Health Sciences

This study aims to determine the effect of implementation of government accounting standards (SAP), use of information technology, the role of internal audit, finance administration, and conflict of interest on the quality of local government financial reports in the Government of North Sumatera. In addition, this study also examines whether the implementation of the government’s internal control system (SPIP) can be used as a moderating variable in this research model or not. The type of research conducted is causal-associative research. The location of this research was the OPD in the Government of North Sumatera. The method of data collection in this study was documentation and observation techniques using a questionnaire. The data analysis technique used in this research is the PLS (partial least squares) technique using the analysis tool SmartPLS version 3.0 software, which is run on computer media. The results obtained in this study indicate that the implementation of SAP, the...

Despite high rates of chronic pain among their patients, opioid agonist treatment (OAT) counselors report an absence of training to manage chronic pain. A multidisciplinary team developed a tailored training for counselors to screen and address chronic pain via a brief psychosocial intervention, and implemented it with 52 addiction counselors. Data on knowledge (9 true-false items) as well as attitudes, interest, and perceived ability (scored on 5-point Likert-type scales) were collected from counselors before (pre-test), after (post-test) training, and after 6 months (follow-up). Pre-test knowledge scores varied considerably. Compared to pre-test, mean counselor knowledge scores increased significantly post-training and at follow-up (p's.<05). The training was associated with increases in positive attitudes toward the role of counselors in managing chronic pain, interest in assessing chronic pain, and counselor ability to assess as well as suggest appropriate interventions f...

There is a pressing need for global health preventions to curb the escalating burden of non-communicable diseases (NCDs). Utilising multi-country study designs can improve our understanding of how socio-economic context shapes the aetiology of NCDs, and this has great potential to advance global health interventions. We examined the association between socio-economic status (SES) and NCD risk, and the potential confounding effects of smoking and alcohol intake in young adults (18–35-year-olds) from Kenya, South Africa (SA), and the United Kingdom (UK). Our study was a cross-sectional online survey that included 3000 respondents (n = 1000 per country, 50% women) conducted in April 2022. We utilised information on twelve NCDs to classify respondents as having “no condition”, “one condition”, and “multimorbidity” (having two or more conditions). A total household asset score was calculated and used as a proxy of SES, and subsequently categorised into quintiles (Q1–Q5; lowest-highest). ...

Purpose: To describe adolescents as a vulnerable population with unique healthcare needs, especially in relation to their sexual risk-taking behaviors; and to explicate the necessity of nurse practitioners advocating for youth-friendly services and policies to meet adolescents' sexual and reproductive healthcare needs. Data Sources: CINAHL, Medline, PsychInfo, and PsychArticle data bases were searched to identify theoretical and empirical literature regarding adolescence, vulnerability, sexual health outcomes, barriers to accessing reproductive health services, what it means to be youth friendly, and health advocacy to meet the health needs of adolescents. Conclusions: Adolescents' health needs may not be fully met in traditional healthcare settings. Lack of access to youth-friendly sexual and reproductive health services increases adolescents' risks for poor health outcomes including sexually-transmitted disease and unplanned pregnancy. Clinic, state, and national policies can create barriers for adolescents in obtaining sexual-health services. Implications for Practice: Nurse practitioners are philosophically and educationally prepared to be leaders in improving adolescent health outcomes. Nurse practitioners can directly provide youth-friendly care as well as advocate for youth-friendly practices within their health system. In addition, nurse practitioners are well-positioned to be leaders in advocating for state and national policies that improve adolescents' access to appropriate sexual and reproductive healthcare.

Gina Dahlem: developed the table and co-wrote the risk assessment tool section in the body of the article, as well as overall editing of the manuscript. Nicole Boucher: co-wrote the introduction and background section, as well as overall editing of the manuscript. Cindy Darling-Fisher: co-wrote the discussion and clinical implication section of the paper, as well as overall editing of the manuscript.

Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma. A review of current assessment tools used in assessing this population in health settings is needed to determine how screening for ACEs is being performed. Clinically efficient tools for screening and assessment of high-ACE youth in primary care settings are lacking.  Developing a process to assess ACEs, risk behaviors, and physical and mental health status that is efficient to use during a time limited clinical visit is an important step in providing holistic care to a challenging population. Primary care NPs are in the perfect positio...

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3•5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.

Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson&#...

BACKGROUND: Though smokers are known to have elevated blood carboxyhemoglobin (COHb), due to inhalation of carbon monoxide (CO) in cigarette smoke, limited data exist regarding COHb levels in nonsmokers exposed to secondhand smoke. METHODS: COHb was measured using a new noninvasive pulse CO-oximeter (Rad-57, Masimo, Irvine, California) in 38 subjects entering a bingo hall where smoking was allowed, then again as they exited 3 hours later. RESULTS: The mean ؎ SD baseline COHb for the entire group was 3.3 ؎ 1.8%, for the 23 nonsmokers it was 2.2 ؎ 0.7%, and for the 15 smokers it was 4.9 ؎ 1.9%. The nonsmokers' mean COHb was unchanged, at 2.2 ؎ 0.8%, whereas the smokers' mean COHb fell to 3.2 ؎ 1.9%. CONCLUSIONS: The nonsmokers were not significantly exposed to CO from secondhand smoke in the setting we tested. The smokers probably consumed fewer cigarettes while playing bingo than they did prior to arrival. The Rad-57 pulse CO-oximeter is easy to use in the ambulatory setting.

Though smokers are known to have elevated blood carboxyhemoglobin (COHb), due to inhalation of carbon monoxide (CO) in cigarette smoke, limited data exist regarding COHb levels in nonsmokers exposed to secondhand smoke. COHb was measured using a new noninvasive pulse CO-oximeter (Rad-57, Masimo, Irvine, California) in 38 subjects entering a bingo hall where smoking was allowed, then again as they exited 3 hours later. The mean +/- SD baseline COHb for the entire group was 3.3 +/- 1.8%, for the 23 nonsmokers it was 2.2 +/- 0.7%, and for the 15 smokers it was 4.9 +/- 1.9%. The nonsmokers' mean COHb was unchanged, at 2.2 +/- 0.8%, whereas the smokers' mean COHb fell to 3.2 +/- 1.9%. The nonsmokers were not significantly exposed to CO from secondhand smoke in the setting we tested. The smokers probably consumed fewer cigarettes while playing bingo than they did prior to arrival. The Rad-57 pulse CO-oximeter is easy to use in the ambulatory setting.

A lthough we have the same last name, the author of Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America and the present reviewer are not related. If I have bias, it can be attributed to my having read some of his previous works including Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (2002), one of his books and articles that have won national awards. At present, building on his previous research and further rigorous inquiry into virtually every aspect of the accelerating, particularly, American phenomenon of promoting psychiatric diagnoses and drugs, Robert Whitaker has documented the devastating but persistently denied long-term consequences of psychiatric drugs. Anatomy of an Epidemic is so well researched and written and its findings so evidently truthful that any reasonably intelligent reader might assume it would quickly be adopted in all mental health policy and practice. However, another kind of reality keeps getting in the way. Briefly stated, the other reality comprises moneyed interests synergistically compounded with our universal desire for quick fixes alleged to make us more comfortable in the short run. Thus influenced, even the most intelligent of our species may persistently deny this book's validity. The author, keenly aware of the business aspects of clinical drug testing and the lure of denial, chose to eschew assumptions about psychiatric drugs and to take the reader through his step-by-step investigatory process. In 1994, Robert Whitaker began his "long intellectual journey as a believer in the conventional wisdom . . . that psychiatric researchers were discovering the biological causes of mental illnesses (leading) to a new generation of psychiatric drugs that helped 'balance' brain chemistry . . . like 'insulin for diabetes.' " (p. xi). There was much history to investigate because the so-called modern era of psychiatry dates back to 1954 with the introduction of "antipsychotic" drugs such as Thorazine and the promise of preventing mental patients from becoming chronically ill. More than a half century later, the U.S. General Accounting Office concluded that 1 in every 16 young adults was seriously mentally ill, and we had outstripped all other nations with our plague of mental illness in newly minted adults. Whitaker's latest book takes the reader with him on his rigorous scientific discovery process, integrated with patient accounts illustrating particularly how they suffer the consequences of having believed in the pseudoscience of psychiatric drugs. It is a story told by a master science journalist integrating a wealth of carefully researched facts into a major discovery. Instead of producing medical miracles, fulfilling fervent promises to prevent, cure, or at least ameliorate "mental diseases," psychiatric drugs, their supposed increasingly strong scientific foundation disproven with each claim investigated, have done the opposite; in

Aos meus pais, Laura e Aníbal (in memoriam), grandes forças da natureza e modelos de coragem de quem aprendi que o objetivo da vida é uma vida de objetivo. À minha mulher, Paula, verdadeira origem da inspiração para enfrentar mais este desafio, pelo seu apoio incondiconal, incentivo, amizade e paciência demonstrada e total ajuda na superação dos obstáculos que ao longo da minha caminhada foram surgindo. À minha filha primogénita Shary Rafaela (in memoriam), sempre recordada com tristeza e saudade, porque partiu cedo demais, não permitindo sequer o apreciar do brilho do seu olhar e o encanto de um sorriso inocente. Ao meu filho Ricardo Jorge, a quem dedico um amor incondicional, sincero, que está bem diante do nosso abraço e que mesmo voltando-nos para outros abraços, o nosso valerá sempre a pena! À minha filha Maria Laura, realidade palpável ao fim de 37 duras semanas, onde tantas vezes obtive alento para continuar. Na sua existência vive o segredo da minha plena felicidade. Que o futuro lhe sorria! Aos meus irmãos e irmãs, que tanta falta me fizeram, nos momentos difíceis em que as vicissitudes da vida não permitiram que juntos sempre estivéssemos! Aos meus mestres e colegas, pelo encorajamento, apoio sempre prestado, entusiasmo que nos transmitiram, pelo muito que com eles aprendemos, dinamismo permanente, confiança em nós depositada e oportunidades V DEDICATÓRIAS profissionais que nos proporcionaram, verdadeiras forças motrizes de muito do que fizemos. À minha terra natal, Angola, berço da minha formação médica e atividade profissional, onde fortaleci a ideia de que para se ser um bom médico necessitamos de outras habilidades além do conhecimento científico, fazendo sentido a ideia de que a medicina, nos dias de hoje, apenas tem sentido se o seu entendimento e as suas atividades estiverem num contexto moral. VI

Objective: Chronic Kidney Disease (CKD) has become a major health problem as a result of complicated interrelationships with diabetes mellitus, hypertension and other associated diseases. Effective management of CKD depends on patient's adherence to their dialysis plan, medications, dietary and fluid restrictions. This study aimed at systematically reviewing the adherence of adult Chronic Kidney Disease (CKD) patients with regard to their dialysis, medication, dietary and fluid restriction. Methods: Key words were used for the search in various data bases: "adherence", "Chronic Kidney Disease", "dialysis", "medication", "dietary" and "fluid restriction". Online data bases namely Medline, PubMed, Ebsco Host, CINAHL, google scholar and grey literature were used to identify published research from 1993 -2016. Forty three (43) articles were identified regarding adherence of CKD patients to dialysis, medication, dietary and fluid restriction. Results: Medication non adherence ranged from 3 to 80% through self-report, structured interview and biological markers. Fluid non-adherence was 10-74%. Using self-report and biological markers, nonadherence to diet was 2-39% and 19-57% respectively. With regards to dialysis, skipping and shortening hemodialysis adherence ranged from 2.5% -19% and 20.3% -32.3 % respectively. Globally, adherence rates to CAPD are not well documented in literature. Non-adherence to dialysis, medication, dietary and fluid restriction is an area of concern internationally in CKD population. Furthermore, non-adherence rates are not well researched and documented in African literature. Therefore, Nephrology professionals in clinical practice are agents of improving adherence of CKD patients to ensure effective management of the disease.

Breast cancer is one of the leading causes of death in developing as well as in developed countries. It is the second most common cancer accounting for 12.4% of the cases in black women in Zimbabwe, the highest being cancer of the cervix (30.2%). Objective: To establish knowledge of breast cancer and screening practices among women in Bindura District. Materials and Methods: A descriptive cross-sectional research study was conducted. The study sample consisted of 232 consenting women who were selected from Chipadze and Chiwaridzo Council Clinics in Bindura District using simple random sampling method. Data were collected by face to face interviews using a questionnaire. Data were processed using Statistical Package Social Sciences (SSPS) software version 16, 2012 and analyzed descriptively. Results: Data revealed that 78.4% of the respondent had heard of breast cancer, 24.6% had an in-depth understanding of breast cancer, 97% could not correctly identify risk factors for breast cancer, 60.3% had never heard of breast self examination (BSE) and only 3% knew how often BSE is done. Only 0.9% of the respondents had gone for mammography. Breast cancer knowledge level was very low as only 4.7% of the respondents had moderate knowledge scores of 18 to 26. Conclusion: Breast cancer knowledge level was very low and screening practices were very poor. Therefore, health care providers need to intensify awareness on breast cancer through health education across all age groups including women in rural areas. The government should also make mammography screening available and accessible at most health care facilities for free if possible or subsidized price for the low income women.

A new biosensor is described for the detection of S-nitrosothiols (RSNOs) based on their decomposition by immobilized glutathione peroxidase (GPx), an enzyme containing selenocysteine residue that catalytically produces nitric oxide (NO) from RSNOs. The enzyme is entrapped at the distal tip of a planar amperometric NO sensor. The new biosensor shows good sensitivity, linearity, reversibility, and response times towards various RSNO species in PBS buffer, pH 7.4 . In most cases, the response time is less than 5 min, and the response is linear up to 6 mM of the tested RSNO species. The lowest detection limit is obtained for S-nitrosocysteine (CysNO), at approx. 0.2 mM. The biosensors sensitivity is not affected by the addition of EDTA as a chelating agent; an advantage over other potential catalytic enzymes that contain copper ion centers, such as CuZn-superoxide dismutase and xanthine oxidase. However, lifetime of the new sensor is limited, with sensitivity decrease of 50% after two days of use. Nonetheless, the new amperometric GPx based RSNO sensor could prove useful for detecting relative RSNO levels in biological samples, including whole blood.

We report here on the electrochemical reduction of S-nitrosothiol species (RSNO). Nitric oxide (NO) is the reported common product from electrochemically reduced RSNOs at physiological pH. However, studies here at pH 7.4 show that during the reduction of RSNOs (-0.6 V to -0.9 V, vs. Ag/AgCl), no significant amount of NO is detected. Gas analysis suggests RSNO are reduced to nitrous oxide (N 2 O) at pH 7.4 and can only be converted back to NO at more oxidizing voltages. Interestingly, at pH 4.0, a direct one-electron reduction of RSNOs appears to occur and generates significant amounts of NO from RSNO species.

Kurangnya petugas puskesmas yang berlatar belakang promosi kesehatan, sehingga ditunjuklah petugas dengan latar belakang pendidikan berbeda untuk menjadi petugas penyuluh kesehatan dengan pertimbangan mereka mengikuti pelatihan sebagai penyuluh kesehatan. Tujuan : Penelitian ini bertujuan untuk mengelaborasi Kompetensi Penyuluhan Petugas Promosi Kesehatan di Wilayah Kabupaten Sidenreng Rappang. Metode : Penelitian ini menggunakan penelitian kualitatif dengan pendekatan studi kasus. Informan penelitian sebanyak 10 orang. Teknik pengumpulan data menggunakan indepth interview, telaah dokumen dan observasi. Hasil : (1) Kemampuan menganalisis sasaran dan menentukan prioritas petugas promosi kesehatan masih terbatas. (2) Kemampuan menentukan identitas penyuluhan petugas promosi kesehatan bervariasi (3) Kemampuan implementasi penyuluhan petugas promosi kesehatan sudah baik. (4) Kemampuan menentukan metode penyuluhan petugas promosi kesehatan sudah baik (5) Kemampuan evaluasi penyuluhan petugas promosi masih terbatas pada melihat umpan balik atau bertanya langsung kesasaran untuk mengevaluasi kegiatan penyuluhan Kesimpulan : Kesimpulan kemampuan menganalisis sasaran atau menentukan perioritas, menentukan identitas dan evaluasi kegiatan penyuluhan petugas promkes masih harus ditingkatkan. Sedangkan kemampuan media /alat bantu penyuluhan dan metode penyuluhan sudah baik.

Analisa os aspectos histopatologicos da polpa em dentes humanos portadores de doenca periodontal envolvendo o apice radicular. Foram selecionados 22 pacientes, cuja idade variou entre 22 e 62 anos, sendo obtidos 30 dentes unirradiculares, isentos de carie, abrasao, atricao, erosao e/ou restauracao, cujo exame radiografico mostrava destruicao de todo o osso de suporte ate o apice radicular. A avaliacao periodontal foi realizada medindo-se a profundida e clinica de sondagem, e a distância da juncao esmalte-cemento ate a margem gengival, nas faces vestibular, lingual/palatina, mesial e distal de cada dente. Estes dados nos permitiram avaliar a perda de insercao que cada dente havia sofrido. Os valores obtidos para perda de insercao quando comparados com o comprimento medio das raizes de cada dente, confirmaram que a destruicao dos tecidos de suporte ultrapassava o apice radicular. A avaliacao periodontal foi realizada medindo-se a profundidae clinica de sondagem, e a distância da junca...

Ayurveda is the ancient Indian system of medicine and yoga is the ancient Indian style of living. Ayurveda, the ancient Indian system of medicine, emphasizes the role of individual constitution (deha prakriti) in health. Modern Ayurgenomics integrates Ayurvedic principles with genomic analysis, aiming to personalize yogic interventions for cancer patients.

Aim:
The current study aims to explore the intersection of Ayurgenomics, deha prakriti, and yoga therapy in the context of cancer oncology.

Method:
The study included 60 chemotherapy patients admitted to the oncology department, with no exclusion based on cancer type, stage, or demographics. Using AyuSoft, an application developed by the Centre for Development of Advanced Computing, each patient’s deha prakriti was assessed. Based on their anatomical, physiological, and psychological traits, AyuSoft divides patients into 10 combinations of vata, pitta, or kapha on the basis of the dominance of Prakriti. The data were systematically recorded and analyzed to observe any correlation between Prakriti type and chemotherapy response.

Result:
Our observational findings revealed that vata-dominant patients required more immediate intervention due to rapid tumor growth, while pitta-dominant patients were more susceptible to chemotherapy side effects. Patients who were dominant in the kapha prakriti showed less immediate concern due to slower tumor growth. Furthermore, the loss of vitality during chemotherapy can be better managed through appropriate yogic interventions and dietary adjustments when the patient’s Prakriti is identified.

Conclusion:
The study highlights the growing relevance of integrating traditional Eastern wisdom, such as Ayurveda, with Western scientific approaches in the rapidly evolving field of individualized medicine. It emphasizes the potential of combining Ayurveda with genetic technology for individualized cancer therapy. Ayurgenomics could pave the way for more targeted yogic interventions, aligning an individual’s genetic and constitutional profiles to enhance therapeutic outcomes in oncology.

Background Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Between 1990 and 2019, the HAQ Index increased overall (by 19•6 points, 95% uncertainty interval 17•9-21•3), as well as among the young (22•5, 19•9-24•7), working (17•2, 15•2-19•1), and post-working (15•1, 13•2-17•0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30•7 (28•6-33•0) on average in low-SDI countries to 83•4 (82•4-84•3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40•4-89•0), working (33•8-82•8), and post-working (30•4-79•1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding Bill & Melinda Gates Foundation.

Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the ...

Background Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162-593 145) among children younger than 5 years globally in 2017, a rate of 78•4 deaths (70•1-87•1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69•6% (63•1-74•6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13•3% decrease, 11•2-15•5), childhood wasting (9•9% decrease, 9•6-10•2), and low use of oral rehydration solution (6•9% decrease, 4•8-8•4). Interpretation Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors-particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution-appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Funding Bill & Melinda Gates Foundation.

Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1-4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980-2015. We also estimated numbers and r...

toxicity ≥G2 was observed in 111 (42.7%) pts, 65 (25%) pts presented with infections and 44 (17%) pts with febrile neutropenia. Bleomycin lung-toxicity (BLT) was documented in 25 (18%) pts: 6 (4 %) pts had mild toxicity (radiologic changes only), 12 (9%) pts had severe toxicity (leading to hospitalization), in 7 (5%) pts severity was unknown. In 58 (24%) pts treatment was discontinued prematurely due to toxicity. 171 (68.7%) pts achieved complete remission, 30 (12%) partial response. 58 (23%) pts relapsed/progressed after first line treatment. 25 (23%) pts died of HL and 15 (14%) of treatment toxicity. With a median follow-up of 4.1 years (range: 0.05 -17.95) for the whole study population, progression-free survival (PFS) at 2 and 5 years was 81% and 72% respectively, cause-specific survival (CSS) at 2 and 5 years was 85% and 78%, respectively. CSS for pts 71-80 years vs 60-70 years; HR = 3.25, p<0.001 and > 80 years vs 60-70 years; HR 3.84, p = 0.001. Conclusion: Cause-specific survival of unselected, elderly HL pts > 71 years decreased significantly in comparison to those 60 to 70 years. Toxicities appeared to be relevant, in particular infections and BLT. Bleomycin needs to be used with extreme caution in this particular group of patients. New treatment strategies with a low toxicity profile are clearly needed, in particular for frail pts and pts older than 70 years.

Artificial intelligence (AI) is a hot topic in digital health, as automated systems are being adopted throughout the health care system. Because they are still flexible, emerging technologies can be shaped significantly by media representations as well as public engagement with science. In this context, we examine the belief that negative news media coverage of AI-and specifically, the alleged use of imagery from the movie Terminator-is to blame for public concerns about AI. This belief is identified as a potential barrier to meaningful engagement of AI scientists and technology developers with journalists and the broader public. We name this climate of risk perception the ''Terminator Syndrome''-not because of its origins in the movie of the same name per se, but because such unchecked beliefs can terminate broad public engagement on AI before they even begin. Using both quantitative and qualitative approaches, this study examined the hypothesis that the news media coverage of AI is negative. We conducted a sentiment analysis of news data spanning over six decades, from 1956 to 2018, using the Google Cloud Natural Language API Sentiment Analysis tool. Contrary to the alleged negative sentiment in news media coverage of AI, we found that the available evidence does not support this claim. We conclude with an innovation policy-relevant discussion on the current state of AI risk perceptions, and what critical social sciences offer for responsible AI innovation in digital health, life sciences, and society.

Inflamasi merupakan respon imun nonspesifik yang terjadi akibat adanya kerusakan jaringan atau paparan agen asing, seperti mikroorganisme atau senyawa kimia proinflamasi. Praktikum ini bertujuan untuk mengamati respon inflamasi akut melalui perubahan volume udem dan dinamika leukosit pada mencit (Mus musculus) yang diinjeksi dengan larutan karagenan 1% sebagai agen inflamasi. Dua perlakuan dilakukan, yaitu injeksi aquades sebagai kontrol dan karagenan 1% sebagai perlakuan. Volume udem diamati melalui metode pengukuran volume kaki mencit berdasarkan prinsip Archimedes, sedangkan dinamika leukosit diamati melalui preparat apusan darah dan pengamatan mikroskopis. Hasil menunjukkan bahwa mencit yang diinjeksi karagenan mengalami peningkatan volume udem sebesar 112,5%, jauh lebih tinggi dibandingkan kontrol (aquades) 17%.  Selain itu, jumlah leukosit juga meningkat di menit 60 signifikan pada kelompok karagenan (mean 26,3) dibandingkan dengan aquades (mean 11). Hal ini menunjukkan bahwa karagenan mampu memicu respon inflamasi akut yang ditandai dengan edema dan leukositosis. Respon tersebut merupakan bagian dari mekanisme pertahanan tubuh dalam menghadapi senyawa asing yang dimediasi oleh pelepasan histamin dan aktivasi mediator inflamasi lainnya.

Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer&#39;s disease and other dementias, Parkinson&#...

Terapi adjuvan yang biasanya diberikan pada pasien kanker payudara dan kanker kolorektal adalah kemoterapi dan radioterapi. Terapi adjuvan biasanya diberikan setelah terapi primer untuk meningkatkan angka kesembuhan penyakit, mencegah rekurensi, dan membunuh sel-sel kanker yang tersisa ataupun yang telah bermetastasis (terutama mikrometastasis). Terapi adjuvan juga berfungsi sebagai terapi paliatif untuk meningkatkan harapan hidup pasien kanker. Dalam kenyataannya banyak pasien kanker, khususnya kanker payudara dan kolorektal yang menghindari tindakan kemoterapi dan radioterapi. Dari 38 orang pasien kanker payudara dan kolorektal, didapatkan bahwa 26,3% takut gagal, 39,5% takut efek samping, 7,9% biaya yang mahal, 10,5% karena berlangsung dalam jangka waktu yang lama, dan 15,8% tidak takut terhadap kemoterapi dan radioterapi. Hasil penelitian ini menunjukkan bahwa tingkat pemahaman pasien kanker payudara dan kanker kolorektal terhadap tindakan kemoterapi dan radioterapi masih cukup rendah dimana 68,4% sampel tidak tahu dan tidak mengerti tentang tindakan kemoterapi dan radioterapi. Pemahaman yang kurang tentang tindakan kemoterapi dan radioterapi ini nantinya dapat mengakibatkan timbulnya persepsi negatif terhadap tindakan kemoterapi dan radioterapi. Maka dari itu sangat diperlukan adanya suatu edukasi yang baik bagi setiap pasien tentang penyakit dan modalitas terapi yang akan diberikan. Dokter diharapkan mampu untuk mengubah persepsi negatif pasien terkait tindakan kemoterapi dan radioterapi.

Leukemia remains a major health challenge in Africa, where limited access to advanced diagnostic technologies often leads to delayed diagnosis and suboptimal treatment outcomes. This review explores the role of WHO-supported laboratory innovations in advancing leukemia diagnosis across the continent. It examines key technologies such as molecular diagnostics, flow cytometry, and cytogenetics, highlighting how these innovations have enhanced the accuracy and speed of leukemia detection in resource-limited settings. By facilitating early and precise diagnoses, these technologies are improving patient management and treatment outcomes. Despite the promising advancements, significant barriers to widespread implementation persist, including high costs, inadequate infrastructure, and a shortage of trained personnel. WHO's efforts to address these challenges through regional collaborations, technical assistance, and capacity-building initiatives are pivotal in overcoming these obstacles. The establishment of specialized diagnostic centers and the integration of advanced technologies into national healthcare systems are key strategies to expand access and improve leukemia care in Africa.

This paper describes and evaluates a funded longitudinal teaching development project that aims to bridge the gap from classroom-based theory learning to experiential professional learning, and thereby prepare ideal and competent world class graduates. To align with the University&#39;s shared mission to foster links with the business community, the design of the internship program has a threefold purpose and was implemented in stages. It intends to enhance students&#39; professional awareness-knowledge-skills through a multi-leveled approach integrating classroom learning with professional practice. A debriefing mechanism was also built in enabling students to share their learning and professional challenges, and theory application to problem-solving scenarios. A 360 degree multiple evaluation procedure were used to measure the project effectiveness, including the use of industry consultants, student interns, hosts, and academic supervisors. The project has proved to promote closer...

This study aims to investigate EFL teachers&#39; perspectives towards using extracurricular activities in developing secondary school students&#39; performance in learning English language. To achieve the aim of the study, the researchers conduct a survey of a questionnaire. The participants were 340 (235 females and 105 males) EFL teachers from the public schools in the Second Al-Karkh General Directorate of Education in Baghdad, Iraq during the academic year 2020-21. The design of the study is a quantitative descriptive study which based on a questionnaire to collect the data. After analyzing the data, the results revealed that EFL teachers have positive perspectives toward applying extracurricular activities in developing secondary school students&#39; language performance. There are no statistically significant differences in the Iraqi EFL teachers&#39; perspectives towards applying extracurricular activities in developing secondary school students&#39; language performance due ...

Background: Respiratory infection account for the majority of acute illnesses in children.1 Acute respiratory infections (ARIs) continue to be the leading cause of acute illnesses worldwide and remain the most important cause of infant and young children mortality, accounting for about two million deaths each year.2 This research study was conducted to find out the knowledge regarding Acute respiratory infection and its management among mothers of under five children attending OPD of Teaching Hospital, Birgunj, Parsa. Methods: A Descriptive cross sectional research design was used and a total of 116 mothers of under five children attending Pediatric OPD of National Medical College and Teaching Hospital were selected by using Non probability purposive sampling technique. Data was collected by using semi- structured knowledge questionnaires. Results: The study results show that 60.3% of the respondents had inadequate knowledge and 39.7% of the respondents had adequate knowledge regard...

Background: Marriage is an important part of human life, which is an association that demands maturity, ability and responsibility. Child marriage in Nepal is considered a major barrier to the nation&#39;s social and economic development, as well as a major women&#39;s health concern.1 This research study was conducted to assess the knowledge regarding factors contributing to early marriage and its consequences among adolescence in selected rural area, Dhangadhi. Methods: A Descriptive cross-sectional research design was used and a total of 184 adolescences of Fulbari-18 rural area, Dhangadhi were selected by using Non probability Purposive sampling technique. Data was collected by using structured Interview schedule and analyzed by using descriptive and inferential statistical techniques. Results: The study revealed that majority (64.68%) of the respondents had inadequate knowledge whereas 35.32% of the respondents had adequate knowledge regarding factors contributing to early marr...

To determine whether hyperglycemia is related to prevalent frailty status in older women. DESIGN: Secondary data analysis of baseline data of a prospective cohort study. SETTING: Baltimore, Maryland. PARTICIPANTS: Five hundred forty-three women aged 70 to 79. METHODS: Research used baseline data from 543 participants in the Women's Health and Aging Studies I and II aged 70 to 79 who had all variables needed for analyses. The dependent variable was baseline frailty status (not frail, prefrail, frail), measured using an empirically derived model defining frailty according to weight loss, slow walking speed, weakness, exhaustion, and low activity (1-2 characteristics present 5 prefrail, !3 5 frail). Covariates included body mass index (BMI), interleukin-6 (IL-6), age, race, and several chronic diseases. Analyses included descriptive methods and multinomial logistic regression to adjust for key covariates. RESULTS: A hemoglobin A1c (HbA1c) level of 6.5% or greater in older women was significantly associated with higher likelihood of prefrail and frail status (normal HbA1c o6.0% was reference). The association between HbA1C levels of 6.0% to 6.5% and frailty status was not different from that of normal HbA1c, but HbA1c levels of 6.5% to 6.9% had nearly twice the likelihood of frailty (odds ratio (OR) 5 1.96, 95% confidence interval (CI) 5 1.47-2.59) as normal HbA1c. A HbA1c level of 9.0% or greater was also strongly associated (OR 5 2.57, 95% CI 5 1.99,3.32). Significant associations were also seen between baseline prefrail and frail status and low (18.5-20.0 kg/m 2 ) and high (430.0 kg/m 2 ) body mass index (BMI), interleukin-6, and all chronic diseases evaluated, but controlling for these covariates only minimally attenuated the independent association between HbA1c and frailty status. CONCLUSION: Hyperglycemia is associated with greater prevalence of prefrail and frail status; BMI, inflammation, and comorbidities do not explain the association. Longitudinal research and study of alternative pathways are needed.

Radiation therapy is a basic tool in cancer treatment and so maximising safety during these procedures is essential. Here we present the evolution and development of these safety protocols in Spain by leveraging the so-called risk matrix tool. We also tested its application to 3D radiotherapy treatments. A working group comprising members of the Spanish Society of Medical Physics (SEFM), Spanish Society of Radiation Oncology (SEOR), Spanish Association of Radiotherapy Technicians (AETR), and Spanish Society for Radiation Protection (SEPR) was created with the collaboration of the Nuclear Safety Council, all under the auspices of the Spanish Health Authority, to adapt risk matrix methodology to radiotherapy applications in Spain (the Risk Matrices in Radiotherapy, or MARR project). The application we developed was a very effective tool to integrate the entire methodology as well as previous user experiences into risk analysis. Among its main qualities was the ease with which it could be modified to allow each hospital to generate analysis elements and parameters specific to its own practice and to accommodate process changes as part of their continuous improvement plans. As a continuation of this work, the MARRTA project, which includes the latest application techniques in external radiotherapy (IMRT and IGRT, among others) is currently in its latter research stages.

Background Accurate childhood cancer burden data are crucial for resource planning and health policy prioritisation. Model-based estimates are necessary because cancer surveillance data are scarce or non-existent in many countries. Although global incidence and mortality estimates are available, there are no previous analyses of the global burden of childhood cancer represented in disability-adjusted life-years (DALYs). Methods Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 methodology, childhood (ages 0-19 years) cancer mortality was estimated by use of vital registration system data, verbal autopsy data, and population-based cancer registry incidence data, which were transformed to mortality estimates through modelled mortality-to-incidence ratios (MIRs). Childhood cancer incidence was estimated using the mortality estimates and corresponding MIRs. Prevalence estimates were calculated by using MIR to model survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated by multiplying age-specific cancer deaths by the difference between the age of death and a reference life expectancy. DALYs were calculated as the sum of YLLs and YLDs. Final point estimates are reported with 95% uncertainty intervals. Findings Globally, in 2017, there were 11•5 million (95% uncertainty interval 10•6-12•3) DALYs due to childhood cancer, 97•3% (97•3-97•3) of which were attributable to YLLs and 2•7% (2•7-2•7) of which were attributable to YLDs. Childhood cancer was the sixth leading cause of total cancer burden globally and the ninth leading cause of childhood disease burden globally. 82•2% (82•1-82•2) of global childhood cancer DALYs occurred in low, low-middle, or middle Socio-demographic Index locations, whereas 50•3% (50•3-50•3) of adult cancer DALYs occurred in these same locations. Cancers that are uncategorised in the current GBD framework comprised 26•5% (26•5-26•5) of global childhood cancer DALYs. Interpretation The GBD 2017 results call attention to the substantial burden of childhood cancer globally, which disproportionately affects populations in resource-limited settings. The use of DALY-based estimates is crucial in demonstrating that childhood cancer burden represents an important global cancer and child health concern.

Background Stroke is a leading cause of mortality and disability worldwide and the economic costs of treatment and post-stroke care are substantial. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic, comparable method of quantifying health loss by disease, age, sex, year, and location to provide information to health systems and policy makers on more than 300 causes of disease and injury, including stroke. The results presented here are the estimates of burden due to overall stroke and ischaemic and haemorrhagic stroke from GBD 2016. We report estimates and corresponding uncertainty intervals (UIs), from 1990 to 2016, for incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs). DALYs were generated by summing YLLs and YLDs. Cause-specific mortality was estimated using an ensemble modelling process with vital registration and verbal autopsy data as inputs. Non-fatal estimates were generated using Bayesian meta-regression incorporating data from registries, scientific literature, administrative records, and surveys. The Socio-demographic Index (SDI), a summary indicator generated using educational attainment, lagged distributed income, and total fertility rate, was used to group countries into quintiles. In 2016, there were 5•5 million (95% UI 5•3 to 5•7) deaths and 116•4 million (111•4 to 121•4) DALYs due to stroke. The global age-standardised mortality rate decreased by 36•2% (-39•3 to -33•6) from 1990 to 2016, with decreases in all SDI quintiles. Over the same period, the global age-standardised DALY rate declined by 34•2% (-37•2 to -31•5), also with decreases in all SDI quintiles. There were 13•7 million (12•7 to 14•7) new stroke cases in 2016. Global age-standardised incidence declined by 8•1% (-10•7 to -5•5) from 1990 to 2016 and decreased in all SDI quintiles except the middle SDI group. There were 80•1 million (74•1 to 86•3) prevalent cases of stroke globally in 2016; 41•1 million (38•0 to 44•3) in women and 39•0 million (36•1 to 42•1) in men. Interpretation Although age-standardised mortality rates have decreased sharply from 1990 to 2016, the decrease in age-standardised incidence has been less steep, indicating that the burden of stroke is likely to remain high. Planned updates to future GBD iterations include generating separate estimates for subarachnoid haemorrhage and intracerebral haemorrhage, generating estimates of transient ischaemic attack, and including atrial fibrillation as a risk factor.

Background: Essential hypertension tends to a familial mode. Its pattern of inheritance is heterogeneous, but the frequencies of different mode of inheritance vary in different populations. Determining of the mode of inheritance in each family is the basic information that is needed for the risk estimation in those family members. Determination of pattern of inheritance in families with at least two members affected with essential hypertension in Hamadan city, west of Iran, was the goal of the present paper. Methods: The present study was a cross sectional descriptive one. The cases were patients in Dr Emami Clinic in Hamadan that were diagnosed as essential hypertension and also a familial recurrence pattern among their families. Then we prepared a suitable questionnaire containing some questions about their medical and family histories as well as pedigree containing 3 to 4 generations. After drawing their pedigree we determined their patterns of inheritance based on the standard method. The data were expressed in tables according to our variables to show the results. Totally we could include 100 families in this study. The number of live patients in 100 studied families was 285 (84 males and 201 females, aver-age=62.7 y). Our primary results showed that the ages of diagnoses were from 30 to 81 y (average 54.24) for men and 28, 90 and 54.127 y in that order for women. The consanguineous marriages were done in 10.52% of the parents of affected persons (8.07% degree 3 and 2.45% degree 4). Frequencies of patients in different age groups, according to the age of diagnosis, were statistically significant (P<0.05), but not significant between the males and females. Our family study and pedigree patterns of essential hypertension showed that the mode of inheritance in 40% of families was autosomal dominant. Autosomal recessive was the pedigree pattern of 8% of our cases. Although in 52% of remainders the mode of inheritance was familial, but there were not enough evidences for single gene trait. It seemed that in recent families the etiology of the defect was multifactorial. Conclusion: Essential hypertension in our subject families was heterogenic. Their frequency orders were multifactorial, autosomal dominant and autosomal recessive trait, respectively. Such order is adopted with the literature but it seems that in our population, the essential hypertension with autosomal recessive mode is more frequent than the western populations.

Backgounds: A number of studies have focused on the effects of season of birth, as an environmental factor, on embryonic development. Methods: In a retrospective descriptive work, heights (crown to heel), weights and head circumferences of the full term, normal, and singleton newborn infants in Hamadan City (west of Iran) were collected from their randomly selected files in Fattemieh Hospital during five consecutive years (1998-2002). The studied files were 1800 cases, about 15% of total live births in the hospital during the considered period. We statistically compared the above parameters in four seasons. Results: Seasonal variation of mean birth weight and mean birth height were not statistically different. However, mean head circumference showed a peak in winter and a decline in autumn with statistical significant (P&lt;0.005). Conclusion: We can conclude that season of birth can be considered as one of the environmental factors that affect on embryonic development

The Klippel-Feil syndrome is a congenital anatomical defect which occurs due to the failure of fusion of two or more cervical vertebrae at the neck region. Features include a short neck, low hairline at the back of the head, and restricted movement of the upper spine. This case study includes audiological test battery of a 3 years old with Klippel-Feil syndrome with features of hearing impairment, severely dysplastic internal acoustic meatus [IAM] along with delayed speech and language development. A detailed audiological evaluation was done and the management options were been further discussed. Key words: Klippel-Feil syndrome, hearing loss, CI, ABI.

Engagement between health researchers and local schools, or School Engagement, has become incorporated into the engagement strategies of many health research institutions worldwide. Innovative initiatives have emerged within Wellcome Trust-funded African and Asian Programmes (APPs) and elsewhere, and continued funding from the Wellcome Trust and other funders is likely to catalyse further innovation. Worldwide, engagement between scientists and schools is well-described in the scientific literature (1-4), however, engagement between health researchers and schools is much newer, particularly in Africa, and rarely documented in the academic literature. In November 2018 the KEMRI-Wellcome Trust Research Programme (KWTRP) hosted an international meeting in Kilifi, Kenya, drawing on an emerging community of School Engagement practitioners towards exploring the broad range of goals for School Engagement, learning about the breadth of evaluation approaches and exploring the usefulness of a...

Purpose – The purpose of this paper is to propose a conceptual framework of Halal Product Design Accreditation adopted by manufacturers in designing their product with the integration of halal value in their design for better understanding on the matter. Design/methodology/approach – This paper develops a new combination of variables that is essential to consider for producing and desgning a halal product. Knowledge, attitude, religious and packaging are used as pre-determined variables for the design and production of the halal products.Findings – The hypotheses revealed that knowledge and attitude have significant influence towards creating a purchase intention among the consumers. As for the halal concept, it is strongly influenced by religious and packaging. The findings show that the purchase intention and halal concept are critical variables in the product development process, which will eventually lead to the production of halal products with accreditation. Implications – As ...

Workplace environment plays a major role towards the employees’ performance since job performance is important as it plays a major role in determining the productivity of the organization itself. For the older the worker of aging adult worker, this group are more concern on ergonomics issues and needed to be see to ensure the continuity of excellent performance and productivity of the company. Thus, this research explores how the workplace ergonomics affect job performance among aging workforce. Previous studies focused on ergonomics among workers but not specific towards aging workforce. This study aims on how to increase or maintain older workers’ job performance by providing better workplace ergonomics and proposed a conceptual framework of the factors of ergonomics workplace for aging workforce.

Aims: Mucoepidermoid carcinomas (MEC) are the most common malignant neoplasms of salivary glands, but are uncommon in other sites. Salivary gland MEC are most frequently associated with CRTC1-MAML2 translocations. Exceedingly rare MEC of the breast demonstrate a basal-like and often triple (oestrogen and progesterone receptor, HER2)-negative immunophenotype, with a single case previously reported to show MAML2 rearrangement, although the fusion partner was not known. Comprehensive genomic studies of breast MEC are lacking. In this study, we analysed the immunophenotype and molecular landscape of two breast MEC to elucidate the pathogenesis of these rare tumours. Methods and results: Two breast MEC were subjected to capture-based next-generation DNA sequencing of 479 cancer-related genes. The presence of the CRTC1-MAML2 fusion transcript was interrogated by reverse transcriptase-polymerase chain reaction. In addition, the immunoprofiles of breast MEC were compared to salivary gland MEC. Both breast MEC harboured CRTC1-MAML2 fusions. In contrast to most triple-negative breast carcinomas of no special type, the mutational burden of MEC was very low, with one case demonstrating only an inactivating SETD2 mutation, and the other harbouring no somatic variants in genes on the panel. No copy number alterations were identified. The immunoprofiles of breast and salivary gland MEC were overlapping, but not identical. Conclusions: The findings highlight MEC as a breast cancer subtype more closely related to its salivary gland counterpart than to basal-like/triple-negative breast cancers of no special type.

"This study examines the transition from the paradigm of singular truth—rooted in classical metaphysics, monotheistic theology, and deterministic science—to a contemporary epistemic landscape characterized by informational pluralism and cognitive decentralization. Through an interdisciplinary methodology that integrates philosophical inquiry, cognitive neuroscience, and information theory, the research traces how notions of truth, authority, and knowledge have evolved under the influence of digitization, algorithmic mediation, and networked communication.
The paper introduces the concept of a hybrid epistemological paradigm—one that reconciles objective anchoring with contextual adaptability, convergent reasoning with pluralistic negotiation. It proposes a functional epistemology for the post-digital age, grounded in neuroplasticity, pragmatic validation, and epistemic virtue.
While the study acknowledges the limits of certainty in an era marked by complexity and fragmentation, it argues for a renewed responsibility in meaning-making, cognitive discernment, and institutional legitimacy.
Future developments—including the integration of religious pluralism and phenomenological pluralism (PP)—are outlined as directions for a complementary study."

Kutatásunk tárgyát képezte a pénzügyi fogyasztó magatartásának, döntéseinek vizsgálata. Ettől a ponttól kezdődően beszélhetünk tudatosságról. Mit érthetünk tudatos pénzügyi fogyasztó alatt. Milyen pszichológiai és szociológiai tényezők állnak-e tudatosság mögött, és mennyiben befolyásolják választásában, döntésében ezek a tényezők.

Kutatásunk tárgyát képezte a pénzügyi fogyasztó magatartásának, döntéseinek vizsgálata. Ettől a ponttól kezdődően beszélhetünk tudatosságról. Mit érthetünk tudatos pénzügyi fogyasztó alatt. Milyen pszichológiai és szociológiai tényezők állnak-e tudatosság mögött, és mennyiben befolyásolják választásában, döntésében ezek a tényezők