Exploring medical students' experience of the learning environment: a mixed methods study in Saudi medical college.

BACKGROUND: In medical education, the learning environment (LE) significantly impacts students' professionalism and academic performance. Positive LE perceptions are linked to better academic outcomes. Our study, which was conducted 15 years after curriculum reform at King Saud University's College of Medicine, aimed to explore students' perspectives on their LE and identify areas for improvement. By understanding their experiences, we strive to enhance LE and promote academic success. METHODS: This mixed-method study employed an explanatory sequential approach in which a cross-sectional analytical survey phase was collected first using the Johns Hopkins Learning Environment Scale (JHLES), followed by qualitative focus groups. Findings from quantitative and qualitative methods were integrated using joint display. RESULTS: A total of 653 medical students completed the JHLES. The total average score was 81 out of 140 (16.8), and the average subscale scores ranged from 2.27 (0.95) for inclusion and safety to 3.37 (0.91) for community of peers. The qualitative approach encompasses both inductive and deductive analyses, identifying overarching themes comprising proudness, high expectations and competition, and views about the curriculum. The integration of results emphasizes the need for continued efforts to create a supportive and inclusive LE that positively influences students' experiences and academic success. CONCLUSION: This research offers valuable insights for educational institutions seeking to enhance medical education quality and support systems. Recommendations include faculty development, the cultivation of supportive environments, curriculum revision, improved mentorship programs, and initiatives to promote inclusivity and gender equity. Future research should explore longitudinal and comparative studies, innovative mixed methods approaches, and interventions to further optimize medical education experiences. Overall, this study contributes to the ongoing dialog on medical education, offering a nuanced understanding of the complex factors influencing students' perceptions and suggesting actionable strategies for improvement.

[Head-to-head studies on radiographic progression in axial spondyloarthritis]. / Head-to-head-Studien zur Röntgenprogression bei axialer Spondyloarthritis.

In this review article four clinical comparative studies in axial spondylarthritis (axSpA) are presented and discussed. SURPASS as the only head-to-head study investigated the effect of adalimumab biosimilar disease-modifying antirheumatic drug (bsDMARD) or secukinumab on radiographic progression over a time period of 2 years. Overall, the radiographic progression of the spine was low and no significant difference between adalimumab bsDMARD or secukinumab was noted. The three other studies were not constructed as direct head-to-head studies but compared the efficacy of non-steroidal antirheumatic drugs (NSARD) with and without simultaneous treatment with biological DMARDs (bDMARD). The CONSUL study showed no statistically significant difference in the delay of radiographic progression of the spine over 2 years in radiographic axSpA (r-axSpA) patients, who underwent either combined treatment with golimumab and celecoxib or treatment with golimumab alone over 2 years. The ESTHER study showed that patients with early axSpA active inflammatory lesions, which were detected by whole-body magnetic resonance imaging (MRI), showed a significantly greater improvement under treatment with etanercept than those treated with sulfasalazine. The INFAST study showed that patients with early active axSpA who received a combined treatment of infliximab and naproxen, achieved a clinical remission twice as frequently as those who only received naproxen. Therefore, for the endpoint of radiological progression no difference could be shown in the inhibition of radiological progression between the mechanisms of action investigated. The comparative data for the endpoint of clinical efficacy showed that patients with bDMARDs showed a clearly better response to treatment than patients with NSAR or conventional synthetic DMARDs (csDMARD).

Development and Validation of a Multimodality Model Based on Whole-Slide Imaging and Biparametric MRI for Predicting Postoperative Biochemical Recurrence in Prostate Cancer.

Purpose To develop and validate a machine learning multimodality model based on preoperative MRI, surgical whole-slide imaging (WSI), and clinical variables for predicting prostate cancer (PCa) biochemical recurrence (BCR) following radical prostatectomy (RP). Materials and Methods In this retrospective study (September 2015 to April 2021), 363 male patients with PCa who underwent RP were divided into training (n = 254; median age, 69 years [IQR, 64-74 years]) and testing (n = 109; median age, 70 years [IQR, 65-75 years]) sets at a ratio of 7:3. The primary end point was biochemical recurrence-free survival. The least absolute shrinkage and selection operator Cox algorithm was applied to select independent clinical variables and construct the clinical signature. The radiomics signature and pathomics signature were constructed using preoperative MRI and surgical WSI data, respectively. A multimodality model was constructed by combining the radiomics signature, pathomics signature, and clinical signature. Using Harrell concordance index (C index), the predictive performance of the multimodality model for BCR was assessed and compared with all single-modality models, including the radiomics signature, pathomics signature, and clinical signature. Results Both radiomics and pathomics signatures achieved good performance for BCR prediction (C index: 0.742 and 0.730, respectively) on the testing cohort. The multimodality model exhibited the best predictive performance, with a C index of 0.860 on the testing set, which was significantly higher than all single-modality models (all P ≤ .01). Conclusion The multimodality model effectively predicted BCR following RP in patients with PCa and may therefore provide an emerging and accurate tool to assist postoperative individualized treatment. Keywords: MR Imaging, Urinary, Pelvis, Comparative Studies Supplemental material is available for this article. © RSNA, 2024.

Healthcare provision for medical tourism: A comparative review.

Providing quality services, using modern technologies, having effective marketing, and providing services at an international level have led to the globalization of hospital services. This study aimed to identify the components of health services in developing countries that provide services to international patients. A comparative review was conducted by searching in PubMed, Scopus, Web of Science, Google Scholar, Google, and the websites of the World Medical Tourism Organization, the World Bank, and the Ministry of Health of the selected countries from 2000 to 2022. Iran, Turkey, Jordan, Costa Rica, the UAE, and Singapore were selected. The data were collected and analyzed using a comparative table. Different strategies were used to develop the medical tourism industry among the studied countries, but the main challenges in this field included the inappropriateness of the quality of the services provided or the provision of services that did not meet the needs of patients, the lack of expert human resource, not using medical facilitation companies, communication problems with patients, insufficient government support for medical tourism, and strict laws regarding business. The development of activities in the medical tourism industry requires planning in various dimensions. It seems that developing the medical marketing and activities of facilitator companies to facilitate patient admission, monitoring the quality of services provided, improving interdepartmental coordination, and considering a single trustee for this industry will improve the medical tourism status in Iran.

PREFUL MRI for Monitoring Perfusion and Ventilation Changes after Elexacaftor-Tezacaftor-Ivacaftor Therapy for Cystic Fibrosis: A Feasibility Study.

Purpose To assess the feasibility of monitoring the effects of elexacaftor-tezacaftor-ivacaftor (ETI) therapy on lung ventilation and perfusion in people with cystic fibrosis (CF), using phase-resolved functional lung (PREFUL) MRI. Materials and Methods This secondary analysis of a multicenter prospective study was carried out between August 2020 and March 2021 and included participants 12 years or older with CF who underwent PREFUL MRI, spirometry, sweat chloride test, and lung clearance index assessment before and 8-16 weeks after ETI therapy. For PREFUL-derived ventilation and perfusion parameter extraction, two-dimensional coronal dynamic gradient-echo MR images were evaluated with an automated quantitative pipeline. T1- and T2-weighted MR images and PREFUL perfusion maps were visually assessed for semiquantitative Eichinger scores. Wilcoxon signed rank test compared clinical parameters and PREFUL values before and after ETI therapy. Correlation of parameters was calculated as Spearman ρ correlation coefficient. Results Twenty-three participants (median age, 18 years [IQR: 14-24.5 years]; 13 female) were included. Quantitative PREFUL parameters, Eichinger score, and clinical parameters (lung clearance index = 21) showed significant improvement after ETI therapy. Ventilation defect percentage of regional ventilation decreased from 18% (IQR: 14%-25%) to 9% (IQR: 6%-17%) (P = .003) and perfusion defect percentage from 26% (IQR: 18%-36%) to 19% (IQR: 13%-24%) (P = .002). Areas of matching normal (healthy) ventilation and perfusion increased from 52% (IQR: 47%-68%) to 73% (IQR: 61%-83%). Visually assessed perfusion scores did not correlate with PREFUL perfusion (P = .11) nor with ventilation-perfusion match values (P = .38). Conclusion The study demonstrates the feasibility of PREFUL MRI for semiautomated quantitative assessment of perfusion and ventilation changes in response to ETI therapy in people with CF. Keywords: Pediatrics, MR-Functional Imaging, Pulmonary, Lung, Comparative Studies, Cystic Fibrosis, Elexacaftor-Tezacaftor-Ivacaftor Therapy, Fourier Decomposition, PREFUL, Free-Breathing Proton MRI, Pulmonary MRI, Perfusion, Functional MRI, CFTR, Modulator Therapy, Kaftrio Clinical trial registration no. NCT04732910 Supplemental material is available for this article. © RSNA, 2024.

Social ecological determinants of the mental distress among Syrian refugees in Lebanon and Turkey: A transnational perspective.

OBJECTIVE: Refugees are frequently shown to have worse mental health outcomes than non-displaced populations. This fact is commonly attributed to traumatic pre-displacement experiences. While important, the focus on trauma risks overlooking the role socioeconomic living-conditions in different arrival and transit contexts can play in determining refugees' mental distress. Building on the ecological model of refugee distress, we investigate how social ecological conditions relate to the mental distress of Syrians in Lebanon and Turkey. Both countries present important spaces of arrival and transit for millions of displaced Syrians, each with a specific historical, political, social and economic context. METHODS: The empirical analysis is based on data gathered in early 2021 in face-to-face surveys among displaced Syrians in Lebanon (N = 1127) and Turkey (N = 1364). Individual mental distress is evaluated using the Patient Health Questionnaire (PHQ-8) score as the dependent variable in a multivariate regression analysis. RESULTS: Social ecological factors do not only differ in their extent of deprivation between Lebanon and Turkey. They also differ in their relationship with individual mental health outcomes. In Lebanon, limited access to the health care system and having family in the same city are major risk factors for elevated mental distress, whereas in Turkey, these are low education, poverty, unemployment as well as employment as day laborer. Discrimination and social isolation emerge as relevant predictors in both countries. CONCLUSION: Based on this analysis, we argue that a context-specific understanding of mental distress amidst the social ecology refugees face in countries of refuge and transit is necessary. This approach needs to be pursued to provide adequate support and alleviate refugees' mental distress both, in the country of first refuge and after possible onward migration. In addition to clinical implications, the study particularly highlights the important role anti-discrimination and social inclusion policies could play in promoting refugee mental health.

Development and Validation of a Deep Learning Model to Reduce the Interference of Rectal Artifacts in MRI-based Prostate Cancer Diagnosis.

Purpose To develop an MRI-based model for clinically significant prostate cancer (csPCa) diagnosis that can resist rectal artifact interference. Materials and Methods This retrospective study included 2203 male patients with prostate lesions who underwent biparametric MRI and biopsy between January 2019 and June 2023. Targeted adversarial training with proprietary adversarial samples (TPAS) strategy was proposed to enhance model resistance against rectal artifacts. The automated csPCa diagnostic models trained with and without TPAS were compared using multicenter validation datasets. The impact of rectal artifacts on the diagnostic performance of each model at the patient and lesion levels was compared using the area under the receiver operating characteristic curve (AUC) and the area under the precision-recall curve (AUPRC). The AUC between models was compared using the DeLong test, and the AUPRC was compared using the bootstrap method. Results The TPAS model exhibited diagnostic performance improvements of 6% at the patient level (AUC: 0.87 vs 0.81, P < .001) and 7% at the lesion level (AUPRC: 0.84 vs 0.77, P = .007) compared with the control model. The TPAS model demonstrated less performance decline in the presence of rectal artifact-pattern adversarial noise than the control model (ΔAUC: -17% vs -19%, ΔAUPRC: -18% vs -21%). The TPAS model performed better than the control model in patients with moderate (AUC: 0.79 vs 0.73, AUPRC: 0.68 vs 0.61) and severe (AUC: 0.75 vs 0.57, AUPRC: 0.69 vs 0.59) artifacts. Conclusion This study demonstrates that the TPAS model can reduce rectal artifact interference in MRI-based csPCa diagnosis, thereby improving its performance in clinical applications. Keywords: MR-Diffusion-weighted Imaging, Urinary, Prostate, Comparative Studies, Diagnosis, Transfer Learning Clinical trial registration no. ChiCTR23000069832 Supplemental material is available for this article. Published under a CC BY 4.0 license.

Image Quality and Diagnostic Performance of Low-Dose Liver CT with Deep Learning Reconstruction versus Standard-Dose CT.

Purpose To compare the image quality and diagnostic capability in detecting malignant liver tumors of low-dose CT (LDCT, 33% dose) with deep learning-based denoising (DLD) and standard-dose CT (SDCT, 100% dose) with model-based iterative reconstruction (MBIR). Materials and Methods In this prospective, multicenter, noninferiority study, individuals referred for liver CT scans were enrolled from three tertiary referral hospitals between February 2021 and August 2022. All liver CT scans were conducted using a dual-source scanner with the dose split into tubes A (67% dose) and B (33% dose). Blended images from tubes A and B were created using MBIR to produce SDCT images, whereas LDCT images used data from tube B and were reconstructed with DLD. The noise in liver images was measured and compared between imaging techniques. The diagnostic performance of each technique in detecting malignant liver tumors was evaluated by three independent radiologists using jackknife alternative free-response receiver operating characteristic analysis. Noninferiority of LDCT compared with SDCT was declared when the lower limit of the 95% CI for the difference in figure of merit (FOM) was greater than -0.10. Results A total of 296 participants (196 men, 100 women; mean age, 60.5 years ± 13.3 [SD]) were included. The mean noise level in the liver was significantly lower for LDCT (10.1) compared with SDCT (10.7) (P < .001). Diagnostic performance was assessed in 246 participants (108 malignant tumors in 90 participants). The reader-averaged FOM was 0.880 for SDCT and 0.875 for LDCT (P = .35). The difference fell within the noninferiority margin (difference, -0.005 [95% CI: -0.024, 0.012]). Conclusion Compared with SDCT with MBIR, LDCT using 33% of the standard radiation dose had reduced image noise and comparable diagnostic performance in detecting malignant liver tumors. Keywords: CT, Abdomen/GI, Liver, Comparative Studies, Diagnosis, Reconstruction Algorithms Clinical trial registration no. NCT05804799 © RSNA, 2024 Supplemental material is available for this article.

Evaluation of clinical practice guideline-derived clinical decision support systems using a novel quality model.

Over the last decade, clinical practice guidelines (CPGs) have become an important asset for daily life in healthcare organizations. Efficient management and digitization of CPGs help achieve organizational objectives and improve patient care and healthcare quality by reducing variability. However, digitizing CPGs is a difficult, complex task because they are usually expressed as text, and this often leads to the development of partial software solutions. At present, different research proposals and CPG-derived CDSS (clinical decision support system) do exist for managing CPG digitalization lifecycles (from modeling to deployment and execution), but they do not all provide full lifecycle support, making it more difficult to choose solutions or proposals that fully meet the needs of a healthcare organization. This paper proposes a method based on quality models to uniformly compare and evaluate technological tools, providing a rigorous method that uses qualitative and quantitative analysis of technological aspects. In addition, this paper also presents how this method has been instantiated to evaluate and compare CPG-derived CDSS by highlighting each phase of the CPG digitization lifecycle. Finally, discussion and analysis of currently available tools are presented, identifying gaps and limitations.

Medial versus anterior approach for open reduction of hip in children with DDH under two years - A meta-analysis of comparative studies.

Purpose: Open reduction (OR) is usually required in developmental dysplasia of hip (DDH) for children below 24 months of age, those who failed to achieve a satisfactory reduction by the closed method. OR in this age group can be performed either through a medial or anterior approach. However, there is a paucity of literature and a lack of more substantial evidence regarding which approach (medial versus anterior) is superior for performing OR in this age group with minimal complications. Methods: Four databases (PubMed, Embase, Scopus, and Cochrane Library) were searched for relevant articles reporting outcomes and complication rates of DDH children less than 24 months undergone OR either through medial or anterior approach using pre-defined keywords. Data on avascular necrosis (AVN) rates, further corrective surgery (FCS) rates, and clinical and radiological grading using McKay clinical criteria and Severin radiological criteria were assessed. Meta-analysis was carried out using RevMan (Review Manager 5.4) software. Results: Five comparative studies, having a minimum of two-year follow-up, were included for final analysis. According to the MINORS tool assessment, all five studies were of good to high quality. Of 257 hips, 151 and 106 underwent OR through medial and anterior approaches, respectively. Our meta-analysis showed a statistically significant (p = 0.01) number of AVN cases with the anterior approach compared to the medial approach. The overall random effect showed the odds of having AVN with an anterior approach to be 2.27 (95% CI: 1.18,4.38) times more than the same with a medial approach. Regarding FCS rates, the meta-analysis depicted no significant difference between the two groups (p = 0.63). The two groups had no statistically significant difference regarding clinical and radiological outcomes using McKay and Severin criteria, respectively. Following surgery, improvement in the acetabular index from pre-operative value showed no statistically significant difference between the two groups (p = 0.48). Conclusions: Medial approach is safe and effective for OR of the hip in DDH up to 24 months of age. Our analysis showed that AVN rates are lower with a medial approach than the anterior approach, with similar clinical and radiological outcomes and rates of FCS. However, one should consider the surgeon's expertise while choosing between these approaches.

Raising the 'environmental question' in social work in Canada and Scotland.

This article contributes a comparative review of social work in Canada and Scotland to international conversations about social work and the environment. The 'environmental question' of the 21st century is a radical challenge to social work developed in relation to the 'social question' of the 19th century. Work to begin to include the natural environment within high-income state social work can expect to encounter established infrastructures of thinking and doing that will be difficult to shift. We, therefore, compare guiding social work policy documents and identify points of tension that are likely to be shared across wealthy national contexts.

Insights into virulence: structure classification of the Vibrio parahaemolyticus RIMD mobilome.

IMPORTANCE: The pandemic Vpar strain RIMD causes seafood-borne illness worldwide. Previous comparative genomic studies have revealed pathogenicity islands in RIMD that contribute to the success of the strain in infection. However, not all virulence determinants have been identified, and many of the proteins encoded in known pathogenicity islands are of unknown function. Based on the EOCD database, we used evolution-based classification of structure models for the RIMD proteome to improve our functional understanding of virulence determinants acquired by the pandemic strain. We further identify and classify previously unknown mobile protein domains as well as fast evolving residue positions in structure models that contribute to virulence and adaptation with respect to a pre-pandemic strain. Our work highlights key contributions of phage in mediating seafood born illness, suggesting this strain balances its avoidance of phage predators with its successful colonization of human hosts.

[Efficacy evaluation of symptom-complex physiotherapy in polymorbidity based on randomized comparative studies]. / Otsenka effektivnosti simptomokompleksnoi fizioterapii pri polipatii na osnove randomizirovannykh sravnitel'nykh issledovanii.

The problem of comprehensive physical therapy in polymorbidity (PM) identifies among the most urgent difficulties of modern rehabilitation medicine. It is known that PM are more common than it is generally accepted, and their impact on the endpoints of rehabilitative treatment is more significant. Yet, many problems of PM have not been investigated and properly solved. OBJECTIVE: To evaluate the efficacy of comprehensive physical therapy (CPT) in PM in the age aspect on the basis of correlation analysis and ANOVA indicators (OR, RR, Q, x2, r2), as well as evidence-based medicine (EBM), in particular randomized comparative study (RCS). MATERIAL AND METHODS: A number of patients with PM equal 554 underwent CPT, of which 204 (36.8%) were male and 350 (63.2%) female. The identified age cohorts were following: the 1st group - 188 (33.9%) patients aged from 45 to 59; the 2nd group - 366 (66.1%) patients aged from 60 to 74. The ratio of middle-aged and elderly patients was 1.9:1. RESULTS: The efficacy of CPT in patients with PM was judged, first of all, by documentary (medical histories and medical records of patients) and mathematical data (OR, RR, Q, x2, r2). The evidence level of CPT effect was determined on the basis of the analysis of the particular method's study results. CONCLUSION: The incidence of positive CPT result in middle-aged patients was higher than in elderly. The positive strong statistical correlation between comprehensive physical therapy and the endpoint in most classes of diseases of patients with PM. The comparative assessment of CPT efficacy based on the EBM principles revealed the advantages of their use for elderly patients relative to middle-aged group.

Contemporary pharmacologic treatments of MRSA for hospitalized adults: rationale for vancomycin versus non-vancomycin therapies as first line agents.

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) remains an important pathogen in the hospital setting and causes significant morbidity and mortality each year. Since the initial discovery over 60 years ago, vancomycin has remained a first-line treatment for many different types of MRSA infections. However, significant concerns related to target attainment and nephrotoxicity have spurred efforts to develop more effective agents in the last two decades. AREAS COVERED: Newer anti-MRSA antibiotics that have been approved since 2000 include linezolid, daptomycin, and ceftaroline. As clinical evidence has accumulated, these newer agents have become more frequently used, and some are now recommended as co-first-line options (along with vancomycin) in clinical practice guidelines. For this review, a scoping review of the literature was conducted to support our findings and recommendations. EXPERT OPINION: Vancomycin remains an important standard of care for MRSA infections but is limited with respect to nephrotoxicity and rapid target attainment. Newer agents such as linezolid, daptomycin, and ceftaroline have specific indications for treating different types of MRSA infections; however, newer agents also have unique attributes which require consideration during therapy.

Comparison of treatment outcomes and complications of coil embolization in elderly and very elderly patients with cerebral aneurysms: a propensity score matching analysis.

PURPOSE: This single center study aims to compare the treatment outcomes and procedure-related complications of coil embolization in elderly patients (60-79 years) and very elderly patients (aged 80 years or older) with cerebral aneurysms. METHODS: Data was collected from 504 elderly patients aged 60 years or older who underwent coil embolization for intracranial aneurysms from 2018 to 2021. The study evaluated patient-related and anatomical factors and assessed various outcomes, comparing results between groups using statistical analysis and propensity score matching. RESULTS: A total of 503 cerebral aneurysms were analyzed from individuals aged 60-79 years (n = 472) and those aged 80 years or older (n = 31). The majority of the aneurysms were unruptured with an average size of 3.5 mm in height and 3.4 mm in width. The patients were compared using 1:1 propensity score matching, and no significant differences were found in factors other than age and aortic elongation. Logistic analysis revealed that being over 80 years old and having a severe aortic arch elongation were identified as risk factors for procedure-related events in both total and unruptured cases. CONCLUSIONS: The study compared coil embolization treatment for cerebral aneurysms in patients aged 60-79 and over 80, finding no significant difference in treatment outcomes except for procedure-related events. Procedure-related events were associated with severe aortic arch elongation and being over 80 years old. Coil embolization can be considered safe and effective for patients over 80, but further trials are needed for accurate conclusions.

Head-to-Head Comparison of Dual-Source and Split-Beam Filter Multi-Energy CT versus SPECT/CT for Assessing Lobar Lung Perfusion in Emphysema.

Purpose: To evaluate dual-source and split-beam filter multi-energy chest CT in assessing pulmonary perfusion on a lobar level in patients with lung emphysema, using perfusion SPECT as the reference standard. Materials and Methods: Patients with emphysema evaluated for lung volume reduction therapy between May 2016 and February 2021 were retrospectively included. All patients underwent SPECT and either dual-source or split-beam filter (SBF) multi-energy CT. To calculate the fractional lobar lung perfusion (FLLP), SPECT acquisitions were co-registered with chest CT scans (hereafter, SPECT/CT) and semi-manually segmented. For multi-energy CT scans, lung lobes were automatically segmented using a U-Net model. Segmentations were manually verified. The FLLP was derived from iodine maps computed from the multi-energy data. Statistical analysis included Pearson and intraclass correlation coefficients and Bland-Altman analysis. Results: Fifty-nine patients (30 male, 29 female; 31 underwent dual-source CT, 28 underwent SBF CT; mean age for all patients, 67 years ± 8 [SD]) were included. Both multi-energy methods significantly correlated with the SPECT/CT acquisitions for all individual lobes (P < .001). Pearson correlation concerning all lobes combined was significantly better for dual-source (r = 0.88) than for SBF multi-energy CT (r = 0.78; P = .006). On the level of single lobes, Pearson correlation coefficient differed for the right upper lobe only (dual-source CT, r = 0.88; SBF CT, r = 0.58; P = .008). Conclusion: Dual-source and SBF multi-energy CT accurately assessed lung perfusion on a lobar level in patients with emphysema compared with SPECT/CT. The overall correlation was higher for dual-source multi-energy CT.Keywords: Chronic Obstructive Pulmonary Disease, Comparative Studies, Computer Applications, CT Spectral Imaging, Image Postprocessing, Lung, Pulmonary Perfusion© RSNA, 2023.

Are domesticated animals dumber than their wild relatives? A comprehensive review on the domestication effects on animal cognitive performance.

Animal domestication leads to diverse behavioral, physiological, and neurocognitive changes in domesticated species compared to their wild relatives. However, the widely held belief that domesticated species are inherently less "intelligent" (i.e., have lower cognitive performance) than their wild counterparts requires further investigation. To investigate potential cognitive disparities, we undertook a thorough review of 88 studies comparing the cognitive performance of domesticated and wild animals. Approximately 30% of these studies showed superior cognitive abilities in wild animals, while another 30% highlighted superior cognitive abilities in domesticated animals. The remaining 40% of studies found similar cognitive performance between the two groups. Therefore, the question regarding the presumed intelligence of wild animals and the diminished cognitive ability of domesticated animals remains unresolved. We discuss important factors/limitations for interpreting past and future research, including environmental influences, diverse objectives of domestication (such as breed development), developmental windows, and methodological issues impacting cognitive comparisons. Rather than perceiving these limitations as constraints, future researchers should embrace them as opportunities to expand our understanding of the complex relationship between domestication and animal cognition.

A comparative review of the mineralogical and chemical composition of African major bauxite deposits.

Bauxite, which is the main raw material that aluminium is extracted from was discovered in Africa in the early 1900s. Currently, the production and export capacities of the African Bauxite ore are about a third of the World's total capacity. However, the processes leading to the final finished product of; surface mining of the ore, refining ore into alumina and finally extracting the pure aluminium metal in high energy consuming smelters that employ the Hall-Héroult electrolysis process; seldom take place inside Africa. The main goal of this work is to analyse the mineralogical and geochemical characteristics of bauxite deposits from some prominent bauxite producing and exporting countries of Africa in order to fashion out if a trend exist for the type of source rocks. Judging from the data obtained, gibbsite is found to be the main aluminium oxide in all the bauxite deposits with slight occurrence of boehmite in 3 out of the 13 deposits, while goethite is the main oxyhydroxide iron mineral. The compiled results of the various investigations highlighted the fact that the deposits are of diverse qualities with respect to world standard of major element content of bauxite; with average percentage concentration in the ranges as: Al2O3 (43.73-61.25), Fe2O3 (1.55-34.25), SiO2 (0.42-10.84); except two of the deposits with alumina content less than 40%. With evaluated silica moduli less than 8 for only two (2) of the deposits (4.76 and 6.94), the rest have higher moduli that ranges between (14.49 and 75.45). The higher percentage of iron oxide content (>20) in six (6) out of the 13 ore deposits, allowed the deposits to be grouped into three (3) categories of grades; high alumina ore, ferruginous ore, siliceous ore and combination of each. Source rock of the deposits were determined through geochemical and petrographic considerations of laterisation products of the rocks through evaluation of the weathering indices of; Chemical Index of Alteration which was in the range (97.16-99.98) while the Ruxton ratio ranged between (0.0133-0.2100); signifying the parent rock underwent intensive weathering process. This is indicative of the source rocks of the Bauxite deposits being either (i) anorthositic, (ii) argillite and dolerite, (iii) granulite and feldspathic gneiss, and/or, (iv) mafic-basaltic andesite igneous. Awareness of new and yet-to-commence emerging bauxite producing African countries was created, by highlighting the economic impact those respective countries will experience when that mining sector is developed for the aluminum industry at home and world at large.

Comparative performance of microscopy, nested PCR, and real-time PCR for screening avian haemosporidian parasites in Afrotropical starlings (family Sturnidae).

Prevalence studies of avian haemosporidian parasites frequently use microscopy and the nested polymerase chain reaction (PCR) protocols for detecting infections. Newer PCR protocols to detect parasites are being developed, with the distinct advantage of reducing screening cost and time, as well as increasing efficiency and sensitivity. The detection ability of microscopy and nested PCR was compared against a real-time PCR (qPCR) protocol using genomic DNA extracted from 240 bird blood samples collected from three starling species (Cape Starling, the Greater Blue-eared Starling, and the Wattled Starling; family Sturnidae) in the Kruger national park, South Africa. All three protocols successfully detected avian haemosporidian parasites with the qPCR having a considerable edge against the other two methods. Fifteen unique cytochrome b lineages were identified of which seven were new lineages. Microscopy and nested PCR recorded similar prevalence (32.92% and 35.42% respectively). The qPCR protocol used here, although more sensitive (52.92% prevalence), is not able to differentiate between parasite genera but provides the opportunity to screen a large number of samples in large-scale studies within a specific region. This study recommends the development and adoption of new molecular protocols with increased sensitivity and accuracy in prevalence studies. Nevertheless, microscopy remains essential for the morphological description of parasites and for distinguishing between abortive and successful chronic infections. The PCR-based method displays the detection of the parasitic genome but does not reveal whether parasites have or will develop into a successful infection.

A comparative analysis between Mexican and Chinese health systems / Un análisis comparativo entre los sistemas de salud de México y China

Abstract Objective: The comparative network analysis of national health macrosystems is an area whose academic development has not reached due relevance if its influence on decision-making related to the design of public health policies is considered; the establishment of comparative elements between two socially, economically and culturally distant countries, such as Mexico and China, is a complex process given the difficulty of locating equivalent evaluation indicators among some of its elements. Materials and methods: The present work reflects on the similarities and dissimilarities between the national health systems, with an impact on the care provided to the most vulnerable population segments, applying a comparative nodes and networks analysis considering social and economic factors. Results: The network analysis shows that, for practical purposes, the nodes considered in the Mexican health system is superior to those nodes identified in the Chinese health system in terms of quality, mainly in nodes such as convenience of the location, using cutting-edge technology in health institutions and the skill and competence of medical personnel; conversely, the Chinese system is superior to the Mexican in terms of efficiency, mainly involuntary co-payment insurance systems to reduce the catastrophic health expenditure of the vulnerable rural population. Conclusions: The conclusions drawn may serve for subsequent studies to identify opportunities for improvement, correlations and/or trends that could be implemented in the Mexican health system, once the pertinent feasibility studies have been carried out.

Resumen Objetivo: El análisis de redes comparativo de macrosistemas nacionales de salud es un ámbito cuyo desarrollo académico no ha alcanzado la relevancia debida si se considera su influencia en la toma de decisiones relativas al diseño de políticas de salud pública. Así, el establecimiento de elementos comparativos entre dos países social, económica y culturalmente distantes, como México y China, es un proceso complejo dada la dificultad de ubicar indicadores equivalentes de evaluación entre algunos de sus elementos. Materiales y método: El presente trabajo reflexiona sobre las similitudes y diferencias entre los mencionados sistemas nacionales de salud, con incidencia en la atención que se brinda a los segmentos poblacionales más vulnerables, aplicando un análisis comparativo de nodos y redes considerando factores sociales y económicos. Resultados: El análisis de red muestra que, para efectos prácticos, los nodos considerados en el sistema de salud mexicano son superiores a los nodos identificados en el sistema de salud chino en términos de calidad, principalmente en nodos como conveniencia de la ubicación, utilizando tecnología de punta en instituciones de salud y la habilidad y competencia del personal médico; Por el contrario, el sistema chino es superior al mexicano en términos de eficiencia, principalmente sistemas de seguro de copago involuntario para reducir el gasto catastrófico en salud de la población rural vulnerable. Conclusiones: Las conclusiones extraídas podrán servir a estudios posteriores para identificar oportunidades de mejora, correlaciones y/o tendencias que pudieran implementarse en el sistema mexicano de salud, una vez efectuados los estudios de viabilidad pertinentes.