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Abstract In this systematic review and meta-analysis, we aim to evaluate the efficacy and safety of catheter ablation as the first-line treatment of ventricular tachycardia (VT) in patients with structural heart disease (SHD) and preserved left ventricular ejection fraction (LVEF). Patients with SHD are particularly susceptible to VT, a condition that increases the risk of sudden cardiac death (SCD). Implantable cardioverter-defibrillators (ICDs) can terminate VT and prevent SCD but do not prevent VT recurrence. The efficacy and safety of CA as a first-line treatment in SHD patients with preserved LVEF remain unclear. We searched PubMed/Medline, EMBASE, Web of Science, and Cochrane CENTRAL for studies reporting the outcomes of CA therapy in patients with VT and preserved LVEF, published up to January 19, 2023. The primary outcome was the incidence of SCD following catheter ablation as the first-line treatment of VT in patients with SHD and preserved LVEF. Secondary outcomes included all-cause mortality, VT recurrence, procedural complications, CA success rate, and ICD implantation after catheter ablation. We included seven studies in the meta-analysis, encompassing a total of 920 patients. The pooled success rate of catheter ablation was 84.6% (95% CI 67.2–93.6). Complications occurred in 6.4% (95% CI 4.0–9.9) of patients, and 13.9% (95% CI 10.1–18.8) required ICD implantation after ablation. VT recurrence was observed in 23.2% (95% CI 14.8–34.6) of patients, while the rate of sudden cardiac death (SCD) was 3.1% (95% CI 1.7–5.6). The overall prevalence of all-cause mortality in this population was 5% (95% CI 1.8–13). CA appears promising as a first-line VT treatment in patients with SHD and preserved LVEF, especially for monomorphic hemodynamically tolerated VT. However, due to the lack of direct comparisons with ICDs and anti-arrhythmic drugs, further research is needed to confirm these findings.

Abstract Electronic interferometers using the chiral, one-dimensional (1D) edge channels of the quantum Hall effect (QHE) can demonstrate a wealth of fundamental phenomena. The recent observation of phase jumps in a Fabry-Pérot (FP) interferometer revealed anyonic quasiparticle exchange statistics in the fractional QHE. When multiple integer edge channels are involved, FP interferometers have exhibited anomalous Aharonov-Bohm (AB) interference frequency doubling, suggesting putative pairing of electrons into $${{\boldsymbol{2}}}{{\boldsymbol{e}}}$$ 2 e quasiparticles. Here, we use a highly tunable graphene-based QHE FP interferometer to observe the connection between interference phase jumps and AB frequency doubling, unveiling how strong repulsive interaction between edge channels leads to the apparent pairing phenomena. By tuning electron density in-situ from filling factor $${{\boldsymbol{\nu }}} \, < \, {{\boldsymbol{2}}}$$ ν < 2 to $${{\boldsymbol{\nu }}} \, > \, {{\boldsymbol{7}}}$$ ν > 7 , we tune the interaction strength and observe periodic interference phase jumps leading to AB frequency doubling. Our observations demonstrate that the combination of repulsive interaction between the spin-split $${{\boldsymbol{\nu }}}={{\boldsymbol{2}}}$$ ν = 2 edge channels and charge quantization is sufficient to explain the frequency doubling, through a near-perfect charge screening between the localized and extended edge channels. Our results show that interferometers are sensitive probes of microscopic interactions and enable future experiments studying correlated electrons in 1D channels using density-tunable graphene.

Background: Hypertension can lead to cardiovascular and other health complications. Many hypertensive patients in the community may receive poor care and monitoring due to financial and other concerns. Pharmacists could support patients in improving their health outcomes. This research aims to assess the impact of pharmacist-led hypertensive clinics in a community pharmacy setting. Methods: The study was an interventional exploratory design in a community pharmacy in Dubai, UAE. All eligible patients who consented were enrolled in the study, making it a population-based study. Patients’ blood pressure (BP) was measured before starting the intervention and measured monthly for a minimum of 6 months of care. Measuring BP, physician referral for management of hypertension, lifestyle, diet, and medication counseling were the interventions provided by the researcher on a case-to-case basis as needed in each patient encounter. Toward the end of the study, a patient satisfaction survey was conducted. The survey form showed internal consistency, Cronbach’s alpha = 0.895. Results: About 30 patients were provided pharmacy services by a pharmacist for 613 months. All patients’’ BP were monitored monthly. Patients showed reductions in their systolic and diastolic BP levels with the continued care of the pharmacist. (The mean systolic BP significantly decreased from 155 mmHg (standard deviation (SD) = 14.4, median = 151) at baseline to 128 mmHg (SD = 3.1, median = 129) with a P = 0.001. The mean diastolic BP showed a decrease from 95 mmHg (SD = 8.4, Median = 93) at baseline to 82 mmHg (SD = 1.2, Median = 81) with a P = 0.17. The participants showed a high level of patient satisfaction. Some were willing to pay for the pharmacist’s professional service. Conclusion: In conclusion, the study has shown the impact of pharmacist-led antihypertensive clinics in systolic BP control and achieving high patient satisfaction. The study generated insights into participant cooperation with pharmacist services and needs. More research on different outcomes is planned for future studies, including systematic pharmacotherapy work-up, patient medication adherence, and other clinical outcomes in the study population.

Objective(s): Paraquat (PQ), a potent environmental herbicide, is recognized for inducing irreparable toxic damage to biological systems. This study aimed to evaluate the effectiveness of N-acetylcysteine (NAC) and broccoli extract, individually and in combination, in alleviating PQ poisoning in rats, leveraging the exceptional anti-oxidant, anti-inflammatory, and anti-apoptotic properties of broccoli.Materials and Methods: Seventy Wistar rats were categorized into seven groups: C (control, vehicle), PQ (paraquat at 40 mg/kg), BC (broccoli extract at 300 mg/kg), NC (N-acetylcysteine at the same dose of 300 mg/kg), and combined groups PQ+BC, PQ+NC, and NC+PQ+BC, all administered equivalent doses. After 42 days, blood samples were collected to evaluate liver and kidney parameters, proinflammatory biomarkers, caspase-3, and caspase-9. Lung tissues were excised, with one part preserved for hydroxyproline and oxidative stress parameter measurement and another sectioned and stained for histopathological analysis.Results: The PQ group exhibited the highest lung-to-body weight (LW/BW) ratio, while the PQ+BC+NC group demonstrated the lowest ratio. Results indicated an elevated lung hydroxyproline concentration and a significant reduction in anti-oxidant enzymes (catalase, glutathione peroxidase, superoxide dismutase, and total anti-oxidant capacity) (P

Background and purpose: Diabetes is the most common metabolic disorder associated with chronic hyperglycemia and a disfunction in carbohydrate metabolism, fat, and protein. Oral complications of diabetes include gingival hyperplasia, periodontitis, dental caries, and xerostomia. Although diabetes can be effective on oral and dental health, limited studies have investigated the increase of oral and dental caries in children with type 1 diabetes compared to healthy children. This study compares oral health and quality of life in two to five-year-old children with type 1 diabetes with healthy children in Sari City in 2022. Materials and methods: In this case-control study, 33 children aged 2-5 with type 1 diabetes (case group) and 33 healthy children matched in terms of age and gender (control group) referred to BuAli Hospital in Sari were included using the census method. After obtaining informed consent from the parents, the Early Childhood Oral Health Impact Scale (ECOHIS) was provided to them. This questionnaire was classified into two areas: the child impact section (CIS) and the family impact section (FIS). Generally, the sum of the raw scores of this index varies from 0-52, which includes 0-26 scores for the CIS section and 0-16 for the FIS section. The higher score in the ECOHIS index suggests worse oral health-related quality of life (OHRQOL). Children were examined for dmft index under sufficient light. Data was analyzed using SPSS 22 statistical software. Results: In this investigation, 36 boys (54.5 %) participated, of which 19 (57.6%) were in the case group and 17 (51.5%) were in the control group. The girls also made up 45.5 % (30 cases) of the sample size, of which 42.4 % (14 cases) were in the case group and 45.5 % (16 cases) were in the control group. The findings revealed that the mean FIS, ECOHIS, and dmft scores in the case group were significantly higher than the control group (P0.05). Conclusion: According to the current results, the oral health-related quality of life according to the ECOHIS index in type 1 diabetic children is more inappropriate than healthy patients at the same age. Moreover, as the child with type 1 diabetes grows older, the oral health-related quality of life decreases. The results of the present study also show that children with type 1 diabetes are at risk of dental caries (more dmft), which increases with age but does not have any significant association with sex.

Abstract Background Estrogen receptors express in nearly 70% of breast cancers (ER-positive). Estrogen receptor alpha plays a fundamental role as a significant factor in breast cancer progression for the early selection of therapeutic approaches. Accordingly, there has been a surge of attention to non-invasive techniques, including circulating Cell-free DNA (ccfDNA) or Cell-Free DNA (cfDNA), to detect and track ESR1 genotype. Therefore, this study aimed to examine the diagnosis accuracy of ESR1 mutation detection by cell-free DNA in breast cancer patientsthrough a systematic review and comprehensive meta-analysis. Methods PubMed, Embase, and Web of Science databases were searched up to 6 April 2022. Diagnostic studies on ESR1 measurement by cfDNA, which was confirmed using the tumour tissue biopsy, have been included in the study. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were considered to analyse the data. Results Out of 649 papers, 13 papers with 15 cohorts, including 389 participants, entered the meta-analyses. The comprehensive meta-analysis indicated a high sensitivity (75.52, 95% CI 60.19–90.85), specificity (88.20, 95% CI 80.99–95.40), and high accuracy of 88.96 (95% CI 83.23–94.69) for plasma ESR1. We also found a moderate PPV of 56.94 (95% CI 41.70–72.18) but a high NPV of 88.53 (95% CI 82.61–94.44). We also found an NLR of 0.443 (95% CI 0.09–0.79) and PLR of 1.60 (95% CI 1.20–1.99). Conclusion This systematic review and comprehensive meta-analysis reveal that plasma cfDNA testing exhibits high sensitivity and specificity in detecting ESR1 mutations in breast cancer patients. This suggests that the test could be a valuable diagnostic tool. It may serve as a dependable and non-invasive technique for identifying ESR1 mutations in breast cancer patients. However, more extensive research is needed to confirm its prognostic value.

This study focuses on producing polyurethane dispersion (PUD)/carboxylated nitrile butadiene rubber (XNBR) blends with different types of crosslinkers without both accelerators and sulphur. Two types of crosslinkers: epoxide crosslinker and organo-modified siloxane, are introduced in the PUD/XNBR (blending ratio of 80:20). The zeta potential and particle size of the PUD/XNBR blends were determined using a dynamic light-scattering nanoparticle analyser. The chemical interaction and surface roughness of the PUD/XNBR blends were evaluated using Fourier transform infrared spectroscopy (FTIR) and atomic force microscopy (AFM). The zeta potential and particle size of the PUD were influenced by XNBR blending and the types of crosslinkers. FTIR observations indicate that the XNBR and the crosslinkers facilitated intermolecular hydrogen bonding and different extents of ordered hydrogen bonding. A higher degree of ordered hydrogen bonding can be associated with a higher surface roughness of the PUD/XNBR blends. Nevertheless, the hybrid crosslinkers can be used to achieve reasonable surface roughness for the easier donning of latex gloves. The research findings can be applied to design glove products with desirable surface roughness and intermolecular bonding.

The present study sought to investigate the effects of meaning-focused input (MFI) and meaning-focused output (MFO) activities on willingness to communicate (WTC) of English as a Foreign Language (EFL) learners. The study aimed at exploring learners' perceptions towards the efficacy of MFO and MFI activities for developing WTC. The participants of study were 70 learners homogenized via an Oxford Placement Test, who were then randomly divided into two groups of 35. The WTC questionnaire, adopted from MacIntyre et al. (2001), was used both as pretest and posttest, and a semi-structured interview was used to probe participants' perceptions towards MFI and MFO. The first experimental group received MFO activities and were given a reading text and asked to present a summary in spoken form based on the notes they took during the reading. In experimental group two, the reading activities were administered in an input mode. The learners were asked to read the texts and answer some reading comprehension questions. The results of statistical analyses indicated that the MFO group outperformed the MFI group for WTC. The content analysis of the interview also revealed students receiving MFO had more positive perception and found it more useful in enhancing WTC than those receiving MFI. Pedagogical implications are offered to teachers and material developers.

Memfasilitasi peserta didik agar dapat belajar secara maksimal tentu menjadi fokus penting pendidik, sehingga pembelajaran berdiferensiasi memiliki urgensi tersendiri. Penelitian ini bertujuan untuk mengetahui persepsi guru biologi terhadap pembelajaran berdiferensiasi. Kuantitatif deskriptif digunakan sebagai metode penelitian dengan random sampling. Data diperoleh melalui survey melalui kuesioner yang diberikan kepada guru biologi di Provinsi Jambi. Hasil analisis data menunjukan bahwa persepsi guru biologi terhadap pembelajaran berdiferensiasi berada pada kategori baik. Hal ini mengindikasikan nilai yang positif, namun perlu optimalisasi guna memastikan bahwa peserta dapat belajar sesuai dengan kebutuhannya, khususnya pada mata pelajaran biologi. Dukungan dari setiap pihak terkait diperlukan untuk penerapan pembelajaran biologi berdiferensiasi di kelas.

The flaxseed oil extraction process has been investigated and enhanced by applying Ultrasonic-Assisted Extraction (UAE), and Mixer-Assisted Extraction (MAE) methods in this study. Response Surface Methodology (RSM) was also utilized to find the optimal values of the extraction parameters. The optimal conditions for UAE were determined to be 42.7 min extraction time, 0.283 mm particle size, and 2.48 W/mL power intensity, achieving the oil yield of 94.56 %. For MAE, the optimal conditions were 54.5 min extraction time, 0.274 mm particle size, 21.1 °C temperature, and 0.74 W/mL agitation intensity, resulting in the oil yield of 96.73 %. RSM showed high reliability with R2 values above 0.99 for both methods. Gas Chromatography Flame Ionization Detector (GC-FID) analysis revealed that UAE and MAE resulted in higher unsaturated fatty acids concentrations (85.8 % and 86 %, respectively) compared to CPE (78.2 %). Kinetic studies indicated that UAE and MAE are more efficient in extracting unsaturated fatty acids, with MAE showing the highest double bond content. The Kinetic models demonstrated that extraction kinetics were controlled primarily by solid-phase resistance, with the washing coefficients being significantly higher than the diffusion coefficients. The Perez model calculated diffusion coefficients of 8.03 × 10⁻12 m2/s for UAE and 1.41 × 10⁻11 m2/s for MAE, activation energies of 16.44 kJ/mol for UAE and 15.64 kJ/mol for MAE.

This study investigates the relationship between board characteristics and firm efficiency in emerging Asian economies, using stochastic frontier analysis and a panel dataset of 5829 firm-year observations. The results suggest that companies with strong monitoring boards concerning diversity, size, and independence achieve higher efficiency. This study provides more specific results on the importance of board characteristics for firm-level governance and highlights the Asian emerging markets’ focus on good governance practices. The study’s use of firm efficiency as a proxy for performance is a unique framework that mitigates endogeneity issues common in corporate governance variables. This approach is an improvement over previous research that has relied on financial ratios, which need to consider the value of management’s actions and investment decisions affecting future performance. The results contribute to the literature on corporate governance and provide valuable insights for investors in emerging markets.

Medical and dental professionals should continue to adhere to preventive measures after COVID-19 vaccination due to their increased risk of exposure to the virus, particularly as new variants emerge that may heighten their risk perception and susceptibility. Therefore, this study aimed to explore the effects of COVID-19 vaccination on complacency to adherence to COVID-19 preventive behavioral measures and mental health among medical and dental professionals. In this cross-sectional study 410 medical and dental professionals were recruited from different medical and dental hospitals in Islamabad, Pakistan. The data was collected using a valid and reliable questionnaire comprising of three sections (socio-demographic, information of preventive behaviors performance against COVID-19 after vaccination, mental health status). A chi-square test and ordinal logistic regression were used for analysis. Post COVID-19 vaccination there was decrease in the frequency of use of hand washing, sanitizers (70.2%), and social distancing (60.5%), however greeting with a handshake (58.8%) and use of public transport (45.9%) seen upward trend among participants. Only face mask usage post-vaccination was statistically significant (p

Using the upper echelon framework, the present study delves into the interplay between the financial styles of senior executives (CEOs and CFOs) and their impact on earnings and risk management within non-financial firms across BRICS countries: Brazil, Russia, India, China, and South Africa. The period of study is 2011–2022. The analysis utilizes panel data that aligns managers with their respective firms to track the fixed effects of managers on earnings and risk management practices. The overall result of the study underline that the financial styles of top executives, captured through their manager-fixed effects, along with their observable characteristics, exert significant influence on decisions related to earnings and risk management. This study's findings contribute a novel contextual perspective and enhance comprehension within the realm of emerging markets, thereby enriching the existing understanding of the subject matter.

Computational Pathology (CPath) is an interdisciplinary science that augments developments of computational approaches to analyze and model medical histopathology images. The main objective for CPath is to develop infrastructure and workflows of digital diagnostics as an assistive CAD system for clinical pathology, facilitating transformational changes in the diagnosis and treatment of cancer that are mainly address by CPath tools. With evergrowing developments in deep learning and computer vision algorithms, and the ease of the data flow from digital pathology, currently CPath is witnessing a paradigm shift. Despite the sheer volume of engineering and scientific works being introduced for cancer image analysis, there is still a considerable gap of adopting and integrating these algorithms in clinical practice. This raises a significant question regarding the direction and trends that are undertaken in CPath. In this article we provide a comprehensive review of more than 800 papers to address the challenges faced in problem design all-the-way to the application and implementation viewpoints. We have catalogued each paper into a model-card by examining the key works and challenges faced to layout the current landscape in CPath. We hope this helps the community to locate relevant works and facilitate understanding of the field’s future directions. In a nutshell, we oversee the CPath developments in cycle of stages which are required to be cohesively linked together to address the challenges associated with such multidisciplinary science. We overview this cycle from different perspectives of data-centric, model-centric, and application-centric problems. We finally sketch remaining challenges and provide directions for future technical developments and clinical integration of CPath. For updated information on this survey review paper and accessing to the original model cards repository, please refer to GitHub. Updated version of this draft can also be found from arXiv.

هدفت هذه الدراسة إلى تحديد مستوى جودة الخدمات الرياضية في النوادي محل الدراسة، وتحديد تأثير المهارات الفنية لمقدمي الخدمة على تحسين جودة الخدمة الرياضية، وتحديد تأثير المهارات السلوكية لمقدمي الخدمة على تحسين جودة الخدمة الرياضية في النادي، واعتمد الباحث على المقاربة الاستنباطية كمنهج عام للتفكير، وعلى المنهج الوصفي التحليلي كمنهج عام للدراسة، وتم الاعتماد على البيانات الثانوية من دوريات ورسائل ماجستير لصياغة الإطار النظري، وعلى البيانات الأولية باستخدام استبانة نظمها الباحث بعد الاطلاع على الدراسات السابقة التي تناولت المتغيرات المدروسة، حيث عمل الباحث على توزيع الاستبانة على عملاء النوادي الرياضية محل الدراسة في محافظة اللاذقية. بلغ عدد الاستبانات الموزعة 90 استبانة قبل منها 50 استبانة للتحليل الإحصائي، وتم الاعتماد على البرنامج الاحصائي SPSS (20) كأداة لتحليل البيانات. وقد تمثلت أهم نتائج هذه الدراسة بالتالي: وجود تأثير لمهارات مقدمي الخدمة (المهارات السلوكية والفنية) على تحسين تقييم جودة الخدمات الرياضية في النوادي محل الدراسة، ومن أهم التوصيات التي قدمها الباحث: إعطاء الأولوية للاستماع إلى احتياجات العملاء واهتماماتهم، والرد على استفساراتهم على الفور، ويمكن تحقيق ذلك من خلال تخصيص وقت للعملاء لطرح الأسئلة وتقديم إجابات واضحة وموجزة عليها.

The present study sought to replicate two non-intuitive effects reported in the literature on lateral manual interception of uniformly moving targets, the angle-of-approach (AoA) effect and the reversal-movement (RM) effect. Both entail an influence of the target trajectory’s incidence angle on the observed interceptive hand movements along the interception axis; they differ in the interception location considered. The AoA effect concerns all trajectory conditions requiring hand movement to allow successful interception, while the RM effect concerns the particular condition where the target will in fact arrive at the hand’s initial position and no hand movement is therefore required but nevertheless regularly produced. Whereas the AoA effect has been systematically replicated, the RM effect has not. To determine whether the RM effect is in fact a reproducible phenomenon, we deployed a procedure enhancing the uncertainty about the target’s future arrival locations with respect to the hand’s initial position and included low-to-high target motion speeds. Results demonstrated the presence of both the AoA effect and the RM effect. The AoA effect was observed for all relevant interception locations, with the effect being stronger for the farther interception locations and the lower target speeds. The RM effect, with the hand first moving away from its initial position, in the direction of the target, before reversing direction, was observed in a higher proportion of trials for target trajectories with larger incidence angles and lower speeds. Earlier initiation gave rise to reversal movements of larger amplitude. Both effects point to visual guidance of hand movement partially based in reliance on information with respect to current lateral ball position. We conclude that the information used in lateral manual interception is of an intermediate order, which can be conceived as resulting from a partial combination of target position and velocity information or information in the form of a fractional order derivative.

Knowledge of anticipatory stress responses before sports competitions is limited, thus this study examined the relationship between anticipatory stress in terms of salivary cortisol secretion in athletes on the morning of a competition and a comparison baseline day. Thirty-seven athletes collected three saliva samples over a 45-min period post-awakening (0, 30 and 45 min). Anticipatory stress was expressed as Area Under the Curve compared to ground (AUCg; total cortisol secretion). There was no significant difference in AUCg between baseline and competition days. However, a mixed two-factor ANOVA with day and sport type (individual vs. team) revealed a significant main effect of sport type (p

Caseous lymphadenitis (CLA) presents a significant challenge to the dairy goat industry worldwide, negatively affecting animal health, productivity, and economic sustainability. It is a disease caused by Corynebacterium pseudotuberculosis, and its symptoms include the development of abscesses in lymph nodes and other organs. Generally, animals affected by CLA experience reduced milk output, reproductive problems, and higher morbidity and death rates. Furthermore, CLA could harm the well-being of animals by causing pain, discomfort, and disruption of normal behaviours. This review aims to determine the prevalence of CLA cases affecting dairy goats, map the geographical distribution of the disease in dairy goat herds throughout different locations, determine hotspots of CLA incidence and comprehend regional differences. Additionally, the study included relevant information on CLA prevalence in Asia. This comprehensive review is expected to help develop educational strategies for CLA prevention and control among dairy goat farmers. Moreover, an assessment of the economic impact of CLA in dairy goat operations on a global scale was performed. The losses associated with CLA are reduced milk production, lower meat yield, and increased veterinary costs. Besides, the variability of clinical presentation and the limits of conventional diagnostic methods make diagnosing CLA in dairy goats difficult. However, new developments in diagnostics, such as serological testing and polymerase chain reaction (PCR) assays, present chances for early detection and targeted control strategies. Examples of management strategies for CLA in dairy goat herds include vaccination, strict biosecurity protocols, and targeted treatment of infected animals. To surmise, the dairy goat industry can strive to mitigate the effects of CLA and maintain the well-being of dairy goat populations by tackling these challenges and executing comprehensive management strategies.

Oil palm is one of the largest economic sectors in Malaysia. Among the problems faced in the estates is oil palm loose fruit deposition, which is currently being collected manually in the industry. Hence, an oil palm loose fruit collector was designed using a cyclone separator mechanism and was studied using computational fluid dynamics (CFD). In the current study, Reynold’s stress model (RSM) and the discrete phase model (DPM) were employed to navigate numerical simulations where air speed intake of the designed machine was varied at 13, 30, and 46 m/s, respectively. The wall was set to a no-slip condition with standard wall functions. The hydraulic diameter of the gas outlet was Bc = 0.1 m. The hydraulic diameters of the particle’s outlet were Jc = 0.15 m and 0.2 m, respectively. Turbulence intensity at the gas and particle outlet was specified at 5%. An injection with density of 995.7 kg/m3 and a diameter of 0.04 m was set to simulate oil palm loose fruit collection into the system. Effects of air speed variations on the pressure drop and collection efficiency were then analyzed. It was found that increasing the inlet air speed from 13 m/s to 30 m/s reduced the collection efficiency by 14.92 % from 80.05% to 66.13%, while a 54.444% collection was recorded at 46 m/s inlet air speed. Ultimately, results indicate that a lower air speed is favorable in terms of pressure drop and collection efficiency.

Hospitals function to provide health services to the community, but they have the potential to be contributors to hazardous waste, climate change, and global warming. The concept of green hospitals is now necessary for changing hospital functions developed by various hospitals worldwide. The success of the green hospital concept requires support from the perspective of the surrounding society. The research aims to analyze public awareness, attitudes, behavior, and norms to build the power of green hospitals. This research method is simple linear regression. The research instrument used a questionnaire. The respondents of this research were 400 green hospital users from Indonesia and Taiwan. The data analysis method includes tests for normality, linearity, and heteroscedasticity. Once these three tests are met, a linear regression analysis is conducted to understand the influence and prediction of public awareness, attitudes, behavior, and norms on building the power of green hospitals. The research results show that each aspect of public awareness, attitudes, behavior, and norms significantly positively influence the building of the power of green hospitals. Each additional value of public awareness, attitudes, behavior, and norms is expected to strengthen the image of a green hospital. Maintaining the sustainability of green hospital programs worldwide not only focuses on implementing the green concept but also needs to pay attention to public perception when choosing a hospital. The research contribution is significant to developing more sustainable green hospitals, increasing knowledge about green hospitals, and increasing public interest and perception of green hospitals.

Dengue virus (DENV), a common and prevalent mosquito-borne endemic disease, is caused by four serotypes (DENV-1–4) and has spread rapidly on a global scale over the past decade. A crucial step in the development of antiviral therapeutics requires the utilization of in vitro cell-based techniques, such as plaque assays and focus-forming assays (FFA) for virus quantification. Vero cells have been widely used for FFA and plaque assay; however, there are instances when their efficacy and efficiency in the detection of certain clinical DENV isolates are low. Here, we showed that BHK-21 cells are more sensitive than Vero cells in the detection of all DENV-1–4 plaques and foci. In addition, we developed an improved FFA protocol for the quantification of all four DENV serotypes. Using a pan-flavivirus envelope (E) antibody, we reduce the possibility of false positives by defining a focus to consist of a minimum of eight infected cells. We outlined a protocol using the Operetta® high-content imaging system to automate the digital capture of these infected cells. A pipeline was also designed using the CellProfilerTM automated image analysis software to detect these foci. We then compare the results of the improved FFA with plaque assay. Notably, the improved FFA detected clear foci of the DENV-4 strain that does not form distinct plaques. We subsequently demonstrated the potential application of the improved FFA protocol in antiviral testing, utilizing a nucleoside inhibitor of DENV, NITD008 as a control. The protocol is amenable to a diverse array of applications, including high-throughput compound screening (HTS).