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Catheter-associated urinary tract infections (CAUTIs) cause serious complications among hospitalized patients due to biofilm-forming microorganisms which make treatment ineffective by forming antibiotic-resistant strains. As most CAUTI-causing bacterial pathogens have already developed multidrug resistance, there is an urgent need for alternative antibacterial agents to prevent biofilms on catheter surfaces. As a trial to find out such a potential agent of natural origin, the bark of Tamarix ericoides Rottl., a little-known plant from the Tamaricaceae family, was examined for its antibacterial and antibiofilm activities against one of the major, virulent, CAUTI-causing bacterial pathogens: Enterococcus faecalis. The methanolic T. ericoides bark extract was analyzed for its antibacterial activity using the well diffusion method and microdilution method. Killing kinetics were calculated using time–kill assay, and the ability of biofilm formation and its eradication upon treatment with the T. ericoides bark extract was studied by crystal violet assay. GC-MS analysis was performed to understand the phytochemical presence in the extract. A in vitro bladder model study was performed using extract-coated catheters against E. faecalis, and the effect was visualized using CLSM. The changes in the cell morphology of the bacterium after treatment with the T. ericoides bark extract were observed using SEM. The biocompatibility of the extract towards L929 cells was studied by MTT assay. The anti-E. faecalis activity of the extract-coated catheter tube was quantified by viable cell count method, which exposed 20% of growth after five days of contact with E. faecalis. The anti-adhesive property of the T. ericoides bark extract was studied using CLSM. The extract showed potential antibacterial activity, and the lowest inhibitory concentration needed to inhibit the growth of E. faecalis was found to be 2 mg/mL. The GC-MS analysis of the methanolic fractions of the T. ericoides bark extract revealed the presence of major phytochemicals, such as diethyl phthalate, pentadecanoic acid, methyl 6,11-octadecadienoate, cyclopropaneoctanoic acid, 2-[(2-pentylcyclopropyl) methyl]-, methyl ester, erythro-7,8-bromochlorodisparlure, etc., that could be responsible for the antibacterial activity against E. faecalis. The killing kinetics of the extract against E. faecalis was calculated and the extract showed promising antibiofilm activity on polystyrene surfaces. The T. ericoides bark extract effectively reduced the E. faecalis mature biofilms by 75%, 82%, and 83% after treatment with 1X MIC (2 mg/mL), 2X MIC (4 mg/mL), and 3X MIC (6 mg/mL) concentrations, respectively, which was further confirmed by SEM analysis. The anti-adhesive property of the T. ericoides bark extract studied using CLSM revealed a reduction in the biofilm thickness, and the FDA and PI combination revealed the death of 80% of the cells on the extract-coated catheter tube. In addition, SEM analysis showed extensive damage to the E. faecalis cells after the T. ericoides bark extract treatment, and it was not cytotoxic. Hence, after further studies, T. ericoides bark extract with potential antibacterial, antibiofilm, and anti-adhesive activities can be developed as an alternative agent for treating CAUTIs.

Introduction: Infected diabetic foot ulcers may lead to serious complications if not recognised in the early stage. Diagnosis of infection is particularly challenging at that stage; thus, a sensitive inflammatory biomarker may be helpful. We aimed to evaluate the role of procalcitonin (PCT) as an early biomarker for infected diabetic foot ulcers (IDFU). Materials and method: This cross-sectional study was conducted at Klinik Rawatan Keluarga (KRK), Orthopedic clinic and wards in Hospital Universiti Sains Malaysia (USM) from May 2020 to December 2020. A total of 264 participants were recruited and divided into three groups: 50 diabetic patients with no ulcers (control), 107 patients with non-infected diabetic foot ulcers (NIDFU), and 107 patients with infected diabetic foot ulcers (IDFU). The level of PCT was taken for all patients. Total white count (TWC) and C- reactive protein (CRP) were taken only for IDFU patients. Diagnosis of infection was based on the Infectious Disease Society of America-International Working Group of Diabetic Foot (IDSA-IMWGDF), and the severity of infection was graded according to the Wagner Classification. Results: The level of PCT was higher in IDFU than in NIDFU and diabetic patient, with a median (IQR) of 0.355 (0.63) ng/mL, 0.077 (0.15) ng/mL and 0.028 (0.02) ng/mL, respectively. PCT and CRP showed moderate positive correlations in IDFU patients (p

Catheter-associated urinary tract infections (CAUTIs) cause serious complications among hospitalized patients due to biofilm-forming microorganisms which make treatment ineffective by forming antibiotic-resistant strains. As most CAUTI-causing bacterial pathogens have already developed multidrug resistance, there is an urgent need for alternative antibacterial agents to prevent biofilms on catheter surfaces. As a trial to find out such a potential agent of natural origin, the bark of Tamarix ericoides Rottl., a little-known plant from the Tamaricaceae family, was examined for its antibacterial and antibiofilm activities against one of the major, virulent, CAUTI-causing bacterial pathogens: Enterococcus faecalis. The methanolic T. ericoides bark extract was analyzed for its antibacterial activity using the well diffusion method and microdilution method. Killing kinetics were calculated using time–kill assay, and the ability of biofilm formation and its eradication upon treatment with the T. ericoides bark extract was studied by crystal violet assay. GC-MS analysis was performed to understand the phytochemical presence in the extract. A in vitro bladder model study was performed using extract-coated catheters against E. faecalis, and the effect was visualized using CLSM. The changes in the cell morphology of the bacterium after treatment with the T. ericoides bark extract were observed using SEM. The biocompatibility of the extract towards L929 cells was studied by MTT assay. The anti-E. faecalis activity of the extract-coated catheter tube was quantified by viable cell count method, which exposed 20% of growth after five days of contact with E. faecalis. The anti-adhesive property of the T. ericoides bark extract was studied using CLSM. The extract showed potential antibacterial activity, and the lowest inhibitory concentration needed to inhibit the growth of E. faecalis was found to be 2 mg/mL. The GC-MS analysis of the methanolic fractions of the T. ericoides bark extract revealed the presence of major phytochemicals, such as diethyl phthalate, pentadecanoic acid, methyl 6,11-octadecadienoate, cyclopropaneoctanoic acid, 2-[(2-pentylcyclopropyl) methyl]-, methyl ester, erythro-7,8-bromochlorodisparlure, etc., that could be responsible for the antibacterial activity against E. faecalis. The killing kinetics of the extract against E. faecalis was calculated and the extract showed promising antibiofilm activity on polystyrene surfaces. The T. ericoides bark extract effectively reduced the E. faecalis mature biofilms by 75%, 82%, and 83% after treatment with 1X MIC (2 mg/mL), 2X MIC (4 mg/mL), and 3X MIC (6 mg/mL) concentrations, respectively, which was further confirmed by SEM analysis. The anti-adhesive property of the T. ericoides bark extract studied using CLSM revealed a reduction in the biofilm thickness, and the FDA and PI combination revealed the death of 80% of the cells on the extract-coated catheter tube. In addition, SEM analysis showed extensive damage to the E. faecalis cells after the T. ericoides bark extract treatment, and it was not cytotoxic. Hence, after further studies, T. ericoides bark extract with potential antibacterial, antibiofilm, and anti-adhesive activities can be developed as an alternative agent for treating CAUTIs. [ABSTRACT FROM AUTHOR]

ATP-binding cassette (ABC) transport systems are crucial for bacteria to ensure sufficient uptake of nutrients that are not produced de novo or improve the energy balance. The cell surface of the pathobiont Streptococcus pneumoniae (pneumococcus) is decorated with a substantial array of ABC transporters, critically influencing nasopharyngeal colonization and invasive infections. Given the auxotrophic nature of pneumococci for certain amino acids, the Ami ABC transporter system, orchestrating oligopeptide uptake, becomes indispensable in host compartments lacking amino acids. The system comprises five exposed Oligopeptide Binding Proteins (OBPs) and four proteins building the ABC transporter channel. Here, we present a structural analysis of all the OBPs in this system. Multiple crystallographic structures, capturing both open and closed conformations along with complexes involving chemically synthesized peptides, have been solved at high resolution providing insights into the molecular basis of their diverse peptide specificities. Mass spectrometry analysis of oligopeptides demonstrates the unexpected remarkable promiscuity of some of these proteins when expressed in Escherichia coli, displaying affinity for a wide range of peptides. Finally, a model is proposed for the complete Ami transport system in complex with its various OBPs. We further disclosed, through in silico modelling, some essential structural changes facilitating oligopeptide transport into the cellular cytoplasm. Thus, the structural analysis of the Ami system provides valuable insights into the mechanism and specificity of oligopeptide binding by the different OBPs, shedding light on the intricacies of the uptake mechanism and the in vivo implications for this human pathogen., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Alcorlo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Co-curricular activities equip students with essential skills and knowledge for personal and professional growth. Despite their importance, many students exert minimal effort to complete the assigned tasks. Instructors perceive that the lack of emphasis on final exams in co-curricular subjects reduces student effort and commitment. Moreover, poor time management and lack of effort in completing tasks have increased across various subjects in recent years. Therefore, it is important to investigate the factors that contribute to student commitment towards co-curricular subjects. In this study, the submission status of 339 tasks was retrieved from the student learning system to measure student commitment based on whether tasks were submitted on time, delayed, or not submitted. A chi-square test f was used to investigate the relationship between students' demographic characteristics and their commitment. The findings revealed a significant association between student commitment and the type of task given (p < 0.001). Students were more likely to submit presentations on time compared to written assignments. Projects were more likely to be delayed, while written assignments had a high frequency of no submission. Age was a significant predictor of commitment (p < 0.05), with students over 20 more likely to submit on time and students under 20 more likely to ignore submission. Gender was also a significant predictor of commitment (p < 0.001), with female students having a higher percentage and frequency of on-time submissions while male students having a higher number of no submissions. However, no significant association was found between the study year and commitment (p > 0.05), indicating that the year of the study could not determine the level of commitment to the course. Overall, these findings could be used to guide the preparation of tasks and assignments in co-curricular subjects to enhance student commitment and holistic development., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

The identification and prediction of athletic talent are pivotal in the development of successful sporting careers. Traditional subjective assessment methods have proven unreliable due to their inherent subjectivity, prompting the rise of data-driven techniques favoured for their objectivity. This evolution in statistical analysis facilitates the extraction of pertinent athlete information, enabling the recognition of their potential for excellence in their respective sporting careers. In the current study, we applied a logistic regression-based machine learning pipeline (LR) to identify potential skateboarding athletes from a combination of fitness and motor skills performance variables. Forty-five skateboarders recruited from a variety of skateboarding parks were evaluated on various skateboarding tricks while their fitness and motor skills abilities that consist of stork stance test, dynamic balance, sit ups, plank test, standing broad jump, as well as vertical jump, were evaluated. The performances of the skateboarders were clustered and the LR model was developed to classify the classes of the skateboarders. The cluster analysis identified two groups of skateboarders: high and low potential skateboarders. The LR model achieved 90% of mean accuracy specifying excellent prediction of the skateboarder classes. Further sensitivity analysis revealed that static and dynamic balance, lower body strength, and endurance were the most important factors that contributed to the model's performance. These factors are therefore essential for successful performance in skateboarding. The application of machine learning in talent prediction can greatly assist coaches and other relevant stakeholders in making informed decisions regarding athlete performance., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ab Rasid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The success and enjoyment of a football match depend heavily on referees and their ability to ensure fair play and uphold the rules of the game. However, there is limited research investigating the disciplinary measures and booking activities of referees in top European football leagues. In the current investigation, we explored the disciplinary measures and booking activities of top-European football league referees. The dataset of the referee activities concerning 15 indicators containing 602 matches from five consecutive seasons across the five top European leagues, namely, the English Premier League, Spanish Laliga, Italian Serie A, French Ligue1, and German Bundesliga were utilized for this study. K-means cluster analysis was used to define the activity levels of the referees. The Mann-Whitney U test was employed to determine the differences in the levels of the referees' activity with respect to the disciplinary measures, while binary regression analysis was applied to examine the association between the disciplinary measures and the activity levels of the referees. Two groups of activities were defined by k-means, that is, high and low activity. The Mann-Whitney U test revealed statistically significant differences in all 15 indicators examined between high and low activity. However, the regression model demonstrated that only fouls, yellow cards, and air challenges could significantly describe referees' activity levels. These indicators appear to be predictors of high referee activity in elite European Football. Specific training on dealing with increased aggression and foul behaviour coupled with improved game organisational management could be further incorporated into referees' training programmes amongst other measures., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Nuclear Magnetic Resonance (NMR) spectra of human serum and plasma show, besides metabolites and lipoproteins, two characteristic signals termed GlycA and B arising from the acetyl groups of glycoprotein glycans from acute phase proteins, which constitute good markers for inflammatory processes. Here, we report a comprehensive assignment of glycoprotein glycan NMR signals observed in human serum, showing that GlycA and GlycB signals originate from Neu5Ac and GlcNAc moieties from N-glycans, respectively. Diffusion-edited NMR experiments demonstrate that signal components can be associated with specific acute phase proteins. Conventionally determined concentrations of acute phase glycoproteins correlate well with distinct features in NMR spectra (R 2 up to 0.9422, p-value <0.001), allowing the simultaneous quantification of several acute phase inflammation proteins. Overall, a proteo-metabolomics NMR signature of significant diagnostic potential is obtained within 10-20 min acquisition time. This is exemplified in serum samples from COVID-19 and cardiogenic shock patients showing significant changes in several acute phase proteins compared to healthy controls., (© 2023 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

Bone morphogenetic protein (BMP)-9 is considered a member of the transforming growth factor (TGF)β superfamily. It was first found as an inducer of bone and cartilage formation and then discovered that this factor mediates several physiologic functions and hemostasis. Besides physiological conditions, BMP9 has also been elucidated that it is involved in several pathological situations, especially cancer. In various cancers, dysregulation of BMP9 has raised the issue that BMP9 might play a conflicting role in tumour development. BMP9 binding to its receptors (BMPRs), including ALKs and BMPRII, induces canonical SMAD-dependent and non-canonical PI3K/AKT and MAPK signalling pathways in tumour cells. BMP9, via inducing apoptosis, inhibiting tumour-promoting cell signalling pathways, suppressing epithelial-mesenchymal transition (EMT) process, blocking angiogenesis, and preventing cross-talk in the tumour microenvironment, mainly exerts tumour-suppressive functions. In contrast, BMP9 triggers tumour-supportive signalling pathways, promotes EMT, and enhances angiogenesis, suggesting that BMP9 is also involved in tumour development. It has been demonstrated that modulating BMP9 expression and functions might be a promising approach to cancer treatment. It has also been indicated that evaluating BMP9 expression in cancers might be a biomarker for predicting cancer prognosis. Overall, BMP9 would provide a promising target in cancer management.

In the present work, a WC particle-reinforced CoCrFeMnNi high-entropy alloy (HEA) was fabricated by laser melting deposition (LMDed). The LMDed CoCrFeMnNi high-entropy alloy (CoCrFeMnNi) composite is primarily comprised of a face-centered cubic (FCC) crystal structure. However, in the case of CoCrFeMnNi with 2.5 wt.% WC, it exhibits a combination of an FCC matrix and a ceramic phase known as M 23 C 6 . The corrosion behavior of CoCrFeMnNi and CoCrFeMnNi with 2.5 wt.% WC particle in 0.5 M H 2 SO 4 was comparatively investigated. Compared with CoCrFeMnNi, the passive film formed on the CoCrFeMnNi with 2.5 wt.% WC had a more stable and stronger protective property. The corrosion current density of the CoCrFeMnNi with 2.5 wt.% WC dropped by 149.1% compared to that of the CoCrFeMnNi, indicating that the CoCrFeMnNi with 2.5 wt.% WC had better corrosion resistance than that of the CoCrFeMnNi.

Introduction: The objective of this study was to investigate the effect of convalescent plasma (CP) transfusion on clinical and serial laboratory parameters in severe COVID-19 patients. The Coronavirus Disease 2019 (COVID-19) pandemic presents a challenge to the healthcare system worldwide due to the limited treatment options available. The body of evidence reported that CP containing anti- COVID-19 antibodies could be effective against the infection., Materials and Methods: This was a cross-sectional study that involved retrospective data collection of severe COVID-19 adult patients who received CP transfusion along with the best-of-care (CP group, n: 53) and best-of-care only (control group, n: 53). An age, gender, and comorbidity were manually matched approximately at a 1:1 ratio., Results: The prevalence of adverse transfusion reactions was 5.7%. A shorter duration of oxygen support (median: 12 days vs 14 days, P=0.030) and a shorter duration of mechanical ventilation (median: 6 days vs 10 days, P=0.048) were found in the CP group. The laboratory parameters were also improved. However, there was no significant difference in the mechanical ventilation rate, length of hospital stay, length of intensive care unit (ICU) stay, and mortality rate across both groups (P = 0.492, 0.614, 0.793, 0.374)., Conclusion: CP transfusion is safe and effective in the treatment of severe COVID-19 patients. However, a revision of our approaches such as early CP transfusion and use of a high-titre anti-COVID-19 neutralising antibody (nAb) unit is necessary to unlock the full potential benefits of CP transfusion among COVID-19 patients.

Artemisia is a perennial wild shrub with large branches and compound leaves. Artemisia contains about 400 types, and its medical importance is due to the presence of many active substances and compounds such as volatile oils, alkaloids and flavonoids, glycosides, saponins, tannins, and coumarins. This study was designed to study the effect of the aqueous extract of the fruit of the Artemisia plant on the organs of the body, as well as to know its ability to activate the hepatic enzyme alanine transaminase (ALT/GPT). The fruit of this shrub was extracted using the measurement technique gas chromatography-mass spectrometry (GC/MASS) and organic solvent hexane and ethyl acetate in one to one ratio. It contained 21 compounds, a high percentage of their terpenes, essential aromatic oils, alkaloids, and phenolic compounds. The results showed a significant improvement in the enzyme (ALT/GPT) level after adding different concentrations of hot aqueous extract to the fruit of the Artemisia plant. The fruit of the Artemisia plant can be used to treat many diseases and improve the activity of liver enzymes., Competing Interests: The authors declare that they have no conflict of interest.

We performed this cohort study to test whether further analysis of intrathecal inflammation can be omitted if the free light chain kappa (FLCκ) quotient is within the reference range in the corresponding quotient diagram. FLCκ concentrations were measured in serum and cerebrospinal fluid (CSF) samples. The intrathecal fraction (IF) of FLCκ was calculated in relation to the hyperbolic reference range. 679 patient samples were used as a discovery cohort (DC). The sensitivity and negative predictive value (NPV) of the FLCκ-IF for the detection of an intrathecal humoral immune response (CSF-specific OCB and/or IF IgG/A/M > 0%) was determined. Based on these data, a diagnostic algorithm was developed and prospectively validated in an independent validation cohort (VC, n = 278). The sensitivity of the FLCκ-IF was 98% in the DC and 97% in the VC with a corresponding NPV of 99%. The use of the FLCκ-IF as a first line analysis would have reduced the Ig and OCB analysis by 62% in the DC and 74% in the VC. The absence of a FLCκ-IF predicts the absence of a humoral intrathecal immune response with a very high NPV of 99%. Thus, integration of our proposed algorithm into routine CSF laboratory analysis could help to reduce analytical efforts.

Preventive strategies involving the use of pneumococcal conjugate vaccines (PCVs) are known to drastically reduce pneumococcal disease. However, PCV vaccination has been plagued with serotype replacement by non-PCV serotypes. In this study, we describe the prevalence and molecular characteristics of non-PCV13 serotypes (non-vaccine serotypes, NVTs) from pneumococcal carriage isolates obtained from children < 5 years old in Cape Coast, Ghana, after PCV introduction. The isolates were subjected to antibiotic susceptibility testing and multilocus sequence typing (MLST), and molecular techniques were used to detect the presence of virulence genes. Serotypes 11A, 13, 15B, 23B, and 34 formed the top five of the 93 NVT isolates. As such, 20 (21.5%), 49 (48.4%), and 70 (74.3%) isolates were non-susceptible to penicillin, tetracycline, and cotrimoxazole, respectively. Sixteen (17.2%) multidrug-resistant isolates were identified. However, non-susceptibility to ceftriaxone and erythromycin was low and all isolates were fully susceptible to levofloxacin, linezolid, and vancomycin. Whereas pcpA, pavB, lytA, and psrP genes were detected in nearly all serotypes, pilus islet genes were limited to serotypes 11A, 13, and 23B. MLST for predominant serotype 23B isolates revealed three known and seven novel sequence types (STs). ST172 and novel ST15111 were the most dominant and both STs were related to PMEN clone Columbia23F-26 (ST338). In conclusion, non-PCV13 serotype 23B was the most prevalent, with characteristics of rapid clonal expansion of ST172 and ST15111, which are related to international clones of the pneumococcus. Continuous monitoring of NVTs in Ghana is, therefore, essential, as they have the potential to cause invasive disease, show high antibiotic resistance, and attenuate the effects of PCV vaccination.

The study aims to examine the moderating effect of self-efficacy on supervisory support and organizational citizenship behavior (OCB). An individual's self-efficacy is defined as their belief in their own ability to successfully complete a goal or task, which influences their motivation, persistence, and decision-making. This study is based on the Conservation of Resource Theory, which holds that personal resources such as self-efficacy can influence employees' perceived support and extra-role behavior (OCB). The data were collected from 618 employees in four public sector organizations in Putrajaya, Malaysia through a questionnaire survey and analyzed using the partial least squares structural equation modeling (PLS-SEM) technique. Resultantly, supervisory support demonstrated a significant positive relationship with OCB. The results suggested that personal resources, such as self-efficacy increase the level of OCB with lower or higher perceived supervisory support. The results highlighted that self-efficacy strengthens supervisory support relations with OCB when supported by employees' self-belief and confidence. It is critical to investigate the role of self-efficacy because industries must constantly change, and employees must have self-efficacy resources to continuously improve and sustain their performance level. The findings can contribute to the literature and open new avenues for future research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abdullah and Wider.)

The non-complexity of tennis, coupled with its health benefits, renders it appealing and encourages varying competitions at different levels of age, gender, and expertise. However, the rapid increase in the participation rates witnesses a surge in injury occurrences, prompting the need for in-depth analysis to facilitate immediate intervention. We employed a media content analysis technique in which tennis-associated articles published in the last 5 years were examined. A total of 207 news reports were gathered and screened for analysis. Subsequently, 71 articles were excluded from the study due to content duplications or summary updates of existing news articles, while 23 news articles were also excluded from the study due to inappropriateness. Finally, 113 news reports directly related to injury in tennis were coded and analyzed. We examined various types of injuries reported from the screened articles with respect to their status (fresh, recurrent, and recovery) across expertise levels i.e., elite, or amateur. Similarly, the incidence of injury occurrences based on the types of tournaments the players engage in was also investigated. A chi-square analysis was employed to achieve the objectives of the study. Occurrences of tennis-associated injuries are disseminated across expertise levels [ χ ( 18 ) 2 = 16.542; p = 0.555], with knee, hip, elbow, and shoulder injuries being highly prevalent in both elite and amateur players. Nevertheless, it was noted that elite players suffered a staggering 72.60% of injury-related problems, while amateur players sustained 27.40% of injuries. Moreover, the status of injury spreads based on types of tournaments [ χ ( 4 ) 2 = 3.374; p = 0.497], with higher occurrences of fresh and recurrent injuries, while low recovery rates were observed. The findings further demonstrated that injuries are sustained regardless of tournament types [ χ ( 36 ) 2 = 39.393; p = 0.321]. However, most of the injuries occurred at international tournaments (85%). Whereas, only 5.30% of the injuries occurred at national/regional tournaments while 9.70% were unidentified. It could be deduced from the findings of this investigation that elite players are more prone to injuries compared with amateur players. Furthermore, the most common tennis-related injuries affect the lower, trunk, and upper regions of the body, respectively. A large number of the reported tennis injuries are fresh and recurrent, with a few recoveries. The international tennis tournaments are highly attributed to injury occurrences as opposed to the national/regional tournaments. The application of the media-based data mining technique is non-trivial in projecting injury-related problems that could be used to facilitate the development of an injury index peculiar to the tennis sport for prompt intervention., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Musa, Hassan, Abdullah, Latiff Azmi, Abdul Majeed and Abu Osman.)

Learners’ engagement is shown to be a major predictor of learning, performance, and course completion as well as course satisfaction. It is easier to engage learners in a face-to-face teaching and learning format since the teacher can observe and interpret the learner’s facial expression and body language. However, in a virtual setting with the students sitting behind cameras, it is difficult to ascertain engagement as the students might be absent-mindedly attending the class. Henceforth, with the rapid transition to online learning, designing course content that could actively engage the students towards achieving the said elements is, therefore, necessary. We applied a data-driven approach in designing a virtual physical education and sport science−related course via a learner engagement model. A fully online course catering to 132 students that runs for a total of 14 weeks was used as a case study to develop the course. The study was conducted during the 2020/2021 academic year, which was the period of the peak COVID-19 pandemic in Malaysia. The delivery of the course content was implemented in stages to achieve three essential educational outcomes namely, skill and knowledge acquisition, and personal development as well as course satisfaction. We hypothesised that the developed learners’ engagement approach will promote the students’ acquisition of skills and knowledge and foster the personal development of the students through fitness improvement. It is also hypothesised that the students will be satisfied with the course developed upon successful completion. A chi-square analysis projected a statistically significant difference in the skill and knowledge acquisition before and after the programme (p < 0.001). A Wilcoxon rank-sum test demonstrated personal improvement in the overall fitness of the student upon completing the prescribed activity of the course content. Moreover, a total of 96.2%, 95.5% and 93.2% of students expressed their satisfaction with the clarity of the learning objectives, good organisational and course content plan, and appropriate workload of the course designed, respectively. There is sufficient evidence to accept all hypotheses formulated, and hence, we postulated that, since students spend more time outside the classroom, out-of-class learners’ engagement activity should be considered when designing a virtual course to promote lifelong learning, experience, and higher-order thinking. The techniques presented herein could be useful to academics, professionals, and other relevant stakeholders in developing virtual course content within a specific domain of interest.

Anthropometric variables (AV) are shown to be essential in assessing health status and to serve as markers for evaluating health-related risks in different populations. Studying the impact of physical activity (PA) on AV and its relationship with smoking is a non-trivial task from a public health perspective. In this study, a total of 107 healthy male smokers (37 ± 9.42 years) were recruited from different states in Malaysia. Standard procedures of measurement of several anthropometric indexes were carried out, and the International Physical Activity Questionnaire (IPPQ) was used to ascertain the PA levels of the participants. A principal component analysis was employed to examine the AV associated with physical activity, k-means clustering was used to group the participants with respect to the PA levels, and discriminant analysis models were utilized to determine the differential variables between the groups. A logistic regression (LR) model was further employed to ascertain the efficacy of the discriminant models in classifying the two smoking groups. Six AV out of twelve were associated with smoking behaviour. Two groups were obtained from the k-means analysis, based on the IPPQ and termed partially physically active smokers (PPAS) or physically nonactive smokers (PNAS). The PNAS were found to be at high risk of contracting cardiovascular problems, as compared with the PPAS. The PPAS cluster was characterized by a desirable AV, as well as a lower level of nicotine compared with the PNAS cluster. The LR model revealed that certain AV are vital for maintaining good health, and a partially active lifestyle could be effective in mitigating the effect of tobacco on health in healthy male smokers.

Antibiotic resistance in pneumococci contributes to the high pneumococcal deaths in children. We assessed the molecular characteristics of multidrug-resistant (MDR) pneumococci isolated from healthy vaccinated children under five years of age in Cape Coast, Ghana. A total of 43 MDR isolates were selected from 151 pneumococcal strains obtained from nasopharyngeal carriage. All isolates were previously serotyped by multiplex PCR and Quellung reaction. Susceptibility testing was performed using either the E-test or disk diffusion method. Virulence and antibiotic resistance genes were identified by PCR. Molecular epidemiology was analyzed using multilocus sequence typing (MLST). Vaccine-serotypes 23F and 19F were predominant. The lytA and pavB virulence genes were present in all isolates, whiles 14-86% of the isolates carried pilus-islets 1 and 2, pcpA , and psrP genes. Penicillin, tetracycline, and cotrimoxazole resistance were evident in >90% of the isolates. The ermB , mefA , and tetM genes were detected in (n = 7, 16.3%), (n = 4, 9.3%) and (n = 43, 100%) of the isolates, respectively. However, >60% showed alteration in the pbp2b gene. MLST revealed five novel and six known sequence types (STs). ST156 (Spain 9V -3) and ST802 were identified as international antibiotic-resistant clones. The emergence of international-MDR clones in Ghana requires continuous monitoring of the pneumococcus through a robust surveillance system.

Background: Global progress toward malaria elimination and eradication goals has stagnated in recent years, with many African countries reporting increases in malaria morbidity and mortality. Insecticide-treated nets and indoor residual spraying are effective, but the emergence and increased intensity of insecticide resistance and the challenge of outdoor transmission are undermining their impact. New tools are needed to get back on track towards global targets. This Perspective explores the major challenges hindering wider-scale implementation of larviciding in Africa and identifies potential solutions and opportunities to overcome these barriers. Larviciding in Africa: overview, challenges, and solutions Larviciding is a valuable vector control tool with strong potential for regional scale-up. There is considerable evidence of its effectiveness, and the World Health Organization (WHO) recommends it as a supplemental intervention. However, malaria programmes hoping to implement larviciding face significant barriers, including (1) poor global technical, policy, and funding support; (2) fragmented implementation and experience; (3) high complexity of delivery and impact evaluation; and (4) limited access to the full range of WHO prequalified larvicide products. Strategic barriers related to global policy and donor hesitancy can be overcome through a coordinated demonstration of cost-effectiveness. Technological advancements and strengthened operational capacity have already overcome technical barriers related to larvicide delivery, targeting, coverage, and evaluation. Developing a Community of Practice platform for larviciding has strong potential to consolidate efforts, addressing the challenge of fragmented implementation and experience. Such a platform can serve as a resource center for African malaria programmes, collating and disseminating technical guidance, facilitating the exchange of best practices, and aiding malaria programmes and partners in designing and evaluating larviciding projects. Conclusion: The global shift toward targeted and adaptive interventions enables the incorporation of larviciding into an expanded vector control toolbox. As more African countries implement larvicide programmes, establishing a regional Community of Practice platform for exchanging experiences and best practices is necessary to strengthen the evidence base for cost-effective implementation, advocate for support, and inform policy recommendations, thus supporting Africa's progress toward malaria elimination. [ABSTRACT FROM AUTHOR]

Background: This qualitative analysis aimed to: identify the physical and physiological factors that characterize elite WKF kumite and kata athletes, identify testing protocols that are used to examine the above mentioned profiles of WKF karatekas and indicate the variables that are significant for elite-level performance. Methods: A search of electronic databases (PubMed, EBSCO, Scopus) was conducted to identify all studies on physical and physiological profile in elite karatekas from 2012 to 2024. A JBI Qualitative Data Extraction Tool for systematic reviews of qualitative evidence was fulfilled in order to determine which variables should be extracted. The quality of the included studies was assessed based on the JBI Critical Appraisal Checklist. Results: 164 full-text articles were evaluated to determine eligibility, while 20 met the inclusion criteria and were subjected to detailed analysis, including risk of bias assessment. Finally, 17 full-text articles were included in the qualitative analysis. The following motor abilities and physiological components were evaluated by researchers: muscular strength (n = 8) muscular power (n = 11), speed (n = 8), agility (n = 6), flexibility (n = 6), aerobic metabolism (n = 9), anaerobic metabolism (n = 5). Conclusions: The force-velocity characteristics with the dominant effect of the velocity component seem to be crucial in regard to performance outcomes in WKF karatekas. Moreover, elite karatekas are characterized by high flexibility of the hamstring muscles and well developed speed and agility abilities. The efficiency of aerobic and anaerobic metabolism is significant for high-performance in elite WKF kumite athletes, however aerobic capacity may be crucial. It is difficult to confirm the impact of the above mentioned energy systems on kata performance. Athlete's age category and sex-related variables may affect the level of the analyzed motor abilities. [ABSTRACT FROM AUTHOR]

The aim of this study was to conduct a scoping and bibliometric review of articles using artificial intelligence (AI) in tennis. The analysis covered various aspects of tennis, including performance, health, match results, physiological data, tennis expenditure, and prize amounts. Articles on AI in tennis published until 2024 were retrieved from the Web of Science database. A total of 389 records were screened, and 108 articles were retained for analysis. The analysis identified intermittent gaps in publication output during certain intervals, notably in the years 2007–2008 and 2012–2013. From 2012 onward, there was a clear upward trend in publications and citations, peaking in 2022. The theme was led by China, the United States, and Australia. These countries maintain their status as the top contributors in terms of publications. The analysis of author collaborations revealed multiple clusters, with notable contributions from researchers in China, Australia, Japan, and the United States. This bibliometric review has elucidated the evolution of AI research in tennis, highlighting the countries and authors that have significantly contributed to this field over the years. The prediction model suggests that the number of articles and citations on this topic will continue to increase over the next decade (until 2034). [ABSTRACT FROM AUTHOR]

Background: Stunting is a significant public health concern in Indonesia. It represents a form of chronic malnutrition that manifests not only as a short stature for one's age, but also as a profound challenge affecting children's physical and cognitive development. This study aims to provide more research basis for the government to formulate stunting policies by exploring the ecological factors associated with stunting, consistent with the goal of reducing stunting according to Sustainable Development Goals (SDGs) targets by 2030. Methods: Data were collected on stunting and ecological factors from 34 provinces in Indonesia from 2015-18, sourced from Statistics Indonesia and the Ministry of Health. A framework of ecological factors that influence stunting, consisting of health, socioeconomic status, and the environment was developed. A panel data model to test the influence of each ecological factor on stunting was created. Results: Among the 27 independent variables of health, economic status, and environment, the results of this study show that malnutrition, diarrhea, dependency ratio, and hygiene significantly affect the risk of stunting. Meanwhile, antenatal care, nurses, and sanitation have an effect on reducing the risk of stunting. Conclusion: To achieve the SDGs targets associated with malnutrition by 2030, addressing stunting in Indonesia requires a comprehensive and multisectoral approach that addresses the fundamental causes of stunting, including health, socioeconomic status, and environmental factors. Addressing stunting is crucial for Indonesia, not only to improve the health and well-being of its children, but also for the long-term benefits of enhancing educational outcomes and economic productivity. [ABSTRACT FROM AUTHOR]

Oligoclonal bands (OCB) analysis is the reference standard for detecting an intrathecal IgG synthesis. Alongside OCB, free light chains kappa (FLCκ) are considered an additional sensitive biomarker for determining patterns 2 or 3, indicating intrathecal Ig synthesis. However, kFLC IF is not suitable for detecting a monoclonal pattern 5. The primary aim of this study was to evaluate the impact of incorporating FLCκ analysis into routine cerebrospinal fluid (CSF) diagnostics instead of OCB testing on the rate of missed monoclonal IgG detection. A two-center retrospective biomarker study was conducted. OCB were identified using isoelectric focusing in polyacrylamide gels followed by silver staining or in agarose gels followed by immunofixation. FLCκ were quantified using nephelometry and FLCκ assay (Siemens). Out of a combined total of 17,755 OCB analyses conducted between 2011 and 2021, a subset of 269 cases (1.5 %) exhibited pattern 5. 98 samples (36 %), which included 18 samples with intrathecal inflammation as determined by additional OCB pattern 2 were included in the FLCκ analysis. Of those, 16 (89 %) had intrathecal FLCκ synthesis. While FLCκ offers a promising avenue for detecting an intrathecal inflammation, the pattern 5, though rare, remains a valuable additional finding of OCB analysis. A combined approach of FLCκ and OCB analysis is recommended for a comprehensive assessment of the humoral intrathecal immune response. [ABSTRACT FROM AUTHOR]

In Taekwondo, core stability and physical fitness are vital for performance, with spinal deep muscles playing a key role. This study explored the relationship between spinal deep muscle strength and physical fitness in 104 adolescent Taekwondo athletes, using a cross-sectional design in a laboratory setting. Participants were classified into groups based on spinal muscle strength at various angles, measured with a Centaur 3D machine. Outcome measures included body composition (height, weight, BMI) and physical fitness (grip strength, back muscle strength, endurance, flexibility, balance, and leg strength). Latent profile analysis identified five profiles: G2 and G4 showed higher body weight and skeletal muscle mass, with G2 also having the highest grip, back, and leg strength. No significant relationship was found between spinal muscle strength and balance. The findings suggest spinal muscle strength and physical fitness do not always correlate, highlighting the need for further research to optimize training. [ABSTRACT FROM AUTHOR]

Background: Caring behaviour is critical for nursing quality, and the clinical internship environment is a crucial setting for preparing nursing students for caring behaviours. Evidence about how to develop nursing students' caring behaviour in the clinical environment is still emerging. However, the mechanism between the clinical internship environment and caring behaviour remains unclear, especially the mediating role of moral sensitivity and the moderating effect of self-efficacy. Research objective: This study aimed to examine the mediating effect of moral sensitivity and the moderating function of self-efficacy on the association between the clinical internship environment and caring behaviours. Research design: A cross-sectional design used acceptable validity scales. The hypothesised moderated mediation model was tested in the SPSS PROCESS macro. Participants and research context: This survey collected data from 504 nursing students in an internship at a teaching hospital in Changsha, China. Ethical considerations: This study was pre-approved by the ethics committee of the medical school (No. E2022210). Informed consent was obtained from all students. Results: The clinical internship environment (B = 0.450, 95% CI = [0.371, 0.530]) and moral sensitivity (B = 1.352, 95% CI = [1.090, 1.615]) had positive direct effects on nursing students' caring behaviours. Clinical internship environment also indirectly influenced students' caring behaviours via moral sensitivity (B = 0.161, 95% CI = [0.115, 0.206]). In addition, self-efficacy played a moderating role between the clinical internship environment and caring behaviours (B = 0.019, 95% CI = [0.007, 0.031]), as well as the relationship between the clinical internship environment and moral sensitivity (B = 0.006, 95% CI = [0.003, 0.010]). Conclusion: Moral sensitivity mediates the effect of the clinical internship environment on caring behaviour, and self-efficacy strengthens both direct and indirect effects. This study emphasises the importance of self-efficacy in developing moral sensitivity and caring behaviours in nursing students. [ABSTRACT FROM AUTHOR]

Context: Musculoskeletal system disorders (MSD) are prevalent around the world affecting the health of people, especially farmers who work hard in the field. Karen farmers use many medicinal plants to treat MSD. Objective: This study collects traditional plant-based remedies used by the Skaw Karen to treat MSD and evaluates their active phytochemical compounds. Materials and methods: The ethnobotanical study was conducted in six Karen villages in Chiang Mai province using semi-structured interviews were of 120 informants. The data were analyzed using ethnobotanical indices including use values (UV), choice value (CV), and informant consensus factor (ICF). Consequently, the 20 most important species, according to the indices, were selected for phytochemical analysis using LC–MS/MS. Results: A total of 3731 use reports were obtained for 139 species used in MSD treatment. The most common ailments treated with those plants were muscular pain. A total of 172 high-potential active compounds for MSD treatment were identified. Most of them were flavonoids, terpenoids, alkaloids, and steroids. The prevalent phytochemical compounds related to treat MSD were 9-hydroxycalabaxanthone, dihydrovaltrate, morroniside, isoacteoside, lithocholic acid, pomiferin, cucurbitacin E, leonuriside A, liriodendrin, and physalin E. Sambucus javanica Reinw. ex Blume (Adoxaceae), Betula alnoides Buch.-Ham. ex D.Don (Betulaceae), Blumea balsamifera (L.) DC. (Asteraceae), Plantago major L. (Plantaginaceae) and Flacourtia jangomas (Lour.) Raeusch. (Salicaceae) all had high ethnobotanical index values and many active compounds. Discussion and conclusions: This study provides valuable information, demonstrating low-cost medicine plants that are locally available. It is a choice of treatment for people living in remote areas. [ABSTRACT FROM AUTHOR]

Background: It is of great importance for archers to have a stable posture for successful shooting. In studies conducted on this subject, attention is drawn to the necessity of postural stability in archers for a successful shooting performance. Balanced posture, which is an important parameter, includes the preservation of the center of mass on the support base. In this study, it is aimed to examine the correlation between dynamic and static balance and achievement score in archers. Methods: This study is a cross-sectional and correlational research and is conducted with 18 archery athletes. Flamingo balance test was used to measure static balance and Y-Balance test was used to measure dynamic balance. For statistical analysis, since the distribution was normal, Pearson correlation coefficient was used for observing the correlation between parameters. Results: It has been observed that archery mean scores and right leg absolute reach distance have a moderate (r = 0.592, p = 0.010) positive correlation and a moderate (r = 0.670, p < 0.05) positive correlation with the left leg. As the dynamic balance success increases, the archery score also increases. Similarly, the dynamic balance success increases with the higher static balance success. Conclusion: This study represents that a linear relationship was observed between dynamic balance ability and shooting on target and emphasizes the importance of dynamic balance for successful shooting in archers. These findings support that archer will contribute positively to their success score with balance training in addition to their routine training. [ABSTRACT FROM AUTHOR]

Background: Obesity is a complex, diverse and multifactorial disease that has become a major public health concern in the last decades. The current classification systems relies on anthropometric measurements, such as BMI, that are unable to capture the physiopathological diversity of this disease. The aim of this study was to redefine the classification of obesity based on the different H-NMR metabolomics profiles found in individuals with obesity to better assess the risk of future development of cardiometabolic disease. Materials and methods: Serum samples of a subset of the Di@bet.es cohort consisting of 1387 individuals with obesity were analyzed by H-NMR. A K-means algorithm was deployed to define different H-NMR metabolomics-based clusters. Then, the association of these clusters with future development of cardiometabolic disease was evaluated using different univariate and multivariate statistical approaches. Moreover, machine learning-based models were built to predict the development of future cardiometabolic disease using BMI and waist-to-hip circumference ratio measures in combination with H-NMR metabolomics. Results: Three clusters with no differences in BMI nor in waist-to-hip circumference ratio but with very different metabolomics profiles were obtained. The first cluster showed a metabolically healthy profile, whereas atherogenic dyslipidemia and hypercholesterolemia were predominant in the second and third clusters, respectively. Individuals within the cluster of atherogenic dyslipidemia were found to be at a higher risk of developing type 2 DM in a 8 years follow-up. On the other hand, individuals within the cluster of hypercholesterolemia showed a higher risk of suffering a cardiovascular event in the follow-up. The individuals with a metabolically healthy profile displayed a lower association with future cardiometabolic disease, even though some association with future development of type 2 DM was still observed. In addition, H-NMR metabolomics improved the prediction of future cardiometabolic disease in comparison with models relying on just anthropometric measures. Conclusions: This study demonstrated the benefits of using precision techniques like H-NMR to better assess the risk of obesity-derived cardiometabolic disease. [ABSTRACT FROM AUTHOR]

This study focuses on analyzing the damages and ballistic limit for the fiber metal laminate (FML) and nano-silica reinforced FML. FML materials are hybrid sandwich composite materials used in lightweight structural applications. FML is constructed as a sandwich structure by bonding an aluminum alloy and a glass fiber reinforced composite. To enhance the impact strength of the FML composite, it was reinforced with nano-silica particles within the epoxy resin at various concentrations ranging from 1 wt% to 7 wt%. The laminates are then subjected to high-velocity impact tests using a single-stage gas gun setup, to assess the failure modes of the FML in an aluminum sheet and nanocomposite layers. The influence of nano-silica on natural frequency and damping factor is also examined by using a shock sensor and DAQ (Data Acquisition system). Results indicate that the FML laminate containing 5 wt% nano-silica demonstrates superior impact resistance compared to other filler percentages, as demonstrated by the ballistic limit and damage assessment. The ballistic limit for the pure FML laminate without nano-silica is 98 m/s, whereas the FML laminate containing 5 wt% nano-silica exhibits a peak value of 112 m/s, presenting a notable 14.3% increase in ballistic limit compared to the pure FML. Additionally, the dynamic response analysis reveals changes in the natural frequency values of the laminates before and after impact, indicating permanent damage to the laminate structure. [ABSTRACT FROM AUTHOR]

Introduction: Construction sites generate high levels of air pollution, contributing to more than 4% of particulate matter in the atmosphere. Literature indicates that on-site pollution is an important factor that contributes to lung impairments in construction workers. Chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ADRS) are known to be exacerbated because of exposure to a variety of construction pollutants mainly particulate matter (PM10, PM2.5). Methods: We conducted a systematic review and meta-analysis to assess whether exposure to construction site pollutants is associated with impairment of pulmonary parameters like Forced vital capacity (FVC), Forced expiration volume in 1 sec (FEV1) and FEV1/FVC. A total of 221 publications of observational studies were reviewed and 18 were selected; the data of which were meta-analyzed. Results and Discussion: In all studies the test subjects (construction workers) exposed to occupational air pollutants showed significantly lower FVC and FEV1 as compared expected levels (p≤ 0.01). The calculated Odds ratio indicates that there is positive association between COPD as compared to ARDS and exposure to pollutants. [ABSTRACT FROM AUTHOR]

The sandwich panels are widely used in many industrial applications due to their high mechanical properties. Their core design is most important parameter in enhancing their mechanical strength. Flexibility in the design of the core structure leads to the achievement of high strength and light structures. In this paper, the results of the optimized geometry in the previous work are used to investigate the capability of the core geometry design with different materials. Therefore, using the different materials, the peak enhancement of strength-to-weight ratio in sandwich panels besides core behavior during pressure testing are investigated. To this end, a new lattice core is brought forth as the first level; then, three types of materials including AL3105, glass, and innegra fiber/epoxy composites are used to fabricate the cores, in order to compare the compressive strength and the peak. The Nano-clay cloisite 20A is also utilized in construction of sandwich panels. The result indicates that the AL3105 lattice core has the highest strength-to-weight ratio, while the innegra fiber composite core has the highest toughness. Applying curve studies and the SEM Fig. 13, it is concluded that the addition of Nano-clay to composites leads to an increase in both of the strain and the core strength. Comparing the results of experimental and finite element modeling (FEM) data (in ABAQUS software) represented that there is a suitable compliance between them. Our results with the positional variation in core design can pave way in designing advanced engineered sandwich structures in aerospace, shipping, automotive industries. Therefore, these structures will have wide applications in the field of light structure, heat and fluid transfer, sound and vibration control. [ABSTRACT FROM AUTHOR]

Evaluating remote sensing techniques (RST)-based water quality monitoring systems in hydrological applications is a complex multi-attribute decision-making (MADM) problem due to several integrated issues. These issues include the need to consider 15 evaluation criteria, the importance of these criteria in relation to their application and network infrastructure, data variation, and trade-offs and conflicts between them. Therefore, this study proposes an MADM integrated modelling approach to weight these criteria and rank the selected RSTs using the "Fuzzy Weighted with Zero Inconsistency" (FWZIC) method coupled with the "Vlse-kriterijumska Optimizcija I Kaompromisno Resenje" (VIKOR) method. First, a decision matrix was developed for the evaluation criteria and their intersection with various RSTs in different network categories. Next, the assessment criteria were weighted using FWZIC, followed by ranking the RSTs for each category using VIKOR. The findings reveal that the criteria weighting varied across categories, as assigned by specialists-based FWZIC. For example, the "data acquisition system complexity" criterion received the maximum weight (w = 0.081) for mesh-based sensing and the lowest (w = 0.057) for cellular-based sensing. Using the obtained weights and based on the ascending order of the performance score value (Q), various RSTs were benchmarked using VIKOR. This includes (n = 22) RSTs in fixed star, (n = 8) RSTs in mesh sensing, (n = 6) RSTs in cellular sensing, (n = 3) RSTs in fixed cable sensing, and (n = 2) RSTs in movable sensing. Finally, the evaluation process for the benchmarked RSTs involved systematic ranking, sensitivity analysis, and comparison analysis, which confirmed the robustness of the proposed approach across all RST categories. [ABSTRACT FROM AUTHOR]

Objective: To establish the reference standard of the median nerve conduction study (NCS) in Korea. Methods: A total of 648 median motor and 602 median sensory NCSs from 349 Korean healthy volunteers were tested and analyzed prospectively. Equipment calibration, assessment of intra- and inter-rater reliability, and the NCSs per se were conducted according to a predetermined protocol. A reference standard was established from uncertainty components for the following parameters: the onset and peak latencies; the baseline-to-peak and peak-to-peak amplitudes; the area and duration of the negative wave; and the nerve conduction velocity. The effects of sex, age and stimulation intensity were analyzed. Results: Each measured value of 648 median motor and 602 median sensory nerves were obtained and presented with both mean and expanded uncertainties, as well as mean and standard deviations. The cut-off values with expanded uncertainty were determined for different age and sex groups. After adjusting for anthropometric covariates, all parameters except duration were affected by age, and sex appeared to influence both duration and area. While stimulation intensity significantly affected some parameters including latencies, the effect sizes were negligible. Conclusion: We propose the median NCS reference standard using the largest Korean dataset ever available. The use of the traceable and reliable reference standard is anticipated to promote more accurate and dependable diagnosis and appropriate management of median neuropathies in Korea. [ABSTRACT FROM AUTHOR]

Background: Students' approaches to learning are of essence in nursing education. This is because nursing is a profession where classroom learning leads to clinical performance. Although the literature recognizes student's approaches to learning as a significant aspect affecting the quality of students' learning, studies suggest that quality of learning has not been highly achieved in Malawian nursing colleges. Currently, there is a scarcity of empirical data on the learning approaches that Malawian nursing and midwifery students in nursing colleges employ. This study assessed the different approaches to learning among nursing and midwifery students in selected Malawian nursing colleges. Methods: This was a cross- sectional study that employed quantitative methods. The target population was nursing and midwifery students pursuing nursing diplomas from Nkhoma College of Nursing, Ekwendeni College of Health Sciences and Malawi College of Health Sciences. A total of 251 students were sampled randomly from the three nursing colleges. Data was collected through a self-administered questionnaire (R-SPQ-2 F) by Biggs. The data was analyzed using chi-square and binary logistic regression. In this study Cronbach's alpha was 0.6. Results: Most students had used a deep approach to learning (M = 3.201, SD = 0.623) than the surface approach (M = 2.757, SD = 0.732). Being in the age category of 16–20 had more likelihood of adopting a surface approach to learning compared to other age categories (X2 = 7.669, DF 2, P =.02). Students from Malawi College of Health Sciences were more likely to adopt a surface approach to learning compared to students from Nkhoma Nursing College and Ekwendeni College of Health Sciences (X2 = 12.388, df = 2, P =.002). Conclusion: A deep approach to learning emerged as the most preferred approach to learning which indirectly implies that most students attain meaningful learning. Age and environment are some of the key determinants associated with different learning approaches. More attention should be given to younger students during teaching and learning to promote deep learning. [ABSTRACT FROM AUTHOR]

In this work, a unique fiber-metal laminate for steam turbine applications was created utilizing natural fiber (Abelmoschus esculentus) and nanosilica particles. This study evaluated how surface treatment affected attributes related to load bearing and impact resistance. Prior to creating the composite, the metal foil was shot-blasted, and fiber and particles were silane-treated. The vacuum bag technique was used to create the composites, and oven drying was used. The results showed that adding biosilica enhanced the thermo-mechanical characteristics. In the silane-treated form of the composite designator EON3, a maximum storage modulus of 7.14 GPa with a loss factor of 0.44 was reported. Similar to this, the composite designation EON3 has the maximum fracture toughness at 29.26 MPa/m and the lowest energy release rate at 0.74 MJ/m2. Last but not the least, the composite designation EON2 at 50% of maximal UTS was determined to have the greatest fatigue life counts of 32,811. The treated metal-fiber interface showed enhanced bonding in the SEM morphological and macroscopic pictures. When both the qualities of metal and fiber are required, steam turbine, aerospace, and energy industries may employ these properties-improved composites. [ABSTRACT FROM AUTHOR]

This study aims to examine, for each head coach (HC) replaced, the association between training intensity and physical performances obtained in games. Furthermore, the study investigated how contextual factors influence locomotor and mechanical performance association. External load variables were collected using Global Positioning System (GPS) devices across the 4 weeks and 4 games before and after the replacement in a professional adult male soccer team. Six different HC records were analysed (48.8 ± 7.4 years of age; 11.2 ± 3.9 years as an HC) during a three-season span (2020/21-2022/2023). There were marked differences within player variability across the two coaching regimes. Game loads didn't reflect training-related performance, with differences ranging from -71.4% to -9.9%. Players under the outgoing coaches have greater coverage of meters per minute. Meters per minute, distance covered over 18 km/h and high-speed running (all in training) are found to be significant variables influenced by contextual factors. Withinsubject and time, training loads did not reflect game-related loads/performances, with starters showing higher deficits (ranging from -79.0 to -14.5). The study suggests that changes in soccer HC can affect players' training intensity and game performance, influenced by various contextual factors and not directly correlated. This type of information might be very suitable to improve training load periodization and programming. For further research avenues, could be the study of the variation of the psychological states of the players at the time of the dismissal and hiring of the HCs, associating them with the physiological performance at the same moments. [ABSTRACT FROM AUTHOR]

The demands of professional tennis, including physical and psychological aspects, contribute to the frequency of retirements at elite levels of the sport. The aim of this study was to analyze epidemiological patterns and risk factors associated with retirements in previous ATP and WTA Tour tournaments. A retrospective cohort study was conducted. This study focused on previous ATP and WTA Tour tournaments. The ATP database encompassed 584,806 matches, while the WTA database included 267,380 matches. To assess retirements, potential risk factors such as playing surface, tournament category, match round, and player age were analyzed. Incidence rates were calculated for the period between 1978–2019 for men and 1994–2018 for women. The overall incidence rate was 1.56 (95%CI: 1.54, 1.59) and 1.36 (95%CI: 1.33, 1.39) retirements per 1000 games played in male and female competitions, respectively. Retirements increased over the years. Higher incidence rates were observed on hard (1.59 [95%CI: 1.56, 1.63] and 1.39 [95%CI: 1.34, 1.44]) and clay (1.60 [95%CI: 1.57, 1.63] and 1.36 [95%CI: 1.32, 1.41]) compared to grass courts (0.79 [95%CI: 0.65, 0.94] and 1.06 [95%CI: 0.88, 1.27]). Risk factors differed by gender, with tournament category significant in males (IRR: 1.23 [95%CI: 1.19, 1.28] in ITF vs ATP) and match round in females (IRR: 0.92 [95%CI: 0.88, 0.98] in preliminary vs final). This study provides valuable insights for coaches, players, support teams, and epidemiologists regarding retirements and associated risk factors in previous ATP and WTA Tour tournaments, contributing to injury prevention strategies. [ABSTRACT FROM AUTHOR]

Polyetheretherketone (PEEK) is considered as an excellent biomaterial for bone grafting and connective tissue replacement. The clinical potential is, however, limited by its bioinertness, poor osteoconduction, and weak antibacterial activity. These disadvantages can be overcome by introducing suitable additives to produce mineral-polymer composites or coatings. In this work, a PEEK-based bioactive composite has been obtained by blending the polymer with magnesium phosphate (Mg3(PO4)2) particles in amounts ranging from 1 to 10 wt.% using the hot press technique. The obtained composite exhibited improved mechanical and physical properties, above the lower limits set for bone engineering applications. The tested grafts were found to not induce cytotoxicity. The presence of magnesium phosphate induced the mineralisation process with no adverse effects on the expression of the marker crucial for osteoblastic differentiation. The most promising results were observed in the grafts containing 1 wt.% of magnesium phosphate embedded within the PEEK matrix. The improved bioactivity of grafts, together with suitable physical–chemical and mechanical properties, indicate this composite as a promising orthopaedic implant material. [ABSTRACT FROM AUTHOR]

Background: In 2012, Botswana introduced 13-valent pneumococcal conjugate vaccine (PCV-13) to its childhood immunization program in a 3+0 schedule, achieving coverage rates of above 90% by 2014. In other settings, PCV introduction has been followed by an increase in carriage or disease caused by non-vaccine serotypes, including some serotypes with a high prevalence of antibiotic resistance. Methods: We characterized the serotype epidemiology and antibiotic resistance of pneumococcal isolates cultured from nasopharyngeal samples collected from infants (≤12 months) in southeastern Botswana between 2016 and 2019. Capsular serotyping was performed using the Quellung reaction. E-tests were used to determine minimum inhibitory concentrations for common antibiotics. Results: We cultured 264 pneumococcal isolates from samples collected from 150 infants. At the time of sample collection, 81% of infants had received at least one dose of PCV-13 and 53% had completed the three-dose series. PCV-13 serotypes accounted for 27% of isolates, with the most prevalent vaccine serotypes being 19F (n = 20, 8%), 19A (n = 16, 6%), and 6A (n = 10, 4%). The most frequently identified non-vaccine serotypes were 23B (n = 29, 11%), 21 (n = 12, 5%), and 16F (n = 11, 4%). Only three (1%) pneumococcal isolates were resistant to amoxicillin; however, we observed an increasing prevalence of penicillin resistance using the meningitis breakpoint (2016: 41%, 2019: 71%; Cochran-Armitage test for trend, p = 0.0003) and non-susceptibility to trimethoprim-sulfamethoxazole (2016: 55%, 2019: 79%; p = 0.04). Three (1%) isolates were multi-drug resistant. Conclusions: PCV-13 serotypes accounted for a substantial proportion of isolates colonizing infants in Botswana during a four-year period starting four years after vaccine introduction. A low prevalence of amoxicillin resistance supports its continued use as the first-line agent for non-meningeal pneumococcal infections. The observed increase in penicillin resistance at the meningitis breakpoint and the low prevalence of resistance to ceftriaxone supports use of third-generation cephalosporins for empirical treatment of suspected bacterial meningitis. [ABSTRACT FROM AUTHOR]