Journals
2026 EN
Boafo George Frimpong · Shaw Ibrahim · Ekpo Marlene Davis
+7 more
The instability of liposomes in blood samples during clinical drug research and drug monitoring results in the inability to accurately determine the actual drug concentrations in the body at the time of collection, mainly due to lipid deterioration, particle fusion or aggregation, and phase separation degradation, resulting in payload leakage. To improve drug monitoring accuracy, we developed a cryopreservation strategy in this study by innovatively combining cryoprotective agents (CPAs), such as L-proline, sucrose, and polyvinyl alcohol (PVA), to prevent liposomal leakage and maintain stability for reliable drug monitoring and clinical drug research applications. Doxorubicin liposomes were prepared, and the CPAs were tested at various concentrations and under different freeze‒thaw protocols in biological matrices, with the stability and leakage of the liposomes assessed. Each CPA contributes distinct stabilization mechanisms, with L-proline's osmoprotective ability, sucrose's hydrogen bonding, and PVA's steric hindrance to form a protective barrier. The optimized CPA combination demonstrated superior performance at 85% (v/v) by preserving liposomal integrity, offering the best cryoprotective effect for liposomes in plasma stored at −20 °C, achieving about 90% entrapment efficiency, compared to about 60% in the control group without CPAs. Mechanistic investigations confirmed that CPAs protect liposomes against mechanical stress, prevent membrane disruption, and reduce ice damage by inhibiting recrystallization and adjusting bilayer hydration. These findings offer practical solutions for accurate pharmacokinetic assessments and reliable personalized dosing, safer alternative for liposomal drug research, biobanking, and real-world therapeutic monitoring.
Journals
2026 EN
Şipal Meriç Selim · Yaşar Evren · Özişler Zuhal
+8 more
Intensive walking practice often demands capabilities that go beyond the limits for both patients and therapists. As a solution, robot-assisted exoskeletons have been developed to deliver efficient rehabilitation sessions. The primary aim was to evaluate the effect of adding exoskeleton training, the FreeGait®, to conventional treatment on walking status in patients with motor incomplete spinal cord injury. The secondary aim was to assess its impact on mobility, functional independence, and health-related quality of life. This study compared exoskeleton gait training with conventional therapy (RBCT) versus conventional therapy alone (CT). Fourteen participants with motor incomplete spinal cord injury were included, with seven in each group. Both groups had 40-minute conventional therapy sessions 5 days a week. Additionally, the RBCT performed exoskeleton walking and balance exercises 3 days a week. The WISCI II (primary outcome), 10MWT, gait speed, TUG, BBS, SCIM III, and WHOQOL-BREF were used for evaluation (see text for acronyms). Walking status and mobility-related measures showed significant improvements in the RBCT (p < 0.05), whereas no significant differences were observed in the CT (p > 0.05). There was a significant difference in the physical health domain of the WHOQOL-BREF only in the RBCT. However, no significant differences were found in the WHOQOL-BREF total score in both groups (p > 0.05). Furthermore, no significant difference was observed between the groups in terms of change (p > 0.05). Gait training with the new exoskeleton combined with conventional therapy, positively contributes to walking status, mobility, and functional independence. Trial registration: ClinicalTrials.gov identifier: NCT06137456 .
Resource
2026 EN
Frisbee Suzanne · Czaplicki Lauren · Ibrahim Maryam
+2 more
Youth under the legal age of sale for tobacco (18–20 years old) remain highly receptive to tobacco advertising despite existing regulations intended to prevent use. Emerging marketing tactics—such as influencer partnerships and lifestyle-oriented messaging—may increase appeal among young audiences. This study explored which advertising features are most associated with ad receptivity among this age group. In 2023, 960 U.S. participants aged 18–20 completed an online survey assessing receptivity (liking, curiosity, interest) to cigarette and e-cigarette ads. Content analysis was used to identify potentially youth-appealing features in the ads. Content coding data and participant ratings were then merged, and mixed effects logistic regression analyses were used to assess the relationship between ad features and youth receptivity. Influencer and celebrity endorsements, rebellious themes, and youth restriction messaging were significantly associated with increased ad liking and curiosity, especially for e-cigarettes. Cigarette ads featuring flavors and celebrity endorsements also showed higher receptivity. Interestingly, youth restriction messages—often intended to deter—were linked to increased interest, potentially due to perceived exclusivity. Flavors wereassociated with appeal for cigarettes, potentially reflecting changing norms in product marketing. Contemporary tobacco ads use both traditional and emerging tactics that appeal to young people. Features like influencer marketing and youth restriction messaging contribute to youth receptivity, highlighting gaps in current advertising regulations. These findings support the need to expand definitions of “youth appeal” and adapt policies to address the evolving nature of tobacco marketing.
Journals
2026 EN
Erden Güner Arzu · Demet Öztürk · Sarı Mustafa
+4 more
This study explored the perceptions and experiences of individuals with Duchenne muscular dystrophy (DMD) and their parents regarding telerehabilitation. This qualitative study involved 11 individuals with DMD and 14 parents. In-depth interviews were conducted, and the audio recordings were transcribed verbatim for analysis. Thematic analysis was used to to identify sub-themes, followed by examining patterns between themes, sub-themes, and codes. Participants’ experiences with telerehabilitation are discussed under 5 themes and 11 sub-themes:(i) application, (ii) the group exercise process, (iii) benefits, (iv) the physiotherapist providing the training, and (v) recommendations. The telerehabilitation program effectively combines easy implementation, exercise facilitation, psychosocial improvement, motivation, and family involvement. Difficulties in the program included the need for parental assistance for individuals with severe DMD, internet interruptions, and occasional hesitation due to camera visibility. Telerehabilitation was perceived as an effective, user-friendly intervention that improves access to exercise, psychosocial well-being, motivation, and family support.
Resource
2026 EN
Ibrahim Sarah · Abdelhady Mohamed · Venckus Jacqueline
+2 more
The Single Accreditation System (SAS) unified graduate medical education (GME) accreditation for allopathic (MD) and osteopathic (DO) programs under the Accreditation Council for Graduate Medical Education (ACGME). Implemented between 2015 and 2020, it aimed to expand access and standardize residency training across degree types. While the SAS succeeded in expanding opportunities for DO graduates in certain specialties, particularly family medicine and pathology, persistent disparities remain across competitive medical and surgical fields. Specialty-specific analyses reveal that DO applicants continue to face significant barriers in dermatology, ophthalmology, plastic surgery, neurosurgery, and orthopedic surgery, with disproportionately lower match rates and limited representation in top-tier residency programs. Structural challenges including the closure of many osteopathic-led programs, limited access to research mentorship, and degree-based bias among residency programs have exacerbated these disparities. Although Osteopathic Recognition and initiatives such as the Pathologist Pipeline have helped support osteopathic participation in select areas, broader reforms are needed to fulfill the original goals of the SAS. Enhancing academic partnerships, expanding research infrastructure, addressing implicit biases, and fostering DO leadership within academic medicine are critical steps toward ensuring equitable residency access for all graduates. Continued monitoring of match trends and specialty-specific outcomes will be essential to assessing the SAS’s long-term impact on healthcare workforce diversity and equity.
Journals
2026 EN
Marta Herlina · Hartono Owen · Arifin Heni Radiani
+6 more
Breadfruit ( Artocarpus altilis ) flour is a promising substitute to wheat flour; however, its native form exhibits low swelling capacity, high gelatinization temperature, and rapid retrogradation. This study examined the effects of heat – moisture treatment (HMT), fermentation with Lactobacillus plantarum, and their combination on the physicochemical and functional properties of breadfruit flour. HMT was performed at 100°C for 16 h (30% moisture), and fermentation was carried out at 37°C for 24 h. Fermentation significantly enhanced viscosity with peak and final apparent viscosities increasing by 36–41% and 16–18%, respectively. Additionally, fermentation increased the swelling volume by 15–22%, while syneresis decreased by 23–35%. In contrast, HMT and combined HMT – fermentation reduced viscosity by more than 99% and swelling by 39–45%, but increased solubility by 81%, suggesting structural compaction and limited hydration. The gel hardness of the fermented flour decreased by 83–84% compared with the native flour, whereas HMT-treated flours exhibited no gel formation. Color analysis showed a slight increase in whiteness (~2%) following fermentation but a 22% reduction in lightness after HMT, mainly due to Maillard browning. All treatments maintained the native B-type crystalline pattern without introducing new functional groups. Overall, fermentation produced the most favorable functional properties, enhancing viscosity, swelling, and freeze – thaw stability, while HMT yielded thermally stable but less functional flour. These findings demonstrate that fermentation and combined modification effectively enhance the physicochemical versatility of breadfruit flour, broadening its potential application in bakery, gluten-free, and thickened food formulations.
Journals
2026 EN
Özgen-Top Özge · Aysert-Yildiz Pınar · Habibi Hamid
+5 more
The study aimed to compare the impact of combination and monotherapy on mortality, antibiotic consumption using ‘Days of Therapy (DOT)’, and antibiotic-related adverse events in patients with methicillin-susceptible S. aureus (MSSA) bacteraemia. This retrospective study included all adult patients (>18 years) with MSSA bacteraemia who received either monotherapy (beta-lactam alone) or combination therapy (beta-lactam plus teicoplanin or daptomycin or linezolid) between 2018 and 2023. Mortality, antibiotic consumption, and factors predicting mortality were analysed. Groups were compared for 30-d mortality with survival analysis. Logistic regression models were used to identify risk factors for mortality. Antibiotic consumption was calculated by DOT. Among 395 patients screened, 185 patients who had an MSSA bacteraemia received either monotherapy ( n = 73, 39.5%) or combination therapy ( n = 112, 60.5%). The 30-d mortality rate was similar between groups (%15.1 vs. 21.4, P = 0.280). Time to bacterial clearance was also similar (median (IQR): 4 (3–7) vs . 4 (3–7) d, P = 0.699). DOT per 1000 patient days was significantly higher in the combination therapy group than in the monotherapy group (median, IQR: 1420, 827–1836 vs. 933, 732–1000), P < 0.001). The 30-d mortality rate was 18.9% ( n = 35/185), and the PITT bacteraemia score was the only independent predictor of mortality (median, IQR: 1506, 1.264–1.794, P < 0.001). Our findings indicate that combination therapy does not confer a survival benefit over monotherapy in patients with MSSA bacteraemia. However, combination therapy was associated with a significant increase in antibiotic consumption. Therefore, our results do not support the routine use of combination therapy for MSSA bacteraemia in this patient population.
Journals
2026 EN
Altheeb Ali · Alshaikh Ibrahim M. H. · Abadel Aref A.
+2 more
The sudden loss of columns due to abnormal loads demonstrates a remarkable example of a localized failure that might ultimately result in the progressive collapse of the complete steel-framed structures. In this study, finite element (FE) simulations are implemented by utilizing ABAQUS-Explicit to investigate the progressive collapse of two-storey steel reduced beam section (RBS) frames with web openings. The reliability and accuracy of the FE models are validated by comparing the obtained results with currently available experimental test results. A numerical investigation is conducted on twenty-eight RBS frames, each with a distinct web opening form (i.e. circular, square, and hexagon holes), different sizes of (D = 75, 90, and 105 mm), and varying distances of (25, 50, and 100 mm) from the center of the flange-reduced to the web opening. The failure modes, load-displacement characteristics, and development of catenary action are evaluated. The results showed that the specimens with square holes showed a greater degree of damage and lower load-carrying capacity compared with the specimens that have circle and hexagonal holes. In addition, an increased opening size resulted in a decrease in load-bearing capacity at small distances, thereby resulting in an increased capacity at a large distance.
Journals
2026 EN
Ashteyat Ahmed M. · Obaidat Ala’ Taleb · Al Hazmi Ibrahim
+1 more
Flat slabs are increasingly utilized in multi-story structures, including office buildings and parking facilities. However, the necessity for punching shear reinforcement arises due to factors such as design deficiencies, fire exposure, non-compliance with updated codes, or increased vertical loading. This study examines the behavior of nine two-way slabs (1050 × 1050 × 70 mm) supported by steel plate columns (150 × 150 × 50 mm). Seven slabs were heated to 600 °C for 3 hours. Six of these slabs were then rehabilitated using near-surface mounted carbon fiber reinforced polymer (NSM-CFRP) ropes and strips, applied in different configurations (orthogonal and radial). Results indicated that thermal exposure led to a significant reduction in ultimate load capacity, up to 48%, increased deflection, and enhanced ductility relative to the control. The incorporation of NSM-CFRP ropes enhanced the ultimate capacity by 11% to 54% compared to the thermally damaged specimens. The most effective configuration involved a single rope in an orthogonal layout, which showed an increase in the ultimate capacity by 30%, while additional ropes provided no significant capacity gain, likely due to reduced effectiveness from close spacing. A finite element model developed in ABAQUS showed strong agreement with experimental data, offering valuable insights for optimizing reinforcement strategies in flat slab construction.
Journals
2026 EN
Ali Nasir M. · Haji-Ibrahim Faheema · Gerstner Nicki L.
Through a collaborative autoethnographic dialogue this article seeks to challenge hierarchical structures of teaching, learning, research, activism, and development through the lens of practitioners who work toward social justice and building a culture of peace through higher education in Somaliland. The main question guiding the article is, how does one HEI in Somaliland transform and embed indigenous conflict resolution mechanisms and peacebuilding processes to engage the communities that they serve, locally and globally? Lederach’s ([1997]. Building Peace: Sustainable reconciliation in divided societies . Washington, DC: United States Institute of Peace Press.) ‘actors and approaches to peacebuilding framework’ is operationalized to analyze and discuss how the HEI and university educators pay careful attention to local contexts in unique and particular ways, and how they work to disrupt colonial and Western hegemonic normative educational paradigms. The paper further contributes to understanding indigenous methods and grassroots concerns for HE research and pedagogical praxis, as well as restructuring global priorities to directly impact the communities they serve, locally and globally.