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The competencies and techniques used by employees, especially those who act as guides, are one of the most important vehicles for the transference of visitors' cultural understanding and memorable experiences. The aim of the study was to identify which guides' competencies can enhance generic learning outcomes of museum visitors. The data were collected from 594 people who visited art and history museums in Toronto (Canada). The results showed that learning outcomes depend on three groups of guide's competencies: handling the group within the "museum environment," "communication skills," and "knowledge and pedagogy." Also, the findings revealed that the guide's competencies that encourage interaction and active participation of visitors were common predictors for all generic learning outcomes. The research findings can serve as guidelines for museums when recruiting or training guides. Also, it can direct museums how to develop their strategy if they want to improve visitors' experiences when engaging with museums' exhibitions, art, and objects.

Background: This cross-sectional study aimed to assess the correlation between subjective oral health status and mental health in a group of university students in Serbia. Methods: The study included 948 students, aged between 18 and 27, from the Faculty of Medical Sciences, University of Kragujevac, Serbia, and was conducted in 2020. The World Health Organization's Oral Health Questionnaire for Adults was utilized to evaluate the respondents' self-perceived oral health and oral hygiene practices. The existence of depressive symptoms was evaluated using the Beck Depression Inventory-II (BDI-II), and the Zung self-rating anxiety scale (SAS) was used for determining anxiety symptoms. Results: It is observed that 28.9% of respondents exhibit symptoms of depression and 42.3% showed symptoms of anxiety. Results show that students with severe depression and anxiety symptoms very often reported lower self-perceived oral health and oral health problems. Although the nature of this relationship has not been thoroughly evaluated, several studies have shown a mutually dependent connection between oral health and mental health. Conclusions: The results suggest that some aspects of oral health are associated with higher risks of developing symptoms of depression or anxiety, and vice versa. [ABSTRACT FROM AUTHOR]

Background: Trees are a critical part of urban infrastructure. Cities worldwide are pledging afforestation objectives due to net-zero targets; however, their realisation requires a comprehensive framework that combines science, policy, and practice. Methods: The paper presents the Green Urban Scenarios (GUS) framework for designing and monitoring green infrastructures. GUS considers weather, maintenance, tree species, diseases, and spatial distributions of trees to forecast their impacts. The framework uses agent-based modelling (ABM) and simulation paradigm to integrate green infrastructure into a city’s ecological, spatial, economic, and social context. ABM enables the creation of digital twins for urban ecosystems at any level of granularity, including individual trees, to accurately predict their future trajectories. Digital representation of trees is created using a combination of datasets such as earth observations from space, street view images, field surveys, and qualitative descriptions of typologies within existing and future projects. Machine learning and statistical models calibrate biomass growth patterns and carbon release schemes. Results: The paper examines various green area typologies, simulating several hypothetical scenarios based on Glasgow’s urban forests. It exhibits the emergence of heterogeneity features of the forests due to interactions among trees. The growth trajectory of trees has a non-linear transition phase toward stable growth in its maturity. Reduced maintenance deteriorates the health of trees leading to lower survival rate and increased CO2 emissions, while the stormwater alleviation capacity may differ among species. Conclusions: The paper demonstrates how GUS can facilitate policies and maintenance of urban forests with environmental, social, and economic benefits. [ABSTRACT FROM AUTHOR]

Application of home mechanical ventilators represents the future in the treatment of children with chronic respiratory insufficiency. In this way patients are treated in the home environment, they have full support from their families, they are protected against nosocomial infections and their condition is monitored by medical staff. The role of regional centers is very important in the future development of the home mechanical ventilation network. Doctors in these centers under the full support of the University Children's Hospital physicians can assist and monitor the treatment of children on the household respirators.

An outbreak of Vero cytotoxin-producing Escherichia coli O157 (VTEC O157) gastroenteritis in visitors to an open farm in North Wales resulted in 17 primary and 7 secondary cases of illness. [...]

Tanycytic ependymoma is a very rare spindle-cell variant of ependymoma derived from tanycytes, which are part of the primitive nervous system. This paper is presenting 48-year old woman who presented with low back and right-sided leg pain of moderate intensity. MRI showed spinal intradural tumor at the level of the L1 vertebral body. Right-sided L1 hemilaminectomy and en bloc tumor resection were performed. Neuroradiological and intraoperative diagnosis of schwannoma was revised to tanycytic ependymoma after careful immunohistochemical analysis. Six months post-operativly, MRI did not show tumor recurrence. Tanycytic ependymoma at the region of filum terminale is extremely uncommon and only three cases have been described in the literature. The low incidence of this tumor and atypical histological image, which is distinct from the typical features of commonly encountered ependymomas, can present a challenge in terms of making an accurate diagnosis. Awareness of this transitional form of ependymoma among neurosurgeons and pathologists may avoid incorrect surgical approaches and postoperative treatment course. [ABSTRACT FROM AUTHOR]

In this article, we proposed a simple neural network (NN) technique for estimating erythemal ultraviolet (UV) radiation in Novi Sad (Serbia) using available input parameters. The technique implies the use of one of two models depending on the availability of the input parameter: (a) NN model 1 (NNM1) which uses global solar radiation, clearness index, cloudiness and air mass; and (b) NN model 2 (NNM2) which adds total ozone content (TOC) to the NNM1 inputs. The three feed‐forward NNs with different internal structures and back propagation learning method for each NN model were used in modelling. The parallel calculation was used for learning each NN. The results showed that the NNM1 provides satisfactory estimate (R = 0.975, MBE = −0.614%, MAPE = 12.580%, RMSE = 17.716%) and that additional use of TOC NNM2 considerably improves the results (R = 0.982, MBE = −0.726%, MAPE = 10.161%, RMSE = 14.509%). The performances of developed NNMs become significantly better if warm part of the year is isolated (MAPE = 10.981 and 8.958; RMSE = 13.889 and 11.709, for NNM1 and NNM2, respectively). Variations of reconstructed annual averages of daily doses in the period 1949–2012 indicate ability of the technique to model the relationship between erythemal UV radiation and the affecting atmospheric factors. The analysis showed that the increasing trend during the warm part of the year in the period 1981–1996 was mainly caused by TOC, while the increase after 1996 was to a greater extent caused by cloudiness. [ABSTRACT FROM AUTHOR]

This study sought to compare the biometric values and intraocular lens (IOL) power obtained by standard ultrasound and optical biometry. We examined 29 eyes in preparation for cataract surgery. None of the patients had refractive surgery or corneal anomaly. In all patients, the horizontal and vertical refractive power of the cornea was determined using a keratometer (Bausch&Lomb). The axial length of the eye was determined via A-scan ultrasound (BVI-compact-V-plus) using Hollady's formula. The IOL power and complete biometric measurements were obtained via an IOL Master-500-Zeiss using the Hollady-2 formula. All obtained values were compared and analysed using the statistical program SPSS 20. The average age of treated patients was 71.21±1.68 years. In 16 patients with dense cataracts (55.17%), it was not possible to determine the IOL power by optical biometry. Optical biometry obtained significantly increased axial length values of 24.04±0.29 mm compared with those obtained with ultrasound biometry (23.89±0.28 mm, p=0.003). The mean refractive cornea power values of the horizontal meridian measured using a keratometer (42.50±0.47 D) and an IOL Master (42.69±0.49 D) were not statistically different (p=0.187). The mean values of the refractive cornea power of the vertical meridian obtained using a keratometer (42.62±0.48D) and an IOL Master (43.36±0.51 D) exhibited a statistically significant difference (p=0.000). The keratometer obtained statistically significant lower mean values of corneal refractive power (42.73±0.32 D) compared with those obtained with optical biometry (43.22±0.35 D, p=0.000). Ultrasound biometry obtained significantly increased the mean values of IOL power (20.19±0.48D) compared with those obtained with optical biometry (19.71±0.48 D, p=0.018). The large number of patients who receive an operation for dense cataracts indicate the need for representation of both biometric methods in our clinical practice. [ABSTRACT FROM AUTHOR]

Background: Information on geographical variation in localised transmission of TB can inform targeting of disease control activities. The aim of this study was to estimate the proportion of TB attributable to localised transmission for the period 2010-2012 in northern England and to identify case characteristics associated with spatiotemporal-genotypical clusters.Methods: We combined genotyping data with spatiotemporal scan statistics to define an indicator of localised TB transmission and identified factors associated with localised TB transmission thus defined in a multivariable logistics regression model.Results: The estimated proportion of TB cases in northern England attributable to localised transmission was 10% (95% CI 9% to 12%). Clustered cases (cases which were spatiotemporally clustered with others of identical genotype) were on average younger than non-clustered cases (mean age 34 years vs 43 years; p value <0.05). Being UK born (adjusted OR (aOR) 3.6, 95% CI 2.9 to 6.0), presenting with pulmonary disease (aOR 2.2, 95% CI 1.3 to 3.6) and history of homelessness (aOR 2.8, 95% CI 1.2 to 6.8) or incarceration (aOR 2.6, 95% CI 1.2 to 5.9) were independently associated with being part of a spatiotemporal-genotypical cluster in a multivariable model. Belonging to an ethnic group other than white or mixed/other was also significantly associated with localised transmission. We identified localised transmission in 103/1958 middle super output areas mostly in urban areas.Conclusions: Incorporating highly discriminatory genotyping data into spatiotemporal analysis of TB incidence is feasible as part of routine surveillance and can provide valuable information on groups at greater risk and areas with localised transmission of TB, which could be used to inform control measures, such as intensified contact tracing. [ABSTRACT FROM AUTHOR]

Presents a study which examined the outbreak of Vero cytotoxin-producing Escherichia coli 0157 gastroenteritis in visitors to an open farm in North Wales. Methods; Results; Discussion

A letter to the editor is presented regarding the article "Should we be doing more to prevent Group C meningococcal infection in school age children? How can we decide?" by A. Round and S. Palmer in a 1999 issue.

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background:  Multicenter precision oncology real-world evidence requires a substantial long-term investment by hospitals to prepare their data and align on common Clinical Research processes and medical definitions. Our team has developed a self-assessment framework to support hospitals and hospital networks to measure their digital maturity and better plan and coordinate those investments. From that framework, we developed PRISM for Cancer Outcomes: PR: agmatic I: nstitutional S: urvey and benchM: arking., Objectives:  The primary objective was to develop PRISM as a tool for self-assessment of digital maturity in oncology hospitals and research networks; a secondary objective was to create an initial benchmarking cohort of >25 hospitals using the tool as input for future development., Methods:  PRISM is a 25-question semiquantitative self-assessment survey developed iteratively from expert knowledge in oncology real-world study delivery. It covers four digital maturity dimensions: (1) Precision oncology, (2) Clinical digital data, (3) Routine outcomes, and (4) Information governance and delivery. These reflect the four main data types and critical enablers for precision oncology research from routine electronic health records., Results:  During piloting with 26 hospitals from 19 European countries, PRISM was found to be easy to use and its semiquantitative questions to be understood in a wide diversity of hospitals. Results within the initial benchmarking cohort aligned well with internal perspectives. We found statistically significant differences in digital maturity, with Precision oncology being the most mature dimension, and Information governance and delivery the least mature., Conclusion:  PRISM is a light footprint benchmarking tool to support the planning of large-scale real-world research networks. It can be used to (i) help an individual hospital identify areas most in need of investment and improvement, (ii) help a network of hospitals identify sources of best practice and expertise, and (iii) help research networks plan research. With further testing, policymakers could use PRISM to better plan digital investments around the Cancer Mission and European Digital Health Space., Competing Interests: None declared., (Thieme. All rights reserved.)

Background and Objectives: Abnormal arterial stiffness (AS) is a major complication in end-stage kidney disease (ESKD) patients treated by dialysis. Our study aimed to determine the significance of AS for survival of prevalent dialysis patients, as well as its association with cardiovascular parameters or vascular calcification promoters/inhibitors or both and AS., Materials and Methods: The study involved 80 adult hemodialysis patients. Besides standard laboratory analyses, we also determined promoters and inhibitors of vascular calcification (bone biomarkers): serum levels of fibroblast growth factor 23 (FGF23), soluble Klotho, intact parathormone (iPTH), 1,25-dihydroxyvitamin D3, osteoprotegerin, sclerostin, AS measured as ankle carotid pulse wave velocity (acPWV), Ankle Brachial Index (ABI), and vascular calcification (VC) score. Patients were monitored for up to 28 months. According to the median acPWV value, we divided patients into a group with acPWV ≤ 8.8 m/s, and a group with acPWV > 8.8 m/s, and the two groups were compared., Results: Values for bone biomarkers were similar in both groups. Mean arterial blood pressure (MAP), central systolic and diastolic brachial blood pressure, heart rate, and pulse pressure were higher in the group with acPWV > 8.8 m/s than in the group with acPWV ≤ 8.8 m/s. The mortality was higher for patients with acPWV > 8.8 m/s at any given time over 28 months of follow-up. In multivariable analysis, predictors of higher acPWV were age >60.5, higher pulse rate, and higher central systolic or brachial diastolic blood pressure., Conclusions: According to our results, we advise the measurement of acPWV preferentially in younger dialysis patients for prognosis, as well as intervention planning before the development of irreversible changes in blood vessels. In addition, measuring central systolic blood pressure seems to be useful for monitoring AS in prevalent hemodialysis patients.

Material and Methods: Retrospective 5-year study based on general and ophthalmic history records, and including 268 eyes (174 patients), aged 50 years and over. Ophthalmological examination involved visual acuity, measuring of intraocular pressure, slit lamp examination and indirect ophthalmoscopy. Type of surgical treatment was tailored for each patient (extra capsular cataract extraction, phaco-emulsiphication)., Results: Preoperative slit lamp examination showed phacodonesis in 17.91% (47), iridodonesis in 2.98% (8), pigment dispersion in 6.72% (18), lens subluxation in 4.85% (13) on the total. Extra capsular cataract extraction was performed in 36.94% (99) and phaco-emulsiphication in the others. Analysis of intra operative complications showed: posterior capsular rupture 17.91% (48), zonular dialysis or break 5.97% (16), lens subluxation 1.86% (5), intraocular bleeding 2.98% (8), vitreous loss 13.80% (37). Postoperative complications include: anterior chamber reaction 45.90% (123), intraocular lens tilt 15.67% (42), endothelial decompensation 21.64% (58), subluxation/luxation IOL 3.73% (10), secondary cataract 21.46% (58), pigment dispersion 37.68% (101), increased IOP 13.80% (37), residual lens matter 13.80% (37), hyphema 3.73% (10), posterior synechiae 6.72% (18), iris prolapsus 2.73% (8)., Conclusion: Cataract surgery in PES will frequently encounter small pupils, shallow anterior chambers, posterior adhesions, weak zonular support, partial subluxation or complete dislocation of lens. Authors presented the best possible approach on PES and surgical methods for patients with cataract with special accent of possible surgical complications.