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Enhancing students' intercultural competences through international higher education requires a thorough understanding of the way in which these competences develop over time, how they relate to outcomes, and which factors predict their growth. To answer these questions, a three-wave longitudinal study was conducted among a sample of first-year students in an international university program (n = 425). Intercultural competences were operationalized through the five dimensions of the Multicultural Personality Questionnaire (MPQ): Cultural Empathy, Openmindedness, Flexibility, Social Initiative and Emotional Stability. We examined development of these traits across one year, as well as their relationship with stress, life satisfaction, and academic performance (GPA). Cultural background (local vs. international student) and prior international experience (yes/no) were included as predictors. Results show that MPQ scores at the beginning of the year negatively relate to change across semester 1, which in turn is negatively related to change across semester 2. These findings suggest the presence of ceiling effects in MPQ development. In semester 1, emotional stability acts as a buffer against stress. In semester 2, stress is lower among students with higher scores on cultural empathy, and lower scores on flexibility. Cultural empathy and social initiative relate positively to academic performance. No significant main effects were found for cultural background, or prior international experience. However, these predictors interact on openmindedness and social initiative: local students with no prior international experience show a significant increase in these dimensions across the first semester, whereas the others do not.

Abstract Background Human T cell lymphotropic virus type 1 (HTLV-1) infection remains a largely neglected public health problem, particularly in resource-poor areas with high burden of communicable and non-communicable diseases, such as some remote populations in Central Australia where an estimated 37% of adults are infected with HTLV-1. Most of our understanding of HTLV-1 infection comes from studies of the globally spread subtype-A (HTLV-1a), with few molecular studies reported with the Austral-Melanesian subtype-C (HTLV-1c) predominant in the Indo-Pacific and Oceania regions. Results Using a primer walking strategy and direct sequencing, we constructed HTLV-1c genomic consensus sequences from 22 First Nations participants living with HTLV-1c in Central Australia. Phylogenetic and pairwise analysis of this subtype-C proviral gDNA showed higher levels of genomic divergence in comparison to previously published HTLV-1a genomes. While the overall genomic homology between subtypes was 92.5%, the lowest nucleotide and amino acid sequence identity occurred near the 3′ end of the proviral genome coding regulatory genes, especially overlapping hbz (85.37%, 77.46%, respectively) and orf-I product p12 (82.00%, 70.30%, respectively). Strikingly, the HTLV-1c genomic consensus sequences uniformly showed a defective translation start codon for the immune regulatory proteins p12/p8 encoded by the HTLV-1A orf-I. Deletions in the proviral genome were detected in many subjects, particularly in the structural gag, pol and env genes. Similarly, using a droplet digital PCR assay measuring the copies of gag and tax per reference host genome, we quantitatively confirmed that provirus retains the tax gene region at higher levels than gag. Conclusions Our genomic analysis of HTLV-1c in Central Australia in conjunction with earlier Melanesian HTLV-1c sequences, elucidate substantial differences with respect to the globally spread HTLV-1a. Future studies should address the impact these genomic differences have on infection and the regionally distinctive frequency of associated pulmonary disease. Understanding the host and virus subtype factors which contribute to the differential morbidity observed, is crucial for the development of much needed therapeutics and vaccine strategies against this highly endemic infection in remote First Nations communities in Central Australia.

Climate change is one of the most critical challenges facing Australia and the global community today. Data from the Australian Bureau of Meteorology (BoM) indicates that Australia has been experiencing rising temperatures, particularly since the late 20th century. The frequency, duration, and intensity of heatwaves are projected to continue increasing . Since national records began in 1910, Australia has warmed by an average of 1.47°C (±0.24°C), with the highest official temperature recorded at 50.7 degrees Celsius in Onslow, Western Australia (WA), on January 13, 2022. Furthermore, a recent unprecedented high temperature of +41.6°C was recorded during winter on August 26, 2024, in Yampi Sound, WA. Among all natural disasters in Australia, heatwave (HW) represents a leading silent killer and pose a significant public health threat. However, innovative methods for assessing vulnerability for HW-related health services remain limited.

This paper presents the results of a systematic literature review of academic publications about digital literacy games. We have analyzed a total of 30 papers and book chapters published in English, Spanish, Portuguese and Dutch between 2005 and 2021 and stored in Scopus. The results of this literature review report on: (1) the topics of the games discussed in the publications; (2) the digital literacy competencies supported by the games studied in the publications; (3) the effects of these games; and (4) ten game design considerations for digital literacy games collected from the results of the publications. This paper also provides detailed access to the original sources by reporting on which paper addressed what.

Whether transcatheter mitral valve replacement (TMVR) devices perform similarly with respect to the underlying mitral regurgitation (MR) etiology remains unknown. The aim of the present analysis was to assess outcomes of TMVR according to the MR underlying etiology among the CHoice of OptImal transCatheter trEatment for Mitral Insufficiency (CHOICE-MI) registry. Of 746 patients, 229 patients (30.7%) underwent TMVR. The study population was subdivided according to primary, secondary, or mixed MR. Patients with mitral annular calcification were excluded. The primary study endpoint was a composite endpoint of all-cause mortality or hospitalization for heart failure at 1 year. Secondary study endpoints were all-cause and cardiovascular mortality at 1 year, New York Heart Association functional class, and residual MR, both at discharge and 1 year. The predominant MR etiology was secondary MR (58.4%), followed by primary MR (28.7%) and mixed MR (12.9%). Technical success and procedural mortality were similar according to MR etiology. Discharge echocardiography revealed residual MR 2+ in 11.3%, 3.7%, and 5.3% of patients with primary, secondary, and mixed MR, respectively (P =.1). MR elimination was similar in all groups up to the 1-year follow-up. There was no difference in terms of primary combined outcome occurrence according to MR etiology. One-year all-cause mortality was reported in 28.8%, 24.2%, and 32.1% of patients with primary, secondary, and mixed MR, respectively (P =.07). In our study we did not find differences in short-term and 1-year outcomes after TMVR according to MR etiology. [ABSTRACT FROM AUTHOR]

Chest radiographs are the most performed radiographic procedure, but suboptimal technical factors can impact clinical interpretation. A deep learning model was developed to assess technical and inspiratory adequacy of anteroposterior chest radiographs. Adult anteroposterior chest radiographs (n = 2375) were assessed for technical adequacy, and if otherwise technically adequate, for adequacy of inspiration. Images were labelled by an experienced radiologist with one of three ground truth labels: inadequate technique (n = 605, 25.5 %), adequate inspiration (n = 900, 37.9 %), and inadequate inspiration (n = 870, 36.6 %). A convolutional neural network was then iteratively trained to predict these labels and evaluated using recall, precision, F1 and micro-F1, and Gradient-weighted Class Activation Mapping analysis on a hold-out test set. Impact of kyphosis on model accuracy was assessed. The model performed best for radiographs with adequate technique, and worst for images with inadequate technique. Recall was highest (89 %) for radiographs with both adequate technique and inspiration, with recall of 81 % for images with adequate technique and inadequate inspiration, and 60 % for images with inadequate technique, although precision was highest (85 %) for this category. Per-class F1 was 80 %, 81 % and 70 % for adequate inspiration, inadequate inspiration, and inadequate technique respectively. Weighted F1 and Micro F1 scores were 78 %. Presence or absence of kyphosis had no significant impact on model accuracy in images with adequate technique. This study explores the promising performance of a machine learning algorithm for assessment of inspiratory adequacy and overall technical adequacy for anteroposterior chest radiograph acquisition. With further refinement, machine learning can contribute to education and quality improvement in radiology departments. [ABSTRACT FROM AUTHOR]

The internationalization of higher education has been driven by an increasingly globalized and interconnected world. One concept that embodies this internationalization process is global citizenship, which can be promoted through student mobility, internationalization-at-home, or other forms of intercultural learning. While global citizenship remains a broad and highly contested term, the increased interest of its role in higher education has inspired research in different fields. The aim of this paper is to provide a review of existing research approaches to studying global citizenship, and to formulate future research directions that may integrate these approaches into a holistic framework. By reviewing literature from different fields in the social sciences, we have identified three main research approaches: intercultural competence, social identification with a global community, and civic engagement. While each approach reflects an important dimension of global citizenship, they remain separate in the literature, complicating the understanding and application of global citizenship in higher education. Therefore, for each approach we present a general conceptualization and a brief overview of prior findings. We discuss how integrating these approaches can lead to a more holistic understanding of global citizenship and guide future avenues for research and practice in higher education. [ABSTRACT FROM AUTHOR]

Background: Significant tricuspid regurgitation (TR) is a predictor of right heart failure (RHF) and increased mortality following left ventricular assist device (LVAD) implantation, however the benefit of tricuspid valve surgery (TVS) at the time of LVAD implantation remains unclear. This study compares early and late mortality and RHF outcomes in patients with significant TR undergoing LVAD implantation with and without concomitant TVS., Methods: A systematic search of four electronic databases was conducted for studies comparing patients with moderate or severe TR undergoing LVAD implantation with or without concomitant TVS. Meta-analysis was performed for primary outcomes of early and late mortality and RHF. Secondary outcomes included rate of stroke, renal failure, hospital and ICU length of stay. An overall survival curve was constructed using aggregated, reconstructed individual patient data from Kaplan-Meier (KM) curves., Results: Nine studies included 575 patients that underwent isolated LVAD and 308 patients whom received concomitant TVS. Both groups had similar rates of severe TR (46.5% vs. 45.6%). There was no significant difference seen in risk of early mortality (RR 0.90; 95% CI, 0.57-1.42; p = 0.64; I 2  = 0%) or early RHF (RR 0.82; 95% CI, 0.66-1.19; p = 0.41; I 2  = 57) and late outcomes remained comparable between both groups. The aggregated KM curve showed isolated LVAD to be associated with overall increased survival (HR 1.42; 95% CI, 1.05-1.93; p = 0.023)., Conclusions: Undergoing concomitant TVS did not display increased benefit in terms of early or late mortality and RHF in patients with preoperative significant TR. Further data to evaluate the benefit of concomitant TVS stratified by TR severity or by other predictors of RHF will be beneficial., (© 2024 The Author(s). Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)

Background: In the current era of heart transplantation, machine perfusion strategies are emerging as potential additions to the armamentarium of a transplant unit. Donation after circulatory death (DCD) donor hearts assessed through normothermic machine perfusion (NMP) has helped expand the donor pool. Hypothermic machine perfusion (HMP) is emerging as an alternative strategy to traditional static cold storage (SCS) when a prolonged ischemic time is anticipated in brain dead (BD) donors, this is important in Australia where long distant procurement is vital. In this study we examine the outcomes in our unit where both forms of machine perfusion (NMP and HMP), as well as SCS is utilized for donor heart preservation, with a particular focus on severe primary graft dysfunction (sPGD) and mortality., Methods: The year 2021 represents the year when both forms of machine perfusion were available to our unit. Heart transplants in our unit from January 2021 to February 2024 were categorized into three groups for retrospective analysis: (I) DCD-NMP group (n=44); (II) BD-HMP group (n=38), and (III) BD-SCS group (n=78)., Results: There were no significant differences in the mean donor and recipient ages between the three groups. Donor preservation time in the BD-HMP group was significantly longer than the donor ischemic time in the BD-SCS group, and organ care system (OCS) run time in the DCD-NMP group (361±89 vs. 208±47 and 249±49 min respectively, P<0.001). For DCD-NMP, BD-HMP and BD-SCS groups respectively: 30-day survival was: 100%, 97% and 100%; 1-year survival was: 94%, 90% and 94%; 2-year survival was: 90%, 90% and 89% (P=0.9). There was no significant difference in the incidence of sPGD between the three groups (DCD-NMP: 7%, BD-HMP: 5%, and BD-SCS: 5%, P=0.9)., Conclusions: Machine perfusion strategies represent important additions to the modern transplant unit and can expand the donor pool. Results are encouraging with no differences in 2-year survival or incidence of sPGD across the preservation modalities: DCD-NMP, BD-HMP, and BD-SCS., Competing Interests: Conflicts of Interest: Y.J. is supported by a National Heart Foundation PhD scholarship. P.M.: modules in kind from XVIVO and Transmedics (unrelated to submitted work); Novartis and Amgen (grant paid to institution), Novartis, Boehringer-Ingelheim and Astra-Zeneca (Advisory board membership). The other authors have no conflicts of interest., (2024 AME Publishing Company. All rights reserved.)

Background: Coronary allograft vasculopathy (CAV) remains a significant cause of morbidity and mortality after heart transplantation. The use of aspirin for CAV prophylaxis has recently garnered interest as a possible therapeutic adjunct in this setting., Methods: This 2-center retrospective cohort study included 372 patients who underwent heart transplantation between January 2009 and March 2018 and were stratified according to the commencement of aspirin during their index transplant admission. The primary outcome was the development of moderate or severe CAV (International Society for Heart and Lung Transplantation grade ≥2) at surveillance coronary angiography. Secondary endpoints included mortality at follow-up., Results: There were no differences in age, sex, and cause of heart failure. In the early aspirin group, the preponderant risk factors included use of ventricular assist devices, pretransplant smoking, and mild or moderate rejection. Multivariable analyses to assess for independent predictors of CAV development and mortality demonstrated that aspirin was associated with reduced mortality (adjusted hazard ratio = 0.19; 95% confidence interval, 0.08-0.47, P < 0.01) and a trend toward a protective effect against the development of moderate or severe CAV (adjusted hazard ratio = 0.24; 95% confidence interval, 0.54-1.19; P = 0.08)., Conclusions: In this retrospective risk-adjusted 2-center cohort study, early aspirin administration was associated with reduced risk of death and a trend toward a protective effect against CAV development. These findings warrant validation in prospective randomized trials., Competing Interests: J.B. is supported by National Health and Medical Research Council (NHMRC) and National Heart Foundation Post Graduate Scholarships. D.K. is supported by an NHMRC Investigator Grant. The other authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)