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Abstract Current malaria diagnostics are invasive, lack sensitivity, and rapid tests are plagued by deletions in target antigens. Here we introduce the Cytophone, an innovative photoacoustic flow cytometer platform with high-pulse-rate lasers and a focused ultrasound transducer array to noninvasively detect and identify malaria-infected red blood cells (iRBCs) using specific wave shapes, widths, and time delays generated from the absorbance of laser energy by hemozoin, a universal biomarker of malaria infection. In a population of Cameroonian adults with uncomplicated malaria, we assess our device for safety in a cross-sectional cohort (n = 10) and conduct a performance assessment in a longitudinal cohort (n = 20) followed for 30 ± 7 days after clearance of parasitemia. Longitudinal cytophone measurements are compared to point-of-care and molecular assays (n = 94). Cytophone is safe with 90% sensitivity, 69% specificity, and a receiver-operator-curve-area-under-the-curve (ROC-AUC) of 0.84, as compared to microscopy. ROC-AUCs of Cytophone, microscopy, and RDT compared to quantitative PCR are not statistically different from one another. The ability to noninvasively detect iRBCs in the bloodstream is a major advancement which offers the potential to rapidly identify both the large asymptomatic reservoir of infection, as well as diagnose symptomatic cases without the need for a blood sample.

Abstract Background The current standard first-line treatment for hormone receptor-positive/human epidermal growth factor receptor 2 negative (HR + /HER2 −) advanced breast cancer (ABC) is a combination of aromatase inhibitor (AI) plus CDK4/6 inhibitors (CDK4/6i). Direct comparison trials of different CDK4/6i are scarce. This real-world study compared the effectiveness of first-line AI plus ribociclib versus palbociclib. Methods This multicenter retrospective cohort study, conducted in six cancer centers in Thailand, enrolled patients with HR + /HER2 − ABC treated with first-line AI, and either ribociclib or palbociclib. Propensity score matching (PSM) was performed. The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), overall response rate (ORR), time to chemotherapy (TTC), and adverse events. Results Of the 250 patients enrolled, 134 patients with ribociclib and 49 patients with palbociclib were captured after PSM. Baseline characteristics were well-balanced between groups. Median PFS in patients receiving ribociclib and palbociclib were 27.9 and 31.8 months, respectively (hazard ratio: 0.87; 0.55–1.37). The median OS in the AI + ribociclib arm was 48.7 months compared to 59.1 months in the AI + palbociclib arm (hazard ratio: 0.55; 0.29–1.05). The median TTC in the AI + palbociclib group was 56 months, but not reached in the AI + ribociclib group (p = 0.42). The ORR of AI + ribociclib and AI + palbociclib were comparable (40.5% vs. 53.6%, p = 0.29). Patients receiving palbociclib demonstrated a higher proportion of neutropenia compared to those receiving ribociclib, despite a similar dose reduction rate (p = 0.28). Hepatitis rate was similar between the ribociclib (21%) and palbociclib groups (22%). Additionally, a low incidence of QT prolongation was observed in both the ribociclib (5%) and palbociclib groups (4%). Conclusion This preliminary analysis of a real-world study demonstrated the comparable effectiveness of ribociclib and palbociclib with AI as an initial therapy for HR + /HER2 − ABC. No statistically significant difference in PFS, OS, and TTC was found in patients treated with AI combined with palbociclib or ribociclib. Longer follow-up and further prospective randomized head-to-head studies are warranted.

Abstract Background Cameroon is a tuberculosis (TB) burden country with a 12% positivity among TB presumptive cases. Of the presumptive cases with a negative TB test, some are infected with Non-tuberculous Mycobacteria (NTM). However, the diagnosis of NTM infections remains difficult due to the lack of tools in many laboratories, particularly in resource limited laboratories and remote setting. The present study was undertaken to determine NTM profile and associated comorbidities among TB presumptive people. Methods A retrospective study was conducted from December 2018 to December 2019 in the Tuberculosis-National Reference Laboratory (TB-NRL) for Bacteriological analysis of samples and Jamot Hospital of Yaounde (JHY) for clinical evaluation of confirmed NTM patients. We included in this study data of 5267 TB presumptive people previously diagnosed using three consecutive samples and having culture and SD Bioline results with or without Microscopy and reverse hybridization-based Line Probe Assay(LPA) results. The data on co-morbidities or history of people infected with NTM were then collected from the three participants with available clinical data. Results We collected data of 5267 presumptive TB people. Among them, 3436 (65.24%), have a positive culture with 3200 (60.75%) isolates belong to Mycobacterium tuberculosis Complex (MBTC) and 236 (4.48%) to NTM. Our results showed that, 123 (52.11%) NTM were isolated from people with negative microscopy and 113 (47.88%) from people with positive microscopy. Among the 236 NTM, 108 (45.8%) isolates were identified using LPA. M. fortuitum was the most represented species (32.41%) followed by M. intracellulare (19.44%). Sputum had the highest proportion of NTM (56%), followed by bronchial aspirations (31%). The extra-pulmonary samples presented lower proportions of isolates compared to pulmonary samples. Some patients affected with NTM presented comorbidities as HIV infection, Pulmonary tuberculosis, Type 2 diabetes, Chronic bronchitis and Alveolar pneumonia. Conclusions Our study showed the presence of NTM strains among presumptive TB people with a predominance of M. fortuitum and M. intracellulare. It is important to implement a surveillance system of NTM in TB burden country and also to develop a point-of-care test for NTM identification in limited-resource settings.

Abstract Aim To explore the strategies used by nursing students in passing the nursing licensure examination. Design This study uses a classic grounded theory design to explore the social processes influencing a nursing license examination. Methods Eight graduate students participated in this research study and were interviewed in‐depth twice. The Classic Grounded Theory method of Glaser was applied to collect and analyse the data until saturation was reached. Results The findings revealed that students who passed the nursing licensure examination described the strategies as a preliminary model comprising a core category, Reviewing (Phase 1), which consisted of two sub‐categories: Entering Time and Reviewing Styles. Additionally, two other main categories emerged: the Tutoring category (Phase 2) and the Testing Practice category (Phase 3). It was observed that each course (subject) does not necessarily follow a specific order in traversing these phases; they may move back and forth between them until the conclusion of the examination. Furthermore, it was found that the time allocated to Entering Time and completing the three phases significantly influences the successful passing of the nursing licensure examination.

This research was carried out to design tutorials on the care of undeveloped social skills of university students, through which they express their needs, feelings, preferences, opinions and rights, respecting others and as a consequence self-reinforcement is observed and the probability of obtaining external reinforcement is maximized. The study was approached from the interpretive paradigm, qualitative approach, the projective-holistic method as a systematic process. Diagnostic information was collected from students and tutors, through interviews and focus groups, focused on behavioral, personal and situational skills. From all of this, categories and subcategories were identified that allowed choosing strategies to meet the needs. As a result, it was demonstrated that social skills, an important aspect for insertion and work performance, have not been developed despite the existence of the accompaniment of tutors. Also, the strategies used in the tutorial actions are not adequate; therefore, they must be modified. Also, it was concluded that university institutions must carry out planning processes for tutorials after diagnosis.

Abstract Background The COVID-19 pandemic drastically affected societies globally, prompting rising unemployment, insufficient household incomes, and stress and undermining women's and children's health within families. This study examined family violence and identified influencing factors during the COVID-19 pandemic in Thailand. Methods A mixed-method design was used, entailing a questionnaire followed by focus group interviews. A cross-sectional survey was administered to investigate family violence among 1285 female respondents aged 15 years and above who were recruited through stratified sampling. The Cronbach alpha and and inter-raters Kappa coefficient values for the questionnaire were 0.67 and 1.00, respectively. In addition, a descriptive qualitative instrument was employed to analyze the data sets from four focus group interviews held with 32 staff members from agencies that deal with family violence. The researchers jointly developed the focus group questions, which focused on the impacts of the COVID-19 pandemic on family violence. They independently analyzed data using content analysis. Results The majority of the study participants were aged above 45 years (>50%), married (61.1%), lived in single-family settings (52.5%), had lost their jobs (64.4%), and had economic constraints that were moderate (37.8%) to severe (40.6%). The prevalence of family violence, which was primarily physical, was 42.2%. Family income, stress, and substance abuse were the main factors associated with family violence. These findings were correlated with those from the qualitative interviews. Conclusions The COVID-19 pandemic had indirect impacts through family violence. Women were subjected to family violence behaviors, which were associated with household income, economic status, stress, and substance abuse. These behaviors included psychological and physical violence, as well as sexual abuse. Future interventions should focus on financial support and stress reduction.

Agriculture in India is a vital sector that contains a major portion of the population and impacts substantially the country’s economy. Cocoa is a crop that has commercial importance and is used for the production of chocolates. It is one of the main crops cultivated in south India due to the humid tropical climate. However, the cocoa plant is susceptible to various diseases caused by bacteria, viruses, and pests resulting in yield losses. Visual analysis is a subjective and time-consuming process. Further, farmers use improper pesticides to prevent diseases, and this will degrade the plant and soil quality. To overcome these problems, this paper proposes an automatic cocoa plant disease detection and pesticide recommendation system using computer vision and deep learning techniques. The proposed system was evaluated on several cocoa plant images, and an accuracy of 97.36% was obtained in disease classification. The proposed system can help cocoa farmers in the detection of cocoa plant diseases in the early stage and reduce the use of excessive pesticides, thus promoting sustainable agriculture practices.

Objective: The aim of this study was to develop and validate a rapid psychosocial well-being screening tool for metastatic breast cancer patients (MBC-PsySoc-Well-being). Methods: Applying a mixed method approach, the study was conducted in two phases. Phase 1, a focus group method was employed for item development, and three focus group sessions were conducted, with patients, caregivers, and medical professionals, respectively. Phase 2, validity and reliability testing were performed. Five experts reviewed items for content validity. Construct validity, criterion-related validity, internal consistency, and test-retest reliability were conducted among a sample of 53 patients with metastatic breast cancer. Results: Six themes were qualitatively analyzed based on focus group participants’ responses. Eight items were then developed based on these themes. The index of Item-Objective Congruence scored by the experts ranged from 0.6 to 1.0. An exploratory factor analysis yielded three factors: Being curious and active in information seeking, Enthusiasm to return to a normal life, and Adjusting to positive lifestyle. The total scores of MBC-PsySoc-Well-being and the European Organization for Research and Treatment of Cancer’s Quality of Life Core Questionnaire (EORTC QLQ-C30) were moderately correlated (r = 0.404, P = 0.003). Cronbach’s α coefficient of the overall scale was 0.686. Pearson correlation coefficients of items between two tests within 14-day ranged from 0.410 to 0.673. Conclusion: This study represents an initiative to develop a rapid psychosocial well-being screening tool for patients with metastatic breast cancer. The results from validity and reliability testing indicate that the scale is moderately suitable for application to patients with metastatic breast cancer. However, a larger scale study should be further administered to confirm the validity and reliability of the measurement.

Abstract In this study, we present a numerical investigation of the direct coupling between the deterministic GeoStudio package (Seepage/W and Slope/W software) and the StRAnD reliability package for normal operating conditions of an existing old earth dam over time. Direct coupling avoids errors associated to point estimate methods and to using response surface surrogates. One relevant feature of the study is the use of realistic pore water pressures for each equilibrium analysis, accomplished by considering a long-term steady-state analysis as an initial condition, followed by four years of equilibrium analysis, before each transient seepage analysis. All reliability analysis were performed using the first-order reliability method. The most important random parameters found in sensitivity analyses are four dam body parameters (saturated hydraulic conductivity, k s ; specific weight, γ; effective cohesion, c′; and friction angle, ϕ′) and two filter parameters (k s and ϕ′). A range of values of the relationship between the reliability index (β) and the factor of safety (FS) was found for all probabilistic and deterministic results. Finally, a large difference in terms of critical deterministic and probabilistic slip surfaces is identified for the same time of analysis. Article highlights Realistic pore water pressures used in dam equilibrium analysis, by considering random seepage analysis in previous 5 to 30 days. Direct coupling of deterministic and reliability softwares avoids errors associated to point estimate and response surface surrogate methods. Existing old earth dam studied in Normal Operating Condition. For same analysis time, large differences are observed between critical deterministic and probabilistic slip surfaces.

The holistic development of every learner is one vital aim of schools. Thus, the College of Education of the University of Batangas maintains and enhances students’ intellectual, physical and socio-emotional growth and development through developmentally-appropriate activities such as the Share a Book Wake a Thought (SABWAT) project. This research intended to enhance the social and emotional learning competencies of the student-donors of the books and eventually improve the ways the SABWAT activity would be handled in the next years. It utilized the descriptive research design with a self-constructed questionnaire as the main data gathering tool based on the Collaborative for Academic, Social and Emotional Learning (CASEL) Frameworks. It also used focus group discussion to verify the information gathered. Using stratified random sampling, the researchers selected 111 out of 235 enrolled students in the College of Education. The researchers used descriptive statistics such as mean and standard deviation. The findings revealed that the Education students, after being involved in the SABWAT activity, gained social awareness, self-awareness, responsible decision making, relationship skills, and self-management skills; the manifested application of these competencies in life. Major issues and challenges were the limited number of books donated, the small number of students being involved in the actual donation day, and the lack of information about the activity. The proposed SABWAT improvement plan aims to address the issues and challenges like the aforementioned. It is also intended to improve the SEL competencies of students through the various activities relative to SABWAT.

Awe-inducing scenes are purported to involve vastness and a need for accommodation. Familiarity with a stimulus should reduce the need for accommodation, thereby reducing the intensity of awe experienced. The present study tested the effect of familiarity to a natural awe-inducing scene on the experience of awe. Forty undergraduate participants (N = 40) participated in a virtual reality experiment. Using a within-subjects design, participants viewed (in counterbalanced order) an awe-inducing nature scene that was either familiar or unfamiliar. The dependent measure was self-reported awe. Results confirmed that participants experienced diminished awe while viewing a familiar awe-inducing scene compared to viewing an unfamiliar awe-inducing scene.