Search Results (11,535)

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a worldwide challenge. There are an estimated 17–24 million patients worldwide, with an estimated 60 percent or more who have not been diagnosed. Without a known cure, no specific curative medication, disability lasting years to being life-long, and disagreement among healthcare providers as to how to most appropriately treat these patients, ME/CFS patients are in need of assistance. Appropriate healthcare provider education would increase the percentage of patients diagnosed and treated; however, in-school healthcare provider education is limited. To address the latter issue, the New Jersey Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Association (NJME/CFSA) has developed an independent, incentive-driven, learning program for students of the health professions. NJME/CFSA offers a yearly scholarship program in which applicants write a scholarly paper on an ME/CFS-related topic. The efficacy of the program is demonstrated by the 2024–2025 first place scholarship winner’s essay, which addresses the biological basis of ME/CFS and how the healthcare provider can improve the quality of life of ME/CFS patients. For the reader, the essay provides an update on what is known regarding the biological underpinnings of ME/CFS, as well as a medical student’s perspective as to how the clinician can provide care and support for ME/CFS patients. The original essay has been slightly modified to demonstrate that ME/CFS is a worldwide problem and for publication. Full article

Lesbian, Gay, Bisexual, Transgender, Questioning, or Queer (LGBTQ) students with disabilities face unique challenges in the educational environment, and educators must provide support based on intersectionality. However, research on LGBTQ students in special needs education is limited, and the extent of educators’ awareness and support is not well documented. Therefore, this study explored the awareness, knowledge, and support practices of special needs school educators regarding LGBTQ students. We conducted a nationwide survey of educators in special needs schools in Japan, and 2024 valid responses were analyzed using multiple correspondence and cluster analyses. The results revealed that many educators lacked an understanding of basic LGBTQ terminology and may have been unaware of their discriminatory behaviors. Additionally, most educators had never encountered LGBTQ students with disabilities, potentially hindering these students’ opportunities to seek support. Furthermore, educators who had received LGBTQ training reported higher awareness and being more proactive in supporting LGBTQ students than those who had not. Thus, training may be associated with support-related attitudes. This highlights the need for ongoing training programs that address LGBTQ identity and disability, considering their intersectionality. These preliminary findings suggest the potential for creating an inclusive environment for LGBTQ students with disabilities; nevertheless, structural barriers remain. Full article

In lace textile manufacturing, the dyeing process in parallel machine environments faces challenges from sequence-dependent setup times due to color family transitions, machine eligibility constraints based on weight capacities, and probabilistic re-dyeing operations arising from quality inspection failures, which often lead to increased tardiness. To tackle this multi-constrained problem, a stochastic integer programming model is formulated to minimize total estimated tardiness. A novel symmetry-driven two-population collaborative differential evolution (TCDE) algorithm is then proposed. It features two symmetrically complementary subpopulations that achieve a balance between global exploration and local exploitation. One subpopulation employs chaotic parameter adaptation through a logistic map for symmetrically enhanced exploration, while the other adjusts parameters based on population diversity and convergence speed to facilitate symmetry-aware exploitation. Moreover, it also incorporates a symmetrical collaborative mechanism that includes the periodic migration of top individuals between subpopulations, along with elite-set guidance, to enhance both population diversity and convergence efficiency. Extensive computational experiments were conducted on 21 small-scale (optimally validated via CVX) and 15 large-scale synthetic datasets, as well as 21 small-scale (similarly validated) and 20 large-scale industrial datasets. These experiments demonstrate that TCDE significantly outperforms state-of-the-art comparative methods. Ablation studies also further verify the critical role of its symmetry-based components, with computational results confirming its superiority in solving the considered problem. Full article

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusion: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity. Full article

In the final phases of casing production, shale gas horizontal wells with a downward slope frequently find it difficult to sustain self-flow production. The ideal tubing insertion depth for self-flow production in gas wells has not been thoroughly studied, even though the timely adoption of tubing production can successfully prolong the self-flow production period. Using a fully dynamic multiphase flow simulation program, the ideal tubing depth for gas well self-flow production was ascertained. A wellbore structural model was built using a particular well as an example. By altering the tubing depth, the formation pressure limit values necessary to sustain gas well self-flow production at various tubing depths were simulated. The appropriate tubing depth for gas well self-flow production was examined, along with the well’s cumulative gas output at various tubing depths. Using the example as a case study, it was discovered that the critical formation pressure for gas well self-flowing production dropped to 7.8 MPa when the tubing was lowered to 2600 m. This effectively increased cumulative production by 56.19 × 10⁶ m³ and extended the self-flow production time by roughly 135 days. The study’s findings offer strong evidence in favor of maximizing shale gas wells’ self-flow production performance in later phases of production. Full article

Saffron (Crocus sativus L.) is a vegetatively propagated crop of high economic and cultural value, potentially affected by viral infections that may impact its productivity. Despite Iran’s dominance in global saffron production, knowledge of its virome remains limited. In this study, we conducted the first nationwide virome survey of saffron in Iran employing a high-throughput sequencing (HTS) approach on pooled samples obtained from eleven provinces in Iran and one location in Afghanistan. Members of three virus families were detected—Potyviridae (Potyvirus), Solemoviridae (Polerovirus), and Geminiviridae (Mastrevirus)—as well as one satellite from the family Alphasatellitidae (Clecrusatellite). A novel Potyvirus, tentatively named saffron Iran virus (SaIRV) and detected in three provinces, shares less than 68% nucleotide identity with known Potyvirus species, thus meeting the ICTV criteria for designation as a new species. Genetic diversity analyses revealed substantial intrapopulation SNP variation but no clear geographical clustering. Among the two wild Crocus species sampled, only Crocus speciosus harbored turnip mosaic virus. Virome network and phylogenetic analyses confirmed widespread viral circulation likely driven by corm-mediated propagation. Our findings highlight the need for targeted certification programs and biological characterization of key viruses to mitigate potential impacts on saffron yield and quality. Full article

Background: Brain health is a growing public health priority due to the high global burden of neurological and mental disorders. Promoting brain health across the lifespan supports individual and societal well-being, creativity, and productivity. Objective: To address the need for specialized education in this field, the University of Bern developed a Certificate of Advanced Studies (CAS) in Brain Health. This article outlines the program’s rationale, structure, and goals. Program Description: The one-year, 15 ECTS-credit program is primarily online and consists of four modules: (1) Introduction to Brain Health, (2) Brain Disorders, (3) Risk Factors, Protective Factors and Interventions, and (4) Brain Health Implementation. It offers a multidisciplinary, interprofessional, life-course approach, integrating theory with practice through case studies and interactive sessions. Designed for healthcare and allied professionals, the CAS equips participants with skills to promote brain health in clinical, research, and public health contexts. Given the shortage of trained professionals in Europe and globally, the program seeks to build a new generation of brain health advocates. It aims to inspire action and initiatives that support the prevention, early detection, and management of brain disorders. Conclusions: The CAS in Brain Health is an innovative educational response to a pressing global need. By fostering interdisciplinary expertise and practical skills, it enhances professional development and supports improved brain health outcomes at individual and population levels. Full article

Background: This systematic review investigates the role of virtual reality (VR)-based multisensory cognitive training in cognitive function, executive function and wayfinding ability among people diagnosed with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Methods: The review was carried out using PRISMA guidelines. PubMed, Scopus, Embase, and Google Scholar were searched up from inception to February 2025 using terms related to MCI, AD, VR, and cognitive functions. Studies were included if they involved participants with MCI or early AD, used VR-based training, collected baseline data, and reported cognitive outcomes. Results: Nine studies with MCI were included, but no eligible studies focused on AD. Seven out of nine eligible studies in MCI reported significant improvements in global cognitive function (MoCA, CERAD-K, MMSE). Some studies showed improvements in executive function (EXIT-25, TMT-A/B, and SCWT), while others found no significant differences. One study reported improved depression/mental status (GDS, MOSES, QoL-AD). Just one study reported improvement in functional ability (IADL). One study reported enhanced cognition and reduced discomfort (SSQ). VR programs were generally well-tolerated, with no significant adverse events reported. Conclusions: VR shows promise for improving cognitive function in MCI. VR also showed potential benefits in executive function and psychological outcomes like depression and quality of life, though consistency varied. Full article

Colorectal cancer (CRC) is not only the third most common cancer worldwide, with 1.1 million new cases per year; it is also the second leading cause of cancer death. However, mortality has decreased since 2012 due to early detection programs and better therapeutic approaches. While many patients are diagnosed at an early stage, there is up to 50% relapse after optimal initial treatment. Therefore, it is crucial to explore the mechanism underlying the development of recurrences and metastasis. It is known that tumors release dormant cells that escape chemotherapy and nest in a target organ without proliferating. Under certain circumstances that are not yet entirely clear, they can be activated and metastasize. Therefore, the objective of this work is to explore the detailed mechanisms of dormancy, including early detection of recurrence and therapeutic approaches for the treatment of CRC. The specific objectives are to determine biomarkers that may be useful in identifying dormant cells to detect minimal residual disease (MRD) after surgery and predicting disease progression, as well as evaluating biomarkers that are susceptible to therapeutic intervention. Full article

(1) The beach areas of Galveston, Texas, USA are heavily used for recreational activities and often experience elevated fecal indicator bacteria levels, representing a potential threat to ecosystem services, human health, and tourism-based economies that rely on suitable water quality. (2) During the span of 15 months (March 2022–May 2023), water samples that exceeded the U.S. Environmental Protection Agency-accepted alternative Beach Action Value (BAV) for enterococci of 104 MPN/100 mL were analyzed via microbial source tracking (MST) through quantitative polymerase chain reaction (qPCR) assays. The Bacteroides HF183 and DogBact as well as the Catellicoccus LeeSeaGull markers were used to detect human, dog, and gull fecal sources, respectively. The qPCR MST data were then utilized in a quantitative microbial risk assessment (QMRA) to assess human health risks. Additionally, samples collected in July and August 2022 were sequenced for 16S rRNA and matched with fecal sources through the Bayesian SourceTracker2 program. (3) Overall, 26% of the 110 samples with enterococci exceedances were positive for at least one of the MST markers. Gull was revealed to be the primary source of identified fecal contamination through qPCR and SourceTracker2. Human contamination was detected at very low levels (<1%), whereas dog contamination was found to co-occur with human contamination through qPCR. QMRA identified Campylobacter from canine sources as being the primary driver for human health risks for contact recreation for both adults and children. (4) These MST results coupled with QMRA provide important insight into water quality in Galveston that can inform future water quality and beach management decisions that prioritize public health risks. Full article

Urban forests, as a form of green infrastructure, play a vital role in enhancing urban resilience, environmental health, and quality of life. However, users perceive and utilize these spaces in diverse ways. This study aims to identify latent perception types among urban forest visitors and analyze their behavioral, demographic, and policy-related characteristics in Incheon Metropolitan City (Republic of Korea). Using latent class analysis, four distinct visitor types were identified: multipurpose recreationists, balanced relaxation seekers, casual forest users, and passive forest visitors. Multipurpose recreationists preferred active physical use and sports facilities, while balanced relaxation seekers emphasized emotional well-being and cultural experiences. Casual users engaged lightly with forest settings, and passive forest visitors exhibited minimal recreational interest. Satisfaction with forest elements such as vegetation, facilities, and management conditions varied across visitor types and age groups, especially among older adults. These findings highlight the need for perception-based green infrastructure planning. Policy recommendations include expanding accessible neighborhood green spaces for aging populations, promoting community-oriented events, and offering participatory forest programs for youth engagement. By integrating user segmentation into urban forest planning and governance, this study contributes to more inclusive, adaptive, and sustainable management of urban green infrastructure. Full article

Background/Objectives: This study aimed to determine whether postpartum mothers exhibit a uniform trajectory of postpartum emotional status (PES) changes or if distinct subgroups with differing trajectories of PES exist. Additionally, it investigated whether intensified tactile stimulation of the infant through Shantala massage influences maternal PES. Method: A quasi-experimental design with a matched control group was employed. Eighty women following their first physiological delivery volunteered to participate. The intervention involved applying intensified tactile stimulation to the infant via Shantala massage over a 12-week postpartum period. Maternal PES, divided into negative and positive emotional domains, was assessed using four standardized questionnaires. Results: Two opposing trajectories of PES change were identified: adverse and favorable. Intensified tactile stimulation was associated with improvement in maternal emotional status along both trajectories. Conclusions: PES changes do not follow a uniform course across all women; notably, those with a favorable trajectory often begin with more severe symptoms. Overlooking this distinction in diagnosis, prevention, and treatment may result in suboptimal care. The factors influencing PES trajectories remain unidentified but may affect clinical intervention outcomes. The Shantala massage intervention appears to slow the progression of emotional disorders in women with adverse PES changes and accelerate recovery in those with favorable changes. Implementation of this approach in clinical settings is recommended. Full article

Understanding the metabolic characteristics of pineapple varieties is crucial for market expansion and diversity. This study performed comparative metabolomic analysis on the “Comte de Paris” (BL) and three Taiwan-introduced varieties: “Tainong No. 11” (XS), “Tainong No. 23” (MG), and “Tainong No. 13” (DM). A total of 551 metabolites were identified across the four varieties, with 231 metabolites exhibiting no significant differences between all varieties. This included major sugars such as sucrose, glucose, and fructose, as well as key acids like citric, malic, and quinic acids, indicating that the in-season maturing fruits of different pineapple varieties can all achieve good sugar–acid accumulation under suitable conditions. The differentially accumulated metabolites (DAMs) that were identified among the four varieties all primarily belonged to several major subclasses, including phenolic acids, flavonoids, amino acids and derivatives, and alkaloids, but the preferentially accumulated metabolites in each variety varied greatly. Specifically, branched-chain amino acids (L-leucine, L-isoleucine, and L-valine) and many DAMs in the flavonoid, phenolic acid, lignan, and coumarin categories were most abundant in MG, which might contribute to its distinct and enriched flavor and nutritional value. XS, meanwhile, exhibited a notable accumulation of aromatic amino acids (L-phenylalanine, L-tryptophan), various phenolic acids, and many lignans and coumarins, which may be related to its unique flavor profile. In DM, the dominant accumulation of jasmonic acid might contribute to its greater adaptability to low temperatures during autumn and winter, allowing off-season fruits to maintain good quality. The main cultivar BL exhibited the highest accumulation of L-ascorbic acid and many relatively abundant flavonoids, making it a good choice for antioxidant benefits. These findings offer valuable insights for promoting different varieties and advancing metabolome-based pineapple improvement programs. Full article

Research on children’s singing development is extensive. Different ages, approaches, and variables have been taken into consideration. However, research on singing with text or a neutral syllable is scarce, and findings are inconclusive. This study investigated the influence of singing with text and a neutral syllable on children’s vocal performance. Children aged 4 to 9 (n = 135) participated in two periods of instruction and assessment. In Period One, Song 1 was taught with text and Song 2 with a neutral syllable, and in Period Two, the text was added to Song 2. In each period, children were individually audio-recorded singing both songs. Three independent raters scored the songs’ vocal performances using two researcher-designed rating scales, one for each song, which included the assessment of tonal and rhythm dimensions. Before data analysis, the validity and reliability of the rating scales used to assess vocal performance were examined and assured. The results revealed that 4-, 5-, and 7-year-olds sang Song 1 significantly better in Period One, and 4- and 5-year-olds sang Song 1 significantly better in Period Two. Thus, singing with text seems to favour younger children’s vocal performance. Findings also revealed that girls scored significantly higher than boys for Song 1 in both periods, but not for Song 2 in Period One. The implications of incorporating songs with text and neutral syllables into music programs, as well as the instruments used to assess vocal performances, are discussed. Full article

This study proposes a coupled constitutive model that captures the anisotropic failure characteristics and damage evolution of nickel-based single-crystal (SX) superalloys under various temperature conditions. The model accounts for both creep rate and material damage evolution, enabling accurate prediction of the typical three-stage creep curves, macroscopic fracture morphologies, and microstructural features under uniaxial tensile creep for specimens with different crystallographic orientations. Creep behavior of SX superalloys was simulated under multiple orientations and various temperature-stress conditions using the proposed model. The resulting creep curves aligned well with experimental observations, thereby validating the model’s feasibility and accuracy. Furthermore, a finite element model of cylindrical specimens was established, and simulations of the macroscopic fracture morphology were performed using a user-defined material subroutine. By integrating the rafting theory governed by interfacial energy density, the model successfully predicts the rafting morphology of the microstructure at the fracture surface for different crystallographic orientations. The proposed model maintains low programming complexity and computational cost while effectively predicting the creep life and deformation behavior of anisotropic materials. The model accurately captures the three-stage creep deformation behavior of SX specimens and provides reliable predictions of stress fields and microstructural changes at critical cross-sections. The model demonstrates high accuracy in life prediction, with all predicted results falling within a ±1.5× error band and an average error of 14.6%. Full article