Search Results (26,383)

Background/Objectives: Point-of-care ultrasound (POCUS) is an accessible and low-cost diagnostic tool that is seldom used by orthopedic residents. This study aims to assess the efficacy of a POCUS training program within an orthopedic surgery residency curriculum in terms of knowledge retention and clinical usage among the group of residents. Methods: This study included didactic and hands-on teaching sessions. The impact of the teaching sessions was evaluated through surveys (pre-course, immediate post-course, and 6 months post-course). The surveys were divided into three sections: participant’s interest in and usage of POCUS, ultrasound-related knowledge, and perceived limitations related to the usage of ultrasound. All orthopedic residents who attended the teaching sessions and completed all the surveys were included. Results: There were 14 participants. There was a significant increase in interest in POCUS (scale 1 to 5) from 3.36 ± 0.50 in the pre-course survey to 3.93 ± 0.83 in the final post-course survey (p = 0.04). However, there was no significant change in the amount of POCUS usage in clinical settings. Levels of comfort with ultrasound-related procedures significantly increased immediately following the teaching session but did not stay significantly higher after 6 months. When tested on knowledge, the residents’ scores were still significantly greater than they were at the time of the pre-course test at 6 months (p = 0.01). Lack of ultrasound-related knowledge, lack of time, and site culture were the two most prevalent perceived barriers. Conclusions: This study demonstrates that POCUS teaching for orthopedic residents yields long-term benefits in terms of interest and knowledge. However, recurrent teaching sessions and further efforts are required to address perceived obstacles to PoCUS usage and increase clinical implementation. Full article

Background: Malignant pleural mesothelioma (MPM) is an aggressive neoplasm, the major cause of which is asbestos exposure. Adjuvant radiotherapy after pleurectomy/decortication (P/D) aims at reducing locoregional recurrence but is limited by the risk of radiation pneumonitis (RP). In this study, we attempted to evaluate the predictive value of conventional and functional dosimetric parameters in assessing RP risk. Methods: This retrospective study analyzed 68 patients with non-metastatic MPM treated with adjuvant radiotherapy after P/D. Dosimetric parameters, including V20, V5, and mean lung dose (MLD), were calculated for both total lung volume and functional lung volume (FLV), with emphysematous regions excluded based on CT imaging thresholds. Statistical analyses assessed correlations between these parameters and acute RP incidence. Results: Acute RP developed in 42% of patients, and 28% had moderate-to-severe (Grade 2–3) events. V20 and FCL_V20 were significantly associated with the risk of RP (p = 0.017 and p = 0.028, respectively). Predictive accuracy for conventional V20 (AUC = 0.668) and Functional Contralateral Lung V20 (FCL_V20) (AUC = 0.655) showed moderate efficacy, without further significant improvement in using functional parameters. A V20 threshold > 1.8% predicted severe RP with high specificity (89.8%). Conclusion: While functional lung delineation provides an alternative in dosimetry, conventional V20 is a robust predictor of RP. Optimization of dosimetric constraints, in an effort to reduce pulmonary toxicity in MPM patients, should be further combined with advanced radiotherapy techniques and biomarkers. Full article

Ship monitoring using Synthetic Aperture Radar (SAR) data faces significant challenges in detecting small vessels due to low spatial resolution and speckle noise. While ESRGAN (Enhanced Super-Resolution Generative Adversarial Network) has shown promise for image super-resolution, it struggles with SAR imagery characteristics. This study proposes SA/SU-ESRGAN, which extends the SU-ESRGAN framework by incorporating a spatial attention mechanism loss function. SU-ESRGAN introduced semantic structural loss to accurately preserve ship shapes and contours; our enhancement adds spatial attention to focus reconstruction efforts on ship regions while suppressing background noise. Experimental results demonstrate that SA/SU-ESRGAN successfully detects small vessels that remain undetectable by SU-ESRGAN, achieving improved detection capabilities with a PSNR of approximately 26 dB (SSIM is around 0.5) and enhanced visual clarity in ship boundaries. The spatial attention mechanism effectively reduces noise influence, producing clearer super-resolution results suitable for maritime surveillance applications. Based on the HRSID dataset, a representative dataset for evaluating ship detection performance using SAR data, we evaluated ship detection performance using images in which the spatial resolution of the SAR data was artificially degraded using a smoothing filter. We found that with a 4 × 4 filter, all eight ships were detected without any problems, but with an 8 × 8 filter, only three of the eight ships were detected. When super-resolution was applied to this, six ships were detected. Full article

Intimate partner violence (IPV) remains a persistent public health and human rights challenge globally, with South Africa experiencing some of the highest rates. This study investigates the intersection between partner substance use, controlling behaviours, and women’s risk of experiencing emotional, physical, and sexual IPV. Using nationally representative data from the South African Demographic and Health Survey (SADHS), a weighted sample of 2354 women was analysed. Findings show that 41.8% of women reported that their partners used alcohol and/or drugs, and IPV prevalence among this group was 36.38%. Multivariate logistic regression revealed that partner substance use more than doubled the risk of emotional violence and nearly tripled the risk of physical and sexual violence. Controlling behaviours also emerged as significant predictor, with affected women facing up to nine times higher odds of IPV. These findings highlight the urgent need for integrated intervention strategies that address substance abuse and coercive control within intimate relationships. Prevention efforts must be context-specific, targeting underlying behavioural and gendered power dynamics to reduce IPV and improve women’s safety. Full article

In this study, phosphorus tailings sand (PTS) was ground into fine powder and incorporated with slag and fly ash to formulate a cementitious material composed solely of solid wastes. The current research aimed to promote the high-value utilization of local solid waste resources in Lianyungang and to explore their potential application in soil stabilization and ground improvement. Through optimization of component dosage and the proportions of alkaline activators, the effects on workability, mechanical properties, drying shrinkage, wet–dry cycles, microstructural evolution, and heavy-metal leaching behavior were comprehensively examined. The findings revealed that at the optimal ratio of PTS–slag powder–fly ash = 5:2.5:2.5, the developed cementitious material demonstrated a 28-day compressive strength of 33.8 MPa, along with 4.5 MPa flexural strength, and 168 mm flow spread. Moreover, the 28-day drying shrinkage reached a minimal value of 0.038%, with reduced mass loss of 6.7% after wet–dry cycling. Furthermore, under non-freezing conditions, the leaching content of Zn, Mn, Pb, and Cu from the PTS-based multi-solid-waste cementitious system remained below the permissible limits for non-hazardous discharge established by Chinese environmental regulations. These findings provide an innovative pathway for the resource-efficient application of phosphorus tailings sand and several solid wastes while offering technical guidance for silt stabilization and ecological restoration efforts in the Lianyungang region, highlighting promising engineering application prospects. Full article

Sorghum is a strategic crop for food, feed, and bioenergy. However, information on its cultivation area and agronomic profile in Indonesia remains limited. Therefore, this study aimed to identify, characterize, and evaluate sorghum cultivation in different agroecosystems and pedoagroclimatic settings in Indonesia. We surveyed published articles, newspapers, and other digital resources, collating a dataset that contained pedoagroclimatic characteristics. We then conducted a field survey to gather data on sorghum farming practices. The results show that sorghum is planted in 11 agroclimatic zones, mainly in D3, B1, and E4, and in seven soil types, mainly in Inceptisols, Mollisols, Vertisols, and Andisols. The cultivated varieties cover Bioguma 1, Bioguma 2, Bioguma 3, Numbu, Kawali, UPCA-S1, Suri 3 Agritan, Soper 9, and local varieties. Under smallholder farmers’ management, the average sorghum yield ranges from 3.6 to 7.5 Mg ha⁻¹. The 15–68% of the yield gap can be closed by implementing site-specific technologies, including high-yielding varieties and soil management. These findings provide a baseline for supporting efforts to increase sorghum production and develop robust sorghum cultivation technologies. Full article

Tantalum pentoxide (Ta₂O₅) films deposited on fused silica substrates are critical components of high-power laser systems. Ion-assisted electron beam evaporation (IAD-EBE) is the mainstream technique for fabricating Ta₂O₅ films. However, it commonly requires extensive experimental efforts for deposition quality optimization, while each coating cycle is extremely time-consuming. To solve this issue, this work establishes a dataset targeting the surface roughness (Rq) and refractive index (n) of Ta₂O₅ films using atomic force microscopy, as well as ellipsometer and deposition experiments. Influence of assisting ion source beam voltage (V)/current (I) and Ar (Q₁)/O₂ (Q₂) flow rate on the n and Rq of Ta₂O₅ films are analyzed. Combining energy-field mechanism analysis with a Bayesian optimization approach (PI-BO), both deposition quality prediction and feature analysis of process parameters are achieved. The determination coefficient/mean absolute error for the prediction models of n and Rq reach 0.927/0.013 nm and 0.821/0.049 nm, respectively. Based on sensitivity analysis, the weight factors of V, I, Q₁, and Q₂ affecting n/Rq of Ta₂O₅ films are determined to be 0.616/0.274, 0.199/0.144, 0.113/0.582, and 0.072/0.000. V and Q₂ are identified as the core factors for regulating deposition quality. The optimal ranges for V and Q₂ are 600~700 V and 70~80 sccm, respectively. This study proposes a PI-BO method for predicting Rq and n of Ta₂O₅ films under small-data conditions, while determining the preferred parameter ranges and their sensitivity weight factors. These findings provide effective theoretical support and technical guidance for IAD-EBE strategy design and optimization of optical films in high-power laser systems. Full article

Background: Traumatic brain injury (TBI) is a leading cause of disability but one of the least recognized health problems in the world, affecting up to 69 million people annually. The associated lifelong disability in survivors, the loss of economic productivity, and being a risk factor for dementia consume 0.5% of global economic activity. Yet TBI is still largely invisible in national surveillance systems and not well represented in chronic disease frameworks. Consequently, governments are not equipped to provide proportional financing of acute care and long-term care of survivors, nor to build health care systems and resources for improving outcomes of TBI through policy frameworks targeting prevention, treatment, and equitable access. Objective: This commentary aims to provide a comprehensive picture of the global effort to formally recognize TBI as a notifiable and chronic condition, including the justifications for recognition, the formation of an international coalition of stakeholders, and the strategic plan for resolution at WHA79 of the World Health Assembly, one of the first concerted multinational efforts that occurred as a side event during the 78th World Health Assembly (WHA78) in May 2025. Methods: This commentary integrates information from epidemiological studies, global registries, and testimonies from people with lived experience of TBI. We analyze these data to develop policy needs and corresponding initiatives to address key needs. These include coordinated efforts to advocate change, such as technical briefings, consultations with stakeholders, and storytelling led by survivors, all of which informed and formed a part of the WHA78 side event. Our efforts have garnered wide, multi-sector support. Results: The WHA78 side event showed that ministries of health, neurosurgical, neurological, and rehabilitation societies, academic researchers, WHO representatives, and survivors all unprecedentedly support the recognition of the importance of TBI, facilitating national policies for its prevention and treatment via standardized surveillance. More than 30 non-governmental groups officially supported the campaign. A sponsoring member state made a public commitment to co-sponsor a WHA resolution, which set the stage for ongoing diplomatic progress and engagement across regions. Conclusion: To improve global brain health equity, access to long-term care, and the resilience of health systems, it is important to recognize TBI as a notifiable and chronic condition. A dedicated WHA resolution would make TBI a part of global health governance, making sure that it is counted, tracked, and dealt with as quickly and comprehensively as possible. It is both a technical necessity and a moral duty to help survivors and families and fight for justice in global health systems. Full article

The rise of multidrug-resistant enteric pathogens and increased demand for antibiotic alternatives have intensified efforts to find reliable, safe, and effective probiotics. This study reports the isolation, characterization, and assessment of the probiotic potential of five Enterococcus strains isolated from the feces of healthy goats aged 7–9 months raised under conventional management. Following an initial screening of 57 lactic acid bacteria, 5 isolates (Enterococcus faecium, E. hirae, E. faecalis, Enterococcus sp., and Streptococcus lutetiensis) were chosen based on their catalase-negative, non-motile, and non-hemolytic characteristics, in addition to their high tolerance to gastric (pH 2.0) and intestinal (pH 8.0, 0.3–1.5% bile salt) stress. In simulated gastric juice, survival rates reached 89.05% (E5) and 85.03% (E3), while in intestinal juice, survival peaked at 78.01% (E4). All strains thrived in 4% NaCl and maintained at least 8 Log₁₀ CFU/mL after 12 h of exposure to 1.5% porcine bile salt. Cell surface hydrophobicity (0.78–93.85%) and auto-aggregation (23–91%) properties were strain-dependent, but exceeded the thresholds required for efficient gut colonization. Co-aggregation assays demonstrated over 45% binding with E. coli and S. typhimurium, suggesting a strong potential to displace pathogens. Cell-free supernatants created inhibition zones measuring 15.02 mm against E. coli and 11.04 mm against S. flexneri, while maintaining activity against methicillin-resistant S. aureus (MRSA). Antibiotic testing indicated that all strains were sensitive to ciprofloxacin and florfenicol. No β-hemolysis or mobile resistance genes were found, supporting the initial safety findings. This study reveals that Enterococcus isolates from goats display a unique combination of gastrointestinal survivability and broad-spectrum antipathogenic activity and, therefore, are promising candidates for the development of next-generation probiotic strains for use in livestock (and, potentially, humans). Further in vivo validation and genome-based safety assessments are warranted. Full article

Grounded in self-determination and mindset theories, the current investigation examined whether students’ homework mindsets and effort mediated the association between autonomy support—from both teachers and parents—and mathematics grades. The study sample included 988 Chinese students in Grade 7 to 9. Structural equation modeling indicated that both teacher autonomy support and parent autonomy support had indirect positive effects on mathematics grades, with homework mindsets (fixed and growth) and homework effort serving as mediators. Additionally, teacher and parent autonomy support directly associated with homework effort, while also exerting indirect associations with homework effort via homework mindsets. Collectively, the current investigation underscores the critical roles of autonomy support, homework mindsets, and homework effort in the homework process, offering important theoretical and practical insights. Full article

Advances in diagnostic techniques, along with environmental changes driven by human activity, have intensified the surveillance and monitoring of virus and arbovirus circulation on the Amazon. These efforts have increased the detection of insect-specific viruses in field-collected hematophagous arthropods. This study reports the first isolation of the Aguas Brancas virus from mosquitoes collected in the Brazilian Amazon and in a rural area of Brasília, Federal District, Brazil. Arthropods of the family Culicidae, genus Limatus durhamii, were collected at ground level in forest fragments. Sample BEAR812610 originated from Ananindeua, Pará, within the Evandro Chagas Institute’s grounds, and sample BEAR839941 from a forest fragment in Brasília (Ceilândia—Núcleo Rural Boa Esperança, Site B4). Specimens were identified to the species/genus level, macerated, and the supernatant inoculated into C6/36 and Vero cell cultures for viral isolation. The presence of arboviruses was determined by indirect immunofluorescence using antibodies against major arbovirus groups. Positive samples were sequenced for nucleotide and amino acid identification, and phylogenetic analysis confirmed the virus as belonging to the genus Orthoflavivirus. This represents the first report of the isolation and characterization of the insect-specific Aguas Brancas virus. Full article

Unless the psychosocial challenges experienced by widows in low-resourced communities are unpacked and understood, efforts to offer them proper and befitting interventions for their experiences will remain scant in South Africa. This paper explores the psychosocial challenges faced by widows in Ngaka Modiri Molema, a district in South Africa’s North West Province with limited resources. Using a qualitative approach and an exploratory descriptive design, this study employed homogeneous purposive sampling to ensure inclusion of widows who have experienced the psychosocial challenges of widowhood in Ngaka Modiri Molema. In-depth interviews conducted with twelve widows provided data saturation. The data were analysed thematically using predetermined and emerging themes, critically discussed and compared to the existing literature. The findings revealed that there were endemic and unexplored psychological issues such as anxiety, stress and depression, whilst some social challenges such as property disputes, eviction from the land and stigma were experienced by widows in the district since the death of their husbands. This paper recommends relevant holistic interventions to ameliorate the psychosocial challenges experienced by the widows in the district. Full article

Neuromuscular diseases are biologically diverse, clinically heterogeneous, and often difficult to diagnose and treat, highlighting the need for computational tools that can help resolve overlapping phenotypes and support timely, mechanism-informed interventions. This narrative review synthesizes recent advances in artificial intelligence (AI) and machine learning applied to neuromuscular diseases across diagnosis, outcome modeling, biomarker development, and therapeutics. AI-based approaches may assist clinical and genetic diagnosis from phenotypic data; however, early phenotype-driven tools have seen limited clinician adoption due to modest accuracy, usability challenges, and poor workflow integration. Electrophysiological studies remain central to diagnosing neuromuscular diseases, and AI shows promise for accurate classification of electrophysiological signals. Predictive models for disease outcome and progression—particularly in amyotrophic lateral sclerosis—are under active investigation, but most remain at an early stage of development and are not yet ready for routine clinical use. Digital biomarkers derived from imaging, gait, voice, and wearable sensors are emerging, with MRI-based quantification of muscle fat replacement representing the most mature and widely accepted application to date. Efforts to apply AI to therapeutic discovery, including drug repurposing and optimization of gene-based therapies, are ongoing but have thus far yielded limited clinical translation. Persistent barriers to broader adoption include disease rarity, data scarcity, heterogeneous acquisition protocols, inconsistent terminology, limited external validation, insufficient model explainability, and lack of seamless integration into clinical workflows. Addressing these challenges is essential to moving AI tools from the laboratory into clinical practice. We conclude with a practical checklist of considerations intended to guide the development and adoption of AI tools in neuromuscular disease care. Full article

The aging population and increasing prevalence of oxidative stress-related diseases underscore the need for functional food and pharmaceutical formulations enriched with bioactive compounds. This study aimed to design sustainable emulsion systems incorporating enzymatically modified fats with enhanced functional and bioactive properties. Enzymatic interesterification was employed as an environmentally friendly alternative to chemical catalysis, enabling the transformation of natural lipids without generating undesirable trans isomers. The lipid phase was formulated from blends of hemp oil, a plant-derived source rich in polyunsaturated fatty acids with documented antioxidant potential, and mutton tallow, in an effort to valorize meat industry by-products. Systematic evaluation of emulsion stability, viscosity, and textural properties was conducted using Turbiscan analysis and texture profile analysis. The results demonstrated that xanthan gum concentration was the primary determinant of structural stability, physicochemical stability, and structural integrity of the emulsion systems. Formulation no. 38 (0.8% w/w xanthan gum) was identified as the statistically most stable system based on Turbiscan Stability Index values (TSI = 1.4). Although emulsions containing 1.0% w/w xanthan gum exhibited similarly low TSI values and slightly smaller final droplet diameters, formulation E38 showed the smallest increase in droplet size during storage (<1 µm), indicating superior resistance to structural changes over time. Fat composition showed minimal influence on emulsion behavior, suggesting that lipid selection should prioritize nutritional and bioactive value. These findings indicate that emulsions based on enzymatically modified fats and stabilized with natural polysaccharides can serve as physically stable systems with potential applicability in food, cosmeceutical, and pharmaceutical formulations intended for bioactive compound delivery. Full article

Background/Objectives: Missed Nursing Care is a global concern that affects nurses’ well-being and patients’ safety. Despite global recognition of Missed Nursing Care, there is limited synthesized evidence that determines its characteristics in a Middle Eastern context. The purpose of the study is to synthesize the existing evidence about the prevalence of Missed Nursing Care among nurses in hospitals, the types of care missed, and reasons for Missed Nursing Care in the Middle East. Methods: A systematic literature review is conducted by using a comprehensive search in CINAHL, Scopus, and ScienceDirect databases for studies published between 2020 and 2025 and utilizing the MISSCARE Survey. Results: 25 studies met the inclusion criteria. The reported prevalence of Missed Nursing Care ranged between 1.06 and 2.9 out of five, indicating a low to moderate level. Frequent missed care activities included ambulation, hygiene, mouth care, and patient teaching. Contributing factors were staffing shortages, heavy workload, resource limitations, and communication issues. Missed Nursing Care critically affected patients’ outcomes, reduced job satisfaction, and caused moral distress and a higher intent to leave the profession. Conclusions: Missed Nursing Care remains a significant, complex challenge in the Middle East. Therefore, understanding this phenomenon in the region is needed. Collaborative efforts among policymakers, administrators, and nursing leaders are essential to implement targeted interventions, supportive policies, and ongoing research to minimize Missed Nursing Care across the Middle East. Full article