Search Results (107)

Instructional leadership is crucial for improving teaching quality and student academic performance, especially in secondary schools where Heads of Department (HoDs) play a vital role. Despite this, there is no empirical evidence on how Science HoDs provide instructional leadership in Lesotho. This study looked at the self-reported instructional leadership techniques of Science HoDs in Lesotho secondary schools and whether they vary based on specific demographic and workload criteria. Using a quantitative descriptive survey approach, data were obtained from 67 Science HoDs using a paper-based questionnaire adapted from the Principal Instructional Management Rating Scale (PIMRS). Descriptive statistics and inferential analysis were employed (t-tests and ANOVA). The data indicate that Science HoDs frequently used tactics such as goal planning and communication, curriculum coordination, learner progress monitoring, teaching time management, and instructional resource availability. However, high-impact pedagogical approaches, such as classroom observation, formal written feedback, and systematic evaluation of teacher learning, were less frequently implemented. Except for the number of courses taught, instructional leadership strategies showed no significant differences by age, gender, qualification, experience, teaching load, or school location. The study reveals a preference for administrative rather than pedagogical instructional leadership, highlighting the need for targeted professional development and policy support to improve HoDs’ capacity for sustained instructional practices in science education. Full article

Introduction: Early detection and timely treatment (Tx) initiation are critical to improving lung cancer (LC) outcomes. This study assessed the natural language processing (NLP)-assisted incidental pulmonary nodule (IPN) evaluation program, which employs chest computer tomography (CT) report analysis as an LC diagnostic screening (LCS) tool to identify suspicious lung findings (SLF) necessitating further investigation, and evaluated its impact on prognosis and diagnostic work-up and Tx timelines for patients with LC. Materials and Methods: Consecutive LC patients (n = 200) diagnosed at Assuta Medical Centers (AMC) between January 2019 and December 2022 were retrieved from the AMC electronic database using the MDClone big data platform, and divided into two groups: group A (NLP-assisted IPN evaluation, n = 100) and group B (traditional referral for evaluation of SLF by the community physician, n = 100). Stage at diagnosis, different diagnostic work-up and Tx timelines, and overall survival (OS) were assessed. Results: The NLP-assisted IPN evaluation program led to a significant stage shift (stage I disease: 48% vs. 27% in groups A and B, respectively, p = 0.013). Although the time from imaging to Tx initiation was similar (2.1 ± 5.3 months vs. 2.6 ± 5.9 months in groups A and B, respectively, p = 0.654), the time to systemic Tx (p = 0.035) and the time to radiotherapy (p = 0.044) were significantly shorter in group A. Conclusions: Implementing an NLP-assisted IPN evaluation program may enable earlier LC detection, driving a stage shift towards earlier diagnosis, improved diagnostic efficiency, and expedited time-critical interventions. Full article

Background/Objectives: While triptans remain the standard of care for moderate-to-severe migraine, the high discontinuation rates and remarkably low prescribing rates of triptans reflect suboptimal therapeutic optimization. Methods: This retrospective cohort study utilized data from Maccabi Healthcare Services (MHS), the second-largest healthcare provider in Israel, spanning 10 years (2012–2022). We identified naïve triptan users aged 21 years or older and evaluated triptan initiation and discontinuation patterns. Median time to discontinuation was assessed using Kaplan-Meier curves. Results: Of 2.8 million MHS members, 91,619 (3.4%) individuals had at least one triptan dispensation or prescription during the study period, including 41,297 triptan-naïve patients who met the study criteria. The median age at triptan initiation was 38.4 years (interquartile range: 28.2–48.0), and 75.6% were female. Overall, the median time to discontinuation was 7.7 months (95% confidence interval: 7.1–8.4). Discontinuation occurred in 70% of the cohort, with approximately 74% of triptan users purchasing only a single triptan formulation throughout the study period. Subgroup analyses by age, sex, socioeconomic status, and anxiety/depression prevalence demonstrated consistent discontinuation patterns across demographic and clinical characteristics, with median time to discontinuation remaining under 12 months in nearly all subgroups. Annual median time to discontinuation consistently remained under 12 months throughout the study period while showing a significant decreasing trend. Conclusions: The low rates of triptan use and high discontinuation rates suggest a possible undertreatment of migraine in Israel. These results highlight the need for improved patient and physician education, and enhanced follow-up protocols. Full article

The hands-off detection (HOD) function plays a critical role in accurately identifying driver hand contact in advanced driver assistance systems (ADAS), thereby ensuring system reliability and safety compliance. Capacitive touch pads, which are extensively utilized for this purpose, are prone to various defects arising from their manufacturing process. These defects include pad friction, plating anomalies, pattern deformation, surface scratches, and press gaps. Despite their extensive utilization, a systematic methodology capable of detecting both surface-level and internal microstructural defects remains to be established. The present study proposes a capacitance defect detection algorithm grounded in charge quantity (Q) analysis. A dedicated main control board was developed, integrating signal amplification, analog-to-digital conversion, noise filtering, defect classification logic, and real-time visualization through a graphical user interface (GUI). The system was implemented on an operational automotive production line and validated through the inspection of over 240,000 capacitive touch pads under real-world manufacturing conditions. In this setting, the system successfully identified subtle defects that conventional visual inspection methods failed to detect. The proposed method addresses the limitations of traditional inspection techniques and introduces a structured approach to detecting complex defects in capacitive touch sensors. This research is of practical relevance in industrial settings and contributes a systematic framework for future advancements in HOD system reliability and quality assurance. Subsequent research endeavors will investigate the integration of artificial intelligence (AI) and machine learning techniques to facilitate predictive maintenance and intelligent defect management. Full article

Hepatic osteodystrophy (HOD) is a frequent complication of chronic liver disease, marked by impaired osteogenesis and elevated fracture risk, particularly under sustained alcohol exposure. Bone morphogenetic proteins (BMPs), which play a crucial role in maintaining bone homeostasis, are dysregulated in alcoholic liver disease. Specifically, decreased BMP2 and increased BMP13 have been linked to impaired osteogenesis and cartilage-like shifts in bone progenitors. A human in vitro system that recapitulates this hepatic BMP imbalance is needed to dissect mechanisms and identify targets. To address this, we established a long-term human three-dimensional liver–bone co-culture model that integrates hepatocytes (HepaRG), hepatic stellate cells (LX-2), and human umbilical vein endothelial cells (HUVECs) with bone scaffolds seeded with osteoblast precursors (SCP-1) and osteoclast precursors (THP-1). This study aimed to characterize the effects of chronic 50 mM alcohol exposure on hepatic fibrogenic activation and BMP ligand secretion, and to investigate the associated BMP-responsive signaling involved in bone cell lineage differentiation and functional activity. The results demonstrated alcohol-induced hepatic CYP2E1 activation and fibrogenic remodeling with EMT signatures, as well as a decrease in BMP2 and an increase in BMP13, without affecting BMP9. Liver-derived factors activated both canonical and non-canonical BMP signaling in bone progenitors, reduced osteoblast activity and mineralization, preserved osteoclast TRAP activity, and shifted the lineage toward chondrogenesis (SOX9↑, RUNX2↓). Notably, this BMP profile and skeletal phenotype reflect clinical observations in chronic liver disease, indicating that the model recapitulates key in vivo pathological features. This human liver micro-organoid co-culture reproduces alcohol-induced hepatic BMP dysregulation and downstream bone defects, offering an organoid-centric, microengineered platform for mechanistic studies and BMP-targeted therapeutic screening in HOD. Full article

Background: Autism Spectrum Disorder (ASD) necessitates enhanced therapeutic support, especially in rural areas. Individual therapeutic sessions are costly, presenting an economic burden on the family of the child with ASD, as well as on healthcare and educational systems. Therefore, the current investigation aimed to assess the feasibility of a new hybrid therapeutic model involving a combination of remote and in situ interventions, ecologically implemented. Methods: The following outcome measures were used to assess the program’s feasibility and preliminary outcomes. The Preschool Language Scales 5th Edition (PLS-5), the Test of Playfulness 4th edition (TOP-4), and individually tailored goals evaluated using the Goal Attainment Scale (GAS) and the Autism Spectrum Rating Scale (ASRS). The evaluated children with ASD (N = 25), age range of 39–76 months (Mean: 53.1 ± 11.9), were treated with the novel Hybrid Ecological Intervention (HEI) method, where each child received bimonthly frontal therapeutic sessions and bi-weekly remote therapeutic sessions by a health care professional (OT or ST), supported by four weekly frontal sessions by a technological support person supervised by healthcare professionals. Results: All qualitative scales presented were associated with improvements in all evaluated areas. Qualitative data mostly supported the HEI and ways to overcome existing challenges, supporting the use of both evaluation methods. Conclusions: The use of quantitative and qualitative data was found to be efficient and complementary to one another. The scales used (ASRS, GAS) were found to be useful tools for this method and for these participants. The HEI model was found to be associated with improvement in play, communication, social abilities, as well as autism severity. Full article

Capacitor-powered resonant inverters are often employed in pulsed-power applications to feed an equivalent series resistance–inductance–capacitance (RLC) load with time-varying component values. Establishing the short-time dynamics of such an arrangement is nontrivial since the system does not reach a steady state within a single pulse period. As a result, linearization around a single operation point cannot be applied for the sake of simplified system modeling. Consequently, the design of feedback controllers for such systems (aiming for, e.g., resonant frequency tracking or energy transfer rate regulation) is highly cumbersome and challenging since a linear time-invariant regulator is unable to bring the system to desired performance within the whole expected operation range. To cope with the modeling task, a reduced-order envelope model of a capacitor-fed resonant inverter feeding a time-varying RLC load was recently proposed by the authors. In this paper, this model is further simplified and split into linear and nonlinear parts, allowing the employment of a combination of feedback linearizing (nonlinear) action with a linear time-invariant regulator to form a nonlinear control structure allowing the attainment of resonant frequency tracking within a wide operation range. The proposed controller design methodology is accurately validated by multiple time-domain simulations. Full article

Background/Objectives: Major depressive disorder (MDD) is often characterized by mood instability and occupational imbalance, leading to impaired functioning and reduced quality of life. Despite increasing recognition of occupational therapy’s (OT’s) role in mental health, few interventions comprehensively describe both their development process and their theoretical rationale. This article aims to present the systematic development of the mood–occupation balance reciprocal model (MOBILE) intervention for people with MDD, guided by the Medical Research Council (MRC) framework for complex intervention. Methods: Development followed three phases: (1) identifying the evidence base, (2) developing theory, and (3) modeling processes and outcomes. Theoretical foundations integrated occupation- and mood/function-based models with client-centered, lived-experience perspectives. A preliminary ecological momentary assessment (EMA) study on mood and daily function interplay further informed the intervention development. Input from focus groups with occupational therapists and individuals with lived experiences supported its iterative refinement. Following MRC guidelines, a small pilot study (N = 2) was conducted with inpatients diagnosed with MDD to assess the feasibility and acceptability of the intervention and EMA procedures. The pilot evaluated recruitment, adherence, engagement, and practicality of delivery within a clinical setting. Results: The pilot study, although it included only two inpatients and thus limits generalizability, demonstrated high adherence, engagement, and feasibility. The EMA protocol was well tolerated, leading to minor refinements that enhanced its clinical applicability. Stakeholders emphasized the program’s relevance, adaptability, and the value of personalized planning tools. Conclusions: The MOBILE intervention is delivered as an individualized program to enhance mood stability and daily functioning among inpatients with MDD. It provides a theoretically grounded, context-sensitive framework integrating personalized goal setting and strategy use with the construction of a balanced routine. Implications: This article provides a comprehensive account of development procedures to support future evaluation, implementation, and integration into OT mental health practice. Full article

Background: Telemedicine has gained significance, especially during the COVID-19 pandemic, offering remote healthcare solutions. However, its adoption in geriatric medical centers (GMCs) remains limited. Understanding the factors influencing telemedicine acceptance among care teams in geriatric medical centers is crucial for successful implementation. Aim: This study examines behavioral factors influencing telemedicine adoption among care teams in Israeli geriatric medical centers through the lens of the Technology Acceptance Model. Methods: A cross-sectional study was conducted with 406 healthcare professionals from four geriatric medical centers in Israel. Participants completed a self-administered questionnaire measuring self-efficacy, subjective norms, anxiety, resistance to change, perceived usefulness, perceived ease of use, and intention to use telemedicine. Structural equation modeling was used to analyze the data. Results: Perceived ease of use mediated the associations between self-efficacy and perceived usefulness and between subjective norms and perceived usefulness, demonstrating how confidence shapes technology acceptance. Perceived usefulness mediated the association between perceived ease of use and intention to use. Perceived ease of use did not mediate the relationship between anxiety or resistance to technological changes and perceived usefulness. Conclusions: The study highlights the importance of perceived ease of use and usefulness in promoting telemedicine adoption among geriatric medical center care teams, emphasizing the need for targeted interventions to enhance these perceptions. Full article

With the global trend of population aging, human-centered development that integrates medical convenience with daily life quality has become a critical necessity. However, conceptual frameworks, evaluation methods, and spatial prototypes for such ‘healthcare–daily-life’ development remain limited. This study proposes Hospital-Oriented Development (HOD) as a framework to promote collaborative development by considering both hospital accessibility and urban development intensity, derived from multi-sourced urban data. First, a conceptual framework was established, consisting of three dimensions, i.e., network accessibility, facility completeness, and environmental comfort, which was then characterized by twelve indicators based on urban morphological features. Second, these indicators were quantitatively evaluated through detailed values measured among 20 exemplary hospitals in Shanghai selected via user-generated content. Finally, HOD performance and morphology informed the spatial prototype. The results reveal confidence intervals for each indicator and recommended spatial features. Numerically, there was a positive correlation between facility completeness and network accessibility, but a negative correlation with environmental comfort. Spatially, a context-specific HOD prototype for China was developed. This study proposes the concept of HOD, delivers quantitative measurements, and develops a spatial prototype via empirical research, providing theoretical insights and evidence to support the improvement in healthcare environments from a human-centered perspective. Full article

Introduction: Hypertrophic olivary degeneration (HOD) is a rare form of trans-synaptic degeneration involving the Guillain–Mollaret triangle, characterized by enlargement of the inferior olivary nucleus—unlike the atrophy typical of most neurodegenerative processes. It is usually associated with stroke, surgical injury, or demyelination, but rarely follows hemorrhage from a cavernous malformation (CM). This report presents a case of HOD secondary to a mesencephalic CM hemorrhage, with emphasis on imaging findings and diagnostic considerations. Case Description: A 55-year-old woman presented with acute-onset, right-sided facial, torso, and limb hypoesthesia, along with gait instability. Neurological examination revealed sensory impairment in the right maxillary (V2) and mandibular (V3) trigeminal territories, as well as diminished pain and temperature sensation throughout the right hemibody. MRI revealed a hemorrhage in the posterior mesencephalon near the left red nucleus, leading to the diagnosis of a CM with an associated venous angioma. She was managed conservatively and improved clinically. Six months later, MRI showed hypertrophy and T2/FLAIR hyperintensity of the left inferior olive, consistent with developing HOD. At 1.5 years follow-up, olivary enlargement had progressed—now consistent with stage 2 HOD—and a bilateral palatal tremor was observed, more pronounced on the right side. DTI revealed asymmetric volume loss in the left brainstem fiber pathways at the level of the medulla oblongata, confirming trans-synaptic degeneration. Conclusions: This case highlights HOD as a rare but important complication of mesencephalic CM hemorrhage. Recognition of its characteristic imaging features—olivary hypertrophy with persistent T2/FLAIR hyperintensity—is essential for accurate diagnosis. DTI supports the trans-synaptic mechanism, helping distinguish HOD from other pathologies and preventing unnecessary investigations. Full article

Severe COVID-19 disproportionately impacts patients with comorbidities such as type 1 diabetes (T1D), type 2 diabetes (T2D), obesity (OBCD), cardiovascular disease (CVD), hypertension (HTN), and cerebrovascular disease (CeVD), affecting 10–30% of cases. This study elucidates shared molecular mechanisms by identifying common hub genes and genetic variants across these conditions using an integrative bioinformatics approach. We curated 5463 COVID-19-related genes from DisGeNET, GeneCards, T-HOD, and other databases, comparing them with gene sets for T1D (324 genes), T2D (497), OBCD (835), CVD (1756), HTN (837), and CeVD (1421). Functional similarity analysis via ToppGene, hub gene prediction with cytoHubba, and Cytoscape-based protein–protein interaction networks identified four hub genes—CCL2, IL6, IL10, and TLR4—consistently shared across all conditions (p < 1.0 × 10⁻⁵). Enrichr-based gene ontology and KEGG analyses revealed cytokine signaling and inflammation as key drivers of COVID-19 cytokine storms. Polymorphisms like IL6 rs1800795 and TLR4 rs4986790 contribute to immune dysregulation, consistent with previous genomic studies. These genes suggest therapeutic targets, such as tocilizumab for IL6-driven inflammation. While computational, requiring biochemical validation, this study illuminates shared pathways, advancing prospects for precision medicine and multi-omics research in high-risk COVID-19 populations. Full article

The research reviews and contrasts two studies based on the gas-phase reaction OH + D₂(v, j). In these studies, Quasi-Classical Trajectory (QCT) calculations and the Gaussian Binning (GB) technique were used on the Wu–Schatz–Lendvay–Fang–Harding (WSLFH) potential energy surface. Large sample sizes allow for precise energy state distribution analysis across translational, vibrational, and rotational components in the products. A key observation is the influence of the vibrational and rotational excitation of D₂ on the total angular momentum (J′) of the HOD* product. This study reveals that increasing the vibrational level, vD₂, significantly shifts P(J′) distributions toward higher values, broadening them due to increased isotropy. In contrast, increasing the rotational level, jD₂, results in a smaller shift but introduces greater anisotropy, leading to a more selective distribution of J′ values. The dual Gaussian Binning selection—Vibrational-GB followed by Rotational-GB—further highlights a preference for either odd or even J′ values, depending on the specific excitation conditions. These findings have implications for the development of chemical lasers, as the excitation and emission properties of HOD* can be leveraged in the laser design. Future research aims to extend this study to a broader range of initial conditions, refining the understanding of reaction dynamics in controlled gas-phase environments. Full article

De novo metastatic breast cancer (dnMBC) accounts for 3–10% of newly diagnosed cases, with 20–40% presenting as a bone-only metastatic disease, which can achieve survival outcomes exceeding 10 years with multimodal therapy. However, the role of multimodal therapy remains controversial in the guidelines. Objective: This study aims to identify dnBOMBC subgroups to develop a pragmatic staging system for guiding locoregional therapy decisions. Materials and Methods: Data from the MF07-01 phase III randomized trial (2021, median follow-up time (mFT): 40 months (range 1–131)) and the BOMET prospective multi-institutional registry trial (2021, mFT: 34 months (range 25–45)) were combined for analysis, including only patients who presented with bone-only metastases. Exclusion criteria were patients under 18 and those with a history of prior cancer or cancer metastases. Patients with missing data and positive surgical margins were excluded. Out of 770 patients, 589 were included. Survival analyses were first conducted according to molecular subgroups, after which patients were further stratified by hormone receptor status, human epidermal human epidermal growth factor receptor 2 (HER2) status, tumor grade, and clinical T (cT) stage. Group A (GrA) included hormone receptor (HR)-positive, low- or intermediate-grade tumors at any cT; HR-positive, high-grade tumors with cT0–3; or any HER2-positive tumors. Group B (GrB) included HR-positive, high-grade tumors with cT4 disease or any triple-negative (TN) tumors. Results: The hazard of death (HoD) was 43% lower in GrA than in GrB. Median OS was 65 months (39–104) for GrA patients and 44 months (28–72) for GrB patients (HR 0.57, 95% CI 0.41–0.78, p = 0.0003). Primary tumor surgery (PTS) significantly improved OS in GrA patients, regardless of the number of metastases (solitary: HR, 0.375, 95% CI 0.259–0.543, p < 0.001; multiple: HR 0.435, 95% CI 0.334–0.615, p < 0.001). Conversely, GrB patients did not experience a significant benefit from PTS. Conclusions: This study demonstrates that GrA patients have better OS than GrB patients, and PTS reduces the HoD in GrA patients compared to systemic therapy alone. These findings support using a modified staging system in dnBOBMC to identify patients who may benefit from multimodal therapy including PTS. Full article

The anticancer activity of 3′-deoxyadenosine (Cordycepin, or dCor) is known to be linked to the inhibition of the MAPK/ERK signalling and Hedgehog pathways, as well as the termination of primer elongation by primase in DNA lagging-strand synthesis. In this study, the electronic properties of dCor, 7,8-dihydro-8-oxo-3′-deoxyadenosine (^OXOdCor), and 8-hydroxy-3′deoxyadenosie (^HOdCor), together with their spin densities, charge distributions, and global reactive descriptors, have been taken into consideration at the M06-2x/6-31++G** level of theory in the aqueous phase. It was found that dCor predominantly adopts a 3′-endo,anti conformation, while ^OXOdCor and ^HOdCor adopt a 2′-endo,syn conformation. Also, the keto form of oxidised dCor was found to be energetically preferred to its enolic form. The adiabatic ionisation potentials (AIPs) were noted as follows (in eV): 6.29 for dCor, 6.21 for ^OXOdCor, and 6.17 for ^HOdCor. The lowest adiabatic electron affinity among all the discussed adenine nucleosides analogues was assigned for ^OXOdCor at 1.12 eV. A thorough analysis of the spin density distribution of the adiabatic radical cation reveals that it has a higher accumulation at N6 > C5 > C8 > 3 of dCor, C5 > N6 > N7 > O8 of ^OXOdCor, and N6 > C5 > C8 > C2 of ^HOdCor. The results suggest that Cordycepin is more easily converted to ^OXOdCor and ^HOdCor than canonical adenine nucleosides. Much like typical drugs, after its administration and release, Cordycepin is exposed to various physiological factors and can be exposed to ionisation radiation during combined therapy. These factors can influence the therapeutic potential of Cordycepin. Therefore, further studies on its stability are of utmost importance. Full article