Search

Background and Methods: A primary survey of a multi-national sample of higher institutional educators has been conducted to investigate the determinants of the adoption of management simulation games. The research model is developed based on the technology acceptance model (TAM) and technology–organisation–environment (TOE). Structural equation modelling has been used to test the research model. The paper focuses on the use of management simulation games among educators in higher educational institutions (HEIs). Its purpose is to determine the factors influencing educators’ use of these games from both individual and institutional perspectives. The TAM captures the individual perspective, while the TOE framework addresses the institutional perspective. The structural equation model confirmed most of the TAM hypotheses. Results: However, the model does not support the hypotheses regarding the relationship between perceived ease of use and attitude toward usage or between perceived ease of use and perceived usefulness. The technological factors within the TOE framework did not significantly impact perceived usefulness, only perceived ease of use. Conclusion: The combined TAM-TOE model has demonstrated valid representativeness. Previous research on the usage of management simulation games has primarily focused on students, neglecting the broader perspective of educators in HEIs in business and economics within both the TAM and TOE frameworks.

Background: Inflammation and subsequent mitochondrial dysfunction and cell death worsen outcomes after revascularization in ischemic stroke. Receptor-interacting protein kinase 1 (RIPK1) activated dynamin-related protein 1 (DRP1) in a NLRPyrin domain containing 3 (NLRP3) inflammasome-dependent fashion and Hypoxia-Inducible Factor (HIF)-1α play key roles in the process. This study determined how phenothiazine drugs (chlorpromazine and promethazine (C + P)) with the hypothermic and normothermic modality impacts the RIPK1/RIPK3-DRP1 and HIF-1α pathways in providing neuroprotection. Methods: A total of 150 adult male Sprague-Dawley rats were subjected to 2 h middle cerebral artery occlusion (MCAO) followed by 24 h reperfusion. 8 mg/kg of C + P was administered at onset of reperfusion. Infarct volumes, mRNA and protein expressions of HIF-1α, RIPK1, RIPK3, DRP-1, NLRP3-inflammation and cytochrome c-apoptosis were assessed. Apoptotic cell death, infiltration of neutrophils and macrophages, and mitochondrial function were evaluated. Interaction between RIPK1/RIPK3 and HIF-1α/NLRP3 were determined. In SH-SY5Y cells subjected to oxygen/glucose deprivation (OGD), the normothermic effect of C + P on inflammation and apoptosis were examined. Results: C + P significantly reduced infarct volumes, mitochondrial dysfunction (ATP and ROS concentration, citrate synthase and ATPase activity), inflammation and apoptosis with and without induced hypothermia. Overexpression of RIPK1, RIPK3, DRP-1, NLRP3-inflammasome and cytochrome c-apoptosis were all significantly reduced by C + P at 33 °C and the RIPK1 inhibitor (Nec1s), suggesting hypothermic effect of C + P via RIPK1/RIPK3-DRP1pathway. When body temperature was maintained at 37 °C, C + P and HIF-1α inhibitor (YC-1) reduced HIF-1α expression, leading to reduction in mitochondrial dysfunction, NLRP3 inflammasome and cytochrome c-apoptosis, as well as the interaction of HIF-1α and NLRP3. These were also evidenced in vitro, indicating a normothermic effect of C + P via HIF-1α. Conclusion: Hypothermic and normothermic neuroprotection of C + P involve different pathways. The normothermic effect was mediated by HIF-1α, while hypothermic effect was via RIPK1/RIPK3-DRP1 signaling. This provides a theoretical basis for future precise exploration of hypothermic and normothermic neuroprotection.

The optoelectronic devices play a crucial role in our daily lives by seamlessly integrating optics and electronics, enabling technologies like smartphones, solar cells, and optical communication. Solar cells have been very vital in terms of providing sustainable and clean energy. Conventional Perovskite-based solar cells possess limitations like stability and toxicity. Recently, ABO4-type materials have gained attention in optoelectronic devices due to their structural stability and suitable optoelectronic properties for solar cell applications. The structural, electronic, and optical properties of AgWO4 and PdWO4 have been explored using the first principal simulations in line with density functional theory (DFT) using WIEN2K simulation software. The Perdew-Burke-Ernzerhof Generalized-Gradient-Approximation (PBE-GGA) is acclimated to optimize the geometry of both materials under consideration. Trans-Balha modified Becke-Johnson approximation (TB-mBJ) approximation is implemented to study materials' optoelectronic properties. Structural analysis revealed the stable structure of AgWO4 and PdWO4 in the monoclinic phase with increasing lattice parameters and decreased unit cell volume upon replacement of Ag with Pd cation on the A site. Both materials ' negative values of ground state energies indicate the stability of both compounds. Upon analysis of the band structure of AgWO4 and PdWO4, it is found that both materials possess a band gap of 1.34eV and 0.73eV,respectively, signifying that both materials under consideration are semiconductors, with a potential for a controlled flow of electrical charges, coming up with promising various optoelectronic applications. Optical characteristics were explored and examined in depth in the framework of hypothetical dielectric constant. It has been discovered that the dielectric function has a broad span of energy integrity when it comes to its dielectric function. Materials with narrow bandgaps and excellent UV light absorption were found suitable for optoelectronic and solar cell applications.

As the financialization issue is getting more and more attention, the behavioral motives and effects behind this appearance should not be ignored, and it is of great practical significance for the high-quality development of China's real economy to explore the impact and mechanism of the financialization trend on the investment and financing maturity mismatch of China's real enterprises. Using sample data of Chinese A-share listed companies from 2013 to 2020, this article empirically examines the impact of financialization on the investment and financing maturity structure from a new perspective of asset classification by using a fixed-effect model, and explores the mechanism of the financial regulatory environment's moderating effect on the relationship between the two mentioned above. The study shows that: there is an inverted U-shaped nonlinear relationship between the financialization of investment income and fixed income and “maturity mismatch “. The term mismatch of investment and financing increases with the degree of financialization, after reaching the critical point, it eases with the deepening of financialization. However, the specific point of view is different. In the sample interval, the investment income financialization exacerbates the investment and financing maturity mismatch more obviously; the fixed income financialization inhibits the investment and financing maturity mismatch more obviously. Under the different perspectives of the firms' ownership nature, financing constraints, and principal-agent problems, there are differences in the impact of firms' allocation of different types of financial assets on the investment and financing term structure. In addition, the regulatory effect of financial supervision weakens the inverted U-shaped relationship of investment income financialization with investment and financing maturity mismatch; it enhances the inverted U-shaped relationship between fixed income financialization and investment and financing maturity mismatch. In general, financial supervision has had a significant positive effect on investment and financing maturity mismatches. The findings have important policy implications in terms of corporate real investment, financial market development, and financial regulation, which can help promote China's economic development and stability.

Abstract Because of the detrimental effects of terrestrial invasive plant species (TIPS) on native species, ecosystems, public health, and the economy, many countries have been actively looking for strategies to prevent the introduction and minimize the spread of TIPS. Fast and accurate detection of TIPS is essential to achieving these goals. Conventionally, invasive species monitoring has relied on morphological attributes. Recently, DNA‐based species identification (i.e., DNA barcoding) has become more attractive. To investigate whether DNA barcoding can aid in the detection and management of TIPS, we visited multiple nature areas in Southwest Michigan and collected a small piece of leaf tissue from 91 representative terrestrial plant species, most of which are invasive. We extracted DNA from the leaf samples, amplified four genomic loci (ITS, rbcL, matK, and trnH‐psbA) with PCR, and then purified and sequenced the PCR products. After careful examination of the sequencing data, we were able to identify reliable DNA barcode regions for most species and had an average PCR‐and‐sequencing success rate of 87.9%. We found that the species discrimination rate of a DNA barcode region is inversely related to the ease of PCR amplification and sequencing. Compared with rbcL and matK, ITS and trnH‐psbA have better species discrimination rates (80.6% and 63.2%, respectively). When ITS and trnH‐psbA are simultaneously used, the species discrimination rate increases to 97.1%. The high species/genus/family discrimination rates of DNA barcoding indicate that DNA barcoding can be successfully employed in TIPS identification. Further increases in the number of DNA barcode regions show little or no additional increases in the species discrimination rate, suggesting that dual‐barcode approaches (e.g., ITS + trnH‐psbA) might be the efficient and cost‐effective method in DNA‐based TIPS identification. Close inspection of nucleotide sequences at the four DNA barcode regions among related species demonstrates that DNA barcoding is especially useful in identifying TIPS that are morphologically similar to other species.

Summary: Environmental enteric dysfunction (EED) is a subclinical enteropathy challenging to diagnose due to an overlap of tissue features with other inflammatory enteropathies. EED subjects (n = 52) from Pakistan, controls (n = 25), and a validation EED cohort (n = 30) from Zambia were used to develop a machine-learning-based image analysis classification model. We extracted histologic feature representations from the Pakistan EED model and correlated them to transcriptomics and clinical biomarkers. In-silico metabolic network modeling was used to characterize alterations in metabolic flux between EED and controls and validated using untargeted lipidomics. Genes encoding beta-ureidopropionase, CYP4F3, and epoxide hydrolase 1 correlated to numerous tissue feature representations. Fatty acid and glycerophospholipid metabolism-related reactions showed altered flux. Increased phosphatidylcholine, lysophosphatidylcholine (LPC), and ether-linked LPCs, and decreased ester-linked LPCs were observed in the duodenal lipidome of Pakistan EED subjects, while plasma levels of glycine-conjugated bile acids were significantly increased. Together, these findings elucidate a multi-omic signature of EED.

OBJECTIVES This study aimed to evaluate the clinical outcomes of Anterior Cervical Discectomy and Fusion (ACDF) treatments for cervical disc degenerative disease (CDDD) using a Zero Profile cage. METHODOLOGY A retrospective study of 26 patients with cervical disc disease treated with a zero-profile cage was designed and followed up for an average of 12 months in descriptive research. For arm and neck pain, the Neck Disability Index (NDI) and Visual Analogue Scale (VAS) scores were used to assess function. Nurick’s myelopathy classification scheme based on gait impairments was also documented. RESULTS The average age of the 26 patients was 48.96 13.13 years (mean SD), with 44 percent falling into the 40-60-year age bracket. The male/female gender distribution was 21 (84%) and 04 (16%) male/female. Radiculomyelopathic symptoms were detected in 11 (28%) of the patients, with radicular pain occurring bilaterally in seven (28%) of the patients and on the left side in four (16%). A radiological examination of fusion was performed at six months and one year. The fusion had a success rate of 95 percent at six months (19 patients) and 100 percent at one year. CONCLUSION A zero-profile device provides biomechanical stability and fusion rates with excellent outcomes for one- and two-level ACDFs. Advantages include low rates of dysphagia, decreased operative time, restoration of cervical lordosis and disc height, and lack of cage subsidence or screw back out.

Objective: To analyze the role of ASA status in carrying out laparoscopic cholecystectomies by evaluating the perioperative findings of patients. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jan 2019 to Jan 2021. Methodology: Laparoscopic cholecystectomies were performed on 385 patients with symptomatic gallstones. The inclusion criteria comprised of symptomatic cholelithiasis, acute cholecystitis and chronic cholecystitis. Data for the perioperative findings such as gallbladder grades, bile, cystic duct, cystic artery and Common Bile Duct were recorded during the study. Results: The study included 226(59%) female patients and 159(41%) males. The mean age was 48.15±15.5 years. There were 145(37.66%) patients in American Society of Anesthesiologists Classification ASA-I, 174(45.20%) patients in ASA-II and 66(17.14%) in ASA-III. Results showed that the abnormalities of cystic duct were 34(23.4%) in ASA-I, 68(39.1%) in ASA-II and 43(65.2%) in ASA-III. For CBD, they were 7(4.8%) in ASA-I, 49(28.2%) in ASA-II and 44(66.2%) in ASA-III. The complications of cystic artery and bile were 34(23.4%) in ASA-I, 60(34.5%) in ASA-II, 46(69.7%) in ASA-III and 82(56.6%) in ASA-I, 119(68.4%) in ASA-II, 50(75.8%) in ASA-III respectively. The gallbladder grades I were 27(18.6%) in ASA-I and (4.5%) in ASA-III whereas, grades V were 7(4.8%) in ASA-I and 20(30.3%) in ASA-III. Conclusion: Peri-operative morbidity increased with increasing ASA status, therefore, there is a significant relationship between ASA Status and peri-operative findings.

Autism, also known as autism spectrum disorder (ASD), is a neurodevelopmental disorder that affects social interaction, communication, and behavior. Autism is a lifelong developmental condition that affects individual’s communication and interaction with others, as well as their understanding of the world. There is limited literature available from Pakistan, therefore this study was designed to find the frequency of autism in nuclear and joint family systems. This was a Cross-sectional observational study conducted in various healthcare settings, including the University of Lahore Teaching Hospital, Mayo Hospital, Orion Center, and Sehat Medical Complex, Pakistan from February 2023 to July 2023. Purposive sampling was the method of sampling used in this investigation (n=133). Parents or caregivers who have a minimum of one ASD-diagnosed child were included in this study. Parents or caregivers who do not have a child diagnosed with autism spectrum disorder (ASD) were excluded from this study. The investigation into the frequency of autism within joint and nuclear families’ reveals that a majority of families with autistic children lean towards nuclear family structures. While joint families exist, they are less prevalent. The study also underlines that parental engagement is high across both family types, with over 90% actively participating in caregiving and decision-making.

Aim of study: To identify and compare the early frost resistance mechanisms in three oak species (Quercus brantii, Quercus libani and Quercus infectoria). Area of study: Zagros forests of Iran. Material and methods: The physiological and biochemical variables such as chlorophyll fluorescence, relative water content (RWC), electrolyte leakage, and osmotic metabolite content, such as proline, glucose, and potassium of three oak species seedlings with varying altitudinal and latitudinal ranges were measured under various treatments, including cold treatments (4°C: control, -20°C (1 hour) and -20°C (2 hours)) and four levels of hardening steps with decreasing temperature and photoperiod. Main results: Results showed that decreasing photoperiod and temperature during cold hardening was associated with decreasing Fv/Fm, ΦPSII and electron transport rate, increasing (NPQ) measured from chlorophyll fluorescence, as well as increasing osmotic metabolite content and decline of RWC, except the glucose content decreased in Q. brantii from lower altitudes and south aspect. On the other hand, Q. libanii, which originates from higher altitudes and north aspect showed the strongest cold-resistance and faster developing cold-acclimation capacity using earlier accumulation of osmotic metabolites, diminishing RWC and subsequently lowest EL compared to the other oak species. Research highlights: The physiological and biochemical responses of oak species differed based on origin and there was a positive relation between osmotic metabolite content, NPQ, altitude, and cold stress resistance. These physiological responses, especially NPQ (as a fast and non-invasive tool) provide a quantitative assessment of the risks associated with autumn freezing in different oak species and ecotypes relevant to conservation and reforestation projects of the Zagros forests under changing climatic conditions.

This study investigated the antioxidant effect of quercetin-treated semen on frozen–thawed spermatozoa quality and in-vivo fertility in crossbred Kamori goats. In total, 32 ejaculates from four fertile bucks were diluted in Tris-based egg yolk extender with varying levels of quercetin (0, 1, 5, 10, and 15 μM). Qualified semen samples were pooled and frozen in French straws. The results revealed that the addition of quercetin in the semen extender increased (p 0.05). Quercetin showed significantly higher (p

Background Accreditation in medical education has existed for more than 100 years, yet the impact of accreditation remains inconclusive. Some studies have shown the effects of accreditation on student outcomes and educational processes at medical schools. However, evidence showing the impact of accreditation on continuous quality improvement of undergraduate medical education programs is still in its infancy. This scoping review explores the impact of accreditation on continuous quality improvement (CQI). Methods This scoping review followed the methodology of the Preferred Reporting Items of Systematic Reviews and the Meta-Analysis extension for scoping reviews (PRISMA-ScR) checklist outlined by Arksey and O'Malley (2005). Databases, including PubMed, Medline, ERIC, CINHAL, and Google Scholar, were searched to find articles from 2000 to 2022 related to the accreditation of undergraduate medical education programs and continuous quality improvement. Results A total of 35 full-text articles were reviewed, and ten articles met our inclusion criteria. The review of the full-text articles yielded four themes: Accreditation and its standards in general, Accreditation and its impact on student outcomes, Accreditation and its impact on medical school's educational processes, Accreditation and CQI. However, the literature evidence suggesting the impact of accreditation on CQI is minimal. The quality assurance approach is based on meeting the standards of accreditation. The quality improvement approach is based on striving for excellence. Literature suggests a requirement to move from student outcomes to CQI measures. CQI requires everyone in the organization to take responsibility and accountability, considering quality as the result of every single step or process and leaders supporting improvements in data collection and data analysis for quality improvement. Conclusions The literature on accreditation and CQI are limited in number. More research studies are required to enhance undergraduate medical education accreditation practices' value to medical students, educators, academic leaders, programs, and the public. It was recommended that medical schools embrace the culture and vision perpetuated by the CQI process.

Musculoskeletal conditions impede patient biomechanical function. However, clinicians rely on subjective functional assessments with poor test characteristics for biomechanical outcomes because more advanced assessments are impractical in the ambulatory care setting. Using markerless motion capture (MMC) in clinic to record time-series joint position data, we implemented a spatiotemporal assessment of patient kinematics during lower extremity functional testing to evaluate whether kinematic models could identify disease states beyond conventional clinical scoring. 213 trials of the star excursion balance test (SEBT) were recorded by 36 subjects during routine ambulatory clinic visits using both MMC technology and conventional clinician scoring. Conventional clinical scoring failed to distinguish patients with symptomatic lower extremity osteoarthritis (OA) from healthy controls in each component of the assessment. However, principal component analysis of shape models generated from MMC recordings revealed significant differences in subject posture between the OA and control cohorts for six of the eight components. Additionally, time-series models of subject posture change over time revealed distinct movement patterns and reduced overall postural change in the OA cohort compared to the controls. Finally, a novel metric quantifying postural control was derived from subject specific kinematic models and was shown to distinguish OA (1.69), asymptomatic postoperative (1.27), and control (1.23) cohorts (p = 0.0025) and to correlate with patient-reported OA symptom severity (R = -0.72, p = 0.018). Time series motion data have superior discriminative validity and clinical utility than conventional functional assessments in the case of the SEBT. Novel spatiotemporal assessment approaches can enable routine in-clinic collection of objective patient-specific biomechanical data for clinical decision-making and monitoring recovery.