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As the educational landscape changes rapidly, secondary schools increasingly adopt digital technologies to transform teaching and learning experiences. Recognizing the challenges and potential advantages that arise in the digital era, educators are actively undertaking digital transformation initiatives across various domains, with secondary schools being the key focus of this paper. To clarify the matter, four research questions were formulated in this systematic literature review: 1) What is the state-of-the-art for digital transformation research in secondary schools? 2) What are the essential indicators for conducting digital transformation in secondary schools, as identified by researchers? 3) What are the models or frameworks for digital transformation in secondary schools? 4) How to implement digital transformation in secondary schools? A formal protocol was followed to conduct automatic and manual searches of relevant articles published between January 2012 to March 2023 using the PSALSAR method. As a result, 65 papers were selected for review. This study highlighted six key factors successfully implemented in digital transformation: leadership, digital competency, professional development, technology access, school evaluation, and school competency. Furthermore, the study discussed current research trends, methods, and strategies to develop standard models and frameworks related to digital transformation in secondary schools. Challenges and potential areas for further development were investigated to facilitate a successful digital transformation.

Dermatofitosis merupakan penyakit kulit yang diakibatkan oleh kolonisasi jamur dermatofita yang menyerang jaringan keratin epidermis bagian superfisial seperti kulit, kuku, dan rambut. Salah satu spesies terbanyak penyebab dermatofitosis yaitu Trichophyton mentagrophytes. Tanaman Kesum (Polygonum minus Huds.) memiliki kandungan senyawa metabolit sekunder yang berpotensi sebagai anti jamur. Tujuan: Penelitian ini bertujuan untuk mengetahui aktivitas anti jamur ekstrak etanol daun Kesum terhadap jamur Trichophyton mentagrophytes, dan mengetahui diameter zona hambat oleh ekstrak etanol daun Kesum terhadap Trichopyton mentagrophytes. Metode: Aktivitas anti jamur diuji dengan metode difusi cakram. Analisis metabolit sekunder ekstrak etanol daun Kesum menggunakan metode kromatografi lapis tipis. Kontrol positif yang digunakan adalah Itrakonazol 8µg, dan kontrol negatif adalah DMSO 10%. Hasil: Ekstrak etanol daun Kesum memiliki aktivitas anti jamur pada konsentrasi 40% dan 80% dengan rata-rata diameter zona hambat 10,125 mm dengan kategori sedang dan 20,625 mm dengan kategori sangat kuat. Hasil skrining fitokimia didapatkan terpenoid, flavonoid, alkaloid, saponin dan fenol. Simpulan: Ekstrak etanol daun Kesum berpotensi sebagai obat anti dermatofita terhadap Trichophyton mentagrophytes.

Demyelinating central nervous system (CNS) disorders are a diverse group of conditions characterised by damage to the myelin sheath. These include not only primary autoimmune disorders such as multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD), but secondary demyelinating conditions caused by infection and neoplasm, where immunosuppressive therapy may worsen the condition or delay definitive treatment. We describe a young man with an unusual presentation of CNS demyelinating disease associated with HIV infection and positive syphilis serology. MRI brain and spine showed a demyelinating tumefactive lesion accompanied by longitudinal extensive transverse myelitis, and we initially suspected NMOSD. However anti-aquaporin 4 antibodies were negative, going against a diagnosis of NMOSD and he then tested positive for HIV which led us to consider TB myelitis, neurosyphilis and HIV vacuolar myelopathy. He was commenced on highly active retroviral therapy and treated with steroids and immunosuppression. He did not respond to treatment as expected so a brain biopsy was required to narrow the differential. Brain biopsy initially raised the possibility of progressive multifocal leukoencephalopathy which is associated with infection with the John Cunningham (JC) virus. Ultimately JC Virus PCR on the biopsy was negative, the final report suggesting nonspecific active chronic inflammation. We detail his clinical course and the diagnostic challenges along the way., (© 2024. The Author(s) under exclusive licence to The Journal of NeuroVirology, Inc.)

On 6 July 2018, the Center for Epidemiology and Public Health of the French Armed Forces was informed of an outbreak of acute gastroenteritis among customers of a dining facility at a military base in Brittany, France. A total of 200 patients were reported out of a population of 1700 (attack rate: 12%). The symptoms were mainly lower digestive tract disorders and occurred rapidly after lunch on 5 July (median incubation period: 3.3 h), suggesting a toxin-like pathogenic process. A case-control survey was carried out (92 cases and 113 controls). Statistical analysis pointed to the chili con carne served at lunch on 5 July as the very likely source of poisoning. Phytohaemagglutinin, a plant lectin, was found in the chili con carne at a concentration above the potentially toxic dose (400 HAU/gram). The raw kidney beans incorporated in the chili con carne presented a high haemagglutination activity (66,667 HAU/gram). They were undercooked, and the phytohaemagglutinin was not completely destroyed. FBDOs due to PHA are poorly documented. This study highlights the need to develop methods for routine testing of plant toxins in food matrices. Improved diagnostic capabilities would likely lead to better documentation, epidemiology, and prevention of food-borne illnesses caused by plant toxins.

Propagation Phase Contrast Synchrotron Microtomography (PPC-SRμCT) is the gold standard for non-invasive and non-destructive access to internal structures of archaeological remains. In this analysis, the virtual specimen needs to be segmented to separate different parts or materials, a process that normally requires considerable human effort. In the Automated SEgmentation of Microtomography Imaging (ASEMI) project, we developed a tool to automatically segment these volumetric images, using manually segmented samples to tune and train a machine learning model. For a set of four specimens of ancient Egyptian animal mummies we achieve an overall accuracy of 94-98% when compared with manually segmented slices, approaching the results of off-the-shelf commercial software using deep learning (97-99%) at much lower complexity. A qualitative analysis of the segmented output shows that our results are close in terms of usability to those from deep learning, justifying the use of these techniques., Competing Interests: The authors have declared that no competing interests exist.

Lemierre's syndrome is a rare and potentially life-threatening condition that follows an oropharyngeal infection, typically from Fusobacterium necrophorum, and usually affects healthy adolescents or young adults. The characteristic features are septic thrombophlebitis of the internal jugular vein and septic embolism leading to multiorgan involvement, commonly the brain, lungs and bones. We report a man with presenting symptoms suggesting hemicrania continua, whose initial imaging showed no features of dural venous sinus or jugular thrombosis. Two weeks later, he had fever, sore throat, cervical lymphadenopathy and Actinomyces meyeri grew from peripheral blood cultures. Further imaging identified thrombosis of the internal jugular vein and cerebral venous sinuses, with multifocal cavitating lung lesions. Following antibiotics and anticoagulation, he recovered without residual deficits. Lemierre's syndrome when recognised and treated early has a good prognosis but delayed treatment may result in significant morbidity or mortality., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Competing interests: None declared.

Background: Novel psychoactive substances (NPS) are a growing public health concern. We aimed to identify the acute neurological consequences of NPS., Method: We performed a retrospective case-note review of patients who presented to the emergency department after taking NPS., Results: We identified 237 admissions from 190 patients, mostly young men. There were high rates of psychiatric comorbidity (43%), unemployment (39%), homelessness (24%) and incarceration (17%). Most reported use of synthetic cannabinoids (SC; 91%). Some took synthetic cathinones (SCath; 7%) or nitrous oxide (NOS; 2%). SC caused impaired consciousness (61%) and seizures (16%). SCath users presented with psychiatric disturbance or seizures (55%). Most patients were managed conservatively (67%) and a small proportion (14%) were referred to drug or psychology services., Conclusions: NPS users represent a vulnerable group in society. Certain clinical features may suggest the type of NPS used. Most patients require supportive management and onward referral to drug addiction services is recommended., (© Royal College of Physicians 2021. All rights reserved.)

Pathogenic variants in the nonimprinted in Prader-Willi/Angelman syndrome (NIPA1) gene typically present with pure hereditary spastic paraplegia (HSP) but complex cases are described. We present a patient with childhood idiopathic generalised epilepsy (IGE) who later developed HSP. She rapidly deteriorated 27 years later with clinically definite amyotrophic lateral sclerosis (ALS). Her family history included HSP, IGE and motor neurone disease. Genetic testing identified a pathogenic variant in the NIPA1 gene associated with spastic paraplegia 6 (SPG6). This case provides the first description of NIPA1 in a family with epilepsy, ALS and thus complex HSP.

Background: The widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care., Methods: Individuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification., Results: Not socializing with heavy drinkers (AOR [95%CI]:3.84[1.66-8.85]), regular smoking (9.72[3.91-24.15]) and feeling discriminated against (2.35[1.10-5.05]) were independent levers to having sought/received care for AUD, while being aged < 50 and employment were independent barriers. The five predominant themes in PWAUD discourses emerging from the textual analysis were: drinking context, medical care, alcohol treatment, tobacco/addiction and family. When triangulating results from the logistic regression and the textual analysis, two barriers (social drinking and difficulties with the medical care system), and two levers (family influence and tobacco addiction), emerged., Conclusion: These results underline the need for interventions targeting families and the social network to increase awareness about AUD and related care. Simplified and novel comprehensive care trajectories are urgently needed to reduce the clinical and public health burden of AUD.

Introduction: Alcohol use disorder (AUD) is a major public health concern worldwide. In France, only 10% of people with AUD (PWAUD) receive medical care. General practitioners (GP) are one of the main entry points for AUD care. The present ongoing study, entitled ASIA (Access to Care and Indifference toward Alcohol, Accès aux Soins et Indifference à l'Alcool in French), aims to improve knowledge about factors associated with access to care for AUD by exploring related GP and PWAUD practices, experiences and perceptions., Methods and Analysis: The ASIA project is an ongoing cross-sectional multisite study based on a complementary mixed-method approach (quantitative and qualitative) using a convergent parallel design. The double-perspective design of the study will enable us to collect and compare data regarding both PWAUD and GP points of view. For the PWAUD quantitative study, 260 PWAUD will be interviewed using a telephone-based questionnaire. For the qualitative study, 36 PWAUD have already been interviewed. The GP quantitative study will include 100 GP in a 15 min survey. Fifteen GP have already participated in semistructured interviews for the qualitative study. Logistic regression will be used to identify predictors for access to care. With respect to data analyses, qualitative interviews will be analysed using semantic analysis while quantitative logistic regression will be used for quantitative interviews., Ethics and Dissemination: This study was approved by the CNIL (French National Commission on Informatics and Liberties) (approval reference number: C16-10, date of approval: 17 July 2017), the CCTIRS (Advisory Committee on Information Processing in Material Research in the Field of Health) and the CEEI (Evaluation and Ethics Committee) (approval reference number: 16-312, date of approval: 8 July 2016) of INSERM (French National Institute of Health and Medical Research). Results from ASIA will be disseminated in peer-reviewed publications, conference presentations, reports and in a PhD thesis., Competing Interests: Competing interests: The commercial company Ethypharm provides financial support, in the form of a salary, to author MCosta., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Current antiepileptic drugs (AEDs) have several shortcomings. For example, they fail to control seizures in 30% of patients. Hence, there is a need to identify new AEDs. Drug repurposing is the discovery of new indications for approved drugs. This drug "recycling" offers the potential of significant savings in the time and cost of drug development. Many drugs licensed for other indications exhibit antiepileptic efficacy in animal models. Our aim was to create a database of "prescribable" drugs, approved for other conditions, with published evidence of efficacy in animal models of epilepsy, and to collate data that would assist in choosing the most promising candidates for drug repurposing., Methods: The database was created by the following: (1) computational literature-mining using novel software that identifies Medline abstracts containing the name of a prescribable drug, a rodent model of epilepsy, and a phrase indicating seizure reduction; then (2) crowdsourced manual curation of the identified abstracts., Results: The final database includes 173 drugs and 500 abstracts. It is made freely available at www.liverpool.ac.uk/D3RE/PDE3. The database is reliable: 94% of the included drugs have corroborative evidence of efficacy in animal models (for example, evidence from multiple independent studies). The database includes many drugs that are appealing candidates for repurposing, as they are widely accepted by prescribers and patients-the database includes half of the 20 most commonly prescribed drugs in England-and they target many proteins involved in epilepsy but not targeted by current AEDs. It is important to note that the drugs are of potential relevance to human epilepsy-the database is highly enriched with drugs that target proteins of known causal human epilepsy genes (Fisher's exact test P-value < 3 × 10 -5 ). We present data to help prioritize the most promising candidates for repurposing from the database., Significance: The PDE3 database is an important new resource for drug repurposing research in epilepsy., (Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.)

Objectives: An outbreak of A(H1N1) virus influenza, detected in Mexico during April 2009, spread around the world in nine weeks. French armed forces had to adapt their epidemiological surveillance systems to this pandemic. Our aim was to present surveillance results., Design: There are two influenza surveillance systems in French armed forces: one permanent throughout the year and one seasonal, the Military influenza surveillance system (SMOG). The pandemic threat led to an early reactivation of SMOG, before the initiation of a daily surveillance system specifically dedicated to A(H1N1) influenza., Results: In metropolitan France, the increase of respiratory infections was observed as of September 2009, with a maximum of 401 cases for 100,000 at the beginning of December according to SMOG. The estimated rate of consultations related to A(H1N1) influenza ranged between 46 and 65 cases for 100,000. For military units operating outside of metropolitan France, a peak of incidence was observed in August (400 cases for 100,000)., Conclusion: The trends observed by influenza military surveillance networks were compatible with French ones. Concerning French forces in operations, the increase of incidence observed in August was the consequence of the influenza outbreak in the Southern hemisphere. Estimations of consultations rate related to A(H1N1) influenza, ranged between 127 and 194 cases for 100,000 at the beginning of December, lower than the national rate (1321 cases for 100,000), a consequence of the age pyramid in the military population., ((c) 2010 Elsevier Masson SAS. All rights reserved.)

The cytologic findings of duodenal smears in diarrheic HIV-positive patients were compared with results of histologic and ultrastructural studies. This study included 50 diarrheic patients undergoing upper gastrointestinal endoscopy. Duodenal biopsies were taken with touch preparations. Smears were stained with Giemsa and then with Ziehl-Neelsen or the PAS method. The biopsy specimens were then processed in a standard fashion for histologic and electron microscopy examination. Cytologic findings included 8 cases of intestinal microsporidiosis, 4 cases of cryptosporidiosis, and 3 cases of atypical mycobacteriosis. Histologic and ultrastructural studies confirmed these diagnoses and showed 8 cases of CMV enteritis, of which 4 were associated with other enteric pathogens. Duodenal cytology complements endoscopic biopsy in the work-up of diarrhea in AIDS patients and may provide a rapid diagnosis especially in the case of intestinal protozoonosis or atypical intestinal mycobacteriosis.