Search Results (8,370)

(1) Background: Simulation is an effective way to develop practical pharmacy skills; combining simulation and self-reflection can increase impacts on learning. While existing literature highlights the benefits of reflection in developing self-awareness, critical thinking, and professional skills, there are few specific insights into how reflective practices enhance learning in patient counselling role-plays. This study aimed to explore pharmacy students’ perceptions of self-reflection and peer and educator feedback on the development of patient counselling skills. (2) Methods: Thematic analysis of student reflections on learning in patient counselling activities. Responses to four structured self-reflection prompts were collected and analyzed thematically. (3) Results: Reflections from 201 students were analyzed. We identified four themes and ten associated subthemes: impact of peer feedback (subthemes supportive peer dynamics and developing a personal counselling style through peer practice); impact of self-reflection and assessment (subthemes goal setting through self-reflection and video review as a tool for skill refinement); impact of educator feedback (subthemes feedback variation in learning growth and addressing self-doubt); and professional identity (subthemes value pharmacists can bring, struggles in real-life practice, incorporating feedback to working opportunities, and reinforcing skills to self-reflect in future practice). (4) Conclusions: Integrating consistent, high-quality feedback from educators and peers with self-reflection in patient counselling activities is perceived as valuable to enhancing enhances students’ learning experiences and preparing them for professional practice. Full article

Background: Medical students often face substantial psychological stress, which can increase the risk of substance use, professional detriment, and insufficient patient care. However, substance use in medical students remains understudied in Iraq. This study highlights the prevalence, patterns, risk factors, and negative effects of substance use among medical students at the University of Baghdad. A cross-sectional study involving 414 medical students at the University of Baghdad was conducted. The questionnaire included sociodemographic variables and the Alcohol, Smoking, and Substance Involvement Screening Test to screen for psychoactive substance use. The lifetime prevalence of substance use was 38.9%. Among substance users, 42.8% used nicotine, 22.3% used sedatives, 4.3% used inhalants, and 3.1% used amphetamines, with only 27.3% reporting polysubstance use. Through multivariate logistic regression, it was identified that males are approximately 2.8 times more likely to use substances compared to females (OR: 2.8, 95% CI: 2.1–5.2, p-value < 0.001), and students with a positive family history of substance use are approximately 3.1 times more likely to use substances compared to those without (OR: 3.1, 95% CI: 2.8–7.5, p-value < 0.001). These findings underscore the importance of implementing early preventive strategies, targeted mental health interventions, and substance use awareness programs within Iraqi medical institutions. Full article

This study investigates the integration of a molten salt thermal energy storage (TES) system into a 330 MW coal-fired power unit to enhance its operational flexibility and exergy-based performance. Using EBSILON Professional (version 13) software, several heat storage and heat release schemes were modeled and analyzed to assess their effects on turbine performance, coal consumption rate, heat rate, and exergy losses under various load conditions. The results reveal that coupling TES with conventional thermal units can effectively decouple heat and power generation, enabling deep peak-shaving operation while maintaining system efficiency. The six heat storage schemes and seven heat release schemes considered in this study were selected based on the physical characteristics of the 330 MW reheat-steam cycle and the practical constraints of integrating a molten salt TES system into an existing coal-fired unit. Specifically, the schemes were designed to represent all feasible pathways for redirecting thermal energy within the boiler–turbine system, including steam extraction from different turbine stages, reheater-side interventions, and electric-heating-assisted charging options. These schemes also reflect the operational boundaries of the unit, such as allowable extraction fractions, steam temperature limits, and turbine safety margins. The findings demonstrate that molten salt TES can serve as a feasible and efficient pathway for retrofitting existing coal-fired power units to improve load-following capability, reduce fuel consumption, and support grid flexibility under renewable-dominated energy scenarios. Full article

Tennis match analysis is a critical component of sports science, offering data on player performance, workload management, and competitive stress. We developed a data-driven framework to classify tennis matches as high-stress or low-stress using the Association of Tennis Professionals’ match statistics. High-stress matches are characterized by extended duration or frequent break points, both representing elevated physical and psychological demands. We implement TabNet and compare its performance with recurrent deep learning models, including long short-term memory (LSTM), bidirectional LSTM, attention-enhanced LSTM, and convolutional LSTM. Experimental results show that TabNet achieves the best accuracy (98%), while the recurrent models maintain accuracies above 93%, demonstrating consistent predictive capability. To enhance interpretability, SHAP analysis identifies break points faced, break points saved, and match duration as the most influential determinants of match stress, with serving and returning features providing secondary contributions. These findings confirm the effectiveness of interpretable deep learning in sports analytics and highlight its potential for guiding training and match preparation. Full article

Reliable communications, accurate localization, and efficient safety monitoring remain critical bottlenecks for sustainable development in remote high-altitude regions. On the Qinghai–Tibet Plateau, harsh topography and sparse infrastructure create a persistent “digital divide” that threatens human safety and limits field governance efficiency. This study aims to design, implement, and evaluate an integrated communication and navigation security assurance platform to bridge this gap. The specific research objectives are (i) to develop a hybrid high-precision positioning model integrating PPP-B2b, RTK, and MEMS inertial constraints; (ii) to implement an adaptive multi-link communication strategy combining BeiDou-3 short message communication (SMC), 4G LTE, and VHF; (iii) to design a lightweight SM1/SM2 security-and-compression framework optimized for bandwidth-constrained satellite messaging; and (iv) to conduct a mixed-methods field evaluation of technical performance and user-level impacts. A six-month field evaluation was conducted in Qinghai Province to validate the platform. Results show that the platform achieves sub-metre positioning accuracy across representative plateau scenarios (horizontal RMSE: 0.06–0.45 m). While terrestrial cellular links in marginal-coverage areas frequently failed (<15%), the BeiDou-3 SMC maintained stable message delivery (87.5–94.7%). Sustainability-oriented indicators suggest marked improvements in disaster resilience: the 95th-percentile emergency notification time was reduced from >180 min to <2 min, and effective route coverage increased from ~15% to ~95%. User surveys (n = 112) indicate high acceptance, with 91.1% of respondents reporting improved perceived safety, though usability gaps persist among non-professional groups. Overall, this indigenous satellite-based platform functions as a practical “social safety net,” narrowing digital exclusion and supporting UN sustainable development goals (SDG 9, 10, and 11). Full article

While skin aging is inevitable, healthy habits, sun protection, skincare, and medical interventions can slow visible skin changes; estrogen is also crucial. In 2002, the Women’s Health Initiative (WHI) results contributed to the subsequent trend toward fear and avoidance of hormone replacement therapy (HRT). Since 2002, the WHI results have been re-evaluated and caused the US FDA to announce “the removal of the misleading FDA warnings on HRT”, stating that “estrogen is a key hormone for women’s health where every single part of a woman’s body depends on estrogen to operate at its best—including the brain, bones, heart, and muscles”. This overview explores this transformation of scientific information/perspective on HRT via (a) aging and skin health; (b) the importance and changes in estrogen in women with a focus on dermal parameters; (c) provides a brief review of the WHI result, impact, and current status of this report; (d) explores the “timing hypothesis” for HRT interventions; and (e) proposes that HRT might be considered not only for symptomatic women but also for esthetic treatment in perimenopause and menopause patients. The latest reviews support a recent large-scale systematic review and meta-analysis on skin parameters, which suggests that HRT may have a place in esthetic treatment. However, beyond esthetic benefits, the positive implications of HRT on several other health parameters in women during aging are briefly presented. Of course, hormonal and numerous other treatments require a review of the risks/benefits and their discussion among the patient and medical professionals to determine the most effective interventions for treating hormone-related skin changes, but this shift in perspective warrants further investigation and validation. Full article

Heritage Building Information Modelling (HBIM) has emerged as a powerful methodology for documenting, analysing, and managing historic buildings. However, its pedagogical potential in teaching adaptive reuse and heritage-sensitive design remains underexplored, particularly in postgraduate architectural education. This study evaluates a pedagogical HBIM framework implemented in a master’s-level course, where students applied HBIM methodologies to propose adaptive reuse interventions for a historic building in Jeddah Historic District, Saudi Arabia. Student design projects were analysed to assess how HBIM informed documentation accuracy, heritage value interpretation, and design decision-making. In addition, a retrospective questionnaire was administered to former students to evaluate the long-term educational effectiveness of the HBIM-based methodology, focusing on learning quality, design comprehension, and professional preparedness. The results indicate that HBIM significantly enhanced students’ understanding of historic fabric, improved their ability to propose context-sensitive reuse strategies, and supported more informed and evidence-based design decisions. Survey findings further demonstrate the high perceived value of HBIM in architectural education, particularly in linking theoretical knowledge with real-world heritage challenges. This research contributes a validated educational framework for integrating HBIM into adaptive reuse curricula and provides evidence-based insights applicable to heritage education and professional practice. Full article

Background: Antineoplastic drugs are essential in the treatment of cancer; however, they are classified as hazardous due to their genotoxic, mutagenic, and carcinogenic properties. Healthcare professionals are at risk of exposure primarily through surface contamination. Despite international safety guidelines and technological innovations during the last decades, contamination remains a global occupational health challenge. Objective: This scoping review aims to identify and compare monitoring and detection methods, as well as cleaning and decontamination strategies, in relation to international occupational-safety standards. Methods: Following Arksey and O’Malley’s methodological framework and PRISMA-ScR reporting standards, the peer-reviewed literature and guidelines from 2000 to 2025 were reviewed. Studies were charted across three domains: contamination prevalence, monitoring/detection methods, and cleaning/decontamination effectiveness. Results: Evidence from twenty-two studies conducted in several countries worldwide demonstrated widespread surface contamination across hospital pharmacies, patient-care units, and outpatient facilities. Cyclophosphamide, ifosfamide, and methotrexate were the most frequently detected agents. LC—MS/MS wipe sampling remains the quantitative gold standard, while rapid immunoassay-based tools allow near real-time assessments but with reduced sensitivity. Cleaning protocols varied significantly: oxidizing and surfactant-based agents such as sodium hypochlorite and hydrogen peroxide achieved the highest removal rates (>90%) yet failed to eliminate residues completely. The included studies reported a wide range of monitoring, detection, and cleaning approaches used in healthcare settings. Conclusion: Surface contamination by antineoplastic drugs persists worldwide. Effective management requires harmonized contamination thresholds, validated cleaning strategies, adoption of rapid detection technologies, and continuous occupational surveillance. Full article

Community and hospital pharmacists in Romania are valuable to healthcare, but their involvement in multidisciplinary teams is still not up to the mark when measured against international standards. A systematic literature review search was conducted using the PubMed, Embase, Web of Science, and Scopus databases, following the PRISMA 2020 guidelines, complemented by a bibliometric analysis with VOSviewer, to identify research trends and key contributors in the field. This review examines studies such as counseling effectiveness, clinical contribution, and professional obstacles faced by pharmacists in Romania published between 2014 and 2025 that mainly focus on community practice, integration into hospitals, and new areas such as pharmacogenetics and pharmacovigilance. The studies surveyed patients on how they evaluated counseling, tracked clinical pharmacists who adjusted drug doses through therapeutic monitoring, checked whether healthcare professionals followed safety warnings, and checked management systems within institutions. High costs and the removal of pharmacovigilance from compulsory university courses add to the obstacles. Romanian pharmacists already possess the knowledge or skills to raise treatment success and shield patients from unsafe self-medication through timely clinical advice. To use this capacity fully, the system must change, including health insurance covering pharmaceutical services, compulsory updating of course content, and official interdisciplinary protocols for this potential to be fully exploited. Full article

Entrustable professional activities (EPAs) define key tasks expected of physicians. The entrustment levels that US pediatric gastroenterology (GI) fellowship program directors (FPDs) expect of graduating fellows remain unclear. This study aimed to identify the minimum entrustment levels FPDs expect for graduation and for safe and effective practice. We conducted a secondary analysis of GI data from a national multispecialty cross-sectional survey. FPDs reported the minimum entrustment level for fellows expected for graduation, whether they would graduate a fellow not meeting this level, and the minimum level for practice. A minimum entrustment level was defined as a level where at least 80% of FPDs would not allow a lower rating. Most FPDs did not require level 5 (unsupervised practice) for graduation or for practice. Instead, level 4 (indirect supervision with discussion of complex cases) was the most commonly required minimum for GI EPAs. When adjusted for FPD willingness to graduate fellows even if they did not meet the expected minimum, the level was 3 (direct supervision for complex cases) across all GI-specific EPAs. These findings underscore the potential need for ongoing mentorship, professional development, and continuing medical education after GI fellowship, particularly in the early practice period. Full article

Enhancing the livelihood resilience of smallholder farmers has become a critical challenge in China’s contemporary agricultural development strategy. Agricultural machinery socialization services represent an important policy measure for facilitating smallholder farmers’ integration into modern agriculture and alleviating practical development constraints; however, as a substantial adjustment to farmer livelihood activities, such services may also disrupt smallholder farmers’ existing livelihood equilibria. Using survey data from smallholder farmers in the major corn-producing regions of Northeast China, this study examines the effects of agricultural machinery socialization services on smallholders’ livelihood resilience and explores the underlying mechanisms. The results show that both the breadth and depth of agricultural machinery socialization services significantly enhance smallholders’ livelihood resilience. These effects operate mainly through two pathways: an empowerment mechanism driven by farmland scale management and the professional division of labor in agriculture, and a capacity expansion mechanism driven by the extension and application of agricultural technologies and the development of social networks. Moreover, the influence of agricultural machinery socialization services on smallholders’ livelihood resilience is positively moderated by both internal perceived value and external policy incentives. Heterogeneity analysis further indicates that these services exert stronger effects on smallholder farmers’ buffering and learning capacities than on self-organizing capacity, with more pronounced impacts in plains areas than in hilly and mountainous regions. Accordingly, policy efforts should focus on the core needs of smallholder farmers by accelerating the development of a diversified, differentiated, and multi-tiered agricultural machinery socialization service system, expanding service coverage, improving service quality, and refining service mechanisms to promote sustained improvements in smallholders’ livelihood resilience. Full article

There has been an increasing need to manage the water, energy, and food (WEF) Nexus in an integrated and sustainable way using Industry 4.0 (4IR) technologies. While 4IR technologies can significantly improve resource management and sustainability in the Nexus, their uptake across the WEF Nexus has been uneven due to institutional fragmentation and limited digital capability. This study assessed a multi-level human capital framework developed to facilitate the structured integration of 4IR technologies into the WEF Nexus. The study leveraged human capital theory and Strategic Human Resource Management to frame capability development as a multi-level process. The study employed a mixed-methods approach, initially surveying 262 professionals in the WEF Nexus to assess essential skill capabilities. This was followed by a two-round Delphi procedure involving 12 experts to refine and validate the multi-level framework. The findings reveal that digital transformation in the WEF Nexus is dependent on the synchronisation of national policy frameworks, organisational learning cultures, and individual skill sets. These levels do not work as separate enablers; instead, they work together as an integrated capacity ecosystem in which misalignment at any point will hinder the effective integration of 4IR technologies. The validated framework provides a systematic approach to understanding the interplay of human capital processes within socio-technical systems and provides a structured approach for designing comprehensive strategies that strengthen digital readiness across sectors. The study advocates for a system-embedded human capital (SEHC) approach and contributes to ongoing discussions on innovation in the public sector by highlighting the systemic nature of human capital development in sustainability- and resource-critical sectors. Full article

Ambient air pollution, particularly fine particulate matter (PM_2.5), poses significant health risks, especially concerning cardiovascular diseases (CVDs). This study assesses the association between PM_2.5 exposure and CVD hospital admissions (HAs) and emergency room (ER) visits in Karachi, Pakistan. Daily PM_2.5 samples were collected from four Karachi sites (Makro, Karachi University, Keamari, and Malir) between October 2009 and June 2011. CVD morbidity data, including HAs and ER visits, were gathered from major hospitals. A single-pollutant model was employed to evaluate associations between PM_2.5 levels and CVD outcomes, adjusting for meteorological variables and other potential confounders. PM_2.5 concentrations and CVD morbidity were significantly associated across all sites Stratification by age and gender revealed stronger associations among males and individuals aged 40 and above. Exposure to elevated levels of PM_2.5 in Karachi was significantly associated with increased CVD HAs and ER visits, with the highest association found between PM_2.5 exposure and arrhythmias. The study underscores the need for effective air quality management policies and interventions to reduce PM_2.5 levels. Karachi’s high PM_2.5 levels demand urgent attention from regulatory agencies and public health professionals to implement interventions that mitigate air pollution and protect vulnerable populations. Full article

Lung cancer remains one of the most formidable health challenges globally, with significant morbidity and mortality rates. Despite advancements in diagnostic and treatment technologies, the disease’s high prevalence, late-stage detection, and complex variations continue to hinder effective management. Early detection and accurate diagnosis play a pivotal role in improving survival rates. Crucially, the clinical and translational relevance of AI-based prediction lies in its potential to significantly reduce the incidence of late-stage diagnoses, thus increasing the chance of successful intervention. Lung cancer was first identified by medical professionals in the mid-19th century. Today, cancer remains a significant global health challenge, affecting an estimated 14 million individuals annually and causing 8.2 million fatalities worldwide. Lung cancer ranks among the leading causes of death associated with cancer. This research aims to bridge gaps in lung cancer diagnosis by exploring various learning methodologies. By focusing on studies from the last 10 years, this survey provides a contemporary understanding of the field, emphasizing the importance of automated diagnostic systems in reducing human error and improving efficiency. The selection of relevant research is based on a rigorous methodology, including specific inclusion and exclusion criteria, which are later discussed in detail with supporting figures and comparative data. Ultimately, this work underscores the critical need for innovative diagnostic solutions and comprehensive screening programs to combat lung cancer, save lives, and advance the field of medical research. Full article

The evaluation of the ability increment of scientific researchers is the most direct method to test the effect of scientific research training. Considering the variety and high professionalism of scientific research positions, and in order to reduce the difficulty of expert evaluation and improve the operability and reliability of the evaluation methods, this paper presents an evaluation method that combines interval evaluation and cloud model theory based on the characteristics of ability increment in scientific researchers. Firstly, the interval weights of each evaluation index are determined based on the interval analytic hierarchy process (IAHP) method without depending on evaluation data. Secondly, the interval weights are converted into value weights based on the constant deviation ratio criterion to avoid cross-hierarchical uncertainty in the evaluation results due to the direct involvement of interval weights in subsequent evaluation. To reversely convert the interval evaluation results of indexes into a cloud model, the probability density function applicable to the interval indexes is analyzed, and the conversion formula from interval-valued evaluation indexes to a cloud model is directly provided based on probability theory. On this basis, this paper describes in detail the method for reversely analyzing the effectiveness of index evaluation based on the characteristics of the cloud model, thus achieving an effective combination of interval evaluation and the cloud model. Finally, effective evaluation of ability increment indexes of scientific researchers at all levels is accomplished by adopting a comprehensive cloud model and a gray cloud clustering method. The effectiveness of the proposed method in this paper is validated through simulation examples. Full article