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BACKGROUND: Serum AFP-L3%, AFP, and DCP are useful biomarkers for HCC detection, but their utility in assessing treatment response remains unknown. We aim to evaluate the accuracy of a biomarker model in the detection of posttreatment viable tumors. METHODS: For model derivation, recipients with HCC undergoing liver transplant from 2018 to 2022 who had biomarkers collected within 3 months before transplant were included. We developed a generalized linear model for detecting posttreatment viable tumors with the 3 biomarkers as covariates, which we termed the LAD Score. An independent cohort of 117 patients with HCC was used for external validation. RESULTS: Among 205 recipients of transplant, 70.2% had evidence of viable tumor on explant. The median LAD score was higher among patients with viable versus nonviable tumors (1.06 vs. 0.465, p < 0.001). The LAD score had a sensitivity of 55.6% and a specificity of 85.1% at the cutoff of 0.927, which was more accurate than imaging for detecting posttreatment viable tumors (AUROC 0.736 vs. 0.643, respectively; p = 0.045). The superior performance of the LAD score over imaging is primarily driven by its greater accuracy in detecting tumors

The colonies of honey bees are mostly sessile organisms. Consequently, the type of nest boxes that beekeepers provide to their bees should impact a colony's ability to maintain homeostasis, which is a key determinant of performance and fitness. Here, we used European honey bees (Apis mellifera) and provided them with two hive setups widely used and known as Langstroth and Warré. We compared colony performance in a Mediterranean climate for five months from late spring to early autumn, which covered the most active time of bees and included periods of heat and drought. We found that irrespective of hive type or season, honey bees kept hive temperature and humidity within a remarkably narrow range. Nevertheless, the hive type impacted the daily fluctuations in temperature and humidity. In Warré hives, where bees have more autonomy to build and maintain their combs, we found that bees were able to reduce daily fluctuations in temperature and humidity and kept both measures closer to the overall average. This increase in colony homeostasis found in Warré hives negatively correlated with other hive performance indicators, such as immunocompetence. We conclude that different hive types affect key areas, such as the central part of the colony with frames of developing brood or the queen, which are the most susceptible individuals. This implies that climatic changes resulting in extreme weather events are expected to impact colony performance and fitness, especially in non-managed honey bees that are limited by available nesting sites. For managed bees, adaptations to existing hive setups could be provided to help bees minimize the effects of abiotic stress.

Abstract Background The Abdominal Compartment Society (WSACS) established consensus definitions and recommendations for the management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in 2006, and they were last updated in 2013. The WSACS conducted an international survey between 2022 and 2023 to seek the agreement of healthcare practitioners (HCPs) worldwide on current and new candidate statements that may be used for future guidelines. Methods A self-administered, online cross-sectional survey was conducted under the auspices of the WSACS to assess the level of agreement among HCPs over current and new candidate statements. The survey, distributed electronically worldwide, collected agreement or disagreement with statements on the measurement of intra-abdominal pressure (IAP), pathophysiology, definitions, and management of IAH/ACS. Statistical analysis assessed agreement levels, expressed in percentages, on statements among respondents, and comparisons between groups were performed according to the respondent’s education status, base specialty, duration of work experience, role (intensivist vs non-intensivist) and involvement in previous guidelines. Agreement was considered to be reached when 80% or more of the respondents agreed with a particular statement. Results A total of 1042 respondents from 102 countries, predominantly physicians (73%), of whom 48% were intensivists, participated. Only 59% of HCPs were aware of the 2013 WSACS guidelines, and 41% incorporated them into practice. Despite agreement in most statements, significant variability existed. Notably, agreement was not reached on four new candidate statements: “normal intra-abdominal pressure (IAP) is 10 mmHg in critically ill adults” (77%), “clinical assessment and estimation of IAP is inaccurate” (65.2%), “intragastric can be an alternative to the intravesical route for IAP measurement” (70.4%), and “measurement of IAP should be repeated in the resting position after measurement in a supine position” (71.9%). The survey elucidated nuances in clinical practice and highlighted areas for further education and standardization. Conclusion More than ten years after the last published guidelines, this worldwide cross-sectional survey collected feedback and evaluated the level of agreement with current recommendations and new candidate statements. This will inform the consensus process for future guideline development.

Abstract There has been a significant interest in venous congestion in recent years, among which the VExUS score has been prominent, both in clinical practice and research efforts. We have noted some recurrent misconceptions among clinicians which are also reflected in certain research efforts. Notably, the misguided attempt to correlate VExUS to volume status, which is only one of the factors influencing it, as well as attempts to re-interpret VExUS in the context of certain pathologies, which reflects a fundamental misunderstanding of its circulatory perspective. In this article we review the physiological basis of the VExUS assessment as a measure and marker of venous congestion from the organs’ standpoint and its role as part of the emerging concept of fluid tolerance, in hopes to address these misconceptions for clinicians and for important further studies.

Abstract Venous congestion, often associated with elevated right atrial pressure presents a clinical challenge due to its varied manifestations and potential organ damage. Recognizing the manifestations of venous congestion through bedside physical examination or laboratory tests can be challenging. Point-of-care ultrasound (POCUS) is emerging as a valuable bedside tool for assessing venous congestion, with the Venous Excess Ultrasound (VExUS) technique gaining prominence. VExUS facilitates non-invasive quantification of venous congestion, relying on measurements of the inferior vena cava (IVC) size and Doppler assessments of the hepatic vein (HV), portal vein (PV), and intrarenal vein, thereby providing real-time insights into hemodynamic status and guiding therapeutic interventions. The grading system outlined in VExUS aids in stratifying the severity of congestion. However, achieving proficiency in VExUS requires a comprehensive understanding of Doppler techniques and their clinical applications. This review article provides practical guidance on performing VExUS, encompassing equipment requirements, preparation, machine settings, and examination techniques for assessing the inferior vena cava (IVC), hepatic vein (HV), portal vein (PV), and intrarenal vein. Potential pitfalls and troubleshooting strategies are discussed to ensure accurate interpretation of Doppler waveforms.

Abstract This study aims to explore the psychometric properties of the Jordanian version of the Modified Checklist for Autism in Toddlers-Revised (M-Chat-R/F). The Jordanian version of M-CHAT-R/F was administered within the Jordanian context among 134 children aged between 6 and 30 months; 37 were diagnosed with autism spectrum disorder (ASD), and 97 were without ASD. The M-CHAT-R/F consists of the modified Autism Spectrum Screening Questionnaire (ASSQ) and a follow-up model. The results revealed that M-Chat-R/F demonstrates acceptable levels of validity and reliability. The content validity was deemed suitable for the Jordanian environment, and the construct validity showed that items relying on a single factor reached saturation. The results also revealed acceptable levels of reliability, with Pearson correlation coefficients ranging between 0.209 and 0.693, all positive, high, and statistically significant. The Cronbach’s alpha coefficient was 0.870, the sensitivity coefficient was 0.786, and the specificity coefficient was 0.957, indicating the checklist's ability to classify cases of ASD in children. In conclusion, the M-CHAT-R/F is a highly valid and reliable instrument that can effectively classify cases of ASD in children aged between 16 and 30 months. A score of 6 or below on the checklist indicates a high probability of ASD, reaffirming the confidence in the potential of the M-CHAT-R/F checklist for healthcare professionals in the field of child development and autism spectrum disorders. Finally, this study emphasizes that the Jordanian version of M-Chat-R/F is a screening rather than a standardized diagnostic tool for ASD, underscoring the need for further validation.

Abstract An integrated membrane filtration system was developed to make water purity suitable for microbiology/molecular biology research. Water samples were collected from outlets in different buildings of the National Research Center and analyzed for their composition before filtration. An integrated membrane system was developed based on mathematical modeling. Flat sheet membranes were produced, including microfiltration, ultrafiltration, and nanofiltration membranes. The flat sheet membranes were converted to a spiral wound module filter to simulate the local market filters and applied in the integrated membrane system that was designed and installed. The produced water was analyzed and compared to molecular-grade water used in different molecular biology/microbiology applications. Both PCR, agarose gel electrophoresis, bacterial liquid cultures, and viral propagation indicated that treated water using the herein-developed system exhibited comparable performance to the molecular grade water provided with imported reagent kits. So, this research can offer a promising solution for producing high-quality water suitable for sensitive laboratory applications.

Abstract Introduction Gram-negative bacteremia is a life-threatening infection with high morbidity and mortality. Its incidence is rising worldwide, and treatment has become more challenging due to emerging bacterial resistance. Little data is available on the burden and outcome of such infections in Lebanon. Methods We conducted this retrospective study in four Lebanese hospitals. Data on medical conditions and demographics of 2400 patients diagnosed with a bloodstream infection based on a positive blood culture were collected between January 2014 and December 2020. Results Most bacteremias were caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, with the more resistant organisms being hospital-acquired. Third-generation cephalosporin and quinolone resistance was steady throughout the study, but carbapenem resistance increased. Mortality with such infections is high, but carbapenem resistance or infection with Pseudomonas or Acinetobacter species were significant risk factors for poor outcomes. Conclusion This is the first multi-center study from Lebanon on gram-negative bacteremia, resistance patterns, and factors associated with a poor outcome. More surveillance is needed to provide data to guide empirical treatment for bacteremia in Lebanon.

Closed-space hand infections are considered an emergency requiring prompt management to avoid debilitating consequences and potential morbidity. Septic arthritis of the wrist is particularly uncommon in comparison to the large joints that are usually affected. We report a case of a 64-year-old female with known rheumatoid arthritis and neuropathic wrist, with superimposed septic arthritis of the wrist, complicated by abscess formation. Ultrasound and Magnetic resonance imaging revealed spread of infection to the midpalmar region and the space of Parona. Although collections in this space are extremely rare, if left untreated, they may lead to permanent disability. Incision and drainage of the abscess along with synovectomy of the affected wrist joint was performed. Streptococcus pneumoniae was the causative organism, despite the fact that Non-gonococcal and Staphylococcus aureus bacteria are the main causative agents of septic arthritis in adults.

Generative artificial intelligence (AI) has rapidly increased capacity for producing textual, visual and auditory outputs, yet there are ongoing concerns regarding the quality of those outputs. There is an urgent need to develop students' evaluative judgement - the capability to judge the quality of work of self and others - in recognition of this new reality. In this conceptual paper, we describe the intersection between evaluative judgement and generative AI with a view to articulating how assessment practices can help students learn to work productively with generative AI. We propose three foci: (1) developing evaluative judgement of generative AI outputs; (2) developing evaluative judgement of generative AI processes; and (3) generative AI assessment of student evaluative judgements. We argue for developing students' capabilities to identify and calibrate quality of work - uniquely human capabilities at a time of technological acceleration - through existing formative assessment strategies. These approaches circumvent and interrupt students' uncritical usage of generative AI. The relationship between evaluative judgement and generative AI is more than just the application of human judgement to machine outputs. We have a collective responsibility, as educators and learners, to ensure that humans do not relinquish their roles as arbiters of quality.

In this article, we explore the concept of belonging and its utility as a means for understanding academics' experiences of working in the academy. Transformative changes have reorientated academic work in recent years and continue to do so as we grapple with what it means to work and live in a post-digital, post-covid, world. We engage a collective biography methodology to highlight the embodied spatial-material assemblages in which belonging can be (un)made, the ways in which belonging may stick, slip and slide, as well how we might support colleagues to deal with the fragility and fluidity of academic work. Collectively, we sketch a portrait of the currents, spaces and relations of belonging that sit uncomfortably alongside common conceptions of belonging as linear, or as an internal, individual, emotion. This study therefore offers new possibilities for enhanced understandings of belonging as mobile, flickering and processual, that are generative within education and beyond.

Assessment drives learning and determines success in higher education. In a robust and defensible system, assessment should not exclude based on extraneous student characteristics, particularly as the student body becomes more diverse. This research sought to examine classroom assessment designs that might make assessment inclusive. A critical literature review was conducted identifying 13 research papers where outcomes of inclusive assessment were reported. Included studies focussed on students with disabilities, international and linguistically diverse students. Only one study examined the effects of inclusive assessment design on student learning. Efforts to make assessment more inclusive were as follows: offering students choice, programmatic approaches to assessment and co-design of assessment and policies that promote inclusion. Universal design for assessment has not been widely implemented within the sector. This is likely due to limited theorisation and operationalisation of inclusive assessment and assessment design processes that favour tradition and taken-for-granted assumptions about how assessment should be. Assessment designers should consider the ways in which assessment might exclude and to foster wider scholarship towards assessment for inclusion.

Transcripts and testamurs serve to confirm the award of a degree but offer limited information on what a student can actually do. This conceptual paper considers the problem of how graduate achievements are represented by universities in typically reductive and limited ways that do not enable student achievements and distinctiveness to be communicated to future employers, communities and students themselves. It argues that refinements to existing methods for the design and development of assessment are needed to encompass both university validated and contextualised credentials along with student-constructed portrayals of achievement and personas. Significant change is needed to assessment design, data capture and storage and the ways in which learning outcomes are tracked across a program and over time. Innovations in assessment representation should strengthen employer trust in the value of degrees, student trust in assessment processes and scaffold student agency in curating their employability narratives.

Knowledge of scientific inquiry (SI) is considered essential to the development of an individual's Scientific Literacy (SL) and therefore, SI is included in many international science education reform documents. Two previous large scale international studies assessed the SI understandings of students entering middle school and secondary students at the end of their formal K-12 science education. The purpose of this international project was to use the VASI-E to collect data on what primary level students have learned about SI in their first few years of school. This study adds to previous research to bridge the landscape of SI understandings now with representation from primary, middle and high school samples. A total of 4,238 students from 35 countries/regions spanning six continents participated in the study. The results show that globally, primary students are not adequately informed about SI for their age group. However, when compared with the students in the previous international studies (grades seven and 12), the primary students' understandings were surprisingly closer to the levels of understanding of SI of the secondary school students than those in the seventh grade study.

Clinical supervisors play key roles in facilitating trainee learning. Yet combining that role with patient care complicates both roles. So, we need to know how both roles can effectively co-occur. When facilitating their trainees' learning through practice, supervisors draw on their skills - clinical and supervisory - and available opportunities in their practice. This process can be conceptualised as supervisory knowing in practice (or contextual knowing) and offers ways to elaborate on how facilitating trainees' learning can be optimised. The practice-based study presented and discussed here examined clinical supervisors' knowing in practice related to facilitating trainee learning, across three medical specialities. Nineteen clinical supervisors from emergency medicine, internal medicine and surgery, were interviewed about their roles and engagement with trainees. Interview transcripts were analysed in two stages. Firstly, a framework analysis, informed by interdependent learning theory was conducted, focussing on affordances and individual engagement. Secondly, drawing on practice theory, a further layer of analysis was undertaken interrogating supervisors' knowing in practice. We identified two common domains of supervisor practice used to facilitate trainee learning: (1) orientating and assessing trainees' readiness (or capabilities), (2) sequencing and enriching pedagogic practices. Yet across the speciality groups the supervisors' knowing in practice differed and were shaped by a trio of: (i) disciplinary practices, (ii) situational requirements and (iii) clinician preference. Overall, we offer a new reading of clinical supervision as practice differences generated distinct supervisory knowing in practice. These findings emphasise clinical supervision as fundamentally entwined in the speciality's practice; and reinforce alignments with patient care.

Academic failure is commonplace in higher education. Some students persist and go on to complete their courses. However, some do not, and this can create problems for themselves and the institutions in which they are enrolled. If we could understand students' lived experiences of academic failure and persistence, it may be possible to design strategies that assist others to more effectively navigate the demands of higher education. A narrative inquiry was undertaken with students who failed and persisted with their course to understand how identities and agency influenced persistence following failure. Using figured worlds theory and narrative analysis, three patterns of persistence were identified characterised as a hero's journey, surviving failure and stuck in the system. The positions students adopted in relation to other actors within their narratives ranged from active to passive, highlighting different agentic responses of students. Implications for supporting students to recover from failure are discussed.

This article discusses the ecological environment moral education of college students based on deep learning. This article first points out the concept of deep learning and the relationship between ecological civilization and college students' ecological environment morality. Then, it expounds the latest concepts and achievements of ecological civilization in China, analyzes the deficiencies and reasons of current college students' ecological moral education, and clearly points out the significance of strengthening college students' ecological moral education based on in-depth learning. This article focuses on the main contents and principles of setting suggestions of the ecological environment moral education for college students. Finally, it gives the countermeasures for the ecological environment moral education of college students based on deep learning. It focuses on the theoretical realization of college students' ecological environmental moral education from the perspective of deep learning, aiming at promoting the construction of ecological civilization.

Numbers of online postgraduate coursework students are increasing within higher education and this raises questions of identity - what being a student means to this more mature cohort. This in-depth qualitative investigation explores postgraduate student identities within online learning. We conducted interviews (14) and collected completed longitudinal audio diaries from students (3) enrolled in a range of postgraduate programs. We interpreted two social imaginaries or 'figured worlds' that describe participants' sense of who they ought to be. The "life-on-campus" figured world projected a 'traditional' student who read textbooks, inhabits classrooms and talks with lecturers. Alternatively, "my-time-and-screen" figured world projected a technologically-enabled student whose world is mediated by software, devices, their own spaces and a sense of self-sufficiency. These insights afford new ways of thinking about the diversity of the student cohort and how course designs might accommodate the multiplicity of ways online postgraduate students view themselves and their studies.

For over 30 years, the notion of authentic assessment in higher education has been adopted in academic practice, but it has managed to escape substantial critique. Although there have been multiple definitions and operationalisations of authentic assessment, current practice tends to foreground mimicking of work tasks. Authenticity cannot be completely unmoored from the reality of workplaces, the demands of the discipline, and the overall intended learning outcomes, however, a restricted view of how these aspects are represented in assessment can limit the sector's ability to prepare graduates who can engage with and shape the changing world. This paper elaborates the multiple challenges that some conceptualisations of authentic assessment contribute to assessment planning, recognising that assessment design always requires compromise. Three theoretical perspectives on authenticity are introduced to open new possibilities for authenticity in assessment. These are (1) psychological authenticity; (2) ontological fidelity; and (3) practice theory perspectives. The final section discusses how learning design might offer a means to operationalise theory. The paper concludes by suggesting that "authenticity" in assessment continues to hold value for the sector beyond its current uses through stronger theoretical conceptualisation and operationalisation of authenticity.

Background: Serum vitamin B12 plays a crucial role in cellular growth, DNA synthesis, and maintaining a healthy nervous system. Its deficiency can lead to various health issues, including cardiovascular problems. The reference range for vitamin B12 varies between populations due to cultural, genetic, and dietary differences. Methods: A cross-sectional study was conducted on 127 healthy An-Najah National University students aged between 18 and 25. Blood samples were collected, and a questionnaire assessed factors affecting vitamin B12 levels. Serum vitamin B12 levels were measured using ACCUBIND ELIZA microwells. Results: The study found a reference range for serum vitamin B12 of 136–640 pg/mL (5th to 95th percentile) among the studied population, which differed from the manufacturer’s claimed range of 200–835 pg/mL. Gender did not significantly affect the reference intervals. Conclusion: The study highlights the importance of establishing local reference values for laboratory tests like vitamin B12 due to variations in demographics. Further research in different Palestinian regions and age groups with larger sample sizes is recommended to refine these reference values.

Extreme climate events such as floods and droughts are becoming increasingly frequent and intense across the world. Future climate scenarios predict both an increase in individual extreme events, as well as chronic changes in climatic seasonality. Yet, the combined and relative effects of these pressures on ecosystems remain unknown. Concurrently, human-induced ecological disruption is accelerating species extinction rates, which are estimated to be 100 to 1000 times greater than pre-human levels. This is alarming as greater biological diversity is thought to buffer ecosystem functioning against extreme climate events, thereby safeguarding the provisioning of essential ecological services that contribute to human well-being. However, how and to what extent biodiversity buffers ecosystems against climate variability remains unclear. We recently constructed experimental grassland communities in a mesocosm-based field design representing a realistic gradient of plant diversity. Both extreme events (drought and flood) and a change in seasonality of precipitation are manipulated in a full factorial design to quantify the effects of future seasonal shifts and extremes in precipitation. We will: 1) determine to what extent higher biological diversity ensures that grasslands can continue to provide multiple ecosystem services even in the context of climate change and 2) unravel the fundamental mechanisms by which this is achieved including species asynchrony and positive species interactions. Results of our experimental approach will advance our understanding of the buffering potential of plant diversity and contribute to the development of strategies for sustainable service provisioning of our ecosystems in the face of climate change.

Abstract Background The allometric body shape index (ABSI) and hip index (HI), as well as multi-trait body shape phenotypes, have not yet been compared in their associations with inflammatory markers. The aim of this study was to examine the relationship between novel and traditional anthropometric indexes with inflammation using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) and UK Biobank cohorts. Methods Participants from EPIC (n = 17,943, 69.1% women) and UK Biobank (n = 426,223, 53.2% women) with data on anthropometric indexes and C-reactive protein (CRP) were included in this cross-sectional analysis. A subset of women in EPIC also had at least one measurement for interleukins, tumour necrosis factor alpha, interferon gamma, leptin, and adiponectin. Four distinct body shape phenotypes were derived by a principal component (PC) analysis on height, weight, body mass index (BMI), waist (WC) and hip circumferences (HC), and waist-to-hip ratio (WHR). PC1 described overall adiposity, PC2 tall with low WHR, PC3 tall and centrally obese, and PC4 high BMI and weight with low WC and HC, suggesting an athletic phenotype. ABSI, HI, waist-to-height ratio and waist-to-hip index (WHI) were also calculated. Linear regression models were carried out separately in EPIC and UK Biobank stratified by sex and adjusted for age, smoking status, education, and physical activity. Results were additionally combined in a random-effects meta-analysis. Results Traditional anthropometric indexes, particularly BMI, WC, and weight were positively associated with CRP levels, in men and women. Body shape phenotypes also showed distinct associations with CRP. Specifically, PC2 showed inverse associations with CRP in EPIC and UK Biobank in both sexes, similarly to height. PC3 was inversely associated with CRP among women, whereas positive associations were observed among men. Conclusions Specific indexes of body size and body fat distribution showed differential associations with inflammation in adults. Notably, our results suggest that in women, height may mitigate the impact of a higher WC and HC on inflammation. This suggests that subtypes of adiposity exhibit substantial variation in their inflammatory potential, which may have implications for inflammation-related chronic diseases.

Background: Hypertension (HTN) is a prevalent and impactful health concern associated with cardiovascular morbidity and mortality. This research delves into the intricate relationship between HTN and lower urinary tract symptoms (LUTS), acknowledging the multifaceted nature of these conditions and their potential impact on individuals’ quality of life. Materials and Methods: This cross-sectional study, conducted in Nablus, Palestine, employed convenient sampling to recruit hypertensive patients from the Ministry of Health clinics between September and December 2023. The inclusion criterion involved confirmed hypertensive patients, while the exclusion criterion included individuals with specific health conditions. The collected data included demographic, comorbidity, and lifestyle factor data. The study utilized the urogenital distress inventory 6 (UDI-6) and Incontinence Impact Questionnaire (IIQ)-7 short forms to assess urinary distress symptoms and the impact of urinary incontinence on quality of life. All the statistical analyses, including Pearson, Chi-square, Fisher’s exact, Kruskal-Wallis, and Mann-Whitney tests, were performed with various tests for significance, and the significance level was set at P < 0.05. Results: Among the 351 participants meeting the inclusion criteria, females (62.1%) and married individuals (83.5%) were the predominant participants. The majority were aged 58–67 (42.5%), had a high school education (39.0%), and had a body mass index (BMI) of 30–34.9 (30.2%). Significant correlations were found between UDI-6 scores and sex, age, marital status, education level, employment status, and comorbidities. The IIQ-7 score was significantly correlated with female sex, marital status, age, comorbidities, duration of HTN, employment status, and education level. Both the UDI-6 and IIQ-7 scores revealed considerable impacts on urinary symptoms and quality of life. A significant negative correlation (r = −0.579) between the IIQ-7 score and UDI-6 score emphasized the interconnectedness of urinary distress symptoms and their impact on quality of life (P < 0.001). These findings underscore the multifaceted nature of LUTS and their profound effects on hypertensive patients’ well-being. Conclusion: Our study revealed a significant association between HTN and LUTS, especially among females and specific demographic groups. This emphasizes the need for comprehensive management. The observed negative impact on quality of life emphasizes the significance of adopting holistic approaches to address both conditions.

Abstract Introduction Physicians working in primary health care (PHC) centers are the first contact for patients and expected to deal with emergencies. Emergency care training in PHC settings has been neglected globally, especially in low to middle income countries. Adequate preparation becomes especially important during periods of conflict. The study objectives are to identify the barriers facing PHC physicians when dealing with emergency cases in the northern region of Palestine during the current conflict. Methods A cross-sectional study was conducted with 179 physicians working in the 10 PHC centers distributed among 5 northern governances in Palestine. The study period was from July through December 2023. Data were collected electronically using a self-administered questionnaire, which was adapted from a comprehensive literature review. The questionnaire’s internal validity was confirmed by a Cronbach’s alpha coefficient of [0.85], indicating high reliability. Results The ages of the physicians ranged from 25 to 60 years, with a mean ± SD of 35.3 ± 8.15 years. A significant majority (91.6%) were not boarded in any specialty. Most physicians (85.5%) had attended Basic Life Support (BLS) courses, whereas 45.2% and 72% had never attended Advanced Cardiovascular Life Support (ACLS) or Advanced Trauma Life Support (ATLS) courses, respectively. Physicians with emergency department experience (P = 0.002) and those who had attended ACLS courses (P

In this work, the corrosion inhibition performance of polyethyleneglycol bisphenol A epichlorohydrin copolymer (PEG-BEC) against mild steel in 1 M HCl was studied by electrochemical and weight loss techniques. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDAX) were applied to characterize the surface morphology of the mild steel samples. The corrosion mitigation efficiency was observed to rise as the concentration of PEG-BEC rises in the corrosive medium while increasing the temperature (25 °C -65 °C) resulting in a drop in the inhibition ability. Furthermore, under hydrodynamic conditions, the corrosion of the mild steel was found to deteriorate both in the absence and presence of PEG-BEC. Just with 10 ppm, an inhibition efficiency (IE) of 97.6% was obtained at 25 °C by EIS. PEG-BEC acts as a mixed-type inhibitor as observed by potentiodynamic polarization (PDP) technique. The observed corrosion inhibition action of PEG-BEC could be ascribed to the adsorption of the molecules and the formation of a protective film on the steel surface as evidenced by static water contact angle (WCA). Langmuir isotherm best describes the PEC-BEG-metal adsorption with large Kads values indicating a thermodynamically stable nature inhibition process. The obtained ∆G°ads = -35.138 to -39.522 kJ/mol indicate that the PEG-BEC spontaneously adsorbed onto the steel with strong tendency to provide protection to the mild steel surface via combination of chemisorption and physisorption processes. The ΔHads -53.07 kJ/mol and ΔSads= +0.048 kJ/mol-k, respectively, suggests an exothermic reaction accompanied by relatively increase in entropy of the PEG-BEC adsorption on the mild steel surface.