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Abstract Citrus-flavored vegetable oils (CFVO) demand has grown rapidly in the food industry due to increasing consumer demand for salads as a healthy food choice. Salad dressing has a distinctive taste from sour-tasting citrus that when added to salads to increase acceptance. This study primarily aimed to characterize antioxidant activity, total flavonoid content, and sensory quality by hedonic and organoleptic test between all unflavored oil and CFVO from three different vegetable oils (coconut oil (Cocos nucifera L.), palm oil (Elaeis guineensis L.), sesame oil (Sesamum indicum L.)) and three citruses (key lime (Citrus aurantifolia), kaffir lime (Citrus hystrix), and nasnaran (Citrus ambylcarpa)). One-Way ANOVA with post hoc Tukey were conducted to assess antioxidant and flavonoid differences. ANOVA with Tukey HSD and HSD, PCA and HCA, and a Spearman correlation analysis were conducted to assess the sensory qualities of citrus-flavored vegetable oils. There were different hedonic responses towards citruses in addition to the vegetable oils for each hedonic attribute. There is also a different response to the antioxidant and total flavonoids content of each treatment. The best formula according the multi-attribute decision using a compensatory model and additive weighting technique (MADCAW) score describes key lime (140%) flavored coconut oil as the best formula as having 56.58% antioxidant, 37.00 mg QE/100 g flavonoid and color liking 1.84, aroma liking 3.56, and taste liking 1.88. In conclusion, citrus-flavored vegetable oil has the potential to be a high-antioxidant vegetable oil with good acceptance by consumers.

Abstract Aims Inflammation has emerged as a potential key pathophysiological mechanism in heart failure (HF) in general and acute HF (AHF) specifically, with inflammatory biomarkers shown to be highly predictive of adverse outcomes in these patients. The CORTAHF study builds on both these data and the fact that steroid burst therapy has been shown to be effective in the treatment of respiratory diseases and COVID‐19. Our hypothesis is that in patients with AHF and elevated C‐reactive protein (CRP) levels without symptoms or signs of infection, a 7‐day course of steroid therapy will lead to reduced inflammation and short‐term improvement in quality of life and a reduced risk of worsening HF (WHF) events. Methods and results The study, which is currently ongoing, will include 100 patients with AHF ages 18–85, regardless of ejection fraction, screened within 12 h of presentation. Patients will be included who have NT‐proBNP > 1500 pg/mL and CRP > 20 mg/L at screening. Exclusion criteria include haemodynamic instability and symptoms and signs of infection. After signed consent, eligible patients will be randomized according to a central randomization scheme stratified by centre 1:1 to either treatment once daily for 7 days with 40 mg prednisone orally or to standard care. Patients will be assessed at study day 2, day 4 or at discharge if earlier, and at days 7 and 31 at the hospital; and at day 91 through a telephone follow‐up. The primary endpoint is the change in CRP level from baseline to day 7, estimated from a mixed model for repeated measures (MMRM) including all measured timepoints, in patients without a major protocol violation. Secondary endpoints include the time to the first event of WHF adverse event, readmission for HF, or death through day 91; and changes to day 7 in EQ‐5D visual analogue scale score and utility index. Additional clinical and laboratory measures will be assessed. Conclusions The results of the study will add to the knowledge of the role of inflammation in AHF and potentially inform the design of larger studies with possibly longer duration of anti‐inflammatory therapies in AHF.

Pengalaman proses belajar mengajar pasca pandemi covid 19 menunjukkan adanya penurunan sikap daya juang dari siswa-siswi SD di sekolah XYZ Tangerang. Tidak hanya keterampilan berpikir kritis yang adalah salah satu dari keterampilan pada abad 21 diharapkan oleh pihak sekolah sebagai sebuah keterampilan yang perlu dikembangkan oleh siswa, konsep hidup menggereja ternyata cukup sulit dipahami oleh siswa kelas V. Untuk menjawab permasalah tersebut maka perlu dilakukan upaya untuk meningkatkannya. Dengan demikian tujuan dilakukan penelitian ini adalah menerapkan model pembelajaran student teams achievement division (STAD) untuk meningkatkan keterampilan berpikir kritis, sikap daya juang, dan penguasaan konsep hidup menggereja pada mata pelajaran agama kelas V SD XYZ dengan melakukan penelitian tindakan kelas (PTK). Terdapat tiga instrumen yang dipakai yakni kuesioner, observasi, dan tes. Hasil analisis data menunjukkan bahwa penerapan model STAD dapat meningkatkan keterampilan berpikir kritis, sikap daya juang dan penguasaan konsep hidup menggereja siswa kelas V C sekolah dasar XYZ. Peneliti di masa yang akan datang dapat menjadikan penelitian ini sebagai dasar untuk penelitian terkait variabel yang diukur sekaligus juga mempertimbangkan proporsionalitas jumlah siswa dan ukuran ruangan kelas untuk menjalankan model STAD dengan lebih baik.

Abstract The development of the 21st century learning era and the development of the industrial revolution 4.0, brings the world of education into the arena of competition in all aspects of life. Current advances in science and technology provide their own challenges for teachers in designing a learning model to produce learners according to 21st century competencies. Current education has not been able to produce the quality of 21st century learners who have the ability to think critically, think creatively and think reflectively. It is a challenge for an educator to design the right learning model. This study aims to see whether the application of research-based learning model can develop students' critical thinking, creative thinking, and reflective thinking skills in learning biology. The method used in this research is Classroom Action Research according to Mc. Kernans which was conducted for two cycles in class XI Major A. Data collection techniques used rubrics to measure the achievement of indicators through tests. The results showed that the application of the research-based learning model was able to improve students' critical thinking, creative thinking, and reflective thinking skills in learning biology. Bahasa Indonesia Abstrak Perkembangan era 21 century learning dan perkembangan revolusi industri 4.0, membawa dunia pendidikan memasuki arena kompetisi dalam segala aspek kehidupan. Kemajuan ilmu pengetahuan dan teknologi saat ini memberikan tantangan tersendiri bagi guru dalam merancang sebuah model pembelajaran untuk menghasilkan peserta didik sesuai kompetensi abad 21 saat ini. Pendidikan saat ini belum mampu menghasilkan kualitas peserta didik abad 21 yang memiliki kemampuan berpikir kritis, berpikir kreatif dan berpikir reeflektif. Sebuah tantangan tersendiri bagi seorang pendidik dalam merancang sebuah pemodelan pembelajaran yang tepat. Penelitian ini bertujuan untuk melihat apakah penerapan model research-based learning mampu mengembangkan kemampuan berpikir kritis, berpikir kreatif, dan berpikir reflektif peserta didik dalam pembelajaran biologi. Metode yang digunakan dalam penelitian ini adalah Penelitian Tindakan Kelas oleh Mc. Kernans yang dilakukan selama dua siklus di kelas XI Major A. Instrumen penelitian berupa tes yang telah divalidasi oleh dua orang ahli. Hasil penelitian ini menyatakan bahwa penerapan model research-based learning mampu meningkatkan kemampuan berpikir kritis, berpikir kreatif, dan berpikir reflektif peserta didik dalam pembelajaran biologi.

Background: Pain, as defined by the International Association for the Study of Pain, is an unpleasant sensory and emotional experience associated with, or resembling, that is associated with actual or potential tissue damage. In Ethiopia, where healthcare facilities and offerings are expanding to handle countless patients requiring surgical intervention, managing acute postoperative pain is a serious concern. Objectives: To assess the prevalence of acute postoperative pain and associated factors after elective surgery among adult patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2023 Methodology: This is an institution-based cross-sectional study. A structured data collection format was used to collect data from 219 participants. Bivariable and multivariable logistic regression analyses described the association between independent and dependent variables. Results: Of 219 patients, 180 (82.2 %) had acute postoperative pain. The prevalence of moderate to severe pain was 34.24 %. Preoperative anxiety, the use of intraoperative analgesics, and duration of surgery were the main factors associated with the prevalence of acute postoperative pain. Conclusion: Our study revealed that the overall prevalence of postoperative pain was relatively low in the study area. This suggests that the attention given to postoperative pain recognition and management is better than that in other areas. However, the finding of a significant gap in managing postoperative pain underscores the need for further improvements in pain management practices. This should motivate us to commit to change, particularly in the identified areas of concern, such as preoperative anxiety, use of intraoperative analgesics, and duration of surgery.

Herbs, spices, and citrus have all been widely investigated as natural antioxidants that may be blended into vegetable oils to prevent lipid oxidation. These flavored vegetable oils, made using diverse processes, show considerable increases in stability, sensory properties, and nutritional value. This literature review summarizes the potential for future development of diverse flavored vegetable oils by gathering several research on their features, manufacturing techniques, and stability capabilities during frying and storage. Flavored vegetable oils enriched with herbs, spices, and citrus have been shown to contain a wide range of volatile compounds, to have better oxidative stability during thermal processing and storage, to improve sensory characteristics, which leads to increased consumer acceptance, and to increase and sustain antioxidant levels. Each technique of producing flavored vegetable oils serves a unique purpose and provides distinct benefits, making them suited for various types of natural antioxidants. Future development must solve a number of problems in order to fully realize the promise of flavored vegetable oils, notably in terms of safety and health benefit claims.

Background: Normal reproductive function requires adequate regulation of follicle stimulating hormone (FSH) and luteinizing hormone (LH) secretion. During ovarian stimulation for in-vitro fertilization (IVF), some patients will demonstrate an early rise in LH despite being treated with a gonadotropin releasing-hormone (GnRH) antagonist, sometimes necessitating cycle cancellation. Previous studies have demonstrated a possible link between a premature LH rise with ovarian response to gonadotropins. We sought to determine what clinical parameters can predict this premature LH rise and their relative contribution. Methods: A retrospective study of 382 patients who underwent IVF treatment at Rambam Medical Center. The patients were stratified into age groups. A model predicting premature LH rise based on clinical and demographic parameters was developed using both multiple linear regression and a machine-learning-based algorithm. Results: LH rise was defined as the difference between pre-trigger and basal LH levels. The clinical parameters that significantly predicted an LH rise were patient age, BMI, LH levels at stimulation outset, LH levels on day of antagonist administration, and total number of stimulation days. Importantly, when analyzing the data of specific age groups, the model’s prediction was strongest in young patients (age 25–30 years, R2 = 0.88, p 41 years, R2 = 0.23, p = .003). Conclusions: Using both multiple linear regression and a machine-learning-based algorithm of patient data from IVF cycles, we were able to predict patients at risk for premature LH rise and/or LH surge. Utilizing this model may help prevent IVF cycle cancellation and better timing of ovulation triggering.

Berpacaran umum ditemukan pada mahasiswa yang memasuki usia dewasa muda, periode yang kerap dicirikan dengan tantangan terkait krisis kedekatan. Kualitas hubungan berpacaran menjadi penting karena memberikan dampak pada perkembangan mahasiswa. Oleh karena itu, penting bagi mahasiswa untuk mengevaluasi kualitas hubungan dan mengetahui faktor-faktor yang dapat memengaruhi kualitas hubungan. Kualitas hubungan dapat dievaluasi dengan mengukur kepuasan hubungan. Penelitian ini bertujuan untuk mengkaji kontribusi diferensiasi diri dan karakteristik kepribadian neurotisisme terhadap kepuasan hubungan mahasiswa perempuan di Jabodetabek. Diperoleh data dari 84 partisipan dengan penyebaran kuesioner elektronik melalui media sosial dan secara langsung ke universitas di Jabodetabek. Hasil penelitian menunjukkan bahwa diferensiasi diri dan neurotisisme berkontribusi secara signifikan terhadap kepuasan hubungan pada mahasiswa perempuan di Jabodetabek. Tidak hanya memprediksi kepuasan hubungan, diferensiasi diri dapat mengatasi dampak negatif dari neurotisisme sehingga dapat meningkatkan kepuasan hubungan.

Introducción: La satisfacción del paciente con el cuidado de enfermería es un predictor importante para evaluar la calidad de la atención hospitalaria. Sin embargo, en Perú, la satisfacción y la experiencia del paciente sobre el cuidado de enfermería en el servicio de Emergencias sigue siendo desconocida. Objetivo: Analizar la experiencia y la satisfacción con los cuidados de enfermería percibidas por pacientes hospitalizados en el servicio de emergencia en un hospital de nivel III de Perú. Metodología: Se aplicó el Cuestionario de Calidad del Cuidado de Enfermería que se clasifica en dos dimensiones: experiencia y satisfacción. Las variables independientes fueron factores sociodemográficos y clínicos. Se utilizó la prueba de Chi-cuadrado y la regresión de Poisson para calcular la razón de prevalencia (RP) con un p-valor menor a 0.05. Resultados: De 130 pacientes relevados, el 52,08 % percibió una mala experiencia y el 54,62 % estuvo insatisfecho con los cuidados de enfermería. La edad se asoció con las dimensiones experiencia (RPa: 1.01) y la satisfacción de cuidados de enfermería (RPa: 1.02). Además, el nivel socioeconómico medio-alto (RPa: 0.52) y los días de estancia hospitalaria (RPa: 0.65) se asociaron a una mala satisfacción. Conclusiones: Más de la mitad de los pacientes manifestaron una mala experiencia e insatisfacción con los cuidados recibidos. Esto implica la necesidad de tomar en cuenta las necesidades del paciente hospitalizado en emergencias y gestionar recursos humanos y materiales.

The optimal diagnosis strategy for pulmonary embolism (PE) in the emergency department (ED) remains complex. This review summarizes PE diagnosis with clinical presentation, decision rules and investigations for acute PE. This review was performed using studies published between January 1, 2010, and September 1, 2023. PE should be considered in ED in patients with chest pain, shortness of breath, syncope or signs of deep veinous thrombosis. Definitive diagnosis of PE relies on thoracic imaging, with the use of chest tomographic pulmonary angiogram or ventilation-perfusion lung scintigraphy. To limit the continuous increased use of chest imaging, the clinical probability should be the first step for PE workup. The pulmonary embolism rule-out criteria (PERC) can rule out PE at this stage. If not, for low or intermediate probability, several clinical decision rules have been validated, either by ruling out PE on clinical signs, or by raising D-dimer thresholds (YEARS or PEGeD [Pulmonary Embolism Graduated D-Dimer] criteria) or by combination of these different rules. It is recommended that patients with a high clinical probability of PE should undergo chest imaging without the need for D-dimer testing. The PE diagnostic approach can be tailored in specific populations such as pregnant, younger, COVID-19, or cancer patients. PE diagnosis worup illustrates the complexity of modern probabilistic-based approaches of decision-making in medicine. It is recommended to use a Bayesian approach with the evaluation of clinical probability, then order D-dimer if the PERC rule is positive, then adapt the D-dimer threshold for ordering chest imaging using clinical decision rules.

Abstract The COVID-19 disease is an ongoing global health concern. Although vaccination provides some protection, people are still susceptible to re-infection. Ostensibly, certain populations or clinical groups may be more vulnerable. Factors causing these differences are unclear and whilst socioeconomic and cultural differences are likely to be important, human genetic factors could influence susceptibility. Experimental studies indicate SARS-CoV-2 uses innate immune suppression as a strategy to speed-up entry and replication into the host cell. Therefore, it is necessary to understand the impact of variants in immunity-associated human proteins on susceptibility to COVID-19. In this work, we analysed missense coding variants in several SARS-CoV-2 proteins and their human protein interactors that could enhance binding affinity to SARS-CoV-2. We curated a dataset of 19 SARS-CoV-2: human protein 3D-complexes, from the experimentally determined structures in the Protein Data Bank and models built using AlphaFold2-multimer, and analysed the impact of missense variants occurring in the protein–protein interface region. We analysed 468 missense variants from human proteins and 212 variants from SARS-CoV-2 proteins and computationally predicted their impacts on binding affinities for the human viral protein complexes. We predicted a total of 26 affinity-enhancing variants from 13 human proteins implicated in increased binding affinity to SARS-CoV-2. These include key-immunity associated genes (TOMM70, ISG15, IFIH1, IFIT2, RPS3, PALS1, NUP98, AXL, ARF6, TRIMM, TRIM25) as well as important spike receptors (KREMEN1, AXL and ACE2). We report both common (e.g., Y13N in IFIH1) and rare variants in these proteins and discuss their likely structural and functional impact, using information on known and predicted functional sites. Potential mechanisms associated with immune suppression implicated by these variants are discussed. Occurrence of certain predicted affinity-enhancing variants should be monitored as they could lead to increased susceptibility and reduced immune response to SARS-CoV-2 infection in individuals/populations carrying them. Our analyses aid in understanding the potential impact of genetic variation in immunity-associated proteins on COVID-19 susceptibility and help guide drug-repurposing strategies.

Educational technology has grown rapidly and extensively, but unfortunately its presence in learning mathematics has not been maximized. A preliminary survey and the researchers' personal experience with the use of Smart TVs in one junior high school (SMP) motivated the researchers to do research and development (R&D) which began with a clear and comprehensive needs analysis. The aim of this research is to determine the need to further develop Smart TV learning media and explain ways to improve its use based on the conclusions of the needs analysis. The research method applied is the ADDIE Model with its stages of Analysis, Design, Development, Implementation and Evaluation. The instrument used to collect needs analysis data is a survey which, after being validated and revised, was distributed via g-form to students, mathematics teachers, and junior high school leaders. The results of the needs analysis show that even though Smart TVs were used, the majority of students have difficulty understanding mathematical concepts because Smart TVs are not interesting and interactive. A Smart TV is just a substitute for LCDs and laptops. Therefore, researchers designed learning methods that are interesting and involve students in using Smart TVs should focus on inquiry learning methods and educational games. The implementation steps will help mathematics teachers to maximize the use of Smart TVs in the classroom. BAHASA INDONESIA ABSTRACT: Teknologi pembelajaran telah berkembang begitu cepat dan luas, tetapi kehadirannya di pembelajaran Matematika belum dimaksimalkan. Beberapa sekolah telah menggunakan Smart TV sebagai media pembelajaran di kelas, tetapi survei awal dan pengalaman pribadi peneliti akan kurang maksimalnya penggunaan Smart TV di satu sekolah menengah pertama (SMP) memotivasi peneliti untuk melakukan penelitian R & D yang dimulai dengan sebuah analisis kebutuhan yang jelas dan komprehensif. Tujuan dari penelitian ini adalah untuk mengetahui analisis kebutuhan untuk lebih jauh mengembangkan Smart TV serta menjelaskan cara-cara pengembangan media tersebut berdasarkan temuan-temuan kesimpulan analisis kebutuhan. Model penelitian yang diterapkan dalam penelitian ini adalah model pengembangan ADDIE dengan tahapan Analysis, Design, Development, Implementation and Evaluation. Instrumen yang digunakan untuk mengumpulkan data analisis kebutuhan adalah survei yang setelah divalidasi dan direvisi, survei tersebut disebarkan melalui ke g-form kepada siswa/i, guru matematika dan pimpinan sekolah. Hasil analisis kebutuhan menunjukkan bahwa meskipun Smart TV telah digunakan, siswa/i masih kesulitan menguasai konsep Matematika karena Smart TV kurang menarik dan interaktif. Smart TV hanya sekedar pengganti LCD dan laptop. Oleh karena itu, peneliti merancang metode pembelajaran yang menarik dan melibatkan siswa dalam penggunaan Smart TV yaitu metode pembelajaran inquiri dan permainan edukasi. Langkah-langkah penerapannya akan menolong guru-guru Matematika untuk memaksimalkan penggunaan Smart TV di kelas.

Abstract Background Previously, fragments from Sirtuin 1 (SIRT1) were identified in preclinical and clinical samples to display an increase in serum levels for N-terminal (NT) SIRT1 vs. C-terminal (CT) SIRT1, indicative of early signs of OA. Here we tested NT/CT SIRT1 levels as well as a novel formulated sandwich assay to simultaneously detect both domains of SIRT1 in a manner that may inform us about the levels of full-length SIRT1 in the circulation (flSIRT1) of clinical cohorts undergoing knee joint distraction (KJD). Methods We employed an indirect ELISA assay to test NT- and CT-SIRT1 levels and calculated their ratio. Further, to test flSIRT1 we utilized novel antibodies (Ab), which were validated for site specificity and used in a sandwich ELISA method, wherein the CT-reactive served as capture Ab, and its NT-reactive served as primary detection Ab. This method was employed in human serum samples derived from a two-year longitudinal study of KJD patients. Two-year clinical and structural outcomes were correlated with serum levels of flSIRT1 compared to baseline. Results Assessing the cohort, exhibited a significant increase of NT/CT SIRT1 serum levels with increased osteophytes and PIIANP/CTX-II at baseline, while a contradictory increase in NT/CT SIRT1 was associated with less denuded bone, post-KJD. On the other hand, flSIRT1 exhibited an upward trend in serum level, accompanied by reduced denuded bone for 2-year adjusted values. Moreover, 2 year-adjusted flSIRT1 levels displayed a steeper linear regression for cartilage and bone-related structural improvement than those observed for NT/CT SIRT1. Conclusions Our data support that increased flSIRT1 serum levels are a potential molecular endotype for cartilage-related structural improvement post-KJD, while NT/CT SIRT1 appears to correlate with osteophyte and PIIANP/CTX-II reduction at baseline, to potentially indicate baseline OA severity.

Abstract Concrete’s weak tensile strength renders it susceptible to cracking under prolonged loads, leading to reduced load-bearing capacity and reinforcing bar corrosion. This study investigates the effectiveness of microbial-based self-healing in high-strength concrete, focusing on two bacterial strains: Sporosarcina koreensis and Bacillus. Results demonstrate significant enhancements in micro- and macro-physical properties of high-strength bacterial concrete with Bacillus flexus and S. koreensis, surpassing the control. Bacillus flexus-infused concrete exhibits a remarkable 21.8% increase in compressive strength at 7 days and 11.7% at 56 days. Similarly, S. koreensis-treated concrete shows 12.2% and 7.4% increases at 7 and 56 days, respectively. Enhanced crack healing occurs due to calcite precipitation, confirmed by X-ray diffraction and scanning electron microscopy. Both bacterial strains achieve crack closure within 42 days, with widths of 259.7 µm and 288.7 µm, respectively. Moreover, bacterial concrete from these strains excels in durability against water, acid, and salt exposure, surpassing control concrete. These findings emphasize microbial-based self-healing’s potential in high-strength concrete, providing a practical strategy to enhance structural resilience and extend concrete infrastructure lifespan.

Introduction: While ascariasis is typically asymptomatic or presents with mild gastrointestinal symptoms, it can lead to severe complications, such as intestinal obstruction and volvulus, particularly in children with a high worm burden. Case presentation: A 9-year-old girl presented to the pediatric emergency department with four days of central abdominal pain, repeated bilious vomiting containing worms, increasing abdominal distension, constipation, and a low-grade fever. She was taken to the operating room for an exploratory laparotomy for suspected bowel obstruction. Intraoperatively, 300 mL of pus was found in the peritoneal cavity, along with a 360-degree gangrenous volvulus of small bowel involving most of the small bowel, from 80 cm distal to the ligament of Treitz to 20 cm proximal to the ileocecal valve. Adhesions and fibrin deposits were noted throughout the peritoneum. The purulent fluid was suctioned out, and the ischemic bowel was completely resected. A large burden of Ascaris worms was found in the lumen of the bowel and was completely removed. We did a jejunostomy and an ileal mucous fistula. Postoperatively, the patient received intravenous ceftriaxone, metronidazole, potassium supplements, and maintenance fluids. Due to the high output of the jejunostomy, we decided to take down the jejunostomy shortly after the initial operation. The ostomy closure was complicated by an anastomotic leak. We explored her and found a pin hole on the antimesenteric side of the anastomosis. We repaired the leak primarily, but the patient developed a recurrence of the leak shortly thereafter, at which time we decided tore-create the jejunostomy and the mucous fistula. Before we could provide further care, her parents decided to leave the hospital against medical advice. We eventually contacted the parents and learned that she died at another institution 10 days after leaving our hospital. The cause of her death was not disclosed. Conclusion: Even though intestinal infestations are generally mildly symptomatic, Ascariasis and other parasitic infestations should be included in the differential diagnosis of children who live in endemic areas and develop acute abdominal conditions.

Teaching work has become increasingly complex due to the rapid changes that have marked societies in recent decades, especially due to globalization, advances in communication and the acceleration of knowledge and technology. These transformations have generated high demands on educational systems, which raises fundamental questions about what the teacher should be like and what their personal and professional characteristics are. The profile of the educator, as well as his or her competencies and functions, is a recurring theme in educational theory and practice, presenting both a theoretical and practical challenge.

Desa Wonualaku merupakan Desa baru yang memiliki wilayah cukup luas sehingga perumahan warga masih banyak yang memiliki lahan kosong yang tidak dimanfaatkan. Program pengabdian ini bertujuan untuk meningkatkan kesadaran dan keterampilan masyarakat dalam memanfaatkan lahan perumahan guna mendukung kesehatan mandiri melalui budidaya tanaman obat herbal. Permasalahan utama yang dihadapi oleh masyarakat adalah keterbatasan akses terhadap obat-obatan kimia, serta minimnya pengetahuan tentang manfaat dan cara budidaya tanaman obat herbal. Program ini melibatkan beberapa warga Desa. Metode pelaksanaan meliputi survey lahan, persiapan lahan, pembuatan pagar dan plakat nama tanaman, serta penanaman. Selain itu, peserta diajarkan teknik perawatan dan pemanfaatan hasil panen sebagai obat alami untuk menjaga kesehatan keluarga. Hasil pengabdian menunjukkan bahwa pemanfaatan lahan perumahan untuk budidaya tanaman obat herbal efektif dalam meningkatkan kemandirian masyarakat dalam menjaga kesehatan. Program ini juga memberikan manfaat jangka panjang dengan mengoptimalkan lahan yang sebelumnya tidak produktif, sekaligus mengurangi ketergantungan terhadap obat-obatan kimia. Hasil ini mengindikasikan potensi besar dalam pengembangan kesehatan mandiri berbasis herbal di lingkungan perumahan

Key Clinical Message Abdominal cocoon syndrome is a rare cause of bowel obstruction, with variable presentation. It needs a high index of suspicion for diagnosis. Surgical management with the release of adhesions is the preferred option for a healthy bowel. Iatrogenic bowel perforation is a possibility during bowel manipulation and the release of thick fibrous adhesions resulting in bowel resection. Abstract Abdominal cocoon syndrome, also known as encapsulating peritoneal sclerosis, is a rare cause of intestinal obstruction in which the small intestine may be entirely or partially wrapped in a thick sac of fibrous tissue that resembles a cocoon. We present a male Ethiopian patient, 60 years of age, who had a 6‐day history of symptoms of intermittent intestinal obstruction. Before his current presentation, he had a 6‐month history of sporadic vomiting and periodic abdominal pain. These symptoms would go away on their own. An exploratory laparotomy was performed for the preoperative diagnosis of small intestine obstruction secondary to primary small bowel volvulus after a plain abdomen x‐ray confirmed the small bowel obstruction diagnosis. But during surgery, we discovered something unexpected: a mass formed by the encasing membrane over the small bowel. En bloc resection of the mass and distal ileum with ileo‐transverse anastomosis was performed. The patient was discharged after 5 days of an uneventful post‐operative stay. The morbidity and mortality of this rare instance can be decreased by awareness, prompt diagnosis, and appropriate intervention. We discuss diagnostic and therapeutic challenges encountered during the management of this patient.

Abstract A straightforward analytical approach is proposed for the design of minimally thin metal absorbers. Unlike traditional resonant design principles, where shape, size, and periodicity of a nanostructured film determine the absorption properties, this study uses only the thickness and permittivity (i.e., sheet conductivity) of the material at hand to demonstrate maximal absorption in the minimal possible thickness at any given wavelength in planar layers – guided by only the derived material‐agnostic equations. An alternative mechanism is further proposed and experimentally demonstrated to obtain precise control over the sheet conductivity of metal films necessary for such designs using metal dilution, enabling the tuning of both the amplitude and the phase of reflected waves. Finally, the concept of “phase doping” is proposed and experimentally demonstrated, wherein an ultrathin metal layer is placed within the spacer of the absorber cavity, which spectrally tunes the absorption feature without changing the spacer thickness or participating in the absorption. By judiciously combining the dilution of the absorbing and phase layers, a multifunctional ultrathin absorber architecture is demonstrated with customizable amplitude, spectral position, and selectivity, all leveraging the same vertical stack. These findings are promising for the design of ultrasensitive detectors, thermal emitters, and nonlinear optical components.

A previously healthy man presented in shock due to incessant tachycardia. He ultimately required extracorporeal membrane oxygenation for support and clipping of his appendage for arrhythmia control. This case highlights the importance of early recognition of cardiogenic shock, aggressive hemodynamic support, and a multidisciplinary approach to managing these challenging arrhythmias.

Abstract Introduction Physicians frequently use point-of-care ultrasound for intravenous access and bloodwork in the ED. Recently, AIUM and ACEP released recommendations on ultrasound-guided peripheral intravenous lines (USPIVs), but there are no agreed upon standardized policies. We sought to determine whether the use of sterile-covered transducers (SCT) decreases the rate of contamination when compared to uncovered transducers (UCT) after standard low-level disinfection (LLD). Methods This is a randomized control trial comparing contamination rates of US transducers between SCT and UCT after their use for USPIV by the vascular access team, also known as the “PICC” team, over a 3-month period. A sample of admitted patient with an USPIV order were included and randomized to SCT (experimental) or UCT (control) arms. Transducers were swabbed and inserted into the SystemSURE Plus Adenosine Triphosphate (ATP) Luminometer to calculate Relative Light Units (RLU). We performed a cost analysis of requiring sterile covers for USPIVs. Results The UCT and SCT arms contained 35 and 38 patients, respectively. The SCT group had a mean of 0.34 compared to the UCT group mean of 2.29. Each sterile cover costs $8.49, and over 3000 USPIVs are placed annually by the “PICC” team. Conclusion Contamination rates were similar among the UCT and SCT groups after LLD. 254 inpatient USPIVs are performed monthly, not including failed attempts or covers used in the ED where USPIV placement is an essential part of ED workflow. This study suggests that the use of SCT does not significantly affect transducer contamination rates. These findings question burdensome regulatory hospital policies that are not evidence-based.

Purpose – This research proposed a theoretical framework based on social impact, and community attributes theories to identify factors that influence the formation of trust among tourists towards Social Commerce (SC) utilized by a tourist village in Indonesia, particularly in the aftermath of COVID-19. In detail, this study focused on tourist village marketing through SC which emphasizes trust formation on destination readiness to welcome visitors, leading to the intention to revisit the village in the aftermath of the COVID-19 pandemic. Methodology/Design/Approach – 258 responses were obtained from Indonesian SC users interested in visiting tourist villages in Indonesia to evaluate the proposed model. The collected data were processed using confirmatory factor analysis followed by the Structural Equation Modeling (SEM) technique to analyze the direct, indirect and moderating effects of trust predictors. Findings – The results showed that endorsement by other members had the most significant positive effect on trust, followed by Quality-assured shared information and Online Bridging. In contrast to the proposed hypothesis, responsiveness had a negative impact. Although parasocial interaction and followers’ comments were rejected, the indirect effect suggests that both factors influence trust through quality-assured shared information as a mediator. Overall, the result suggests that the quality of interaction and information in SC can reduce users’ concern about the consequences of COVID-19 in a destination and thus increase users’ trust in the willingness of places to host tourists. Originality of the research – This study provides a comprehensive approach that incorporates social and community aspects that influence tourists’ trust in Social Commerce marketing of tourist destinations after the COVID-19 pandemic. As this approach has not been studied in depth before, this study contributes to filling this gap, followed by a comprehensive analysis that includes direct, indirect and moderating effects

Shiikuwasha, a citrus fruit native to Okinawa, Japan, has various cultivation lines with distinct free volatile and non-volatile components. However, the glycosylated volatiles, which are sources of hidden aromas, remain unknown. This study aimed to characterize the chemical profiles of free and glycosidically bound volatile as well as non-volatile components in the mature fruits of six Shiikuwasha cultivation lines: Ishikunibu, Izumi kugani-like, Kaachi, Kohama, Nakamoto seedless, and Ogimi kugani. Free volatiles were analyzed using solid-phase microextraction–gas chromatography–mass spectrometry. Glycosides were collected via solid-phase extraction and hydrolyzed with β-glucosidase, and the released volatiles were measured. Additionally, the non-volatile components were determined using non-targeted proton nuclear magnetic resonance analysis. Total free and bound volatiles ranged from 457 to 8401 µg/L and from 104 to 548 µg/L, respectively, and the predominant free volatiles found were limonene, γ-terpinene, and p-cymene. Twenty volatiles were released from glycosides, including predominant 1-hexanol and benzyl alcohol, with Kaachi and Ogimi kugani showing higher concentrations. Principal component analysis (PCA) revealed that taste-related compounds like sucrose, citrate, and malate influenced line differentiation. The PCA of the combined data of free and bound volatile and non-volatile components showed flavor component variances across all lines. These findings provide valuable insights into the chemical profiles of Shiikuwasha fruits for fresh consumption and food and beverage processing.

المخلص: أهداف البحث: هدفت الدراسة إلى تقييم فعالية مغلي أوراق الشجرة المعروفة بالمورينجا في إزالة الطبقة السميكة مقارنة بمادتين أخريين وكذلك الأنشطة المضادة للميكروبات. طرق البحث: تم استخراج أوراق الشجرة باستخدام مغلي الماء الساخن بتركيزين مختلفين. تم تحضير ما مجموعه ثلاثين سنا بشريا مستخرجا ذو جذر واحد لتقييم فعالية إزالة الطبقة السميكة. تم حساب وجود الطبقة السميكة في الثلث الأوسط من قناة الجذر باستخدام الميكروسكوب الليزري الماسح الضوئي الحويصلي. ثم تم إجراء النشاط المضاد للبكتيريا على نوعين من البكتيريا باستخدام طريقة تشتت الأغار. النتائج: وجدنا أن التراكيز 2,5% و 5% من المغلي أكثر فعالية بشكل ملحوظ في إزالة الطبقة السميكة، ومع ذلك، لم يتم ملاحظة فرق ملحوظ عند المقارنة مع المادتين الأخريين. أظهرت نتائج اختبار المضادات الحيوية المختبرية أن خمسة بالمائة من المغلي يظهر نشاطا مضادا للميكروبات أعلى ضد كلا المسارين التجريبيين. الاستنتاجات: تشير هذه النتائج إلى أن مغلي أوراق الشجرة يمكن اعتباره محلولا فعالا في علاج الجذور. Abstract: Objective: This study evaluated the effectiveness of moringa (Moringa oleifera) leaves decoction for removing a smear layer compared to sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as its antimicrobial activities. Methods: The moringa leaves were extracted using hot water decoction at two different concentrations (2.5% and 5.0% w/v). A total of 30 extracted human single-rooted teeth were prepared to assess the smear layer removal efficacy. The presence of a smear layer in the middle third of the root canal was detected by confocal microscopy. Then the antibacterial effects were assessed against Enterococcus faecalis and Streptococcus mutans bacteria using the agar diffusion method. Results: The 2.5% and 5.0% decoction were significantly more effective than 0.25% NaOCl in removing the smear layer (p 0.05). The in vitro antimicrobial assay showed that 5.0% decoction had higher antimicrobial activity against both of the test pathogens. Conclusion: The findings of this study suggest that moringa leaves decoction can be considered an effective irrigant in endodontics.

Pendidikan dan pertumbuhan spiritual sering melibatkan fase yang penuh pencarian dan pergumulan yang dapat mengganggu kesejahteraan seseorang. Namun, jika fase pergumulan pencarian ini memang menjadi bagian yang wajar dari perjalanan spiritual, maka diperlukan strategi untuk mengelolanya. Artikel ini meneliti hubungan antara fase psikologis pencarian (Quest) dan kesejahteraan (Flourishing), serta kontribusi dari dimensi Managing Identity dari konsep Diferensiasi Diri. Data diambil dari 303 mahasiswa seminari dari 28 sekolah tinggi teologi di Indonesia. Analisis regresi bertingkat menemukan bahwa Quest memang memprediksi secara negatif kesejahteraan mahasiswa seminari (β=-.13, p

Konflik orang tua-anak merupakan fenomena normatif dari tahapan perkembangan yang harus dilalui, tetapi di saat yang bersamaan dapat menimbulkan luka yang dalam bagi emerging adult sehingga resolusi konflik yang adaptif menjadi hal yang penting. Beberapa penelitian sebelumnya menunjukkan peranan diferensiasi diri dalam pemaafan, hanya saja masih sangat minim di Indonesia dan lebih banyak berfokus pada hubungan romantis sehingga membuat penelitian ini bertujuan untuk melihat peran masing-masing dimensi diferensiasi diri terhadap pemaafan pada emerging adult dalam konflik orang tua-anak. Penelitian ini dilakukan terhadap emerging adult dengan menggunakan alat ukur Differentiation of Self Inventory-Short Form (DSI-SF) yang mengukur tiga dimensi, yaitu emotional distancing, relational sensitivity, dan maintaining identity, serta The Decisional Forgiveness Scale (DFS) dan The Emotional Forgiveness Scale (EFS). Analisis regresi berganda terhadap 235 partisipan (MUsia=21,13; SD=2,19) yang diperoleh melalui teknik convenience sampling menunjukkan bahwa dimensi emotional distancing memiliki peran yang signifikan terhadap pemaafan, baik bagi decisional forgiveness (R2=0,06) maupun emotional forgiveness (R2=0,15), tetapi tidak signifikan pada kedua dimensi lainnya. Selain itu, emotional distancing ditemukan memiliki kontribusi yang lebih besar terhadap emotional forgiveness (β=-0,34, p

Summary: Biochar obtained via microwave-assisted pyrolysis (MAP) at 720 W and 15 min from cocoa pod husk (CPH) is an efficient adsorbent of Cd2+(aq). Biochar of residual biomass of CPH (BCCPH) possesses favorable physicochemical and morphological properties, featuring a modest surface area yet a suitable porous structure. Adsorption, predominantly governed by physisorption, is influenced by the oxygen-containing active sites (-COOR, -C(R)O, and -CH2OR; R = H, alkyl). CdCO3 formation occurs during adsorption. Experimental data were well-fitted into various kinetic models for a broad understanding of the sorption process. Langmuir model indicates a maximum adsorption capacity of 14.694 mg/g. The thermodynamic study confirms the spontaneous and endothermic sorption. Studies at the molecular level have revealed that the Cd2+ ion tends to bind to surface aromatic carbon atoms. This sustainable approach produces BCCPH via MAP as a solution for waste transformation into water-cleaning materials.

Prayer holds a profound significance in a believer’s life, with Lord Jesus teaching specific teachings to his disciples on the subject. It serves as a communication tool bridging the connection between God and humanity, constituting a dialogue rather than solely a platform for pleas or requests. This research delved into the specific text of prayer, focusing on Matthew 6:9–13, commonly known as ‘The Lord’s Prayer’. While many Christians interpret it as a ‘prayer of supplication’, the study questioned whether it truly falls into that category and explored potential contradictions. Utilising a qualitative approach with a pure exegesis study, the author employed hermeneutics based on John D. Grassmick’s steps of exegesis analysis. The examination was centred on the Byzantine Greek Bible text in the Gospel of Matthew 6:14–15. The aim was to grasp the essence of the message within the studied texts, emphasising Lord Jesus’ teachings. Results highlighted the significance of understanding the Lord’s Prayer as taught by Jesus in Matthew 6:9–13. The author emphasised the importance for Christians in Indonesia to comprehend the meaning of this prayer. Contribution: This reconstruction of Matthew’s understanding of the Lord’s Prayer using the Byzantine text anticipated contributions to HTS Theological Studies. The Our Father’s Prayer, a blessing to churches and Christians for over 2000 years, was explored for its proper grammatical translation and the profound contents taught by Jesus. This study aimed to assist Christians in understanding and applying the prayer in their lives, aligning with the true faith and fostering spiritual growth as intended by Lord Jesus.

The KKL inequality and Rademacher type 2, Discrete Analysis 2024:2, 14 pp. The parallelepiped identity in a Euclidean space is the identity $$\|x+y\|^2+\|x-y\|^2=2(\|x\|^2+\|y\|^2),$$ which can easily be checked directly, and which generalizes to the statement $$2^{-n}\sum_\epsilon\|\sum_{i=1}^n\epsilon_ix_i\|^2=\sum_{i=1}^n\|x_i\|^2,$$ where the first sum is over all $\epsilon\in\{-1,1\}^n$. That is, the average square norm of a random $\pm 1$ combination of $n$ vectors is the sum of the square norms of the vectors themselves. (This is trivial if the vectors are orthogonal to each other, but becomes interesting for a general set of vectors.) It is natural to wonder what can be said about such averages in more general Banach spaces. One does not expect the identity to hold -- in fact, it can be shown quite easily to characterize Hilbert spaces -- but it turns out that for many interesting Banach spaces one can at least prove an inequality in one direction or the other, up to a constant. For example, if $1\leq p\leq 2$ and $x_1,\dots,x_n$ belong to $L_p$, then we have the inequality $$2^{-n}\sum_\epsilon\|\sum_{i=1}^n\epsilon_ix_i\|^2\geq c_p\sum_{i=1}^n\|x_i\|^2.$$ Note that we certainly do not have the reverse inequality here, since if $x_1,\dots,x_n$ are disjointly supported functions of norm 1, then the left-hand side is equal to $n^{2/p}$ and the right-hand side (ignoring the constant $c_p$) is equal to $n$. This turns out to be the extremal example, from which one can show that we do at least have the inequality $$2^{-n}\sum_\epsilon\|\sum_{i=1}^n\epsilon_ix_i\|^p\leq c_p\sum_{i=1}^n\|x_i\|^p.$$ If $2\leq p2$ or of cotype $p$ if $p

BackgroundLarge language models (LLMs) hold potential for mental health applications. However, their opaque alignment processes may embed biases that shape problematic perspectives. Evaluating the values embedded within LLMs that guide their decision-making have ethical importance. Schwartz’s theory of basic values (STBV) provides a framework for quantifying cultural value orientations and has shown utility for examining values in mental health contexts, including cultural, diagnostic, and therapist-client dynamics. ObjectiveThis study aimed to (1) evaluate whether the STBV can measure value-like constructs within leading LLMs and (2) determine whether LLMs exhibit distinct value-like patterns from humans and each other. MethodsIn total, 4 LLMs (Bard, Claude 2, Generative Pretrained Transformer [GPT]-3.5, GPT-4) were anthropomorphized and instructed to complete the Portrait Values Questionnaire—Revised (PVQ-RR) to assess value-like constructs. Their responses over 10 trials were analyzed for reliability and validity. To benchmark the LLMs’ value profiles, their results were compared to published data from a diverse sample of 53,472 individuals across 49 nations who had completed the PVQ-RR. This allowed us to assess whether the LLMs diverged from established human value patterns across cultural groups. Value profiles were also compared between models via statistical tests. ResultsThe PVQ-RR showed good reliability and validity for quantifying value-like infrastructure within the LLMs. However, substantial divergence emerged between the LLMs’ value profiles and population data. The models lacked consensus and exhibited distinct motivational biases, reflecting opaque alignment processes. For example, all models prioritized universalism and self-direction, while de-emphasizing achievement, power, and security relative to humans. Successful discriminant analysis differentiated the 4 LLMs’ distinct value profiles. Further examination found the biased value profiles strongly predicted the LLMs’ responses when presented with mental health dilemmas requiring choosing between opposing values. This provided further validation for the models embedding distinct motivational value-like constructs that shape their decision-making. ConclusionsThis study leveraged the STBV to map the motivational value-like infrastructure underpinning leading LLMs. Although the study demonstrated the STBV can effectively characterize value-like infrastructure within LLMs, substantial divergence from human values raises ethical concerns about aligning these models with mental health applications. The biases toward certain cultural value sets pose risks if integrated without proper safeguards. For example, prioritizing universalism could promote unconditional acceptance even when clinically unwise. Furthermore, the differences between the LLMs underscore the need to standardize alignment processes to capture true cultural diversity. Thus, any responsible integration of LLMs into mental health care must account for their embedded biases and motivation mismatches to ensure equitable delivery across diverse populations. Achieving this will require transparency and refinement of alignment techniques to instill comprehensive human values.

Introducción. El autocuidado se refiere a las actividades y prácticas realizadas e iniciadas por un individuo para mantener la vida, la salud y el bienestar, pero su mantenimiento requiere de conocimientos adecuados por parte de los pacientes. Objetivo. Determinar la relación entre los conocimientos y el autocuidado para un envejecimiento con bienestar en adultos mayores de un hospital público de Lima, 2022. Materiales y métodos. Estudio observacional, analítico y transversal. La muestra estuvo conformada por 176 pacientes geriátricos del consultorio de geriatría del hospital Sergio E. Bernales. Se emplearon cuestionarios para medir las variables. En el análisis bivariado se emplearon las pruebas de Chi-cuadrado y la regresión de Poisson para calcular la razón de prevalencia (RP) con una significancia estadística de 0,05. Resultados. Un mayor porcentaje se centra en los adultos mayores que no conocen (52,84%) y tienen prácticas inadecuadas de autocuidado para un envejecimiento con bienestar (52,27%), asimismo, los que tienen educación primaria (58,52%), cuentan con seguro integral de salud (90,34%), no trabajan (95,45), viven sin hijos (54,55%) y tienen antecedentes familiares (71,02%). En el análisis bivariado, los conocimientos se relacionan con las prácticas de autocuidado (PR: 1,49, IC 95%: 1,09-2,05 p valor=0,013). Conclusión. Más de la mitad de todos los pacientes no conocen y practican adecuadamente el autocuidado para un envejecimiento con bienestar. Asimismo, los conocimientos se relacionaron estadísticamente con el autocuidado. Se recomienda considerar estos hallazgos y el perfil sociodemográfico y clínico de los participantes para crear estrategias integrales de salud que consideren sus particularidades y necesidades.

Abstract Background The aim of this trial-based economic evaluation was to assess the incremental costs and cost-effectiveness of the modified diagnostic strategy combining the YEARS rule and age-adjusted D-dimer threshold compared with the control (which used the age-adjusted D-dimer threshold only) for the diagnosis of pulmonary embolism (PE) in the Emergency Department (ED). Methods Economic evaluation from a healthcare system perspective alongside a non-inferiority, crossover, and cluster-randomized trial conducted in 16 EDs in France and two in Spain with three months of follow-up. The primary endpoint was the additional cost of a patient without failure of the diagnostic strategy, defined as venous thromboembolism (VTE) diagnosis at 3months after exclusion of PE during the initial ED visit. Mean differences in 3-month failure and costs were estimated using separate generalized linear-regression mixed models, adjusted for strategy type, period, and the interaction between strategy and period as fixed effects and the hospital as a random effect. The incremental cost-effectiveness ratio (ICER) was obtained by dividing the incremental costs by the incremental frequency of VTE. Results Of the 1,414 included patients, 1,217 (86%) were analyzed in the per-protocol analysis (648 in the intervention group and 623 in the control group). At three months, there were no statistically significant differences in total costs (€-46; 95% CI: €-93 to €0.2), and the failure rate was non inferior in the intervention group (-0.64%, one-sided 97.5% CI: -∞ to 0.21%, non-inferiority margin 1.5%) between groups. The point estimate of the incremental cost-effectiveness ratio (ICER) indicating that each undetected VTE averted in the intervention group is associated with cost savings of €7,142 in comparison with the control group. There was a 93% probability that the intervention was dominant. Similar results were found in the as randomized population. Conclusions Given the observed cost decrease of borderline significance, and according to the 95% confidence ellipses, the intervention strategy has a potential to lead to cost savings as a result of a reduction in the use of chest imaging and of the number of undetected VTE averted. Policy-makers should investigate how these monetary benefits can be distributed across stakeholders. Clinicaltrials Trial registration number ClinicalTrials.gov Identifier: NCT04032769; July 25, 2019.

Abstract Understanding human disease on a molecular level, and translating this understanding into targeted diagnostics and therapies are central tenets of molecular medicine1. Realizing this doctrine requires an efficient adaptation of molecular discoveries into the clinic. We present an approach to facilitate this process by describing the Imageable Genome, the part of the human genome whose expression can be assessed via molecular imaging. Using a deep learning-based hybrid human-AI pipeline, we bridge individual genes and their relevance in human diseases with specific molecular imaging methods. Cross-referencing the Imageable Genome with RNA-seq data from over 60,000 individuals reveals diagnostic, prognostic and predictive imageable genes for a wide variety of major human diseases. Having both the critical size and focus to be altered in its expression during the development and progression of any human disease, the Imageable Genome will generate new imaging tools that improve the understanding, diagnosis and management of human diseases.

Citrus depressa Hayata is a citrus cultivar grown in Japan and Taiwan. To assess the differences in genetic characteristics and volatile organic components (VOCs) in the leaves and edible parts of the fruits of 23 C. depressa accessions from different geographic origins, the tissues were analyzed using cleaved amplified polymorphic sequence markers and gas chromatography-mass spectrometry. A phylogenetic cluster analysis demonstrated that Kagoshima accessions had a close genetic relationship with one another, with Okinawan “Izumi kugani-like” being the most distinct accession. The predominant volatiles in the leaves were γ-terpinene, p-cymene, limonene, and linalool. Multivariate analysis and volcano plots revealed distinct volatiles in the leaves of each cultivation region: piperitone and citronellal (Kagoshima); 5,9,9-trimethyl-spiro[3.5]non-5-en-1-one (Okinawa); and hexanal (Taiwan). Furthermore, the edible parts of Taiwanese fruits contained abundant amounts of monoterpenes, including linalool and 1,8-cineole. In contrast, Kagoshima and Okinawa accessions were rich in aldehydes and esters, respectively. In conclusion, the genetic and volatile profiles of 23 C. depressa accessions of different origins could be distinguished, and multivariate analysis suggested that C. depressa contains diverse VOCs depending on where it is cultivated. These findings demonstrate the exclusivity of C. depressa resources in each region, which could assist farmers and agro-industries in promoting food products derived from C. depressa fruits.

The objective of this study was to analyze the effectiveness of two intravitreal antiangiogenic drugs, ranibizumab and aflibercept, in a Mexican population over a period of 5 years, evaluating the improvement in visual acuity (VA) and central retinal thickness (CRT) in a real-world scenario. This is a retrospective study with subjects diagnosed with diabetic retinopathy (DR), proliferative diabetic retinopathy (PDR), and diabetic macular edema (DME) receiving intravitreal injections of ranibizumab and/or aflibercept. In this study, we analyzed 588 eyes of 294 patients who received intravitreal antiangiogenic injections. The results showed an improvement regardless of antiangiogenic treatment or diagnosis in both VA and CRT. We found that both aflibercept and ranibizumab improved VA, while subjects with DME responded less to antiangiogenic treatment (p < 0.05), and that this difference did not correspond to the CRT measured by OCT. These results support evidence that intravitreal antiangiogenic medications are effective for ophthalmic complications of diabetes in our population; however, damage to visual structures is not reversed in most patients. And that the perception by the patient (VA) and that of the ophthalmologist (CRT) do not completely correlate in our study.

Shiikuwasha (Citrus depressa Hayata) and calamansi (C. microcarpa Bunge) are distinct citrus species with a strong sour taste that grow naturally in Okinawa, Japan. The present study aimed to characterize the physicochemical traits, total carotenoid content, and taste/nutrient-related metabolite and volatile organic compound (VOC) profiles of the mature fruits from three shiikuwasha cultivation lines (“Izumi kugani”, “Izumi kugani-like”, and “Ogimi kugani”) and calamansi. The shiikuwasha lines had higher ratios of soluble solids/titratable acidity but a lower total carotenoid content than calamansi. There were positive statistical correlations between total carotenoids with red, yellow, and orange indices (a*, b*, and a*/b* color spaces, respectively). Principal component analysis (PCA) revealed that shiikuwasha had higher sucrose and choline contents, while calamansi was richer in sourness-related metabolites such as citrate and malate. PCA plots displayed differences in the VOCs between the two citrus cultivars, wherein volatile accumulation was much richer in juices prepared from the whole fruits than in juices from the edible flesh parts. The plots also showed that monoterpenes and sesquiterpenes differentiated the VOC profiles of shiikuwasha and calamansi. This study reveals differences in the flavor components of the two citrus cultivars and highlights the potential uses of each in local and regional agro-business.

Introducción. El objetivo del estudio fue describir las características sociodemográficas, tratamiento y complicaciones pre y posquirúrgicas de las fracturas supracondíleas del húmero distal en niños que requirieron manejo quirúrgico en un hospital de Santander, Colombia. Metodología. Se trata de un estudio observacional, descriptivo, de corte transversal con 58 pacientes que cumplieron los siguientes criterios de inclusión: edad entre 3 a 14 años, fracturas supracondíleas de manejo quirúrgico; como criterios de exclusión se tomó: antecedente de enfermedad ósea o neurológica previa y fracturas de más de 7 días de evolución. Para las variables continuas se usó medidas de tendencia central y dispersión, las categóricas en porcentajes y frecuencias absolutas. Resultados. La edad media de presentación fue de 6.2 años, el principal mecanismo de trauma fue caídas de altura con un 96.5%. El 65.5% provenía de zonas urbanas. El 13.8% se asoció con fracturas de antebrazo, y el 3.4% de epitróclea. La fijación se realizó en un 75% con técnica cruzada y un 17.2% se asoció con lesión iatrogénica del nervio ulnar. Discusión. En el estudio no se informaron lesiones vasculares; sin embargo, se documentó una alta prevalencia de lesión neurológica con la fijación medial, similar a lo descrito en la literatura (1.4%-17.7%); algunos autores describen técnicas que disminuyen estas lesiones hasta en un 0%. Conclusión. Las características sociodemográficas de nuestra población coinciden con la estadística publicada mundialmente; la principal complicación fue la lesión iatrogénica nervio ulnar, que se puede disminuir con un uso racional del pin medial y con el empleo de técnicas que busquen rechazar directamente el nervio. Introduction. The objective of this study was to describe sociodemographic characteristic, treatment, and pre- and post-surgical complications of supracondylar fractures of the distal humerus in children who required surgical management at a hospital in Santander, Colombia. Methodology. This was an observational, descriptive, and cross-sectional study involving 58 patients who met inclusion criteria: age between 3 and 14 years old, supracondylar fractures with surgical management; exclusion criteria include previous bone or neurological illness and fractures with more than 7 days of evolution. Central tendency and dispersion measures were used for continuous variables, and categorical variables in percentages and absolute frequencies. Results. The average age at presentation was 6.2 years old, the main mechanism of trauma was fall from height (96.5%). 65.5% came from urban zones. The 13.8 % were associated with forearm fractures, and 3.4% with epitrochlear fractures. Pinning was performed at 75% with crossed technique and 17.2% were associated with iatrogenic ulnar nerve injury. Discussion. Study didn’t inform vascular injuries. However, a high prevalence of neurological injury with medial pinning was documented, similar to that describe in the literature (1.4%-17.7%); some author described techniques that reduce these lesions by 0%. Conclusion. The sociodemographic characteristics of our population match with worldwide published statistics; the main complication was iatrogenic ulnar nerve injury, which can be reduced with the rational use of medial pin and with the application of techniques that seek to directly spare the nerve. Introdução. O objetivo do estudo foi descrever as características sociodemográficas, o tratamento e as complicações pré e pós-cirúrgicas das fraturas supracondilianas do úmero distal em crianças que precisaram de tratamento cirúrgico em um hospital de Santander, Colômbia. Metodologia. Trata-se de um estudo observacional, descritivo e transversal com 58 pacientes que atenderam aos seguintes critérios de inclusão: idade entre 3 e 14 anos, fraturas supracondilianas tratadas cirurgicamente. Os critérios de exclusão foram: histórico de doença óssea ou neurológica prévia e fraturas com duração superior a 7 dias de evolução. Para variáveis contínuas foram utilizadas medidas de tendência central e dispersão, as categóricas em percentuais e frequências absolutas. Resultados. A média de idade de apresentação foi de 6.2 anos, o principal mecanismo de trauma foi a queda de altura com 96.5%. 65.5% vieram de áreas urbanas. 13.8% estavam associados a fraturas de antebraço e 3.4% a epitróclea. A fixação foi realizada em 75% com técnica cruzada e 17.2% esteve associada à lesão iatrogênica do nervo ulnar. Discussão. Nenhuma lesão vascular foi relatada no estudo. No entanto, foi documentada alta prevalência de lesão neurológica com fixação medial, semelhante à descrita na literatura (1.4%-17.7%). Alguns autores descrevem técnicas que reduzem essas lesões em até 0%. Conclusão. As características sociodemográficas da nossa população coincidem com as estatísticas publicadas mundialmente. A principal complicação foi a lesão iatrogênica do nervo ulnar, que pode ser reduzida com o uso racional do pino medial e com o uso de técnicas que buscam rejeitar diretamente o nervo.

A central part of what is considered as politically hegemonic results from civilizatory and colonial projects outside Europe. In this context, the figure of the Jew has an ambivalent position. On the one hand, it is a central figure of the so-called Judeo-Christian civilization. On the other hand, Jews more often appear to be the victims of this project rather than its perpetrators, hence making the notion of Judeo-Christianity the fruit of antisemitism. This article will argue that Boyarin and Slabodsky present an interesting approach to this dilemma while exploring the way Jewish identity could serve as a counter hegemonic political position.

Abstract Background Medical imaging plays a vital role in the accurate diagnosis, treatment and outcome prediction of many diseases and injuries. However, in many African countries, deserving populations do not have access to the proper medical imaging specialists’ services. As a result, clinicians continue to struggle to provide medical imaging via consultation. However, little is known about conventional referral consultation practices and their challenges. This study, therefore, aimed to explore the practice and challenges of medical imaging service consultation among health professionals and patients in the context of the Ethiopian public healthcare delivery system. Methods Descriptive phenomenological study was employed to explore the practice of medical imaging service consultation among health professionals and patients in public hospitals of Amhara region from October 12, 2021 to December 29, 2021. Semi-structured interview guides were prepared separately for key-informant and in-depth interviews. A total of 21 participants (6 hospital managers, 4 medical directors, 4 department heads, 3 medical imaging coordinators and 4 patients) were selected using the maximum variation sampling technique. All interviews were audio-recorded, transcribed verbatim and subjected to inductive thematic analysis using Open Code 4.02 software. Results Six major themes emerged following the thematic analysis: (1) medical image service delivery practices; (2) medical imaging consultation modalities; (3) benefits and drawbacks of the consultation modalities; (4) challenges; (5) challenge mitigation strategies; and (6) future recommendations. Image films, compact disks, and telegram apps were the consultation modalities used by the referring clinicians to send the medical images to radiologists. Frequent failure of imaging machines, delayed equipment maintenance, inadequate infrastructure, shortage of budget, lack of radiologists, and low-quality of printed image films were among the challenges influencing the medical imaging consultation service. Conclusions This research explored onsite and referral imaging consultation practices. However, there are many challenges encountered by the referring clinicians and the radiologists during the consultation process. These challenges could potentially affect clinicians’ ability to provide timely diagnosis and treatment services which would ultimately affects patient health status and service delivery. Virtual consultation via teleradiology and enhancing clinicians’ competence through long-term and short-term trainings are recommended to improve the referral consultation practice.

Summary: Background: Although immunomodulators have established benefit against the new coronavirus disease (COVID-19) in general, it is uncertain whether such agents improve outcomes without increasing the risk of secondary infections in the specific subgroup of previously immunocompromised patients. We assessed the effect of immunomodulators on outcomes of immunocompromised patients hospitalized for COVID-19. Methods: The protocol was prospectively registered with PROSPERO (CRD42022335397). MEDLINE, Cochrane Central Register of Controlled Trials and references of relevant articles were searched up to 01-06-2022. Authors of potentially eligible randomized controlled trials were contacted to provide data on immunocompromised patients randomized to immunomodulators vs control (i.e., placebo or standard-of-care). Findings: Eleven randomized controlled trials involving 397 immunocompromised patients hospitalized for COVID-19 were included. Ten trials had low risk of bias. There was no difference between immunocompromised patients randomized to immunomodulators vs control regarding mortality [30/182 (16.5%) vs 41/215 (19.1%); RR 0.93, 95% CI 0.61–1.41; p = 0.74], secondary infections (RR 1.00, 95% CI 0.64–1.58; p = 0.99) and change in World Health Organization ordinal scale from baseline to day 15 (weighed mean difference 0.27, 95% CI -0.09–0.63; p = 0.15). In subgroup analyses including only patients with hematologic malignancy, only trials with low risk of bias, only trials administering IL-6 inhibitors, or only trials administering immunosuppressants, there was no difference between comparators regarding mortality. Interpretation: Immunomodulators, compared to control, were not associated with harmful or beneficial outcomes, including mortality, secondary infections, and change in ordinal scale, when administered to immunocompromised patients hospitalized for COVID-19. Funding: Hellenic Foundation for Research and Innovation.

Introducción: el adenocarcinoma es el cáncer de pulmón de mayor incidencia, con tendencia a metastizar de forma amplia, con frecuencia en las glándulas suprarrenales donde solo alcanzan la curación una minoría de pacientes. Objetivo: presentar el caso de un paciente con adenocarcinoma de pulmón con metástasis suprarrenal bilateral. Presentación del caso: paciente masculino de 75 años, fumador inveterado, con diagnóstico de adenocarcinoma de pulmón en el que se detectó, tras estudios imagenológico de seguimiento, metástasis suprarrenal bilateral, se le realizó suprarrenalectomía con un año de diferencia entre ellas, recibió tratamiento con quimioterapia y terapéutica de mantenimiento con doblete de inmunoterapia. Conclusiones: lo más relevante resulta el hecho de poseer una supervivencia mayor a tres años y con buen estado general. Sin embargo, el promedio de supervivencia a nivel mundial es de veintiséis meses y tras la implementación de la inmunoterapia en asociación de quimioterapia se han recogido cifras más elevadas.

Este artículo presenta un nuevo resultado de geometría euclidiana que involucra los baricentros de un triángulo y los triángulos formados modificando un vértice del triángulo anterior por su reflexión axial con respecto a una recta dada. Estos baricentros son colineales, y la recta que los contiene es perpendicular a la recta inicial sobre la cual se consideraron las reflexiones axiales. Adicionalmente, se suministra una generalización del teorema mencionado para cuadriláteros y se detallan las demostraciones formales de ambos resultados. Esto se presenta siguiendo los pasos para la construcción de conjeturas de Benítez Mojica y Santos-Trigo, utilizando ambientes de geometría dinámica que se puedan emplear en experiencias futuras en cursos de geometría euclidiana con ayuda de nuevas tecnologías.

Conclusions: The study highlights the positive user perception of a web-based teleradiology system’s user-friendliness and efficiency. Overcoming challenges and leveraging facilitators are crucial for optimizing teleradiology and improving service delivery and patient outcomes. A centralized consultation center with dedicated radiologists and technical personnel is recommended for maximizing efficiency.

BackgroundConsidering individual differences caused by personality differences is crucial for end users' technology acceptance. However, previous studies overlooked the influence of users' technology readiness on technology acceptance. This study, therefore, aimed to evaluate the influence of technology readiness on teleradiology acceptance in the Amhara Regional State Public Hospitals using a technology readiness acceptance model.MethodsAn institutional-based cross-sectional mixed study design was conducted in September 2021 among 547 health professionals working at sixteen public hospitals in the Amhara region of northwest Ethiopia. Eight key informants were interviewed to explore organizational-related factors. Face-to-face and Google Meet approaches were used to collect the data. We applied structural equation modeling to investigate the influence of technology readiness on health professionals' teleradiology acceptance using Analysis of Moment Structures Version 23 software.ResultsOf the total participants, 70.2% and 85.7% were ready and intended to use teleradiology, respectively. According to technology readiness measuring constructs, optimism and innovativeness positively influenced health professionals' technology acceptance. Perceived ease of use and perceived usefulness showed a statistically positive significant effect on health professionals' intention to use teleradiology. In addition, a statistically significant mediation effect was observed between technology readiness measuring constructs and behavioral intention to use. Furthermore, a shortage of budget, inadequate infrastructure, and users' lack of adequate skills were reported as critical organizational challenges.ConclusionsWe found a higher proportion of readiness and intention to use teleradiology among health professionals. Personality difference measuring constructs and organizational factors played considerable influence on teleradiology acceptance. Therefore, before the actual implementation of teleradiology, ensuring the system's user-friendliness, improving infrastructure, allocating an adequate budget, and availing of capacity-building opportunities are recommended.

Abstract Osimertinib sensitive and resistant NSCLC NCI-H1975 clones are used to model osimertinib acquired resistance in humanized and non-humanized mice and delineate potential resistance mechanisms. No new EGFR mutations or loss of the EGFR T790M mutation are found in resistant clones. Resistant tumors grown under continuous osimertinib pressure both in humanized and non-humanized mice show aggressive tumor regrowth which is significantly less sensitive to osimertinib as compared with parental tumors. 3-phosphoinositide-dependent kinase 1 (PDK1) is identified as a potential driver of osimertinib acquired resistance, and its selective inhibition by BX795 and CRISPR gene knock out, sensitizes resistant clones. In-vivo inhibition of PDK1 enhances the osimertinib sensitivity against osimertinib resistant xenograft and a patient derived xenograft (PDX) tumors. PDK1 knock-out dysregulates PI3K/Akt/mTOR signaling, promotes cell cycle arrest at the G1 phase. Yes-associated protein (YAP) and active-YAP are upregulated in resistant tumors, and PDK1 knock-out inhibits nuclear translocation of YAP. Higher expression of PDK1 and an association between PDK1 and YAP are found in patients with progressive disease following osimertinib treatment. PDK1 is a central upstream regulator of two critical drug resistance pathways: PI3K/AKT/mTOR and YAP.

Objetivo: Evaluar la asociación entre el conocimiento con la práctica y sus dimensiones sobre la prevención de cáncer de mama, en estudiantes del programa de estudios de Enfermería de la Universidad Católica Sedes Sapientiae, 2022. Materiales y métodos: Estudio transversal y correlacional con un total de 224 estudiantes de Enfermería. Se utilizaron cuestionarios autodirigidos para medir las variables. La prueba estadística fue la regresión logística binaria en base de Odds ratio crudo con Intervalo de confianza del 95 % y su valor de ≤ 0,05. Resultados: El conocimiento sobre la prevención del cáncer de mama (OR = 1,77 IC = 1,03 - 3,03 p = 0,038) se asoció con la práctica sobre la prevención del cáncer de mama. Además, el 57,59 % de los estudiantes conoce sobre la prevención del cáncer de mama y el 54,02 % presentó una práctica inadecuada. Conclusión: Los estudiantes que conocen las medidas preventivas del cáncer de mama lo practican. Además, un poco más de la mitad de los estudiantes conoce sobre el cáncer de mama, pero no lo practica adecuadamente. Se recomienda que en los programas de Enfermería se incorporen más cursos sobre salud pública o desalud comunitaria y que tanto mujeres como hombres practiquen medidas de detección temprana.

Abstract. The church’s mission in a fluid world requires new spaces of service. If the church is not responsive and critical of its reality, it is difficult for the church to be present to answer the needs of the people. One interesting reality is the existence of the diaspora. The extent to which the church's mission reaches the diaspora as a missional space is a challenge. This paper aimed to propose a form of diaspora missional fellowship membership in the ministry of the Toraja Church. The method used was a qualitative method with observation survey technique through two congregations in Tana Toraja and North Toraja and interviews with purposive sampling technique to some specifically determined people. Through this research, it was concluded that pilgrimage churches confront the church with a way of doing church based on the spirit of pilgrimage, which crosses the boundaries of geography, territory and church walls. Abstrak. Misi gereja di dunia yang cair membutuh ruang-ruang pelayanan baru. Jika gereja tidak responsif dan kritis terhadap realitasnya, sulit bagi gereja hadir menjawab kebutuhan umat. Salah satu realitas menarik adalah keberadaan diaspora. Sejauh mana misi gereja menjangkau diaspora sebagai ruang missional menjadi sebuah tantangan. Tulisan ini bertujuan untuk mengusulkan bentuk keanggotaan persekutuan misional diaspora dalam pelayanan Gereja Toraja. Metode yang digunakan adalah metode kualitatif dengan teknik survey observasi melalui dua jemaat di Tana Toraja dan Toraja Utara dan wawancara dengan teknik purposive sampling terhadap beberapa orang yang ditentukan secara khusus. Melalui penelitian ini disimpulkan bahwa gereja pilgirimasi memperhadapkan gereja pada cara bergereja yang dilandasi oleh semangat peziarahan, yang melewati batas geografi, teritorial dan tembok-tembok gereja.

Introducción: la hipertensión arterial fundamentalmente la sistólica aislada constituye el patrón predominante en el adulto mayor y es la causa más frecuente de consulta ambulatoria. Es evidente el incremento del índice de adultos mayores con hipertensión arterial en las últimas décadas, lo que representa una cavilación a nivel mundial. Objetivo: caracterizar a los adultos mayores hipertensos del Consultorio Médico Familiar 46 del Policlínico Samuel Fernández del municipio Matanzas en 2020. Métodos: se realizó un estudio observacional, descriptivo y de corte transversal durante el año 2020. El universo estuvo constituido por 152 adultos mayores hipertensos, el cual se estudió en su totalidad. Las variables analizadas fueron: edad, sexo, enfermedades asociadas a hipertensión arterial, factores de riesgos, color de la piel. Se utilizaron los estadígrafos descriptivos frecuencias absolutas y relativas. Resultados: se evidenció predominio de adultos mayores femeninos con 86 pacientes (56,57 %), el grupo etario entre los 60-70 años fue el más afectado lo que representa el 57,89 %, como comorbilidad más frecuente la cardiopatía isquémica con 89 pacientes (58,54 %), el 90,13 % de los encuestados presentaron un estilo de vida sedentario y el color de piel predominante fue el negro lo que representa un 35,52 %. Conclusiones: los resultados obtenidos en este estudio mostraron que en esta área de salud existe mayor predominio de adultos mayores femeninos y negros que superan los 61 años de edad, se evidenció como comorbilidad más frecuente la cardiopatía isquémica la cual puede estar asociada a otros factores de riesgo como el sedentarismo.