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The research aims to: 1) Investigate the results of supervision of teaching and learning managements by educational institution administrators under the jurisdiction of Phitsanulok Primary Educational Service Area Office 2. This is a survey research. The samples in the study include: 1) 97 educational institution administrators under the jurisdiction of Phitsanulok Primary Educational Service Area Office 2, 2) 97 teachers under the jurisdiction of Phitsanulok Primary Educational Service Area Office 2. These participants were selected using simple random method, totaling 194 people. The tools used in this research are: 1) a Document analysis form, and 2) a Questionnaire concerning the supervision of teaching and learning managements of schools under the jurisdiction of Phitsanulok Primary Educational Service Area Office 2. Data was analyzed qualitatively using content analysis and presented in a descriptive analysis format. The results of the study found that: The supervision of teaching and learning managements by educational institution administrators under the jurisdiction of Phitsanulok Primary Educational Service Area Office 2 is generally at the highest level. When considering specific issues, it was found that: in terms of blended learning, the administrators have supported the learning process through online electronic media; in terms of collaborative lesson development, the administrators have identified lesson development issues from classroom problems; and in terms of teaching tasks and mentoring system, the administrators have fostered relationships with teachers in managing teaching and learning teaching and learning managements.

Abstract Interleukin (IL)-35 is an anti-inflammatory cytokine that regulates autoimmune diseases, including systemic lupus erythematosus (SLE). However, the association between the cytokine and disease may vary by geographical region. This study performed a meta-analysis to quantitatively assess the correlation between the serum IL-35 levels in SLE patients and sub-group analyses were conducted. Four main electronic databases—Scopus, Embase, Science Direct, PubMed—were searched for relevant studies. After a database search, Endnote software was used to find and remove duplicate studies. Random-effects models were used to estimate standard mean differences in serum/plasma IL-35 levels by Hedges’ g with 95% confidence intervals (CIs). Publication bias was assessed with funnel plots, and risk of bias was assessed according to the Newcastle-Ottawa Scale (NOS). Sixteen studies met the eligibility criteria and were included in a qualitative review; data from 15 studies were included in the meta-analysis. Total IL-35 levels (pg/mL) did not differ among patients with active SLE and healthy controls (Hedges’s g: 0.22, 95% CI − 0.51, 0.95, p = 0.55). Sub-group analysis revealed that IL-35 levels in patients with active SLE were lower than in healthy controls in Chinese studies (Hedges’s g: − 3.11, 95% CI − 5.72, − 0.51), but not in non-Chinese studies (Hedges’s g: 1.63, 95% CI − 0.31, 3.57). This regional difference was statistically significant (p

Idiopathic granulomatous mastitis (IGM) is a debilitating, chronic, inflammatory condition of the breast. Several studies have emerged evaluating intralesional steroid (ILS) injection and topical steroid administration as a treatment for IGM. However, there is a dearth of international consensuses with regards to the management of IGM. Therefore, we have systematically reviewed the effectiveness of ILS in the management of IGM. A systematic search was conducted in PubMed and Cochrane Library databases, the Google Scholar website and by citation searching up to June 15th, 2023. Eight articles were selected and analyzed. A total of 397 IGM patients were included in the review. The mean patient age was 35.7 years, ranging from 23–62 years. The mean pre-treatment diameter of lesions was 27.5 mm. A total of 184 patients were treated with ILS. The mean complete clinical response time was 2.6 months. The overall complete response rate was 92.8%. Complications following ILS were minor, with hematoma, skin atrophy and hyperemia being commonly described, while avoiding the systemic side effects of oral steroid use, such as weight gain and hirsutism, which were the most commonly reported side effects with oral steroids. The recurrence rates in the ILS group (6.6%) appear to be lower than in the oral steroid group (25.8%) and surgery group (26.3%). ILS seem to show a favorable outcome in terms of complete response rate, complete clinical response time and has a lower recurrence rate and complication rate when compared to other intervention strategies. However, more comparative studies with standardized protocols are necessary to ascertain the optimum type, dosage and frequency of ILS regimens.

Background: Nails are one of the objects that are more durable than other witness objects. This study was interested in whether the Spin column-based nucleic acid purification technique could extract DNA from nails to give satisfactory results. Aims and Objectives: This study aimed to evaluate the yield and quality of DNA extracted from the nail. MATERIALS AND METHODS: Nail samples from 15 males and 15 females over 18 were extracted using GeneAll® Exgene™ Cell SV Mini Kit. The DNA concentration and purity were measured using a NanoDrop Spectrophotometer, and the quality of DNA was assessed by polymerase chain reaction (PCR) using primers specific for human growth hormone (HGH). Results: The average yield of DNA was 0.816 μg (0.141–2.706 μg) obtained from the average nail weight of 30.2 mg (22.2–40.0 mg). The average DNA concentration was 27.2 ng/μL (4.7–90.2 ng/μL), corresponding to 30 μL in volume. Almost all DNA samples (96.7%) had high purity (A260/A280 ≥1.80) and gave a band of PCR product of the HGH gene on agarose gel electrophoresis. Conclusion: Spin column-based nucleic acid purification is recommended for nail DNA extraction due to its simplicity and high quality.

Abstract Urinary tract infections (UTIs) pose a substantial burden on global healthcare systems. When unraveling the complex pathophysiology of UTIs, bladder models are used to understand complex and multifaceted interactions between different components within the system. This review aimed to bridge the gap between in vitro and in vivo experimental bladder models towards UTI research. We reviewed clinical, animal, and analytical studies and patents from 1959 to the end of 2023. Both in vivo and in vitro models offer unique benefits and drawbacks in understanding UTIs. In vitro models provide controlled environments for studying specific aspects of UTI biology and testing potential treatments, while in vivo models offer insights into how UTIs manifest and progress within living organisms. Thus, both types of models are leading to the development of more effective diagnostic tools and therapeutic interventions against UTIs. Moreover, advanced methodologies involving three-dimensional bladder organoids have also been used to study bladder biology, model bladder-related disorders, and explore new treatments for bladder cancers, UTIs, and urinary incontinence. Narrowing the distance between fundamental scientific research and practical medical applications, these pioneering models hold the key to unlocking new avenues for the development of personalized diagnostics, precision medicine, and ultimately, the alleviation of UTI-related morbidity worldwide.

Background: Breast cancer (BC) poses a significant public health concern as it is the most common cancer detected among women worldwide. Early detection and intervention are associated with better prognosis and survival. A primary reason for the rising mortality and morbidity in developing countries is the lack of patient education and practice early detection programs and presentation. Aims and Objectives: The main objective of this study is to evaluate the prevalence of delayed presentation and the factors lead to delay among BC patients in Sri Lanka. Materials and Methods: A descriptive cross-sectional study was conducted from January 01, 2023, to June 30, 2023 among women diagnosed with BC attending two selected state hospitals in Sri Lanka. All women with histological diagnosis of early, locally advanced, or metastatic BC attending for treatment were included and women with recurrent BC and concomitant other cancers were excluded. Presentation delay was defined as ≥3 months. The calculated sample size was 396. Results: About 47.5% of our study population (n=188) had a presentation delay of more than 3 months. The main reasons for the delay in presentation were, being unaware that BC is a major problem in Sri Lanka, difficulty in accessing healthcare, and not being able to find time due to family and social commitments. Women who had not been practicing self-breast examination had a significant association with presentation delay (OR=3.26, 95% CI - 0.090–0.362, P=0.001). The participants who were having a presentation delay were also more likely to be diagnosed with an advanced stage of cancer (OR=2.86, 95% CI - 2.573–3.153, P=0.000). Conclusion: Our study population depicts a good knowledge related to BC symptoms, risk factors, and early detection methods. However, very few are practicing them. There is also a significant delay of presentation due to various factors. Awareness and good practices would lead to early detection and diagnosis and improve overall survival.

Introduction: Despite advancements in understanding color-emotion correlations, the influence of mental health on this relationship is less studied. Our research explores how mental health impacts emotional expression through color and depiction style. Methods: Engaging 212 students, we collected 1272 digital drawings representing six primary emotions: anger, fear, sadness, calm, excitement, and happiness. Our study, conducted from November to December 2023, utilized a cross-sectional design. Participants were recruited through convenience sampling. We collected both survey responses and participant-generated images. Using Python and OpenCV, we quantified subjective emotional expressions. Results: Participants predominantly chose red for anger (57.43%), illustrating the red usage percentage for anger, black for fear (38.14%), gray and blue for sadness (27.86%, 27.83%), green for calm (25.73%), and red for both excitement (27.26%) and happiness (22.85%). Fear was the most frequent color fill at 31.58%, with anger the least at 24.95%. Tangible imagery was prevalent (88%–96.2%), while abstract styles were most common in fear depictions (12%). Emotion significantly influences color choices (P = 0.017~

Background: Antibiotics are drugs used to treat bacterial infections. A major problem with the irrational use of antibiotics is the emergence of drug resistance. Antimicrobial resistance is a current problem worldwide, particularly in developing countries. Objectives: The objectives of the study were to evaluate the knowledge and awareness level of the general public of Shimoga district of Karnataka, regarding responsible antibiotic use and to correlate the findings with the sociodemographic details. Methodology: A community-based cross-sectional study was carried out in the Shimoga district of Karnataka. Data were collected from 800 adults by door-step interview using a questionnaire after obtaining consent. Data were entered in Microsoft Excel and were analyzed using Epi Info software. Results: Hardly 8% of the respondents could recall the name of the antibiotic and most were oblivious about the commonly used classes of drugs. Almost 60% believed that antibiotic therapy could be stopped as and when the symptoms were relieved or they felt alright. We tested the respondents’ knowledge of antibiotics and found that it was not favorable. Conclusions: We observed a significant gap in respondents’ knowledge and awareness of the responsible use of antibiotics. There is an urgent need for enlightening people on the dangers of the irrational use of antibiotics and training them on responsible ways of using antibiotics.

Introduction: Significant reduction of subjective health status is frequently reported by many patients with Hashimoto thyroiditis despite adequate thyroxine replacement therapy. Studies have shown that thyroidectomy improves quality of life (QoL) in patients with HT and persistence symptoms, however there are conflicting evidence and we do not have our own data. QoL is an important aspect in management of chronic diseases like hypothyroidism which is less well touched in our population. Our findings highlight the potential of thyroidectomy in enhancing QoL for HT patients, contributing to the ongoing research on optimal management strategies for this condition. Objectives: To assess the QoL in patients with Hashimoto's thyroiditis (HT) who are biochemically euthyroid on thyroxine replacement therapy and to compare the QoL between patients managed medically and those who have undergone thyroidectomy with histologically confirmed HT. Methodology: We conducted a case-control study to compare the QoL using the SF-36 questionnaire among two groups of euthyroid Hashimoto’s thyroiditis patients: those receiving medical management and those who are post-thyroidectomy, as well as a healthy matched control group. Confounders that could affect QoL were rigorously excluded, and parametric tests were utilized for data analysis. Results: A significantly lower overall QoL was noted in the medically managed group (n=23) compared to the thyroidectomy group (n=24), with mean scores of 63.72 versus 84.25, respectively (P-value < 0.0001). This trend was consistent across all domains of the SF-36 QoL questionnaire. The QoL scores of patients who underwent surgery were similar to those of the healthy control group. Additionally, no significant correlation was found between thyroperoxidase (TPO) antibody titers and QoL in the regression analysis. Conclusion: Overall, patients with Hashimoto's thyroiditis on medical management exhibit significantly poorer QoL, despite adequate thyroxine replacement. This may be attributable to a complex interplay of immunological factors associated with an intact thyroid gland. Thyroidectomy could serve as a viable treatment alternative for these individuals. It is essential to develop algorithms to identify patients who would benefit most from thyroidectomy, ensuring they are thoroughly informed about the risks and benefits. Ongoing studies and the establishment of therapeutic guidelines are crucial for improving the management of patients with Hashimoto's thyroiditis.

Abstract Pesticide contamination and soil degradation present significant challenges in agricultural ecosystems, driving extensive exploration of biochar (BC) and nano-biochar (NBC) as potential solutions. This study examines their effects on soil properties, microbial communities, and the fate of two key pesticides: the hydrophilic methomyl (MET) and the hydrophobic lambda-cyhalothrin (LCT), at different concentrations (1%, 3%, and 5% w w−1) in agricultural soil. Through a carefully designed seven-week black bean pot experiment, the results indicated that the addition of BC/NBC significantly influenced soil dynamics. Soil pH and moisture content (MC) notably increased, accompanied by a general rise in soil organic carbon (SOC) content. However, in BC5/NBC5 treatments, SOC declined after the 2nd or 3rd week. Microbial populations, including total plate count (TPC), phosphate-solubilizing bacteria (PSB), and nitrogen-fixing bacteria (NFB), showed dynamic responses to BC/NBC applications. BC1/NBC1 and BC3/NBC3 applications led to a significant increase in microbial populations, whereas BC5/NBC5 treatments experienced a decline after the initial surge. Furthermore, the removal efficiency of both MET and LCT increased with higher BC/NBC concentrations, with NBC demonstrating greater efficacy than BC. Degradation kinetics, modeled by a first-order equation, revealed that MET degraded faster than LCT. These findings underscore the profound impact of BC/NBC on pesticide dynamics and microbial communities, highlighting their potential to transform sustainable agricultural practices.

The surfaces of many bacteria contain long dynamic appendages called type IV pili (T4P) Researchers have determined the correlation between the movements of T4P and the virulence of bacterial cell colonies. Previously, these movements were quantified through manual hand count- ing systems – a tedious process, taking researchers hours to multiple days to process one colony. This study aimed to develop an automated program to quantify the dynamic movements of T4P in bacterial samples using regression techniques and machine learning. A simple random sampling approach evaluated the program’s accuracy by comparing its output to manual hand-counted data. The results showed an average accuracy of 91.11% across ten analyzed files, with a standard error of 0.43%. This study demonstrates the potential of automated image analysis techniques to expedite the quantification of complex bacterial behaviors, such as T4P dynamics while maintaining high accuracy.

Background: The shadowing house officer is an experiential learning activity that usually takes place within the final year clinical rotations of medical undergraduates. An exposure to a surgical intern is especially useful as the work extends to more practical aspects of ward work. Objective: We assessed the impact of the shadowing house officer experience during medical student clinical rotation on the surgical internship and to evaluate the challenges of the shadowing period. Methods: A descriptive cross-sectional survey was carried out among 108 surgical intern doctors in Sri Lanka via electronic media in 2023. Results: Our study population consisted of 108 interns, with a response rate of 43.2%. This study demonstrates that on average a final year medical student undergoes a 4-day shadowing period in surgery which was considered by a majority to help in smooth transition to internship. 56% had a clear understanding about learning outcomes and less than half has had an induction session prior to commencement of shadowing. Official documentation, routine ward work, team work and communication skills were meaningfully experienced during shadowing. The main criticisms were inadequate breaks leading to exhaustion and missing out on important teaching activities. Another major concern was shadowing close to the final examination. Conclusions: Surgical shadowing house officer is an authentic work experience that intern doctors consider as important component in orientating the role of an intern. Introduction of shadowing at an earlier stage would be more beneficial and provide a broader view about the clinical set up to undergraduates.

Traumatic brain injury (TBI) profoundly affects sleep, mood, and fatigue, impeding daily functioning and recovery. This systematic review evaluates the efficacy of morning shorter wavelength lighting in the visible (blue) range and broad-spectrum or blue-enriched bright white light exposure in mitigating these challenges among TBI patients. Through electronic database searches up to May 2023, studies assessing sleep, circadian rhythm, sleepiness, mood, and fatigue outcomes in TBI patients exposed to morning shorter wavelength lighting in the visible (blue) range and broad-spectrum or blue-enriched bright white light were identified. Seven studies involving 309 participants met the inclusion criteria. Results indicated consistent advancement in sleep timing among individuals with mild TBI, alongside improvements in total sleep time, mood, and reduced sleepiness with both types of light exposure, particularly in mild TBI cases. Notably, two studies demonstrated alleviation of fatigue exclusively in severe TBI cases following light exposure. Despite promising findings, evidence remains limited, emphasizing the need for future research with standardized protocols to confirm the potential and optimize the benefits of light therapy for TBI recovery.

Abstract Gram-negative bacteria (GNB) are a major cause of neonatal sepsis in low- and middle-income countries (LMICs). Although the World Health Organization (WHO) reports that over 80% of these sepsis deaths could be prevented through improved treatment, the efficacy of the currently recommended first- and second-line treatment regimens for this condition is increasingly affected by high rates of drug resistance. Here we assess three well known antibiotics, fosfomycin, flomoxef and amikacin, in combination as potential antibiotic treatment regimens by investigating the drug resistance and genetic profiles of commonly isolated GNB causing neonatal sepsis in LMICs. The five most prevalent bacterial isolates in the NeoOBS study (NCT03721302) are Klebsiella pneumoniae, Acinetobacter baumannii, E. coli, Serratia marcescens and Enterobacter cloacae complex. Among these isolates, high levels of ESBL and carbapenemase encoding genes are detected along with resistance to ampicillin, gentamicin and cefotaxime, the current WHO recommended empiric regimens. The three new combinations show excellent in vitro activity against ESBL-producing K. pneumoniae and E. coli isolates. Our data should further inform and support the clinical evaluation of these three antibiotic combinations for the treatment of neonatal sepsis in areas with high rates of multidrug-resistant Gram-negative bacteria.

In 2016, the Office of the Higher Education Commission issued a directive requiring all higher education institutions in Thailand to have their students take a standardized English proficiency test. According to the directive, the test's results had to align with the Common European Framework of Reference for Languages (CEFR). In response to this directive, this study was conducted to demonstrate how to develop such a test. Grounded in the conceptual frameworks of test usefulness, standardized tests, test development processes, and the CEFR, the study explored six stages in developing a 100-item-multiple-choice standardized English proficiency test: test planning, test design and writing, test reviewing, test piloting, test revising and revised test try-out. The test was piloted during the test piloting and revised test try-out stages with 108 and 88 students, respectively, and underwent item analysis to examine its reliability, difficulty index, and discrimination index. The item analysis conducted after the revised test try-out stage showed that the test's reliability, assessed by Kuder-Richardson Formula 20 (KR-20), was 0.94, suggesting that the test was highly reliable with good internal consistency. How the test was developed in close alignment with test usefulness and the CEFR is discussed in the study.

Objective The American Heart Association (AHA) launched the 2022 guidelines for the diagnosis of hypertension (HT) by ambulatory blood pressure monitoring (ABPM). The present study aimed to evaluate the impacts of the 2022 AHA guidelines on the changes in the prevalence and phenotype of HT in children suspected of HT. Methods Consecutive 100 children aged 6 to 20 suspected of HT who underwent 24-hour ABPM were recruited. The patients were separated into 3 groups: escalated, de-escalated, and unchanged. Demographic data were compared between the 3 groups. Logistic regression analysis was performed to evaluate the factors associated with the escalation in the diagnosis of HT. Results The present study revealed that the prevalence of HT, including sustained and masked HT, increased from 48% by the 2014 AHA guidelines to 65% by the 2022 AHA guidelines. Patients in the escalated group tended to have a higher proportion of male gender, with an older age and a taller height compared to those in the de-escalated group. Multivariate analysis showed that height was the only factor associated with the escalation in the diagnosis of HT [OR 1.09 (1.01-1.19), P -value .04]. Five out of 6 (83.3%) patients in the escalated group with available echocardiographic results had left ventricular hypertrophy (LVH). Conclusion Using the 2022 AHA guidelines resulted in more detection of patients with HT, and almost 30% of the escalated group had LVH. This finding supports using the 2022 AHA guidelines to detect children at risk of developing cardiovascular diseases early.

Background Tumor-associated macrophages (TAMs) play a critical function in the development of tumors and are associated with protumor M2 phenotypes. Shifting TAMs towards antitumor M1 phenotypes holds promise for tumor immunotherapy. Oleamide, a primary fatty acid amide, has emerged as a potent anticancer and immunomodulatory compound. However, the regulatory effects of oleamide on TAM phenotypes remain unclear. Methods We used real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) techniques to study the influence of oleamide on primary human monocyte-derived TAM phenotypes, and we investigated the protein expression profiles based on mass spectrometry to analyze the effect of oleamide on macrophage polarization. Moreover, the advantageous binding scores between oleamide and these target candidate proteins are examined using molecular docking. Results Our study revealed that oleamide effectively suppressed the M2-like TAM phenotype by reducing interleukin (IL)-10 production and downregulating M2-like markers, including vascular endothelial growth factor A (VEGFA), MYC proto-oncogene, bHLH transcription factor (c-Myc), and mannose receptor C-type 1 (CD206). Moreover, the conditioned medium derived from oleamide-treated TAMs induces apoptosis of MDA-MB-231 breast cancer cells. Proteomic analysis identified 20 candidate up- and down-regulation proteins targeted by oleamide, showing modulation activity associated with the promotion of the M1-like phenotype. Furthermore, molecular docking demonstrated favorable binding scores between oleamide and these candidate proteins. Collectively, our findings suggest that oleamide exerts a potent antitumor effect by promoting the antitumor M1-like TAM phenotype. These novel insights provide valuable resources for further investigations into oleamide and macrophage polarization which inhibit the progression of breast cancer, which may provide insight into immunotherapeutic approaches for cancer.

This Proposed work explores how machine learning can be used to diagnose conjunctivitis, a common eye ailment. The main goal of the study is to capture eye images using camera-based systems, perform image pre-processing, and employ image segmentation techniques, particularly the UNet++ and U-net models. Additionally, the study involves extracting features from the relevant areas within the segmented images and using Convolutional Neural Networks for classification. All this is carried out using TensorFlow, a well-known machine-learning platform. The research involves thorough training and assessment of both the UNet and U-net++ segmentation models. A comprehensive analysis is conducted, focusing on their accuracy and performance. The study goes further to evaluate these models using both the UBIRIS dataset and a custom dataset created for this specific research. The experimental results emphasize a substantial improvement in the quality of segmentation achieved by the U-net++ model, the model achieved an overall accuracy of 97.07. Furthermore, the UNet++ architecture displays better accuracy in comparison to the traditional U-net model. These outcomes highlight the potential of U-net++ as a valuable advancement in the field of machine learning-based conjunctivitis diagnosis.

This work presents, for the first time, an exploitation of an argentometric Mohr's method for iodide detection using diameter-based measurement on laminated paper-based analytical device (LPAD). Our LPAD is simplified fabricated with no required hydrophobic barrier for patterning a detection flow channel. In the absence of a flow channel, the liquid is imbibed radially into the filter paper outward from the small center inlet hole. This imbibition leads to the measurement of diameter after the formation of the precipitation product. For LPAD, a rectangular piece of Whatman filter paper is cut and positioned between a top laminating sheet, which has a hole punched for inlet, and a bottom laminating sheet. The central inlet hole enables access to the liquid on the paper. For iodide analysis, silver nitrate is dispensed first, followed by the iodide standard/sample. This process leads to the formation of pale-yellow silver iodide solids on the paper. The chromate indicator solution is subsequently loaded to the paper. The color of the chromate solution imparts a tint to the circular band of silver iodide solids, resulting in an intense yellow color. When the silver iodide precipitates are stained, the chromate solution typically serves as an indicator, chemically reacting to an excess silver nitrate solution moistened on paper. This reaction generates an outer reddish-brown ring of silver chromate. The distinct color contrast between the intense yellow (tinted silver iodide) and reddish-brown (silver chromate) allows for clear observation of the measurement boundary, facilitating diameter-based measurements of the circular band of silver iodide. We demonstrate the applicability in analysis of pharmaceutical KI tablets. The quantitative results obtained from diameter-based measurement LPAD show good agreement with those obtained from the potentiometric method. Our hydrophobic barrier-free LPAD is rapid, cost-effective, low liquid consumption and applicable for onsite analysis.