics among stakeholders, namely, contractors, subcontractors, and construction crews, regarding MST within the framework of HCPs. A tripartite evolutionary game model is developed to analyze the interaction among contractors, subcontractors, and construction crews. The evolutionary stability of the stakeholders’ strategies and the equilibrium point were elucidated by solving the proposed model. A numerical simulation was conducted to validate the rationality of the results. The results show that the choice of behavioral strategies and their evolutionary paths for each stakeholder are closely related to the behavioral strategies of other stakeholders in the game, with significant differences in effects on each other’s initial strategies. The incentive mechanism must match the incentive measures provided to subcontractors and construction crews, ensuring a stable MST. The reward and penalty system implemented by contractors heightens the awareness of subcontractors and construction crews partly. This model provides practical recommendations to enhance training interactions, optimize strategies, increase security awareness, and streamline resource allocation. Full article

Background: Although progress has been made, substantial barriers exist in the development and implementation of pediatric palliative care (PPC) in mainland China, Hong Kong, and Taiwan. Possible explanations include the idea that cultural taboos erect barriers that short-circuit PPC discussions among stakeholders, and secondly, regional guidelines intended to support PPC fail to do so effectively. Here, we aimed to identify and document the scope of barriers to and facilitators of PPC practices in these regions and to explore to what extent and how regional PPC guidelines address these barriers/facilitators. Methods: We identified and compared two kinds of documents: (1) recent journal articles reporting on empirical studies of barriers to/facilitators of PPC practices in mainland China, Hong Kong, or Taiwan and (2) published PPC regional guidelines from the three regions. International and regional databases were searched to identify articles, along with PPC professional organizations in the three regions to identify PPC guidelines. Inductive content analysis was used for data analysis, synthesis, and document comparison. Results: Seventeen relevant articles on PPC barriers/facilitators and 16 documents with PPC guidelines were identified. Barriers/facilitators were reported on three organizational levels: micro, meso, and macro levels. Micro refers to children and parents, meso to medical institutions and healthcare providers (HCPs), and macro to policy/guidelines and networks. Most barriers were addressed by PPC guidelines, and most facilitators were acknowledged and endorsed in the guidelines. For instance, HCPs reported that insufficient PPC-related knowledge among stakeholders was a barrier, while PPC guidelines provided detailed information to address this shortfall. Unaddressed barriers in the guidelines were also uncovered, such as the cultural taboo of discussing death, suggesting that HCPs often struggled to have effective PPC conversations with parents and the child. Conclusions: Our finding that PPC guidelines addressed most barriers/facilitators while HCPs still struggled with implementing PPC indicates that mature PPC guidelines are necessary but not sufficient for PPC practices to improve in these three regions. The wide availability of PPC guidelines and PPC education/training for HCPs and families needs to improve. Full article

Atomically precise control of metal adatoms on metal surfaces is critical for designing novel low-dimensional materials, and the Sn-Cu(111) system is of particular interest due to the potential of stanene in topological physics. However, conflicting reports on Sn-induced superstructures on Cu(111) highlight the need for clarifying their geometric and electronic properties at low temperatures. We employed scanning tunneling microscopy (STM), low-energy electron diffraction (LEED), angle-resolved photoemission spectroscopy (ARPES), and density functional theory (DFT) to investigate submonolayer (<0.25 ML) Sn adsorption on Cu(111) at 100 K. We confirmed a p(2 × 2) Sn/Cu(111) superstructure with one Sn atom per unit cell and found that Sn preferentially occupies three-fold hcp sites. ARPES measurements of the band structure—including a ~0.3 eV local gap between two specific bands at the ${\overline{\Gamma }}_2$ point in a metallic overall electronic structure—were in good agreement with the DFT results. Notably, the STM-observed p(2 × 2) morphology differs from the honeycomb-like or buckled stanene structures reported on Cu(111), which highlights the intricate interactions between adatoms and the substrate. Full article