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School leadership and indigenous student outcomes: A correlational study of Student Needs Management Practices based on Maslow’s Hierarchy of Needs

Indigenous students continue to face persistent educational disadvantages, including lower academic attainment and reduced school engagement, often linked to school systems that do not systematically address students’ hierarchical needs. This study examined the association between principal-led Student Needs Management Practices (SNMP) and Indigenous student outcomes across 93 national primary schools in Orang Asli settlement areas in Peninsular Malaysia. Using a quantitative cross-sectional design, data were collected from 342 teachers through multi-stage sampling. SNMP was operationalised across five Maslow-derived dimensions physiological, safety, belongingness, esteem, and self-actualisation needs while Indigenous student outcomes encompassed academic achievement, co-curricular participation, and character development. Both SNMP (M = 4.63, SD = 0.39) and student outcomes (M = 4.26, SD = 0.49) were rated at very high levels by teacher respondents. Pearson correlation revealed a significant, moderate positive association between SNMP and student outcomes (r = .411, p < .001). Multiple regression indicated that the five SNMP dimensions collectively explained 18.8% of the variance in student outcomes (R 2  = .188, adjusted R 2  = .176), F(5, 336) = 15.559, p < .001. Belongingness needs emerged as the only statistically significant predictor (β = .298, p < .001); safety needs approached significance (β = .124, p = .061); physiological, esteem, and self-actualisation needs were not significant predictors. These findings suggest that emotional and relational dimensions of leadership practice are more directly associated with Indigenous student outcomes than material or recognition-based dimensions, and that the modest direct association is consistent with leadership-influence models in which principals affect student outcomes substantially through intermediate mechanisms such as teacher commitment. The study offers evidence-based implications for needs-responsive school leadership in Indigenous education contexts.

Transdermal Estradiol Patches in Prostate Cancer

Synthetic gRNA-mediated multiplex CRISPR enables the generation of translucent F0 Xenopus laevis for in vivo imaging

Abstract Transparent model organisms are invaluable for live imaging, yet generating them remains challenging. Here, we present a robust strategy to produce translucent Xenopus laevis , enabling non-invasive, deep-tissue imaging in intact organisms. Using CRISPR/Cas9 technology, we generated quadruple knockout animals targeting slc2a7 , hps6 , and the two tyrosinase homeologs. Instead of in vitro-transcribed single guide RNAs, we employed chemically modified, commercially synthesized two-part guide RNAs, which enabled efficient multiplex genome editing. We produced a high proportion of translucent frogs directly in F0 founder tadpoles, eliminating the need for multi-generational breeding. We validated in vivo live imaging using two transgenic reporter lines with GFP expression in the eye, brain, and heart. Loss of both eumelanin and iridescent pigments in tyr ; hps6 knockouts markedly improved optical clarity and fluorescence visibility. Overall, this multiplexed genome-editing strategy enables the rapid generation of translucent transgenic X. laevis suitable for live imaging, while also providing a simple and efficient protocol for simultaneous multi-gene targeting in X. laevis .

Trends in the incidence of asthma, atopic dermatitis, and multiple sclerosis before, during, and after the COVID-19 pandemic in a US claims database

There is limited evidence on how reduced healthcare resource utilization during the COVID-19 pandemic has affected the detection of inflammatory and immunologic diseases. We aimed to describe the observed incidence rates (IRs) of asthma, atopic dermatitis (AD), and multiple sclerosis (MS) before, during, and after the pandemic. Individuals aged ≥6 years were identified in Optum’s de-identified Clinformatics ® Data Mart Database from 2018 to 2022 to make 20 season-based cohorts. Age- and sex-standardized IRs of asthma, AD, and MS were estimated. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were calculated comparing IRs in seasonal cohorts in 2019–2022 to the corresponding timeframe in 2018. Compared to spring 2018, IRs of asthma, AD, and MS in spring 2020 decreased by 14% (IRR: 0.86, 95% CI: 0.84–0.87), 28% (IRR: 0.72, 95% CI: 0.69–0.75), and 23% (IRR: 0.77, 95% CI: 0.68–0.87), respectively. The observed incidence reduction was most profound in children (6–11 years) and adolescents (12–17 years), followed by senior adults (≥65 years). There was no sex difference. IRs returned to or exceeded pre-pandemic levels for AD and MS in summer 2020 and for asthma in spring 2021. COVID-19 led to an apparent decline in incidence for selected inflammatory and immunologic diseases, which was more pronounced for pediatric and senior populations. The observed decrease in incidence likely reflects delayed access to healthcare, resulting in unrecorded (but still occurring) diagnoses for those time periods. Future studies using data that encompass the pandemic period should exercise caution in the design of study and interpretation of incidence or prevalence data.

Pretreatment prognostic nutritional index is associated with survival outcomes in locally advanced NSCLC treated with definitive chemoradiotherapy

TIG welding defect detection using ResNet and Random Forest

Orbital TIG welding is critical in precision manufacturing, where weld defects can affect structural reliability. Manual inspection, analysis, and evaluation of welding defect images are complex because defect characteristics vary in shape, position, and size, making the process time-consuming. This study proposes a method that combines ResNet50 feature extraction with Random Forest classification to improve classification accuracy. A total of 3,219 weld image samples collected from controlled orbital TIG experiments were used for model training and evaluation and divided into four classes: normal weld, lack of fusion, overheating, and uneven weld. Using five-fold cross-validation, the method achieved an overall accuracy of 98% and demonstrated improved performance compared with CNN architectures (VGG16, VGG19, ResNet18, ResNet50) and traditional machine learning approaches such as SVM and Random Forest. ResNet50 extracts hierarchical visual representations through deep residual connections, enabling automatic feature learning, while Random Forest performs the final classification with robustness against overfitting on high-dimensional features.

Comparative metabolomics of serum and serum extracellular vesicles of melanoma and triple-negative breast cancer utilizing biobank samples

Abstract Extracellular vesicles (EVs), abundant in circulation and obtainable through liquid biopsy, carry metabolites that reflect both the activity of EVs and state of the cells of origin. Thereby, metabolomics offers a sensitive means to detect dynamic changes associated with cancer. We compared serum and matched serum-derived EV metabolite profiles from patients with melanoma or triple-negative breast cancer (TNBC) and age- and sex-matched cancer-free controls to evaluate the suitability of biobank serum samples and the corresponding EVs to identify cancer-type -associated metabolic alterations. For untargeted metabolomics and metabolite/pathway identification, EVs were isolated from biobank-derived serum samples by size-exclusion chromatography and ultrafiltration, and preanalytical variables of samples were monitored according to Minimal Information for Blood EV research guidelines. More metabolite differences were found between patients and controls in melanoma than in TNBC. Melanoma serum contained reduced levels of several metabolite groups (amino acids, lipids, and organic acids), whereas melanoma EVs were enriched in polyunsaturated phospholipids. In TNBC, serum contained increased levels of long-chain fatty acid amides, while EVs showed no significant metabolite alterations. These results demonstrate that serum and EVs offer complementary metabolite information, and biobank samples are suitable for EV metabolomics. Monitoring and recording preanalytical factors will enable improved cross-study comparability and biomarker validation.

The role of neutrophil PD-L1 expression in acute exacerbation of COPD

Background and objective The elevation of neutrophil-lymphocyte ratio (NLR) has been shown to be critically involved in unfavorable outcomes among patients with chronic obstructive pulmonary disease (COPD). The mechanism underlying NLR changes during COPD progression remains unclear. This study evaluates the association between neutrophil PD-L1 expression and acute exacerbation of AECOPD and examines its correlation with the NLR. Methods In this prospective observational study from June 1 to December 30 2024, we enrolled 14 patients with acute exacerbation, 27 with stable conditions, and 9 healthy control subjects. Blood samples were collected for neutrophil isolation, and the CD15 + CD274 + neutrophil percentage was measured using flow cytometry. We also recorded and analyzed smoking history, pulmonary function test results, and blood routine test data. Results The percentage of CD15 + CD274 + neutrophils was notably higher in patients with COPD compared to healthy controls and was even more elevated in those experiencing acute exacerbations of COPD (AECOPD) than in patients with stable COPD. This increased percentage was positively correlated with NLR but negatively correlated with FEV 1 % (FEV 1 percentage of the predicted value). The AUC of CD15 + CD274 + neutrophil percentage for predicting AECOPD was 0.894 with 95% CI 0.8–0.989 and a ratio above 3.273 (odds ratio 1.386; 95% CI 1.016–1.891; P = 0.039) independently associated with AECOPD. Conclusion Peripheral blood neutrophil PD-L1 expression was elevated in AECOPD and independently associated with exacerbation status in this pilot cohort. Larger, multi-center studies with mechanistic validation are required to determine its clinical utility.

A frequency-saliency guided multi-scale feature fusion network for robust UAV object detection

Contrastive learning with mutual information enhancement and negative sample augmentation combined with KAN for text clustering

This paper proposes a text clustering model based on mutual information-enhanced contrastive learning combined with Kolmogorov-Arnold Networks (KAN) to address challenges in text clustering, including insufficient robustness of text representations, feature redundancy, and the curse of dimensionality. Text clustering is essential for organizing unstructured textual data, yet existing methods often suffer from weak feature representations and limited scalability in high-dimensional spaces. The proposed model jointly addresses these three core issues by maximizing mutual information to capture nonlinear relationships among positive samples, expanding negative samples to enhance discriminability, and employing the KAN architecture to adapt to the complex structures of high-dimensional data. Experimental results on eight benchmark datasets demonstrate that the proposed model achieves state-of-the-art accuracy on seven out of eight datasets and leads normalized mutual information on six datasets, outperforming existing text clustering baselines. To validate its practical utility, the model was applied to cluster Weibo posts collected via web crawlers using “technology” as the keyword during January and February 2025. The case study results reveal that the model effectively identifies meaningful thematic clusters—such as AI applications, technology industry trends, and consumer electronics discussions—confirming its applicability to real-world social media data.

Interactive effects of ETc-based drip irrigation scheduling and phytohormones on root architecture, physiological traits and yield of wheat

Exploring perceptions, readiness, barriers, and facilitators related to the potential implementation of postpartum depression screening: A mixed-methods study in a Lebanese maternity setting

Background Postpartum depression (PPD) is a common mental health condition affecting mothers, infants, and families, with higher prevalence in middle-income countries. Despite its burden, PPD remains under-screened in Lebanese public hospitals, particularly in disadvantaged areas like Tripoli. Objectives To assess nurses’ knowledge, attitudes, and practices regarding PPD and explore facilitators, and barriers influencing the potential implementation of systematic PPD screening. Methods A mixed-methods study was conducted in a Lebanese public university hospital, combining a quantitative survey with qualitative focus group discussions involving nurses and managers. Descriptive analyses were applied to survey data, and thematic analysis was used for qualitative findings. Results Most nurses were aware of PPD (92.9%) and “baby blues” (92.9%), but only 21.4% were aware of standardized screening tools. Correct identification of key symptoms was reported by 71.4%, while only 35.7% correctly identified all risk factors and 28.6% recognized appropriate combined management (psychotherapy and antidepressants). Regarding attitudes, all participants (100%) agreed that PPD screening should be part of routine postnatal care, and 92.9% recognized its seriousness and the role of nurses in early detection. However, only 78.6% felt confident identifying PPD signs. In terms of practice, only 28.6% consistently assessed mothers’ emotional well-being before discharge. Qualitative findings suggested a generally positive attitude toward the potential implementation of screening, while also highlighting perceived barriers, including insufficient training, unclear role delineation, inadequate referral pathways, time constraints, and weak internal communication regarding mental health services. Conclusion The findings suggest that challenges to the potential implementation of PPD screening may be related to capacity and organizational support than to resistance among participants. Strengthening training, integrating standardized screening into routine postnatal care, clarifying roles and referral pathways may facilitate the implementation of PPD screening. Given the exploratory nature of this single-center study, further research is needed to assess the transferability of these findings to other maternity care settings in Lebanon.

Patterns and trends of mortality in patients with arrhythmia and cerebrovascular disease in the United States: a nationwide analysis of older adults

Abstract Arrhythmias and cerebrovascular disease commonly coexist in older adults and are associated with increased mortality risk. However, population-level trends and demographic disparities in related deaths remain insufficiently characterized, necessitating large-scale analyses to better inform prevention, risk stratification, and healthcare planning. Data from CDC WONDER (1999–2023) identified U.S. mortality rates in adults aged (≥ 65 years) with arrhythmia (ICD-10: I47-I49) and cerebrovascular disease (ICD-10: I60-I69) among U.S. adults aged 65 and older. Age-adjusted mortality rates (AAMRs) per 100,000 were stratified by sex, race, urbanization and regions. Trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Between 1999 and 2023, a total of 733,476 deaths among older adults (≥ 65 years) were attributed to arrhythmias and cerebrovascular disease. The AAMRs exhibited an upward trend from 72.14 in 1999 to 74.62 in 2023 (AAPC: 0.055, 95% CI − 0.62 to 0.74; p 0.87) with a significant rise in AAMR from 65.51 in 2018 to 80.44 in 2021 (APC: 6.65; p 0.01). Men had higher AAMR than women during 1999–2023 with (73.97 to 81.27 vs. 70.22 to 69.2). NH White individuals had the highest AAMR in 2021 (87.43) with a total (631,483 deaths). The South recorded the most deaths (251,478) with a significant decline in AAMR from (70.36) in 2002 to (58.54) in 2008 (APC: − 2.89, 95% CI − 3.85 to − 1.92; p 0.004). Non-metropolitan areas had higher AAMR compared to metropolitan areas (73.62 vs. 64.71). For the place of death, the majority occurred in inpatient medical facilities (38.73%, 284,079 deaths). Mortality related to arrhythmias and cerebrovascular disease has increased in recent years among older adults. While women accounted for more deaths, men consistently had higher AAMRs. Higher mortality burden was also observed among NH White individuals, residents of the South, and urban populations, with most deaths occurring in inpatient medical facilities, highlighting the need for targeted interventions.

Earth pressure analysis of inclined support structures adjacent to existing structures

This study investigates the earth pressure acting on inclined support structures adjacent to existing structures by combining laboratory physical model tests with theoretical derivation. Five groups of model tests were conducted at a constant width-to-height ratio of 0.95, with support inclination angles of 0°, 5°, 10°, 15°, and 20°. Particle image velocimetry (PIV) and multi-point earth pressure monitoring were employed to reveal the failure surface development in the finite soil mass and the distribution characteristics of earth pressure behind the wall. Based on the assumptions of straight failure surfaces and circular-arc major principal stress trajectories, the finite soil mass was divided into several zones. Force equilibrium equations were established for horizontal differential elements in each zone, and theoretical models for earth pressure intensity, resultant force, and the point of application of the resultant force were derived. The theoretical results were generally in good agreement with the experimental results and reasonably reflected the distribution characteristics of passive earth pressure in the finite soil mass under inclined support conditions. In particular, the theoretical predictions were in good agreement with the measured values in the principal compression zone in the middle and lower portions of the soil mass. The measured earth pressures at the upper monitoring points were markedly lower because of local wall-soil separation, the inability of cohesionless sand to transmit tensile stress, and wall-soil contact relaxation. Within the experimental validation range, the resultant earth pressure decreased and its point of application generally shifted upward as the support inclination angle increased. In contrast, an increase in the soil friction angle caused the point of application to shift downward. The findings of this study can provide a theoretical reference for the design of inclined support structures in projects adjacent to existing structures.

Experimental enhancement the evaporator performance using pulsated refrigerant flow

Abstract This study investigates the experimental application of pulsating flow to significantly improve heat transfer rates within an air conditioning system’s evaporator. The core aim is to boost the evaporator’s performance and, consequently, the overall coefficient of performance (COP) of the air conditioning unit. Refrigerant pulsations are generated within the evaporator coil using an electrical pulse control circuit, with tested frequencies of 6, 9, and 12 Hz under variable ambient temperatures of 24 °C, 26 °C, and 28 °C. Experiments conducted on a split air conditioner revealed only a negligible increase in compressor power consumption. Notably, the pulsating technique dramatically reduced the operating time needed to reach a desired temperature, with the most significant impact observed at a frequency of 9 Hz. This modification is characterized by its simplicity and cost-effectiveness, making it easily adaptable to various cooling and air conditioning systems. The results demonstrate a 13.33% increase in the evaporator’s heat transfer rate, a 13.63% improvement in the system’s COP, a 23.3% reduction in operating time, and consistent power consumption. These findings collectively highlight the effectiveness and practicality of integrating pulsating flow for enhancing the evaporator performance of an air conditioning system.

Parental perspectives of prenatal counseling and decision making for termination or hospice birth due to fetal congenital heart defects

Objective To evaluate perspectives of counseling and decision making among birthing parents who chose termination or hospice birth due to a fetal congenital heart defect (CHD). Methods Qualitative analysis of semi-structured interviews with birthing parents who chose either termination or hospice birth due to severe fetal CHD. Participants were recruited from a purposive sample of those who received multidisciplinary counseling at a tertiary congenital heart surgical center between 2019–2023. Thematic analysis was conducted in five stages, using an integrated deductive-inductive approach. Results In total, 20 individuals were eligible; 10 completed interviews. Identified themes were categorized in two domains: Experiences During Counseling and Individual Factors Affecting Decision Making. Themes in the first domain included: areas for improvement during counseling, perceived strengths of counseling, patient attributes affecting counseling, and views on provider recommendations. Themes in the second domain included: emotions affecting decision making, value for reproductive autonomy, family factors, internal factors, outside input, and desire for resources. Conclusions In this study, birthing parents who chose termination or hospice for fetal CHD appreciated information extending beyond clinical outcomes to include family and financial impacts. Their value for reproductive autonomy reflects the need for clinicians to gain skills in empathetic and neutral counseling of all management options.

Morphomolecular characterization and statistical assessment of environmental associations with Diplectanum infestation in cultured European sea bass and bath treatment efficacy

Abstract Monogenean infections are one of the most economically important parasitic constraints in marine aquaculture; however, knowledge remains limited regarding their genetic diversity, epidemiology, and sustainable management strategies. This study investigated the prevalence, morphomolecular characterization, environmental drivers, and eco-friendly control of naturally occurring monogenean infections in European sea bass ( Dicentrarchus labrax ) from two marine farms along the Egyptian Mediterranean coast between February and May 2024. Infected fish exhibited respiratory distress, skin darkening, anorexia, and progressive emaciation under heavy infestation. Examination of gill smears identified an elongate-oval monogenean exhibiting morphological features consistent with D. laubieri . Phylogenetic analysis of partial 18 S rRNA gene sequences placed the specimen within the Diplectanum clade, corroborating its taxonomic affiliation (GenBank accession no. PZ253293.1). Parasitological indices varied significantly between farms, with a higher prevalence recorded at Farm 2 (75.00 ± 6.87%) than at Farm 1 (65.56 ± 7.51%) ( p  < 0.05). Seasonally, the highest prevalence occurred in February, followed by a decline in April and a slight increase in May. Water quality analysis indicated a progressive rise in temperature on both farms, reaching 25.40 ± 0.16 °C in May. In contrast, Farm 2 was characterized by higher salinity, pH, and total ammonia levels, together with lower dissolved oxygen concentrations. Correlation analysis demonstrated a strong negative association between parasite prevalence and water temperature ( r  = − 0.736, p  < 0.05), whereas no significant correlations were observed with salinity, pH, dissolved oxygen, or total ammonia. In trials of treating the affected fish and based on toxicity testing, the safe exposure threshold for Y. schidigera extract was established at 150–200 µg/L, while fenbendazole exhibited a safe exposure limit of 20 µg/L. The experimental cohabitation successfully reproduced the infection, achieving a prevalence of 90% by day 14. Comparative therapeutic efficacy trials demonstrated the superior performance of Y. schidigera relative to fenbendazole under the present study conditions, with parasite reduction rates of 80.4% and 68.5%, respectively, accompanied by a lower incidence of mortality. Collectively, these findings highlight the combined influence of environmental conditions on monogenean infection dynamics and support phytogenic-based Y. schidigera as a promising eco-friendly alternative for parasite control in marine aquaculture systems.

Ultrasound-guided sacral multifidus plane block versus caudal epidural block for postoperative analgesia in pediatric hypospadias surgery: A randomized double-blind controlled trial

Introduction Hypospadias repair is associated with moderate to severe postoperative pain in children. Caudal epidural block is traditionally considered the standard regional anesthetic technique for sub-umbilical pediatric surgeries; however, its duration of analgesia and potential adverse effects may be limited. The sacral multifidus plane block (SMPB) is a novel ultrasound-guided fascial plane technique that may provide prolonged analgesia with fewer complications. The aim of this study is to compare the analgesic efficacy and safety of ultrasound-guided sacral multifidus plane block versus caudal epidural block in children undergoing hypospadias repair. Materials and methods This prospective, randomized, double-blind controlled trial included 30 children aged 1–5 years (ASA I–II) scheduled for hypospadias repair. Patients were randomly allocated to receive either SMPB (n = 15) or caudal block (n = 15), using 1 mL/kg of 0.25% bupivacaine. The primary outcome was time to first rescue analgesia. Secondary outcomes included postoperative FLACC pain scores, total rescue analgesic consumption, intraoperative fentanyl requirements, hemodynamic variables, and block-related complications. Pain was assessed for 24 hours postoperatively. Results Demographic and intraoperative characteristics were comparable between groups. Time to first rescue analgesia was significantly longer in the SMPB group compared with the caudal group (14.8 ± 3.6 vs 9.3 ± 4.2 hours, p = 0.004). FLACC scores were significantly lower in the SMPB group at 6 and 12 hours postoperatively (p = 0.019 and p = 0.001, respectively). Total diclofenac consumption was lower in the SMPB group (0.40 ± 0.20 mg/kg vs 0.70 ± 0.24 mg/kg, p = 0.010). Intraoperative fentanyl requirements and hemodynamic parameters were similar. No major complications were observed. Conclusion Ultrasound-guided sacral multifidus plane block provides longer-lasting postoperative analgesia and reduces rescue analgesic requirements compared with caudal epidural block in pediatric hypospadias surgery, with a comparable safety profile. SMPB may represent a reliable alternative to caudal block for postoperative pain management in this population.

Secure distributed multimodal biometric authentication using blockchain with 3D face and 3D ear recognition

Feedback and feedforward methods in medical and higher health education: A scoping review

Background Programmatic assessment (PA) in health professions education positions continuous feedback and feedforward as key mechanisms for competence development. Feedback focuses on prior performance, whereas feedforward provides future-oriented guidance that supports agency and self-regulated learning. Although their educational value is widely acknowledged, implementation remains challenging and often emphasises performance outcomes rather than action and reflection. Methods A scoping review was conducted to address the research question: “How are feedback and feedforward methods operationalised within assessment situations in medical and higher health professions education? The ECLIPSE framework (Expectation, Client group, Location, Impact, Professionals, Service) guided question formulation and searches in Embase, ERIC and PubMed. Articles published from 2015 up to February 2026 were included. Data were synthesized using descriptive and thematic synthesis. The methodological quality of the included studies was assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Results Database searches identified 3723 records. After deduplication and screening, 91 full texts were assessed, of which 14 studies met inclusion criteria. All studies involved medical students. Five methodological families were identified: expert feedback, self-feedback, peer feedback, video-based feedback, and feedforward. Expert and video-based approaches were consistently associated with performance gains, whereas self- and peer feedback supported reflection and learner agency but showed variable outcomes. Feedforward was rarely explicitly described, although several interventions incorporated forward-looking elements targeting performance. Conclusion Current assessment practices rely on a limited set of recurring methods, with feedforward, predominantly focused on performance, often remaining implicit. Making feedforward explicit and actionable within assessment cycles might strengthen competence development, promote learner agency, and support continuous improvement in PA context.