This investigation pioneers an examination of the scarcely explored terrain of social diversity in medical education, assessing the complex impacts of socioeconomic status (SES), prior working experiences, and completed apprenticeships on a spectrum of psychological and academic facets among first-year medical students (n = 336) in an urban university setting. By utilizing a systematic and detailed approach, the study illuminates prior anatomical knowledge and various psycholog-ical constructs, marking a significant stride into a domain where knowledge remains profoundly limited. Analyses indicated that SES significantly affects financial anxiety (F(4, 331) = 17.391, p < .001) and academic behavioral confidence (F(4, 331) = 4.323, p = 0.002). Students with prior working experience reported higher self-perceived clinical experience but lower A-level grades (t(279.459) = -6.690, p < .001), competence in natural sciences (t(321.045) = -3.178, p = 0.002), and online competence (t(319.429) = -2.026, p = 0.044). Those who completed an apprenticeship showed higher resilience, academic confidence, self-efficacy, and greater concerns about balancing studies and work (t values ranging from 2.020 to 3.158, p < 0.05). Correlation analysis revealed a positive relationship between resilience (RQS) and coping with academic stress (CAS) (r = 0.632, p < .001), as well as between resilience and academic behavioral confidence (ABC) (r = 0.608, p < .001). Negative correlations were observed between resilience, coping with academic stress, academic confidence, and cognitive test anxiety (CTA) (r values from -0.235 to -0.404, p < .001). The findings emphasize the need for tailored support for students from diverse SES backgrounds and with varying expe-riences. The study highlights the value of a comprehensive approach in medical education, con-sidering the diverse backgrounds and experiences of students. Future research should explore the long-term impact of these factors on professional competencies and patient care, leveraging the diversity of the student body for a holistic educational experience.

Rationale: Genetically modified (GM) foods have the potential to reduce food insecurity and address economic and environmental issues. Despite these benefits, GM foods continue to face significant criticism and there is limited information on public awareness and understanding of their nutritional and environmental health benefits in Nigeria. This study aims to fill this gap by investigating public knowledge and perceptions of GM foods in Victoria Island, Lagos. Methods: A convenience sampling method was used to recruit 369 respondents from Victoria Island, Lagos. Data were gathered using a structured questionnaire. The target population comprised employed adults either residing or working on Victoria Island. Statistical analyses were conducted to examine the relationship between sociodemographic factors and awareness of GM foods. Results: The study found that a majority of respondents (62.9%, n=232) were knowledgeable about GM foods and their associated issues. However, many believed that their community was not well-informed on the topic. Awareness of GM foods was significantly associated with sociodemographic factors such as marital status and education (P<0.01). Most respondents were well-informed about the environmental and health benefits of GM foods, with 61.8% believing that GM food production could sustainably reduce reliance on chemical pesticides, fertilizers, and other energy inputs, thus mitigating their ecological impacts. Additionally, most respondents did not feel that purchasing or consuming GM foods conflicted with their beliefs or would affect their food choices. Conclusion: The study concludes that while individual awareness of GM foods is relatively high, there is a perception that community awareness is low. Sociodemographic factors play a significant role in shaping public awareness and perceptions of GM foods. Recommendations: This includes government should actively educate the public on the ecological and health benefits of GM foods and address any safety concerns; Implement strict border controls and food labeling for GM products to protect consumer rights and preferences for organic foods, provide sufficient technical and financial assistance to farmers who participate in organic seed programs to enhance national food security. Significant Statement: This study highlights the importance of public education on GM foods and underscores the need for government intervention to ensure informed consumer choices and support for sustainable agricultural practices.

The construction industry is shifting towards more sustainable practices to address environmental concerns. This review examines the impact of LEED certification on design-build projects, highlighting how the two work together to promote sustainability. By analyzing the article under review, we explore how LEED standards—such as energy efficiency, water conservation, and the use of sustainable materials—are incorporated into design-build projects to create environmentally responsible buildings. The article also discusses the benefits of the design- build approach, which encourages collaboration and early integration of sustainability principles. The review critically assesses the strengths and weaknesses of the article, emphasizing the importance of cost considerations and scalability. Ultimately, it underscores the value of combining LEED certification with design-build to promote green building practices.

Sustainability in construction has emerged as a critical focus in response to growing environmental challenges. This article review explores the intersection of LEED (Leadership in Energy and Environmental Design) certification and design-build construction, highlighting how these two frameworks enhance sustainability in the built environment. By examining the findings of a selected article, the review emphasizes the advantages of LEED certification in promoting energy efficiency, reducing waste, and improving overall environmental performance. The design-build method, with its integrated and collaborative approach, complements LEED’s objectives by ensuring that sustainability is prioritized from the initial planning stages. This review also critically analyzes the strengths and limitations of the article, including its coverage of cost-related challenges and the applicability of LEED in diverse project scales. Ultimately, the review underscores the significant role that LEED certification plays in advancing sustainable construction practices, particularly within the design-build model.

Background: This study addresses the burgeoning impact of Large Language Models (LLMs) such as ChatGPT on the integrity of online examinations and seeks to demonstrate latent and advanced LLM reasoning capabilities. The research devises an iterative self-reflective strategy for invoking critical thinking and higher-order reasoning in LLMs based on multimodal exam questions using visuals and text. Methods: The proposed strategy was demonstrated and evaluated on real exam questions by subject experts and the performance of ChatGPT (GPT-4) with vision was estimated on an additional dataset of 600 text descriptions of multimodal exam questions, focusing on its response to complex, visual, and textual prompts. Results: The results indicate that latent multi-hop reasoning capabilities can be invoked using the proposed self-reflective strategy, which can effectively steer ChatGPT towards correct answers by integrating critical thinking from each modality into the final response. Meanwhile, ChatGPT demonstrated considerable proficiency in being able to answer multimodal exam questions across 12 subjects. Conclusions: This work challenges findings from recent studies which claim that existing LLMs are unable to reason on complex multimodal tasks, and therefore this study underscores the need for enhanced online exam security measures like proctoring software, that can mitigate the potential misuse of AI technologies in educational settings.

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD), which has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as an ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 &amp; 0.91, p values = 0.001, 95% CI: 0.80-0.92 &amp; 0.87 to 0.94, sensitivity = 0.85 &amp; 0.87, specificity = 0.73 &amp; 0.83, Youden index = 0.58 &amp; 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by the irritability expressed stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability resulted from direct and indirect effects of key PTSD symptoms (intrusion, hyperarousal, and numbing). Irritability contributed to traumatic symptoms of sleep disturbance in both samples while the opposite was not true. The findings suggest usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/ co-morbidities (sleep disturbance) in both healthy and diseased groups.

Many academics are critical of the current publishing system, but it is difficult to create a better alternative. This review relates to the Sciences and Social Sciences, and discusses the primary purpose of academic journals as providing a seal of approval for perceived quality, impact, significance, and importance. The key issues considered include the role of anonymous refereeing, continuous rather than discrete frequency of publications, avoidance of time wasting, and seeking adventure. Here we give recommendations about the organization of journal articles, the roles of associate editors and referees, measuring the time frame for refereeing submitted articles in days and weeks rather than months and years, encouraging open access internet publishing, emphasizing the continuity of publishing online, academic publishing as a continuous dynamic process, and how to improve research after publication. Citations and functions thereof, such as the journal impact factor and h-index, are the benchmark for evaluating the importance and impact of academic journals and published articles. Even in the very top journals, a high proportion of published articles are never cited, not even by the authors themselves. Top journal publications do not guarantee that published articles will make significant contributions, or that they will ever be highly cited. The COVID-19 world should encourage academics worldwide not only to rethink academic teaching, but also to re-evaluate key issues associated with academic journal publishing in the future.

Perhaps the greatest challenge in the graft copolymerization of acrylic acid onto starch initiated by Fenton’s is the selectivity of the grafting reaction. Low selectivity means that too much of unwanted homopolymer polyacrylic acid is produced. In this paper, it has been analyzed why with this reaction system, involving a water soluble monomer and indirect initiation, the graft selectivity is such a challenge. Several other grafting reactions, especially with monomers of low water solubility or when direct initiation is applied, show a better grafting performance. A scheme is presented based on reaction engineering principles, that supports an explanation of the observed differences. A more selective activation of starch is a factor, but perhaps even more important is a low monomer to starch ratio at the starting sites of graft reactions. Based on these insights, several methods to improve the graft selectivity are evaluated, with the help of literature data but mostly by experimental explorations in our laboratory. Most promising appears to be a dedicated dosage method, to add monomer in portions over time, tested in a batch reactor with gelatinized cassava starch. This way, both grafting percentage and graft selectivity could be improved. Such could not be realized with the more conventional dosage, which is to add all monomer before the start of the reaction. This can be considered a principal breaktrough. Still, more research and development would be needed to refine the method and to implement the idea also in a continuous reactor at larger scale.

The study comprehensively evaluated the prognostic roles of PLR, NLR, MLR, BLR, and ELR in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD). 619 patients with AECOPD and 300 healthy volunteers were retrospectively included into the study. The clinical characteristics containing laboratory findings of the AECOPD patients and the blood cell counts (CBCs) of the healthy volunteers were collected. Compared with the healthy volunteers, PLR, NLR, and MLR were elevated in COPD patients in stable condition, and were further ele-vated during exacerbation. ELR showed the opposite trend. PLR, NLR, and MLR were all posi-tively correlated with hospital LOS as well as CRP. In contrast, ELR was negatively correlated with hospital LOS as well as CRP. Elevated PLR, NLR, and MLR were all associated with more serious airflow limitation in AECOPD. Elevated PLR, NLR, and MLR were all associated with increased in-hospital mortality while Elevated ELR was associated with decreased in-hospital mortality in AECOPD. A nomogram was construct to predict in-hospital mortality in AECOPD. The nomo-gram had a C-index of 0.850 (95% CI: 0.799 – 0.901) with good predictive value and clinical ap-plicability. In summary, PLR, NLR, MLR, and ELR served as predictors for clinical outcomes in patients with AECOPD.

The advent of the digital age has introduced unprecedented opportunities for communication and connectivity, but it has also given rise to new forms of harassment, collectively termed cyber harassment. This research article provides an in-depth exploration of cyber harassment, examining its prevalence, the profound impact it has on victims, and potential solutions to mitigate its effects.The study is structured around three primary research objectives. Firstly, it investigates the psychological impact of cyber harassment on victims, highlighting the severe emotional and mental health consequences that can arise from such abuse. Secondly, the article scrutinizes the role of social media platforms in both facilitating and combating cyber harassment, analyzing how these platforms can act as both enablers of harassment and as venues for intervention. Thirdly, the research evaluates the current legal frameworks and responses to cyber harassment, considering their effectiveness and suggesting possible improvements. Recent research findings and diverse methodologies are integrated to provide a comprehensive understanding of the multi-faceted nature of cyber harassment. By addressing these key areas, the article aims to contribute to the development of more effective strategies to prevent and respond to cyber harassment, ultimately fostering a safer online environment.

The SARS-CoV-2 virus that causes the COVID-19 disease has wreaked havoc on the world community in terms of every imaginable parameter. The research output on COVID-19 has been nothing short of phenomenal, especially in the medical and biomedical sciences, where the search for a potential vaccine is being conducted in earnest. Much of the advanced research has been distributed in the leading medical journals, including the Journal of the American Medical Association (JAMA), where the latest research is distributed on a daily basis. The purpose of this paper is to provide some perspectives on 44 interesting and highly topical research papers that have been published in JAMA, at the time of writing, within the past two weeks. The diverse topics include public health, general medicine, internal medicine, oncology, paediatrics, geriatrics, and biostatistics.