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BACKGROUND: The Tigertriever device offers a unique feature that enables gradual control of the radial expansion. We sought to evaluate the safety and efficacy of the Tigertriever device in patients with large vessel occlusion (LVO) and underlying intracranial atherosclerotic disease (ICAD). The patients were part of the TIGER trial. METHODS: The presence of underlying ICAD was determined by a core imaging laboratory using CT angiography and digital subtraction angiography. The primary outcomes included successful reperfusion, puncture to reperfusion time, and complications associated with the use of the Tigertriever device. Patients underwent mechanical thrombectomy with the Tigertriever device for up to three passes, and alternative devices were employed for subsequent passes. RESULTS: A total of 160 patients were enrolled in the TIGER trial, and 32 patients had ICAD. Among the patients with ICAD, 78% achieved successful reperfusion within three passes of the Tigertriever device, without requiring rescue therapy. Additionally, a first pass effect was observed in 46.8%. The median time from puncture to reperfusion was 22 minutes. There were no device-related complications. The National Institutes of Health Stroke Scale (NIHSS) score at 24 hours was significantly reduced, from an average of 17 at baseline to 8. At the 3 month follow-up, 50% of patients achieved a modified Rankin Scale score of ≤2. CONCLUSION: Endovascular therapy (EVT) with the Tigertriever device for LVO in patients with underlying ICAD is effective and safe. When compared with historical data from other devices employed in similar cases, we observed a high rate of successful reperfusion, along with a shorter puncture to reperfusion time.

Using a 1/12° regional model of the Northwest Atlantic Ocean (MOM6-NWA12), we downscale an ensemble of retrospective seasonal forecasts from a 1° global forecast model. To evaluate whether downscaling improved the forecast skill for surface temperature and salinity and bottom temperature, the global and downscaled forecasts are compared with each other and with a reference forecast of persistence using anomaly correlation. Both sets of forecasts are also evaluated on the basis of mean bias and ensemble spread. We find that downscaling significantly improved the forecast skill for monthly sea surface temperature anomalies in the Northeast US Large Marine Ecosystem, a region that global models have historically struggled to skillfully predict. The downscaled sea surface temperature (SST) predictions for this region were also more skillful than the persistence baseline across most initialization months and lead times. Although some of the SST prediction skill in this region stems from the recent rapid warming trend, prediction skill above persistence is generally maintained after removing the contribution of the trend, and patterns of skill suggestive of predictable processes are also preserved. While downscaling mainly improved the SST anomaly prediction skill in the Northeast US region, it improved bottom temperature and sea surface salinity anomaly skill across many of the marine ecosystems along the North American east coast. Although improvements in anomaly prediction via downscaling were ubiquitous, the effects of downscaling on prediction bias were mixed. Downscaling generally reduced the mean surface salinity biases found in the global model, particularly in regions with sharp salinity gradients (the Northern Gulf of Mexico and the Northeast US). In some cases, however, downscaling amplified the surface and bottom temperature biases found in the global predictions. We discuss several processes that are better resolved in the regional model and contribute to the improved skill, including the autumn reemergence of temperature anomalies and advection of water masses by coastal currents. Overall, the results show that a downscaled high-resolution model can produce improved seasonal forecast skill by representing fine-scale processes that drive predictability.

Background Social media platforms such as YouTube™ have become a widely popular source for information regarding health-related issues about medical and dental issues. The simplicity of online watching has concealed the drawback that these videos are not regularly reviewed or checked for their suitability as educational resources for dental professionals and students. Aim The purpose of the current study was to evaluate the content and quality of videos on YouTube™ regarding maxillofacial prosthesis as a source of learning by dental professionals. Materials and Methods Fifty-one videos satisfying inclusion criteria were watched and carefully reviewed. After that, the following data were recorded in terms of domain in maxillofacial prosthesis: number of views, likes, comments, subscribers of the channel, viewing rate, duration since upload of video, video length/duration, primary purpose of videos, video sources, target group of video, video content, video content usefulness score, modified discern instrument score, and global quality score. Results No misleading video about said topic was uploaded during the period. Only 5.9% of the YouTube™ videos on maxillofacial prostheses were good. Conclusions There is a dearth of good-quality videos and videos about maxillofacial prosthesis maintenance, which raises questions if maxillofacial videos on YouTube™ would be equally beneficial for patients.

Abstract Tuberculosis (TB) remains one of the leading infectious disease killers in the world. The ongoing development of novel anti-TB medications has yielded potent compounds that often target single sites with well-defined mechanisms of action. However, despite the identification of resistance-associated mutations through target deconvolution studies, comparing these findings with the diverse Mycobacterium tuberculosis populations observed in clinical settings is often challenging. To address this gap, we constructed an open-access database encompassing genetic variations from > 50,000 clinical isolates, spanning the entirety of the M. tuberculosis protein-encoding genome. This resource offers a valuable tool for investigating the prevalence of target-based resistance mutations in any drug target within clinical contexts. To demonstrate the practical application of this dataset in drug discovery, we focused on drug targets currently undergoing phase II clinical trials. By juxtaposing genetic variations of these targets with resistance mutations derived from laboratory-adapted strains, we identified multiple positions across three targets harbouring resistance-associated mutations already present in clinical isolates. Furthermore, our analysis revealed a discernible correlation between genetic diversity within each protein and their predicted essentiality. This meta-analysis, openly accessible via a dedicated dashboard, enables comprehensive exploration of genetic diversity pertaining to any drug target or resistance determinant in M. tuberculosis.

Artificial intelligence (AI) is becoming increasingly popular globally due to its substantial influence in the fields of research and innovation. The utilization of AI in prosthodontics has had a substantial growth in recent years. AI is employed in various aspects of dentistry, including diagnosing, making decisions, predicting outcomes, planning treatments, selecting tooth shades, designing restorations, mapping preparation finishing lines, optimizing casting manufacturing, predicting facial changes in patients with removable prostheses, and determination of treatment outcomes of obstructive sleep apnea, which have a pivotal role in oral health care. The incorporation of AI into prosthodontics has the potential to improve the accuracy and precision of dental procedures. Nevertheless, the scarcity of datasets significantly hinders its practical implementation.

This case report elaborates on conventional immediate denture as treatment modality in partially edentulous patient with torus palatinus and periodontally compromised teeth, who desired no period of complete edentulousness. The prosthesis was designed to fulfill functional, cosmetic and psychological requirements immediately following the removal of remaining natural teeth. The case describes the delivery of complete denture immediately with no intermediate healing phase postextraction of remaining teeth and no surgical excision of torus palatinus.

Abstract Seasonal influenza poses significant health and economic challenges globally each year, particularly impacting the elderly population (aged ≥ 65 years) with increased rates of hospitalization, and mortality. The population of older adults is steadily increasing in the Gulf Cooperation Council (GCC) countries and is likely to increase even further. In addition, there is a high burden of chronic comorbidities in these countries like diabetes and obesity, which increases the likelihood of severe consequences of influenza infection. The GCC countries also host mass gathering events like Hajj, Umrah pilgrimage, Arba’een (nearby Iraq) pilgrimage, and international sports and business events, which further intensify the risk of outbreaks like influenza. These events facilitate the mixing of visitors from various countries. Thus, influenza activity in this North Hemisphere (NH) geography is usually present even before the availability of NH seasonal influenza vaccine. This is especially problematic for the elderly, whose protection from the previous year’s immunization would have waned. Higher dosages of antigens or adjuvants have been used to improve immunogenicity in older people with superior vaccine effectiveness. Therefore, there is a compelling argument in favor of the implementation of high-dose seasonal influenza vaccines in the GCC countries to improve the protection of individuals aged 65 years and older against influenza infection and associated severe complications.

Abstract The myocyte enhancer factor 2B (MEF2B) transcription factor is frequently mutated in germinal center (GC)-derived B-cell lymphomas. Its ammino (N)-terminal mutations drive lymphomagenesis by escaping interaction with transcriptional repressors, while the function of carboxy (C)-terminal mutations remains to be elucidated. Here, we show that MEF2B C-tail is physiologically phosphorylated at specific residues and phosphorylation at serine (S)324 is impaired by lymphoma-associated mutations. Lack of phosphorylation at S324 enhances the interaction of MEF2B with the SWI/SNF chromatin remodeling complex, leading to higher transcriptional activity. In addition, these mutants show an increased protein stability due to impaired interaction with the CUL3/KLHL12 ubiquitin complex. Mice expressing a phosphorylation-deficient lymphoma-associated MEF2B mutant display GC enlargement and develop GC-derived lymphomas, when crossed with Bcl2 transgenic mice. These results unveil converging mechanisms of action for a diverse spectrum of MEF2B mutations, all leading to its dysregulation and GC B-cell lymphomagenesis.

Abstract Circulating cell-free DNA (cfDNA) is emerging as an avenue for cancer detection, but the characteristics of cfDNA fragmentation in the blood are poorly understood. We evaluate the effect of DNA methylation and gene expression on genome-wide cfDNA fragmentation through analysis of 969 individuals. cfDNA fragment ends more frequently contained CCs or CGs, and fragments ending with CGs or CCGs are enriched or depleted, respectively, at methylated CpG positions. Higher levels and larger sizes of cfDNA fragments are associated with CpG methylation and reduced gene expression. These effects are validated in mice with isogenic tumors with or without the mutant IDH1, and are associated with genome-wide changes in cfDNA fragmentation in patients with cancer. Tumor-related hypomethylation and increased gene expression are associated with decrease in cfDNA fragment size that may explain smaller cfDNA fragments in human cancers. These results provide a connection between epigenetic changes and cfDNA fragmentation with implications for disease detection.

Abstract Introduction Amidst the challenges posed by Covid-19, assessing healthcare quality in India is crucial, particularly through patient satisfaction levels. Methodology A cross-sectional survey of 277 participants in Jammu and Kashmir was conducted, utilizing a semi-structured questionnaire and PSQ-18. Data analysis was performed using SPSS (v25) including Chi-Square tests and Descriptive analysis. Results Out of 277 participants, 70.8% expressed high satisfaction with medical care. Majority (70%) agreed that doctors explained medical tests well. Additionally, 70% strongly agreed that their doctor’s office was well-equipped. Dissatisfaction factors were notably low. Significant associations were found between age and alcohol use (p = 0.041), gender and alcohol use (p = 0.007), gender and tobacco use (p = 0.032), and education level and vaccination (p = 0.001). Conclusion The study highlights high patient satisfaction during the pandemic. Improving accessibility and quality of primary healthcare and community centres is essential to meet patient needs effectively.

Rapid advances in technology have resulted in a worldwide drive to enhance science, technology, engineering and mathematics (STEM) workforces to remain internationally competitive and ensure economic prosperity. Despite this, there is ongoing debate about the best strategies for promoting STEM literacy and building national STEM competencies. Women continue to be under-represented within the Australian STEM workforce, impacting Australia's national performance and STEM pipeline figures. Several factors have been determined as crucial components impacting females' perceptions of the STEM fields, and their drive to pursue employment in these areas. One method for analysing these factors is to explore the personal narratives of women in STEM and STEM-related fields to determine which factors impact their engagement with STEM. Our research contributes to this ongoing debate by providing insight into the personal narratives of eight women who participated within the "STEMinist Community of Practice" (CoP) research project, and their fluid experiences of the STEM pipeline. This paper explores the key factors and experiences of the participants, including how their careers progressed over time; and related potential solutions for increasing the number of women in STEM. Additionally, this paper explores the criteria for being considered a 'STEM professional', and how this impacts the fluidity of the STEM pipeline for women. We utilised a qualitative narrative research design through the worldview of interpretivism and employed a storytelling methodology. Thematic analysis was undertaken, and four key themes emerged: influence, perception, self-perception, and community of practice. The research questions are answered through a series of vignettes providing a rich conception of participant experiences. Key recommendations from this article are the development of further communities of practice to empower women within STEM fields, and adjusting the criteria of STEM professionals to include STEM educators, to address STEM pipeline issues.

Purpose: This study aims to gain insights into how students perceive online examination practices and evaluation, as well as identify the key factors that impact their intentions toward online exams. Design/methodology/approach: This empirical study conducted in India utilized an online survey method between May 24 and June 14, 2022. The data were collected from 712 undergraduate and postgraduate students through a Google Docs questionnaire. Descriptive analysis, exploratory factor analysis (EFA), regression and reliability analysis were conducted to analyze the data. Findings: There are many studies related to the adoption of online learning. However, there are limited studies that explore the adoption and acceptance of online examinations and evaluations. This paper intends to fill this gap and tries to highlight important factors influencing online examination usage by the students. Five important factors emerged in the study include "pedagogy, validity, reliability," "practicality," "security," "facilitating condition" and "intention," The study concludes that taking tests online is preferred for several reasons, including the perceived increased dependability of grades and the decreased cost, time and effort associated with taking exams. Research limitations/implications: This research explores students' perceptions of learning management systems (LMS)-based online exams and provides insights for students to better prepare and adapt. It assists policymakers in developing fair assessment policies and improving LMS platforms. The study contributes to the theoretical understanding of e-learning and calls for further research to enhance the effectiveness of online exams. It identifies gaps in existing literature and recommends larger sample sizes, broader representation, longitudinal data collection and conversational methods for future research. Originality/value: This study shows increasing research on e-learning and online examinations, mostly using quantitative methods. The important variables for understanding students' perceptions of online exams are "pedagogy, validity, reliability," "practicality," "security," "facilitating condition" and "intention." Concerns raised include validity, fairness and security. Electronic exams are more suitable for formative evaluation, and validity, reliability, security and adaptability are key pillars for successful online testing.

This study employed a sequential mixed methods explanatory research design to explore the influence of mentoring in the self-efficacy-forming experiences of primary school teachers who participated in a variety of professional development projects on science teaching. In the quantitative phase, survey data drawn from primary school teachers (n = 834) showed that collaborative mentee-mentor activities and metaphorical descriptions of interpersonal relationship were the best predictors of personal science teaching self-efficacy, outcome expectancy, and instructional change. In the qualitative phase, interviews with individual teachers identified their perceptions of how mentoring experiences influenced their development of science teaching self-efficacy and changes they made in their science classrooms. The findings are interpreted through the theoretical lens of the roles of culture and emotions in teacher learning.

The purpose of this study was to examine the relationships between mentoring and coaching experience, teachers' self-efficacy, and job satisfaction. Moreover, the researchers investigated the differences among the group of years of teaching experience of vocational teachers. Structural equation modelling (SEM) and one-way ANOVA were used for analysing the data from 614 participants from five areas in Thailand. The study found positive relationships among the mentoring and coaching experience, teachers' self-efficacy and job satisfaction. There was a significant difference among the group of years of teaching experience in the mentoring and coaching experience of the teachers. These results could be applied in a policy presentation for the education sector to consider driving teacher professional development programmes through mentoring and coaching, especially in the context of vocational teachers. Findings suggest each life phase of the teachers' career demonstrated what administrators should consider when organising professional development programmes in colleges or schools.

Research has shown that cooperative learning (CL) strongly promotes student learning at all educational levels. However, little is known about the CL's influence in teacher education. This study examined the impact of CL on EFL pre-service teachers' learning motivation and academic engagement using a pre-test/post-test quasi-experimental design. Two classes were randomly selected from regional teacher training centres in Cambodia, one class assigned as the experimental group (N = 35) and the other as the control group (N = 30). For one semester, the experimental group were exposed to CL while the control group were taught through lecture-based learning. Data were collected through adapted scales on learning motivation and academic engagement. The ANCOVA results revealed that CL was more effective for learning motivation and academic engagement, but no significant difference was found on extrinsic learning motivation. In conclusion, CL can foster learning motivation and academic engagement among EFL pre-service teachers.

This study aims to examine the effects of e-learning management system -- quality characteristics and student characteristics on continuous intention to use e-LMS. This empirical and quantitative study focuses on emerging nations, specifically India, and explores the acceptance of e-LMS among students. While previous research has examined student acceptance of e-LMS, a limited number of studies investigate the impact of e-learning management system quality and student characteristics on continuing e-LMS usage. This study aims to fill this gap by identifying the key variables that influence the adoption of e-LMS. The survey was disseminated online over four weeks in several departments of an HEI located in a rural, remote, and isolated area of the Himalayan foothills. 469 valid replies were obtained using the purposive sampling technique. The data analysis using the structural equation model showed that learner control, technology experience, motivation for learning related to technology, information quality, system quality, and service quality all had a statistically significant impact on students' continued use of e-LMS. According to the neural network (NN) model results, the most significant factors influencing continuous intention to use e-learning are information quality, technological experience, service quality, system quality, motivation for learning, learner control, and personnel innovativeness.

Purpose: The purpose of this study was to examine the effectiveness of an augmentative and alternative communication (AAC) intervention package consisting of systematic instruction and aided AAC modeling with speech-output technology on the acquisition, maintenance, and generalization of socio-communicative behaviors in four minimally speaking, preschool-aged, autistic children. Method: A multiple-probe design across behaviors (i.e., initiating a request for a turn, answering questions, and commenting) replicated across participants was implemented to evaluate the effects of the intervention package on socio-communicative behaviors. Furthermore, a pretreatment and posttreatment multiple-generalization-probe design was used to assess generalization across typically developing peers who were not a part of the intervention. Maintenance data were collected 3 weeks post intervention. Results: Visual analysis, corroborated by nonoverlapping of all pairs statistics, established a strong functional relationship between the AAC intervention package and all targeted socio-communicative outcomes for two participants. For the other two participants, inconsistent intervention effects were observed. In terms of generalization from interacting with the researcher to typically developing peers, a functional relationship between the intervention and generalization outcomes for all targeted behaviors was established for only one participant (i.e., Aiden). Conclusion: The outcomes of this study suggest that aided AAC modeling and systematic instruction using a speech-output technology may lead to gains in socio-communicative behaviors in some minimally speaking, preschool-aged, autistic children.

With the advent of COVID-19, universities around the world have been forced to move to a fully online mode of delivery because of lockdown policies. This led to a flurry of studies into issues such as internet access, student attitudes to online learning and mental health during lockdown. However, researchers need a validated survey for assessing the classroom emotional climate and student attitudes towards learning in universities that can be used for online, face-to-face or blended delivery. Such a survey could be used to illuminate students' perceptions of the experiences that make up learning at university level, in terms of such factors as care from teachers, collaboration and motivation. In this article, we report the validation of a University Classroom Emotional Climate (UCEC) questionnaire and an Attitudes to Learning scale, as well as their use in comparing the classroom emotional climate and attitudes during COVID-19 lockdown (fully online delivery) with post-lockdown (mixed-mode delivery). Female students experienced the post-lockdown condition significantly more positively than during lockdown for all scales except Care, while the only significant difference for males between the during and post-lockdown was their choice to engage with learning (Control) and the degree of Challenge that they found with the learning materials.

Australia's economic need for innovation has led to Science, Technology, Engineering and Mathematics (STEM) education becoming an essential investment for the future. This study utilised a mixed-methods approach involving a pre-validated quantitative questionnaire together with qualitative semi-structured focus groups with students across four Year 5 classrooms. Students provided their perceptions of their STEM learning environment and their interactions with their teacher to identify factors influencing their engagement for pursuing these disciplines. The questionnaire comprised of scales from three different instruments: Classroom Emotional Climate, Test of Science Related Attitudes, and Questionnaire on Teacher Interaction. Several key factors were identified through student responses, including Student Freedom, Peer Collaboration, Problem Solving, Communication, Time, and Preferred Environments. 33 out of possible 40 correlations between scales were statistically significant, but eta[superscript 2] values were considered low (0.12-0.37). Overall, the students expressed positive perceptions about their STEM learning environment, with Student Freedom, Peer Collaboration, Problem Solving, Communication and Time appearing to impact their perceptions of STEM education. Three focus groups with a total of 12 students identified suggestions for improving STEM learning environments. Implications from this research include the importance of considering student perceptions when measuring the quality of STEM learning environments, as well as how facets of these environments can impact student attitudes towards STEM.

In response to compelling environmental and societal imperatives, the real estate sector is increasingly compelled to adopt environmentally sustainable practices, prompting a significant “green” shift. Drawing upon an extensive literature review and insights garnered through expert interviews, this study identifies 15 critical factors influencing the green supply chain in the Indian real estate domain. Employing the Interpretive Structural Modeling–Dynamic Multi-Attribute Decision-Making Trial and Evaluation Laboratory (ISM–DEMATEL) approach, the hierarchical and contextual relationships among these factors are systematically examined. The ISM–DEMATEL analysis unveils that government policies and legislation, developer orientation and commitment, and green financing emerge as the top three pivotal drivers steering the green supply chain in the Indian real estate sector. To further categorize these drivers, a Matrice d’Impacts Croisés Multiplication Appliquée à un Classement (MICMAC) analysis is employed, resulting in the classification of factors into independent, dependent, autonomous, and linkage categories. The research offers practical insights that may prove invaluable to stakeholders within the real estate industry as well as academicians.

Midfacial defects are defined as ones limited to the middle one-third of the face in the horizontal axis which communes with intraoral maxillary defects. They affect patient’s phonation, chewing capacity, quality of life, and social and community behavior. Surgical reconstruction alone is inadequate to rehabilitate these large midfacial defects, thereby necessitating use of a maxillofacial prosthesis to restore form, function, esthetics and comfort. The present case report presents the prosthetic restoration of a surgical defect secondary to treatment of rhinocerebral mucormycosis with an extraoral (exenteration) and intraoral (Armany Class IV) defect connected with magnetic attachment.