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A massive open online course (MOOC) is a powerful tool for expanding educational opportunities, but one of the major challenges facing MOOCs is the high dropout rate. Low completion rates indicate issues with student engagement and motivation. Gamification, the incorporation of game elements in non-game contexts, has shown promise in increasing engagement and completion rates in education. This systematic review aims to explore the current state of research on gamification in MOOCs, including the most commonly used gamification aspects, their impact on motivation and engagement, and the influence on dropout rates. We searched several databases, such as Google Scholar, Scopus, and ERIC, from 2014 to 2021 and included studies that focused on the application of gamification in MOOCs and its effects on motivation, engagement, and dropout rates. A total of 16 studies were analyzed, and the results were synthesized to address the research questions posed. The results of this systematic literature review indicate that while research on gamification in MOOCs is still in its early stages, several studies have shown that gamification elements such as badges, levels, leaderboards, challenges, and rewards significantly affect student motivation and engagement, and reduce dropout rates in MOOCs. However, the effectiveness of these elements varies depending on their specific design, implementation, and alignment with students' intrinsic motivations and goals.

Clonal cytopenia of undetermined significance (CCUS) represents a distinct disease entity characterized by myeloid-related somatic mutations with a variant allele fraction of ≥2% in individuals with unexplained cytopenia(s) but without a myeloid neoplasm (MN). Notably, CCUS carries a risk of progressing to MN, particularly in cases featuring high-risk mutations. Understanding CCUS requires dedicated studies to elucidate its risk factors and natural history. Our analysis of 357 CCUS patients investigated the interplay between clonality, cytopenia, and prognosis. Multivariate analysis identified 3 key adverse prognostic factors: the presence of splicing mutation(s) (score = 2 points), platelet count

Aysha Aloqab,1,2 Valmore A Semidey,1 Gorka Sesma,3 Abdulmalik AlYahya,1 Khaled Al Malki,1 Abdulrahman Al Yahya,4 Rawa Mosaed Alohali,4 Mozon AlShareef,5 Hassan A Al-Dhibi1 1Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 2Ophthalmology, Bahrain Defence Force Hospital, Riffa, Bahrain; 3Pediatric Ophthalmology and Strabismus Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 4Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 5Medicine Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Valmore A Semidey, King Khaled Eye Specialist Hospital, Al Urubah Road, Riyadh, 12329, Kingdom of Saudi Arabia, Tel +96614281234 ext. 2665, Fax +966114821234 ext. 3773, Email asemidey@hotmail.comPurpose: This study aimed to describe the functional and anatomical outcomes of post-cataract surgery fungal endophthalmitis at King Khaled Eye Specialist Hospital (KKESH).Patients and Methods: A retrospective analysis of clinical data from a single institution was performed. This study included 29 patients with post-cataract surgery endophthalmitis with suspected or confirmed fungal etiology who presented between January 1, 2017, and December 31, 2022. We evaluated demographics, clinical features, microbiological assessments, and treatment strategies. The effects of various treatments on outcomes were analyzed. The need for additional treatment and functional and anatomical outcomes was also investigated.Results: The mean time from surgery to the onset of ocular symptoms was 52.1 (SD ± 59.9; range, 3– 210) days, and the mean time from surgery to the first visit to KKESH was 81.4 (SD ± 103.5; range, 2– 510) days. Low culture positivity was noted in four samples, with two revealing Aspergillus sp. and two revealing Cladosporium sp. Of the 29 patients, 6 underwent pars plana vitrectomy (PPV) and received intravitreal antimicrobial/antibiotic injections. Two of the six patients also underwent simultaneous intraocular lens removal. The average number of additional treatments, regardless of visual acuity, was lower in the PPV group than in the conservative group (0.5 [SD ± 1.1; range, 0– 3] and 1.48 [SD ± 1.47; range, 0– 6], respectively). In the PPV group, 50% (n=3) of the eyes achieved functional success and 83.3% (n=5) of the eyes achieved anatomical success. In contrast, in the conservative group, 43.5% (n=10) of the eyes achieved functional success and 69.6% (n=16) of the eyes achieved anatomical success.Conclusion: For post-cataract surgery fungal endophthalmitis, a high index of suspicion and prompt PPV with empirical administration of intravitreal antifungal agents are required to achieve a favorable prognosis.Keywords: endophthalmitis, fungal, exogenous, pars plana vitrectomy, intraocular lens removal

Abstract Background While there is growing evidence highlighting the prevalence of mental health concerns among university faculty, few studies have examined mental health interventions in this population. The objective of this systematic review and meta-analysis was to collect and critically appraise the available evidence about the effectiveness of interventions designed to improve the mental health of faculty. Methods A systematic search was conducted by searching PubMed, EMBASE, Scopus, Web of Science, and CINAHL to identify relevant studies published in English language from January 1st, 2000 until October 1st, 2023. The search focused on studies done on academic faculty to describe interventions or support programs aimed at improving mental health outcomes, with comparison of mental health data before and after the intervention and an improvement in mental health as study outcome. A random effect meta-analysis method was used to estimate the effectiveness of interventions on faculty mental health. Results Ten publications with 891 participants from 2,217 retrieved records were included. The random effect model showed substantial heterogeneity (I2 = 84.8%, 95% CI: 73.8 − 91.2%, p

Multiple primary malignancies can occur as either synchronous or metachronous tumors, particularly in adults. Retroperitoneal liposarcoma is a rare malignancy arising from adipose tissue, while gastric adenocarcinoma is one of the most common neoplasms worldwide. The simultaneous occurrence of these 2 malignancies is extremely rare, with only 1 case reported worldwide. Here, we present the case of a 52-year-old man diagnosed with both retroperitoneal liposarcoma and gastric adenocarcinoma, marking the second reported case in the world.

Inflammatory pseudotumor (IP) is a rare type of benign tumor. Although initially identified in the lung, it has now been identified in a number of somatic and visceral sites, but mesenteric presentation is uncommon and has a variable clinical presentation. As inflammatory pseudotumor mimic malignancy both clinically and radiologically, the radiologist should be familiar with this entity. The only effective treatment is complete surgical resection. We present the case of a 55-year-old woman who presented with chronic abdominal pain and was diagnosed with a mesenteric inflammatory pseudotumor, in an attempt to illustrate the different imaging aspects of this benign condition in ultrasound, computed tomography and magnetic resonance imaging, and to simplify the description of these tumors.

Abstract This study investigates noise reduction using a periodic arrangement of dual Helmholtz resonators and explores the introduction of defects within this periodic structure. The transfer matrix method was employed to carry out theoretical research. The computations of the interface response function approach results are verified, and consistent outcomes are demonstrated. The simulation results highlight the distinctive dual resonance frequencies of dual Helmholtz resonators. By differentiating dual Helmholtz resonators from traditional Helmholtz resonators, prospective applications for low-frequency noise reduction are envisioned. In this contribution, introducing defects in the middle of perfect dual Helmholtz resonators adds more value to the acoustic filter. In particular, the first neck and cavity of the defective dual Helmholtz resonator. This study shows that introducing a 2D-defect into identical dual Helmholtz resonators can improve the transmission of defect modes by taking advantage of the advantageous interaction of the resonant modes. In such arrangements, the entire structure functioned as a potent selective filter.

Abstract Background Stress-induced activation of ERK/Drp1 serves as a checkpoint in the segregation of damaged mitochondria for autophagic clearance (mitophagy). Elevated cytosolic calcium (Ca2+) activates ERK, which is pivotal to mitophagy initiation. This process is altered in Parkinson’s disease (PD) with mutations in leucine-rich repeat kinase 2 (LRRK2), potentially contributing to mitochondrial dysfunction. Pathogenic LRRK2 mutation is linked to dysregulated cellular Ca2+ signaling but the mechanism involved remains unclear. Methods Mitochondrial damages lead to membrane depolarization. To investigate how LRRK2 mutation impairs cellular response to mitochondrial damages, mitochondrial depolarization was induced by artificial uncoupler (FCCP) in wild-type (WT) and LRRK2R1441G mutant knockin (KI) mouse embryonic fibroblasts (MEFs). The resultant cytosolic Ca2+ flux was assessed using live-cell Ca2+ imaging. The role of mitochondria in FCCP-induced cytosolic Ca2+ surge was confirmed by co-treatment with the mitochondrial sodium-calcium exchanger (NCLX) inhibitor. Cellular mitochondrial quality and function were evaluated by Seahorse™ real-time cell metabolic analysis, flow cytometry, and confocal imaging. Mitochondrial morphology was visualized using transmission electron microscopy (TEM). Activation (phosphorylation) of stress response pathways were assessed by immunoblotting. Results Acute mitochondrial depolarization induced by FCCP resulted in an immediate cytosolic Ca2+ surge in WT MEFs, mediated predominantly via mitochondrial NCLX. However, such cytosolic Ca2+ response was abolished in LRRK2 KI MEFs. This loss of response in KI was associated with impaired activation of Ca2+/calmodulin-dependent kinase II (CaMKII) and MEK, the two upstream kinases of ERK. Treatment of LRRK2 inhibitor did not rescue this phenotype indicating that it was not caused by mutant LRRK2 kinase hyperactivity. KI MEFs exhibited swollen mitochondria with distorted cristae, depolarized mitochondrial membrane potential, and reduced mitochondrial Ca2+ store and mitochondrial calcium uniporter (MCU) expression. These mutant cells also exhibited lower cellular ATP: ADP ratio albeit higher basal respiration than WT, indicating compensation for mitochondrial dysfunction. These defects may hinder cellular stress response and signals to Drp1-mediated mitophagy, as evident by impaired mitochondrial clearance in the mutant. Conclusions Pathogenic LRRK2R1441G mutation abolished mitochondrial depolarization-induced Ca2+ response and impaired the basal mitochondrial clearance. Inherent defects from LRRK2 mutation have weakened the cellular ability to scavenge damaged mitochondria, which may further aggravate mitochondrial dysfunction and neurodegeneration in PD.

Nowadays, ultra high molecular weight polyethylene (UHMWPE), allows the combination of lightweight, high strength and is praised for the design of severely loaded structures. It has become a good option for lightweight armour solutions. It is therefore important to characterise its mechanical behaviour. Up to now, strain rate effects on mechanical behaviour have been poorly explored. In this work, this issue is tackled by studying the strain rate influence on the in-plane deformation, in shear and tension of the Tensylon® HSBD30A, a UHMWPE dedicated to ballistic and blast protection. Two laminates of Tensylon® of respective orientation [0 °/90°]20 and [±45°]20 were subjected to static and split Hopkinson tensile bar (SHTB) tests. A new mounting system was designed, and new specimen shapes were used to match the experimental setup configurations. Digital image correlation (DIC) was used to measure the in-plane strain. A significant strain-rate dependence on the material behaviour.is evidenced. Besides, results exhibit a higher strength for the [0°/90°]20 specimen than for the [±45°]20 one. Despite some limitations, the proposed setup and measurement methods allowed visualisation of strain rate effects on the stress-strain relationship for strain rates ranging from the quasi-static regime to the dynamic one (1500 s–1).

Purpose – Based on relationship marketing theory, this study aims to test the effect of social customer relationship management (social CRM) on customer satisfaction (CS) and loyalty (CL). Design/methodology/approach – To assess the proposed framework, structural equation modeling was performed on the data of 314 automotive customers surveyed online. Findings – Social CRM dimensions [traditional CRM (TCRM) and social media (SM) technology use] have a direct and positive effect on CS. On the other hand, only TCRM has a direct and significant influence on CL, while the SM technology use effect seems to be indirect rather than direct. Indeed, the findings have provided empirical support for the contention that CS plays a mediating role between social CRM dimensions and CL. Practical implications – In the automotive sector and developing countries in particular, companies’ managers could increase CS and CL and consequently enhance their competitiveness and market share by adopting an effective social CRM strategy. From this perspective, companies should focus their social CRM campaigns on the most SM used by customers, offer personalized choices and improve customer experience, interaction and value co-creation. Originality/value – This paper enriches the understanding of how social CRM can affect CS and CL. The scales of social CRM, CS and CL were validated in the context of developing countries and the automotive sector. Furthermore, the direct and mediating effect of CS between social CRM (TCRM and SM) and CL was also confirmed. Objetivo – Basándose en la teoría del marketing relacional, este estudio pretende comprobar el efecto de la gestión social de las relaciones con los clientes (CRM social) sobre la satisfacción y la fidelidad de los clientes. Diseño/metodología/enfoque – Para evaluar el marco propuesto, se realizó un modelado de ecuaciones estructurales sobre los datos de 314 clientes de automoción encuestados online. Resultados – Las dimensiones del CRM social (CRM tradicional y uso de tecnología de medios sociales) tienen un efecto directo y positivo en la satisfacción del cliente. Por otro lado, solamente el CRM tradicional tiene una influencia directa y significativa en la fidelidad del cliente, mientras que el efecto del uso de la tecnología de medios sociales parece ser más indirecto que directo. De hecho, los resultados han proporcionado apoyo empírico a la afirmación de que la satisfacción del cliente desempeña un papel mediador entre las dimensiones del CRM social y la fidelidad del cliente. Valor – Este artículo enriquece la comprensión de cómo el CRM social puede afectar a la satisfacción y la fidelidad de los clientes. Las escalas de CRM social, satisfacción del cliente y fidelidad del cliente se validaron en el contexto de países en vías de desarrollo y del sector automovilístico. Además, también se confirmó el efecto directo y mediador de la satisfacción del cliente entre el CRM social (CRM tradicional y medios sociales) y la fidelidad del cliente. Implicaciones prácticas – En el sector de la automoción y en los países en desarrollo en particular, los directivos de las empresas podrían aumentar la satisfacción y fidelidad de sus clientes y, en consecuencia, mejorar su competitividad y cuota de mercado adoptando una estrategia eficaz de CRM social. Desde esta perspectiva, las empresas deberían centrar sus campañas de CRM social en los medios más utilizados por los clientes, ofrecer opciones personalizadas y mejorar la experiencia del cliente, la interacción y la cocreación de valor. 目的 – 基于关系营销理论, 本研究旨在检验社会化客户关系管理（social CRM）对客户满意度和忠诚度的影响。 设计/方法/途径 – 为评估所提出的框架, 对 314 名汽车客户的在线调查数据进行了结构方程建模。 研究结果 – 社交客户关系管理维度（传统客户关系管理和社交媒体技术使用）对客户满意度有直接的积极影响。另一方面, 只有传统客户关系管理对客户忠诚度有直接和显著的影响, 而社交媒体技术使用的影响似乎是间接而非直接的。事实上, 研究结果为客户满意度在社交客户关系管理维度和客户忠诚度之间发挥中介作用的论点提供了实证支持。 原创性/价值 – 本文丰富了人们对社交客户关系管理如何影响客户满意度和忠诚度的认识。本文以发展中国家和汽车行业为背景, 对社会化客户关系管理、客户满意度和客户忠诚度的量表进行了验证。此外, 还证实了客户满意度在社会化客户关系管理（传统客户关系管理和社会化媒体）与客户忠诚度之间的直接和中介效应。 实践意义–在汽车行业 – 尤其是发展中国家, 企业管理者可以通过采取有效的社交客户关系管理战略, 提高客户满意度和忠诚度, 进而增强竞争力和市场份额。从这个角度来看, 企业应将社交客户关系管理活动的重点放在客户使用最多的社交媒体上, 提供个性化选择, 改善客户体验、互动和价值共创。

PURPOSE: Magrolimab is a first-in-class humanized monoclonal antibody against cluster of differentiation 47, an antiphagocytic signal used by cancer cells to evade phagocytosis. Azacitidine upregulates prophagocytic signals on AML cells, further increasing phagocytosis when combined with magrolimab. We report final phase Ib data for magrolimab with azacitidine in patients with untreated AML ineligible for intensive chemotherapy (ClinicalTrials.gov identifier: NCT03248479). PATIENTS AND METHODS: Patients with previously untreated AML, including TP53-mutant AML, received magrolimab intravenously as an initial dose (1 mg/kg, days 1 and 4), followed by 15 mg/kg once on day 8 and 30 mg/kg once weekly or every 2 weeks as maintenance. Azacitidine 75 mg/m2 was administered intravenously/subcutaneously once daily on days 1-7 of each 28-day cycle. Primary end points were safety/tolerability and proportion with complete remission (CR). RESULTS: Eighty-seven patients were enrolled and treated; 72 (82.8%) had TP53 mutations with a median variant allele frequency of 61% (range, 9.8-98.7). Fifty-seven (79.2%) of TP53-mutant patients had European LeukemiaNet 2017 adverse-risk cytogenetics. Patients received a median of 4 (range, 1-39) cycles of treatment. The most common treatment-emergent adverse events included constipation (49.4%), nausea (49.4%), and diarrhea (48.3%). Thirty (34.5%) experienced anemia, and the median hemoglobin change from baseline to first postdose assessment was -0.9 g/dL (range, -3.6 to 2.5 g/dL). Twenty-eight (32.2%) patients achieved CR, including 23 (31.9%) patients with TP53 mutations. The median overall survival in TP53-mutant and wild-type patients were 9.8 months and 18.9 months, respectively. CONCLUSION: Magrolimab with azacitidine was relatively well tolerated with promising efficacy in patients with AML ineligible for intensive induction chemotherapy, including those with TP53 mutations, warranting further evaluation of magrolimab with azacitidine in AML. The phase III randomized ENHANCE-2 (ClinicalTrials.gov identifier: NCT04778397) and ENHANCE-3 (ClinicalTrials.gov identifier: NCT05079230) studies are recruiting frontline patients with AML.

Ambient energy harvesting has great potential to contribute to sustainable development and address growing environmental challenges. Converting waste energy from energy-intensive processes and systems (e.g. combustion engines and furnaces) is crucial to reducing their environmental impact and achieving net-zero emissions. Compact energy harvesters will also be key to powering the exponentially growing smart devices ecosystem that is part of the Internet of Things, thus enabling futuristic applications that can improve our quality of life (e.g. smart homes, smart cities, smart manufacturing, and smart healthcare). To achieve these goals, innovative materials are needed to efficiently convert ambient energy into electricity through various physical mechanisms, such as the photovoltaic effect, thermoelectricity, piezoelectricity, triboelectricity, and radiofrequency wireless power transfer. By bringing together the perspectives of experts in various types of energy harvesting materials, this Roadmap provides extensive insights into recent advances and present challenges in the field. Additionally, the Roadmap analyses the key performance metrics of these technologies in relation to their ultimate energy conversion limits. Building on these insights, the Roadmap outlines promising directions for future research to fully harness the potential of energy harvesting materials for green energy anytime, anywhere.

The potential utilization of industrial waste, specifically polyethylene wax, to enhance the efficiency of alkyl acrylate polymers as viscosity index improver (VII) additives in lubricating compositions has been investigated. Four terpolymers (w1, w2, w3, and w4) were synthesized via free radical polymerization, incorporating hexyl acrylate, 1-tetradecene, and industrial waste-sourced polyethylene wax at varying molar ratios. These terpolymers were characterized through gel permeation chromatography (GPC) for molecular weight determination, Fourier transform infrared spectroscopy (FTIR), proton nuclear magnetic resonance (1H-NMR) spectroscopy for chemical structure analysis, and thermal gravimetric analysis (TGA) for thermal stability assessment. The study evaluated the efficiency of these terpolymers as viscosity index improvers (VII) in combination with free additives Iraqi lubricating oil (base oil 60). Our results demonstrate the feasibility of significantly enhancing the efficiency of viscosity improvers through the utilization of industrial waste, with improvements proportional to terpolymer concentration. The terpolymer w3, characterized by a balanced molar ratio of 1:1:1, exhibiting the highest degree of efficacy, which gave VI of 206 at 5 wt.% concentration compared with free additive lubricating oil, which gives VI of 98. This study offers promising insights into the sustainable use of industrial waste to improve lubricating compositions.

Background: Child sexual abuse (CSA) has grave implications for survivors, as well as repercussions for the survivors' family members and professionals, such as teachers, who work with child survivors of sexual abuse. Objective: As teachers are often key supportive figures for CSA survivors, the present study aims to contribute to the understanding of teachers' experiences when working with students who have undergone CSA. Methods: Semi-structured interviews were conducted with a purposeful sample of 31 elementary school teachers to illustrate how their basic world beliefs and professional functioning were altered by their encounters with CSA victims. Results: The qualitative thematic analysis indicated that teachers facing pupils who experienced CSA underwent a fracture in their basic beliefs about the safety of the children in their classrooms. The traumatic event elicited a reconstruction of their beliefs about CSA and their role as classroom leaders to meet the demands of the changed classroom environment. Conclusion: The findings highlight the importance of accounting for the needs of teachers, as members of the school community, in responding to CSA. In addition, they suggest the importance of receiving transformative learning skills training to prepare teachers to handle the repercussions of CSA in their classrooms.