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Students based in higher education institutions in rural settings are faced with various challenges. This literature study offers insights into the implication of "rurality" in terms of Higher Education in a rural context, considering student well-being and social work training challenges. It stresses that the University of Zululand has put in place a number of initiatives to support teaching and learning considering the above. The authors present the defining characteristics of rurality and higher education, make a historical rural-urban comparison, and discuss social work fieldwork training challenges and wellbeing. Recognizing the challenges posed, some solutions are posited to mitigate them. The article also stresses the need to be cognisant of the fact that there is not only a problem of marginalization and privilege in rural settings, but also in urban settings where in less affluent areas, the facilities are inferior and numerous other disadvantages manifest. Thus, any desired upward mobility for students from impoverished areas is challenging to say the least. The work is not based on any intellectual framework or theoretical stance but is placed in the socio-economic structure of our South African society and what "rurality" implies.

Surgery is the mainstay of treatment for meningioma, the most common primary intracranial tumor, but improvements in meningioma risk stratification are needed and indications for postoperative radiotherapy are controversial. Here we develop a targeted gene expression biomarker that predicts meningioma outcomes and radiotherapy responses. Using a discovery cohort of 173 meningiomas, we developed a 34-gene expression risk score and performed clinical and analytical validation of this biomarker on independent meningiomas from 12 institutions across 3 continents (N = 1,856), including 103 meningiomas from a prospective clinical trial. The gene expression biomarker improved discrimination of outcomes compared with all other systems tested (N = 9) in the clinical validation cohort for local recurrence (5-year area under the curve (AUC) 0.81) and overall survival (5-year AUC 0.80). The increase in AUC compared with the standard of care, World Health Organization 2021 grade, was 0.11 for local recurrence (95% confidence interval 0.07 to 0.17, P

Background: Unstable “extralateral” fractures of the distal clavicle (lateral to the coracoclavicular ligaments) are not distinguished in the Neer classification system and are commonly included with Neer IIb fractures. In the literature, there is no optimal surgical technique for managing unstable fractures of the distal clavicle, nonetheless for unique “extra-lateral” patterns. The aim of this study is to evaluate the effectiveness and safety of existing coracoclavicular fixation techniques for managing unstable Neer IIb and extralateral (IIc) fractures of the distal clavicle. Methods: We performed a systematic search of the literature to capture all studies evaluating the safety and effectiveness of existing coracoclavicular loop techniques for unstable Neer IIb and extralateral (IIc) fractures of the distal clavicle. We searched the PubMed (MEDLINE and PubMed Central), Scopus, Web of Science, Google Scholar, and Cochrane Central Register of Controlled Trials electronic databases to retrieve studies published between January 2000 and November 2020. Our study was guided by a prospectively developed protocol and reported in accordance with the latest Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Our database search yielded a total of 564 records; of which, 21 were deemed appropriate for inclusion in our qualitative synthesis. The total number of reported IIb/c fractures managed with a coracoclavicular stabilization technique in all studies was 421. In total, 139 (33%) patients received arthroscopic-assisted treatment, and 282 (67%) patients were managed with open coracoclavicular stabilization. The reported clinical results were very good to excellent in most studies, whereas the overall major and minor complication rate was 2.6% and 12.8%, respectively. Major complications were more frequent in arthroscopic-assisted techniques (4.3%) compared with open (1.8%). Conclusion: The present systematic review of coracoclavicular stabilization techniques for unstable Neer IIb and extralateral fractures of the distal clavicle demonstrates promising clinical outcomes, including effectiveness and safety. We support the previously proposed modification of the Neer classification to include this unique type of unstable extralateral fracture (type IIc) to allow for targeted surgical management.

The annual incidence of symptomatic deep venous thrombosis (DVT) and venous thromboembolic (VTE) (DVT plus pulmonary embolism) in the adult population is estimated to be 50–100 and 75–150/100,000, respectively, and the incidence doubles for every 10-year increase in age. Patients admitted to hospitals, both surgical and medical, are at particularly increased risk for VTE, and the problem has been shown to continue after discharge. The risk is increased by age, obesity, malignancy, history of VTE, family history of DVT, stay in the intensive care unit, hereditary or acquired thrombophilia, and more recently, an elevated D-dimer. This risk is also affected by the nature and duration of the operation, type of anesthesia, immobility, dehydration, sepsis, varicose veins, inflammatory bowel disease, hormone replacement therapy, pregnancy, and pregnancy-related complications (stillborn infant, unplanned abortions, placental insufficiency, and growth retarded infant). Several risk assessment scoring systems are now available for clinical use. The ones most commonly used are the Rogers, Caprini, and Chao-Yang in surgical patients and the Padua, International Medical Prevention Registry on Venous Thromboembolism, and IMPROVEDD in acutely ill medical patients. The mandatory use of a risk assessment tool on admission and in high VTE risk patients at discharge as well and implementation of an evidence-based pathway for thromboprophylaxis have made the prevention of many fatal pulmonary emboli after surgery or hospitalization a reality.

Jack Mezirow's (1978, 1991, and 2008) transformative learning (TL) theory was developed with transforming society in mind. However, that intent has been overshadowed by a dominant focus on individual transformation and a rational cognitive approach to critically assessing assumptions as the path to transformation. We (the authors) wonder what happens to the societal side of TL theory when we put it in dialog with enactivism. Reading TL theory in this way illuminates the interdependent intention that self and society are inextricably linked. This conceptual article proposes that TL theory is best understood as an ongoing process of transforming ways of knowing, doing, and being through dynamic intra-actions, ontological entanglements, and appreciation of we-ness. Slow-looking at the implicit intra-actions that TL theory is grounded on will contribute to decolonizing the dominant dualistic view of seeing self and society as separate, making the potential for transformation of self and society more visible.

This article delves into the parallel natures of both the divine law and animal rights within the religious contexts of the Old and New Testaments. Employing a comparative approach, the paper inspects the developing perspectives on the treatment of animals in biblical scriptures, shedding light on the ethical and legal dimensions embedded in religious teachings. The study investigates key subtopics such as sacrificial rituals and moral imperatives, providing a nuanced understanding of the historical development of attitudes towards animals. Additionally, the analysis of this article encompasses ethical considerations, legal implications, and societal attitudes towards animals, drawing connections between ancient laws and contemporary discourse. Moreover, this article will look at the contemporary needs of society and how religious discourse and juristic principles can be applied to ensure the safety and rights of animals.

Despite being the leading cause of cancer-related childhood mortality, pediatric gliomas have been relatively understudied, and the repurposing of immunotherapies has not been successful. Whole- transcriptome sequencing, single-cell sequencing, and sequential multiplex immunofluorescence were used to identify an immunotherapeutic strategy that could be applied to multiple preclinical glioma models. MAPK-driven pediatric gliomas have a higher IFN signature relative to other molecular subgroups. Single-cell sequencing identified an activated and cytotoxic microglia (MG) population designated MG-Act in BRAF-fused, MAPK-activated pilocytic astrocytoma (PA), but not in high-grade gliomas or normal brain. T cell immunoglobulin and mucin domain 3 (TIM3) was expressed on MG-Act and on the myeloid cells lining the tumor vasculature but not normal brain vasculature. TIM3 expression became upregulated on immune cells in the PA microenvironment, and anti-TIM3 reprogrammed ex vivo immune cells from human PAs to a proinflammatory cytotoxic phenotype. In a genetically engineered murine model of MAPK-driven, low-grade gliomas, anti-TIM3 treatment increased median survival over IgG- and anti-PD-1-treated mice. Single-cell RNA-Seq data during the therapeutic window of anti-TIM3 revealed enrichment of the MGAct population. The therapeutic activity of anti-TIM3 was abrogated in mice on the CX3CR1 MG-KO background. These data support the use of anti-TIM3 in clinical trials of pediatric low-grade, MAPK- driven gliomas., Introduction Immunological studies of adult gliomas have been numerous, whereas pediatric gliomas are relatively understudied despite the fact that they are the leading cause of cancer-related childhood mortality (1). Among [...]

Alzheimer's Disease (AD) is characterized by an accumulation of pathologic amyloid-beta (Aβ) and Tau proteins, neuroinflammation, metabolic changes and neuronal death. Reactive astrocytes participate in these pathophysiological processes by releasing pro-inflammatory molecules and recruiting the immune system, which further reinforces inflammation and contributes to neuronal death. Besides these neurotoxic effects, astrocytes can protect neurons by providing them with high amounts of lactate as energy fuel. Astrocytes rely on aerobic glycolysis to generate lactate by reducing pyruvate, the end product of glycolysis, through lactate dehydrogenase. Consequently, limited amounts of pyruvate enter astrocytic mitochondria through the Mitochondrial Pyruvate Carrier (MPC) to be oxidized. The MPC is a heterodimer composed of two subunits MPC1 and MPC2, the function of which in astrocytes has been poorly investigated. Here, we analyzed the role of the MPC in the pathogeny of AD, knowing that a reduction in overall glucose metabolism has been associated with a drop in cognitive performances and an accumulation of Aβ and Tau. We generated 3xTgAD mice in which MPC1 was knocked-out in astrocytes specifically and focused our study on the biochemical hallmarks of the disease, mainly Aβ and neurofibrillary tangle production. We show that inhibition of the MPC before the onset of the disease significantly reduces the quantity of Aβ and Tau aggregates in the brain of 3xTgAD mice, suggesting that acting on astrocytic glucose metabolism early on could hinder the progression of the disease.

The increasing use of innovative materials in blast- and impact-resistant structures underscores the demand for robust simulation and design methods. Concrete, especially Ultra High Performance Fiber Reinforced Concrete (UHPFRC), has emerged as a key player in this domain. The present study delves into the damage investigation and dynamic response assessment of blast loaded UHPFRC panels with optimized mixture design (microsilica content, water curing conditions, and fibre proportions). The so-assembled UHPFRC material is calibrated and validated, adjusting parameters from experimental results addressing the tensile and compressive behaviours of material based on standard experimental methods. The investigation navigates through experimental and numerical challenges, emphasizing the limitations of applying available models to UHPFRC, and necessitates recalibration for optimal alignment with experimental results. An in-depth numerical analysis using LS-DYNA software is also carried out, aiming to understand the dynamic behaviour of UHPFRC panels under blast loading and performing a comparative analysis between UHPFRC and normal strength concrete (NSC) panels with and without reinforcement, emphasizing the superior performance of UHPFRC. Furthermore, the study addresses the importance of determining the minimum thickness for UHPFRC panels as protective barriers. This involves a specific strategy based on regulations and considering minimal damage to the panel, leading to the proposal of an empirical formulation. Additionally, a sensitivity analysis has been conducted to identify the influential parameters on the response of the panel. The findings of this study revealed that modelling the UHPFRC material using finite element analysis and employing advanced material models yield promising outcomes. Moreover, the proposed empirical formulation demonstrates a good level of accuracy and efficiency in predicting the minimum thickness for UHPFRC panels under blast conditions. The results of the sensitivity analysis also indicate that explosive charge weight, standoff distance, and panel thickness are the most critical parameters. These insights contribute to a comprehensive understanding of UHPFRC dynamic behaviour in blast conditions, offering valuable considerations for future applications and design implementations in this evolving field.

This paper uses Vygotsky's cultural-historical development theory to examine the theoretical lineages that influenced Marsick and Watkins' (1990) model of informal and incidental learning. After discussing the context of each influence, the paper applies cultural-historical development theory to the many updates that Marsick, Watkins, and collaborators have contributed, moving the model into a theory. In 1990, Marsick and Watkins named the work of Dewey, Lindeman, Lewin, Knowles, Polanyi, and Argyris and Schön as primary influences for the formation of their informal and incidental learning model. By focusing on the context of each of the theorists who influenced the original Marsick and Watkins model and sketching the connections between the theorists' ideas and experiences, this paper fulfills the twofold purpose of exploring the context of Marsick and Watkins' model-turned-theory and providing a model for Vygotsky-informed literature reviews.

Summary: Background: The field of precision medicine endeavors to transform the healthcare industry by advancing individualised strategies for diagnosis, treatment modalities, and predictive assessments. This is achieved by utilizing extensive multidimensional biological datasets encompassing diverse components, such as an individual's genetic makeup, functional attributes, and environmental influences. Artificial intelligence (AI) systems, namely machine learning (ML) and deep learning (DL), have exhibited remarkable efficacy in predicting the potential occurrence of specific cancers and cardiovascular diseases (CVD). Methods: We conducted a comprehensive scoping review guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. Our search strategy involved combining key terms related to CVD and AI using the Boolean operator AND. In August 2023, we conducted an extensive search across reputable scholarly databases including Google Scholar, PubMed, IEEE Xplore, ScienceDirect, Web of Science, and arXiv to gather relevant academic literature on personalised medicine for CVD. Subsequently, in January 2024, we extended our search to include internet search engines such as Google and various CVD websites. These searches were further updated in March 2024. Additionally, we reviewed the reference lists of the final selected research articles to identify any additional relevant literature. Findings: A total of 2307 records were identified during the process of conducting the study, consisting of 564 entries from external sites like arXiv and 1743 records found through database searching. After 430 duplicate articles were eliminated, 1877 items that remained were screened for relevancy. In this stage, 1241 articles remained for additional review after 158 irrelevant articles and 478 articles with insufficient data were removed. 355 articles were eliminated for being inaccessible, 726 for being written in a language other than English, and 281 for not having undergone peer review. Consequently, 121 studies were deemed suitable for inclusion in the qualitative synthesis. At the intersection of CVD, AI, and precision medicine, we found important scientific findings in our scoping review. Intricate pattern extraction from large, complicated genetic datasets is a skill that AI algorithms excel at, allowing for accurate disease diagnosis and CVD risk prediction. Furthermore, these investigations have uncovered unique genetic biomarkers linked to CVD, providing insight into the workings of the disease and possible treatment avenues. The construction of more precise predictive models and personalised treatment plans based on the genetic profiles of individual patients has been made possible by the revolutionary advancement of CVD risk assessment through the integration of AI and genomics. Interpretation: The systematic methodology employed ensured the thorough examination of available literature and the inclusion of relevant studies, contributing to the robustness and reliability of the study's findings. Our analysis stresses a crucial point in terms of the adaptability and versatility of AI solutions. AI algorithms designed in non-CVD domains such as in oncology, often include ideas and tactics that might be modified to address cardiovascular problems. Funding: No funding received.

The aim of the current study was to investigate the tear proteome in children and adolescents with type 1 diabetes (T1D) compared to healthy controls, and to identify differences in the tear proteome of children with T1D depending on different characteristics of the disease. Fifty-six children with T1D at least one year after diagnosis, aged 6–17 years old, and fifty-six healthy age- and sex-matched controls were enrolled in this cross-sectional study. The proteomic analysis was based on liquid chromatography tandem mass spectrometry (LC-MS/MS) enabling the identification and quantification of the protein content via Data-Independent Acquisition by Neural Networks (DIA-NN). Data are available via ProteomeXchange with the identifier PXD052994. In total, 3302 proteins were identified from tear samples. Two hundred thirty-nine tear proteins were differentially expressed in children with T1D compared to healthy controls. Most of them were involved in the immune response, tissue homeostasis and inflammation. The presence of diabetic ketoacidosis at diagnosis and the level of glycemic control of children with T1D influenced the tear proteome. Tear proteomics analysis revealed a different proteome pattern in children with T1D compared to healthy controls offering insights on deregulated biological processes underlying the pathogenesis of T1D. Differences within the T1D group could unravel biomarkers for early detection of long-term complications of T1D.