Search Results (471)

Manikin-based simulation is widely used in undergraduate medical education to develop clinical reasoning and communication skills. The Borich Needs Assessment Model has been applied in fields such as nursing and global health to identify gaps between perceived importance and performance, but it has not been used to evaluate simulation-based learning in undergraduate medical education. We applied the Borich model to assess student perceptions of competencies developed in an established simulation curriculum and to inform future simulation curriculum development. A cross-sectional survey was administered to first-, second-, and fourth-year medical students at the University of Hawaii John A. Burns School of Medicine. Students rated eight SNAP competencies for importance, self-reported performance, and perceived influence of simulation. Weighted discrepancy scores were calculated using the Borich model. Faculty completed a parallel survey to compare competency prioritization. Among 164 student respondents, all competencies were rated as highly important. The greatest performance and influence gaps were reported for “Apply knowledge covered in the unit or rotation to simulation cases” (MWDS = 1.37 and 1.61, respectively). Priorities varied by student year, and agreement between faculty and student rankings was limited. The findings highlight a perceived gap between simulation curriculum and knowledge application. The Borich model effectively identified performance gaps and can support targeted simulation curriculum refinement. Full article

Background: This single-center, retrospective, non-randomized observational study aims to explore the outcomes of video-assisted thoracoscopic surgery (VATS) wedge resection using the traditional clamp-and-suture technique versus staplers, with a focus on cost-effectiveness, operative time, and short-term postoperative outcomes. Methods: Data from 59 patients who underwent VATS wedge resection between 2018 and 2024 were retrospectively analyzed. Patients were divided into the stapler group (S-group, n = 27) and the clamp-and-suture group (C-group, n = 32). Technique selection was made intraoperatively by the surgeon based on lesion characteristics. Co-primary outcomes were total hospitalization cost and air leak duration > 2 days. Secondary outcomes included drainage time, complications, and hospital stay. The researchers conducted multivariable regression and sensitivity analyses to handle selection bias and confounding variables. Statistical analyses were performed with a significance level of p < 0.05. This study was approved by the Tekirdağ University Faculty of Medicine Ethics Committee (Approval No: 2024.22.02.06). Results: The C-group lesions showed proximity to the pleural surface at 5 mm compared to 8 mm (p = 0.048), indicating significant selection bias. Operation time was longer in the C-group (70 vs. 60 min, p = 0.115). Air leak duration and drainage time were similar between groups (p = 0.872, p = 0.176). Complication rates classified by Clavien–Dindo scale and hospital stay were comparable. The C-group showed reduced hospitalization expenses ($191.6 vs. $371.7) after adjusting for lesion characteristics and confounders while the clinical results between groups remained equivalent (adjusted OR for air leak: 0.68, 95% CI: 0.13–3.51, p = 0.645). The cost advantages persisted through sensitivity analysis which tested for selection bias effects. Conclusions: The clamp-and-suture method appears to offer a potentially cost-effective alternative to staplers for carefully selected peripheral lesions in VATS wedge resection, particularly in resource-limited settings. The preliminary results need to be treated as speculative because the study uses a non-randomized retrospective design with limited data from a small number of patients treated by one surgeon and shows evidence of selection bias. The obtained results do not qualify as practice-changing recommendations. The validation of these findings requires prospective randomized controlled trials with predetermined selection criteria and extended follow-up periods to establish clinical recommendations. Full article

This study investigates digital literacy thresholds within South African higher education institutions in the context of Industry 4.0, focusing on entrepreneurship education. The research addresses the critical gap between current digital competencies and Industry 4.0 requirements, challenging assumptions about “digital natives” and examining factors influencing digital literacy development. A qualitative methodology employing semi-structured interviews was conducted with 25 participants, including 11 faculty members and 14 entrepreneurship students from a South African higher education institution. Data underwent rigorous thematic analysis following Braun and Clarke’s six-phase approach. The study revealed significant disparities in digital competencies among both faculty and students, contradicting binary digital native classifications. Key findings identified distinct transformative thresholds separating performative digital interaction from entrepreneurial digital practice, with access, training, and motivation forming interconnected factors in a digital literacy ecosystem. Most participants demonstrated bounded digital fluency limited to familiar environments rather than transferable entrepreneurial capabilities. The research introduces novel theoretical contributions, including “entrepreneurial digital thresholds” and “digital literacy structuration,” advocating for contextually responsive frameworks addressing socioeconomic inequalities. Practical implications include targeted professional development, multidimensional assessments, and policies prioritising equitable digital participation to prepare graduates for meaningful engagement in the global digital economy rather than passive consumption. Full article

Background/Objectives: Panoramic radiographs aid diagnosis in paediatric dentistry, but errors occur. Deep learning-based artificial intelligence offers improved accuracy by reducing overlap-related and interpretive mistakes. This study aimed to develop a U-Net-based deep learning model for simultaneous tooth segmentation and agenesis detection, capable of distinguishing between primary and permanent teeth in panoramic radiographs. Methods: Publicly available panoramic radiographs, along with images collected from the archives of Burdur Mehmet Akif Ersoy University Faculty of Dentistry, were used. The dataset totalled 1697 panoramic radiographs after applying exclusion criteria for artifacts and edentulous cases. Manual segmentation was performed by two paediatric dentists and one dentomaxillofacial radiologist. The images were split into training (80%), validation (10%), and test (10%) sets. A U-Net architecture was trained to identify both primary and permanent teeth and to detect tooth agenesis. Results: Dental agenesis was detected in 14.6% of 1697 OPGs, predominantly affecting the mandibular second premolars (32.5%) and maxillary lateral incisors (27.6%). Intra- and inter-researcher intraclass correlation coefficients (ICCs) were 0.995 and 0.990, respectively (p > 0.05). On the test set, the model achieved a Dice similarity coefficient of 0.8773, precision of 0.9115, recall of 0.8974, and an F1 score of 0.9027. Validation accuracy was 96.71%, indicating reliable performance across diverse datasets. Conclusions: The proposed deep learning model automates tooth segmentation and agenesis detection for both primary and permanent dentitions in panoramic radiographs. Its high-performance metrics suggest improved accuracy and efficiency in paediatric dental diagnostics, potentially reducing clinician workload and minimizing diagnostic errors. Full article

Over the past decade, many software enterprises have migrated from monolithic to microservice architectures to enhance scalability, maintainability, and performance. However, this transition presents significant challenges, requiring considerable development efforts, research, customization, and resource allocation over extended periods. Furthermore, the success of migration is not guaranteed, highlighting the complexities organizations face in modernizing their software systems. To address these challenges, this study introduces Mono2Micro, a comprehensive framework designed to automate the migration process while preserving structural integrity and optimizing service boundaries. The framework focuses on three core patterns: database patterns, service decomposition, and communication patterns. It leverages machine learning algorithms, including Random Forest and Louvain clustering, to analyze database query patterns along with static and dynamic database model analysis, which enables the identification of relationships between models, facilitating the systematic decomposition of microservices while ensuring efficient inter-service communication. To validate its effectiveness, Mono2Micro was applied to a student information system for faculty management, demonstrating its ability to streamline the migration process while maintaining functional integrity. The proposed framework offers a systematic and scalable solution for organizations and researchers seeking efficient migration from monolithic systems to microservices. Full article

Background: Coronary collateral circulation (CCC) plays a crucial protective role in patients with chronic total occlusion (CTO), mitigating ischemia and improving long-term outcomes. However, the degree of collateral vessel development varies substantially among individuals. Systemic inflammatory and nutritional status may influence this variability. The Naples Prognostic Score (NPS) is a composite index reflecting these parameters, yet its relationship with CCC remains incompletely defined. Methods: We retrospectively analyzed 324 patients with angiographically confirmed CTO at Selçuk University Faculty of Medicine between 2014 and 2025. Coronary collaterals were graded using the Rentrop classification, and patients were categorized as having poor (grades 0–1) or good (grades 2–3) collaterals. The NPS was calculated using serum albumin, cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Baseline clinical and laboratory data were compared between groups. Univariate and multiple binary logistic regression analyses were performed to identify independent predictors of collateral development. Results: Of the 324 patients, 208 (64.2%) had poor and 116 (35.8%) had good collateral circulation. Patients with good collaterals had higher body mass index, HDL Cholesterol (HDL-C), and triglyceride levels, and significantly lower NPS values compared with those with poor collaterals (p < 0.05 for all). In multiple binary logistic regression analysis, HDL-C (OR 1.035; 95% CI 1.008–1.063; p = 0.011) and NPS (OR 0.226; 95% CI 0.130–0.393; p < 0.001) emerged as independent predictors of well-developed collaterals. Conclusions: Both NPS and HDL-C are independently associated with the degree of coronary collateral circulation in CTO patients. These findings highlight the interplay between systemic inflammation, nutritional status, lipid metabolism, and vascular adaptation. As simple and routinely available measures, NPS and HDL-C may serve as practical tools for risk stratification and identifying patients at risk of inadequate collateral formation. Prospective studies with functional assessments of collateral flow are warranted to confirm these associations and explore potential therapeutic interventions. Full article

Against the backdrop of historic and contemporary attacks on diversity, equity and inclusion, what could ethical accountability and a call to action look like in Hispanic Serving Institutions? There are only a handful of institutions in the nation to simultaneously hold the Carnegie distinction of “very high research activity” and the designation of Hispanic Serving Institution (HSI). Yet some of these institutions have historically provided little if any resources to support and retain Hispanic-identifying students, and when programs exist, they tend to be performative rather than substantive. We employ intersectionality as critical inquiry and praxis (action/reflection) to name and shed light on the various mechanisms that continue to marginalize Hispanic students. In this case study, we attempt to examine institutional administrative data to shine a light on the underrepresentation of Latine students and faculty within the institution. Instead, however, we describe the practice of institutional and statistical gaslighting we encountered while trying to obtain this data. We then utilize content analysis of archival documents of two university departments and combine these findings with autoethnographic data to highlight both the past and current state of Latine faculty hires. We further examine the lack of student services and the precarious funding situations of Hispanic-centered programs at the heart of Hispanic student success, and the impact of Presidential Executive orders prohibiting the use of federal funds to support these resources. Finally, we include steps that can lead to institutional transformation as an ethical imperative to serve all students. Full article

This case study evaluates the efficiency of STEM-based sustainability initiatives at the University of Brasilia (UnB) using a Bootstrap Data Envelopment Analysis (DEA) approach. Twenty projects were analyzed based on input variables—team size, budget, and workload—and output variables—number of beneficiaries and published papers. The results indicate higher efficiency in the Mathematics and Civil Engineering departments, while Energy Engineering showed the lowest performance. A strong correlation (r = 0.78) was observed between budget and publication volume, but no significant relationship was found between the inputs and number of beneficiaries. SDG 4 (Quality Education) was the most frequently addressed, whereas SDG 16 (Peace, Justice, and Strong Institutions) and SDG 14 (Life Below Water) received less attention. The study identifies key areas for improvement, emphasizing the need for more balanced resource allocation and contextual awareness over sustainability priorities. It also offers an adaptive and replicable framework to other faculties or institutions seeking to optimize sustainability efforts through the lens of resource allocation optimization. Full article

This paper investigates the thermal performance of an office floor within the Faculty of Engineering at the British University in Egypt (BUE), located in Cairo, a city characterized by a hot arid climate. The study focuses on understanding the building’s thermal behavior by comparing two identical office rooms: Room 212 (north-facing) and Room 201 (south-facing). Utilizing dynamic thermal simulations with TRNSYS 18 for a full year, the research specifically analyzes the impact of these opposite orientations on indoor space temperature, total cooling loads, the monthly heat absorbed by various building surfaces, and the heat absorbed per unit area for each surface. The findings reveal significant disparities in thermal performance, particularly in terms of heat gain and cooling demand, directly attributable to orientation. This research highlights the critical role of facade orientation in mitigating radiative heat absorption and reducing energy consumption in educational buildings within hot climates, providing valuable insights for optimizing building design strategies to enhance thermal comfort and energy efficiency. Full article

Language, a uniquely human cognitive faculty, is fundamentally characterized by its capacity for complex thoughts and structured expressions. This review examines two critical measures of linguistic performance: idea density (ID) and grammatical complexity (GC). ID quantifies the richness of information conveyed per unit of language, reflecting semantic efficiency and conceptual processing. GC, conversely, measures the structural sophistication of syntax, indicative of hierarchical organization and rule-based operations. We explore the neurobiological underpinnings of these measures, identifying key brain regions and white matter pathways involved in their generation and comprehension. This includes linking ID to a distributed network of semantic hubs, like the anterior temporal lobe and temporoparietal junction, and GC to a fronto-striatal procedural network encompassing Broca’s area and the basal ganglia. Moreover, a central theme is the integration of Chomsky’s theories of Universal Grammar (UG), which posits an innate human linguistic endowment, with their neurobiological correlates. This integration analysis bridges foundational models that first mapped syntax (Friederici’s work) to distinct neural pathways with contemporary network-based theories that view grammar as an emergent property of dynamic, inter-regional neural oscillations. Furthermore, we examine the genetic factors influencing ID and GC, including genes implicated in neurodevelopmental and neurodegenerative disorders. A comparative anatomical perspective across human and non-human primates illuminates the evolutionary trajectory of the language-ready brain. Also, we emphasize that, clinically, ID and GC serve as sensitive neurocognitive markers whose power lies in their often-dissociable profiles. For instance, the primary decline of ID in Alzheimer’s disease contrasts with the severe grammatical impairment in nonfluent aphasia, aiding in differential diagnosis. Importantly, as non-invasive and scalable metrics, ID and GC also provide a critical complement to gold-standard but costly biomarkers like CSF and PET. Finally, the review considers the emerging role of AI and Natural Language Processing (NLP) in automating these linguistic analyses, concluding with a necessary discussion of the critical challenges in validation, ethics, and implementation that must be addressed for these technologies to be responsibly integrated into clinical practice. Full article

Background: Data on the incidence of IgG4-related disease (IgG4-RD) are scarce. Our aim was to determine the incidence of IgG4-RD in a well-defined region. Methods: This retrospective study covered the Ljubljana region over the period from January 2012 to December 2024. A review of cases diagnosed with IgG4-RD was performed at several departments of the University Medical Centre Ljubljana—an integrated secondary/tertiary university teaching hospital (rheumatology, nephrology, angiology, gastroenterology, abdominal surgery, ENT surgery, ophthalmology). While IgG4-RD cases at the Department of Rheumatology were collected prospectively, potential cases at other departments were retrieved by searching electronic medical database for the keyword “IgG4”. In addition, the Institute of Pathology, Faculty of Medicine, University of Ljubljana, provided a list of patients with histological features consistent with IgG4-RD. Year-specific incidence rates and an average incidence rate over the 13-year period were determined. Clinical features of patients were analysed. Results: During the observation period, 58 cases of IgG4-RD were diagnosed. Of these, 35 patients were residents of the Ljubljana region, which had an average adult population of 541,600. The estimated average annual incidence rate of IgG4-RD was 5.0 per million (95% confidence interval: 3.5; 6.9), with year-specific incidence rates fluctuating between 1.8 and 9.3 per million adults. The cases were stratified into four phenotypic categories: pancreato-hepato-biliary (17%), retroperitoneal fibrosis-aortitis (43%), head and neck-limited (14%), and Mikulicz syndrome with systemic involvement (26%). Conclusions: The average annual incidence rate of IgG4-RD was 5 per million adults, with the retroperitoneal fibrosis-aortitis phenotype predominating in our cohort. Full article

Electric vehicles are playing an important role in transport, aided by rapid advances in battery technology. The Faculty of Engineering at the University of Debrecen is also engaged research and development in the field of electric vehicles. To support the development of electric vehicle prototypes, a vehicle dynamics simulation program has been designed. The study presents the modeling and simulation of a permanent magnet synchronous motor (PMSM) in MATLAB/Simulink, which has been integrated into the existing vehicle dynamics simulation framework. The methods used to determine the motor characteristics required for the simulation are described in detail. In addition, the performance of the PMSM is compared with that of a brushless DC (BLDC) motor within the vehicle dynamics simulation program. The developed method allows the selection of the appropriate motor type for the given competition tasks. Full article

This systematic narrative review explores implementing the use of magic tricks for individuals with disabilities as a strategy to increase student engagement and meet the 2024 Universal Design for Learning (UDL) Guidelines 3.0 for Engagement Consideration 7.3: Nurture joy and play. The author is a university faculty member in the field of special education and a professional magician. With 30+ years of using magic in educational settings, the author uses the unique combination of understanding pedagogy and the art of magic to make educational inferences of how to successfully nurture joy and play using simple-to-learn magic tricks. Therefore, the intention of this article is to showcase empirical studies that specifically focus on the educational benefits of learning and performing magic tricks and how they may align with nurturing joy and play. A systematic narrative review was conducted using predetermined inclusion and exclusion criteria across six databases (JSTOR, ERIC, DOAJ, EBSCO, ProQuest and Google Scholar) resulting in a total of 153 articles. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and uses an integrative narrative synthesis. Overall, the findings reveal there are many overlapping elements between the experiences of learning and performing magic tricks and nurturing joy and play. Both learning and performing magic tricks can be used to increase engagement for students with disabilities in the classroom setting. Therefore, the findings suggest that teachers may potentially meet the UDL’s nurturing joy and play engagement consideration by incorporating magic tricks in their classrooms. Full article

Background/Objectives: Adenoid hypertrophy (AH), one of the most common pathologies in children, is a major cause of mouth breathing. Mouth breathing causes dry mouth, which removes the beneficial effects of saliva necessary for oral health. Therefore, an oral microflora favorable to caries is promoted. The primary objective of this study is to evaluate the oral health of children diagnosed with AH between the ages of 3 and 14 and to determine the early childhood oral health impact scale. Methods: This descriptive study was conducted between November 2019 and November 2020, involving 16 boys and 14 girls diagnosed with AH at the Department of Otorhinolaryngology, Faculty of Medicine, Atatürk University. These children, diagnosed with adenoid hypertrophy, were referred to the Department of Pedodontics, Faculty of Dentistry, Ataturk University, for the evaluation of their oral health prior to surgery. Oral examinations were performed on the pediatric participants under dental unit light by the same pedodontist, and their demographic data and DMFT/dmft scores were recorded. Data for the Early Childhood Oral Health Impact Scale (ECOHIS-T) were obtained from volunteers with communication skills and their parents. SPSS 21.0 software was used in the statistical evaluation of the data. A Chi-square test was used to assess differences between groups. Results: The mean age of the children was 5.9 ± 2.6 years. There was no statistically significant difference between AH grades 2, 3, and 4 in terms of dentition periods, gender, and occlusion (p = 0.177, p = 0.495). The scores of the first nine and last four questions of the ECOHIS-T were found to be higher in children with grade 4 AH (p = 0.011, p = 0.043). The DMFT index was also higher in children with grade 4 AH (p = 0.010). Conclusions: Tooth decay is more prevalent in children with severe adenoid hypertrophy. This condition was also observed to negatively affect their quality of life. Regular check-ups and preventive care are needed to improve the quality of life of these children. Full article

This study aimed to evaluate the effects of jump rope training on cardiovascular capacity, assessed with the Ruffier test, and muscular strength, measured using isometric dynamometry (BioFET Mustec, Almere, The Netherlands), within a university physical education program. A total of 52 undergraduate students from non-specialist faculties at the University of Oradea were randomly assigned to either an experimental group (EG) or a control group (CG). Over eight weeks, the EG performed a ten-minute jump rope training session once per week in combination with cardiovascular exercises, while the CG participated only in cardiovascular exercises. Statistical analyses revealed a significant group effect on cardiovascular response (Ruffier Index: p = 0.019; Cohen’s d = −0.271) and a substantial increase in right lower limb strength (p = 0.003; d = 1.026) in the EG compared to the CG. Furthermore, improvements were observed in upper limb strength (left arm: p = 0.010; d = 0.922) and left lower limb strength (p = 0.027; d = 0.779). These findings suggest that incorporating jump rope training into university physical education classes may represent an effective and low-cost strategy to enhance both cardiovascular efficiency and muscular strength in young adults. Given its simplicity and affordability, jump rope training appears feasible for implementation in schools and universities, even where resources are limited. Future research should investigate its long-term effects across different populations. Full article