Healthcare human resource planning is one of the biggest challenges facing the healthcare systems in many countries. Inadequate decisions in human resource planning can lead to an insufficient number of healthcare professionals then healthcare inequalities. One of the components of resource planning in the healthcare system is long-term data monitoring and the identification of potential trends. Since 1990, the number of physicians in Lithuania has decreased by 15.3% (−2266), but the decrease in the population has led to a 13.61% increase in the number of physicians per 10,000 inhabitants (5.32). During the analyzed period, the largest decrease in the number of physicians workforce by specialty was the number of medical physicians (−73.08%), epidemiology and hygiene (−69.30%), children’s diseases (−49.08%), the most increased number was of family/general practitioners (GPs), geneticists, physical medicine, and rehabilitation specialists. Since 1992, the number of visits to physicians in Lithuania, which has been decreasing for a long time, began increasing, and in 2022 (9.3 visits) it has almost reached the number of visits (9.5) per capita as in 1991. The aim of this research was to collect long-term data from various databases, summarize them, and identify possible trends and the reasons for data changes. The study analyzed data from the Lithuanian healthcare system from the Declaration of Independence of Lithuania to the last 30 years. The data includes or affects the indicators of the healthcare system, changes in population and doctors, the number of visits to doctors, the number of medical students and residents, and data determining inequalities in the healthcare system. Long-term data analysis is useful for developing a model of healthcare human resource planning and for planning healthcare resources. Full article

The gasification of residues into syngas offers a versatile gaseous fuel that can be used to produce heat and power in various applications. However, the application of syngas in engines presents several challenges due to the changes in its composition. Such variations can significantly alter the optimal operational conditions of the engines that are fueled with syngas, resulting in combustion instability, high engine variability, and misfires. In this context, this work presents an experimental investigation conducted on a port-fuel injection spark-ignition optical research engine using three different syngas mixtures, with a particular focus on the effects of CO/H₂ and diluent ratios. A comparative analysis is made against methane, considered as the baseline fuel. The in-cylinder pressure and related parameters are examined as indicators of combustion behavior. Additionally, 2D cycle-resolved digital visualization is employed to trace flame front propagation. Custom image processing techniques are applied to estimate flame speed, displacement, and morphological parameters. The engine runs at a constant speed (900 rpm) and with full throttle like stationary engine applications. The excess air–fuel ratios vary from 1.0 to 1.4 by adjusting the injection time and the spark timing according to the maximum brake torque of the baseline fuel. A thermodynamic analysis revealed notable trends in in-cylinder pressure traces, indicative of differences in combustion evolution and peak pressures among the syngas mixtures and methane. Moreover, the study quantified parameters such as the mass fraction burned, combustion stability (COVIMEP), and fuel conversion efficiency. The analysis provided insights into flame morphology, propagation speed, and distortion under varying conditions, shedding light on the influence of fuel composition and air dilution. Overall, the results contribute to advancing the understanding of syngas combustion behavior in SI engines and hold implications for optimizing engine performance and developing numerical models. Full article

Vitamin D₃ is a steroid hormone that confers anti-tumorigenic properties in prostate cells. Serum vitamin D₃ deficiency has been associated with advanced prostate cancer (PCa), particularly affecting African American (AA) men. Therefore, elucidating the pleiotropic effects of vitamin D on signaling pathways, essential to maintaining non-malignancy, may provide additional drug targets to mitigate disparate outcomes for men with PCa, especially AA men. We conducted RNA sequencing on an AA non-malignant prostate cell line, RC-77N/E, comparing untreated cells to those treated with 10 nM of vitamin D₃ metabolite, 1α,25(OH)₂D₃, at 24 h. Differential gene expression analysis revealed 1601 significant genes affected by 1α,25(OH)₂D₃ treatment. Pathway enrichment analysis predicted 1α,25(OH)₂D_3- mediated repression of prostate cancer, cell proliferation, actin cytoskeletal, and actin-related signaling pathways (p < 0.05). Prioritizing genes with vitamin D response elements and associating expression levels with overall survival (OS) in The Cancer Genome Atlas Prostate Adenocarcinoma (TCGA PRAD) cohort, we identified ANLN (Anillin) and ECT2 (Epithelial Cell Transforming 2) as potential prognostic PCa biomarkers. Both genes were strongly correlated and significantly downregulated by 1α,25(OH)₂D₃ treatment, where low expression was statistically associated with better overall survival outcomes in the TCGA PRAD public cohort. Increased ANLN and ECT2 mRNA gene expression was significantly associated with PCa, and Gleason scores using both the TCGA cohort (p < 0.05) and an AA non-malignant/tumor-matched cohort. Our findings suggest 1α,25(OH)₂D₃ regulation of these biomarkers may be significant for PCa prevention. In addition, 1α,25(OH)₂D₃ could be used as an adjuvant treatment targeting actin cytoskeleton signaling and actin cytoskeleton-related signaling pathways, particularly among AA men. Full article

The generation of high-quality wideband frequency sweeps presents a significant challenge, particularly in modern telecommunication, radar, and measurement systems where miniaturization is paramount. While phase-locked loops (PLLs) have become the dominant technique for signal generation, their application in broadband sweeps necessitates fractional-N operation. This, in turn, degrades phase noise and introduces unwanted spurs. This paper proposes a novel approach for broadband signal generation. By cascading two PLLs and utilizing a coaxial resonator, we achieve a high-performance oscillator that operates without the excessive fractional spurs, maintaining their level below −80 dBc across the entire frequency band. The prototype demonstrates non-degraded phase noise performance, reaching −102 dBc/Hz at 100 kHz offset and −121 dBc/Hz at 1 MHz offset for signals at 10 GHz. Despite significant frequency jumps, our design achieves lock times below 41 µs. These results, supported by theoretical analysis, validate the proposed method’s effectiveness in generating low-noise broadband frequency sweeps, ideal for local oscillator applications. Full article

Breast cancer represents a significant health concern, particularly in Saudi Arabia, where it ranks as the most prevalent cancer type among women. This study focuses on leveraging eXplainable Artificial Intelligence (XAI) techniques to predict benign and malignant breast cancer cases using various clinical and pathological features specific to Saudi Arabian patients. Six distinct models were trained and evaluated based on common performance metrics such as accuracy, precision, recall, F1 score, and AUC-ROC score. To enhance interpretability, Local Interpretable Model-Agnostic Explanations (LIME) and SHapley Additive exPlanations (SHAP) were applied. The analysis identified the Random Forest model as the top performer, achieving an accuracy of 0.72, along with robust precision, recall, F1 score, and AUC-ROC score values. Conversely, the Support Vector Machine model exhibited the poorest performance metrics, indicating its limited predictive capability. Notably, the XAI approaches unveiled variations in the feature importance rankings across models, underscoring the need for further investigation. These findings offer valuable insights into breast cancer diagnosis and machine learning interpretation, aiding healthcare providers in understanding and potentially integrating such technologies into clinical practices. Full article

In the manufacturing sector, tool wear substantially affects product quality and production efficiency. While traditional sequential deep learning models can handle time-series tasks, their neglect of complex temporal relationships in time-series data often leads to errors accumulating in continuous predictions, which reduces their forecasting accuracy for tool wear. For addressing these limitations, the parallel convolutional and recurrent neural networks with attention-modulated residual learning (ParaCRN-AMResNet) model is introduced. Compared with conventional deep learning models, ParaCRN-AMResNet markedly enhances the efficiency and precision of feature extraction from time-series data through its innovative parallel architecture. The model adeptly combines dilated convolution neural network and bidirectional gated recurrent units, effectively addressing distance dependencies and enriching the quantity and dimensions of extracted features. The strength of ParaCRN-AMResNet lies in its refined ability to capture the complex dynamics of time-series data, significantly boosting the model’s accuracy and generalization capability. The model’s efficacy was validated through comprehensive milling experiments and vibration signal analyses, showcasing ParaCRN-AMResNet’s superior performance. In evaluation metrics, the model achieved a MAE of 2.6015, MSE of 15.1921, R² of 0.9897, and MAPE of 2.7997%, conclusively proving its efficiency and accuracy in the precise prediction of tool wear. Full article

Cover crops in no-tillage systems may alter soil mineral N and influence the N fertilizer use efficiency (NFUE) of subsequent maize. The hypothesis of this work is that no-tillage systems with cover crops affect nitrate, ammonium and maize NFUE availability in the Brazilian Cerrado. The objective was to evaluate the cover crop mineralization effect on soil N mineral and maize NFUE in a no-tillage system, with and without N topdressing. The experiment was arranged in a randomized block split-plot design. The plots were represented by cover crops (Cajanus cajan, Crotalaria juncea, Raphanus sativus and Mucuna aterrima). The subplots consisted of the application (WN) or non-application (NN) of N topdressing to maize. The soil was sampled in six layers (up to 60 cm) at the end (April) and at the beginning of the rainy season (November). NH₄⁺ was lower for all cover crops and WN and NN management in April. NO₃⁻ differed between seasons and cover crops in WN and NN. The lignin concentration and N uptake of M. aterrima were the highest compared to other species. The highest NFUE was on R. sativus, showing higher fertilizer dependency. In a no-tillage system with cover crops, the N topdressing fertilization needs to be improved, considering mineralization. Full article

The emergence of CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized the treatment paradigm for R/R B-cell NHLs. However, challenges persist in accurately evaluating treatment response and detecting early relapse, necessitating the exploration of novel biomarkers. Circulating tumor DNA (ctDNA) via liquid biopsy is a non-invasive tool for monitoring therapy efficacy and predicting treatment outcomes in B-NHL following CAR-T therapy. By overcoming the limitations of conventional imaging modalities, ctDNA assessments offer valuable insights into response dynamics, molecular mechanisms of resistance, and early detection of molecular relapse. Integration of ctDNA monitoring into clinical practice holds promise for personalized therapeutic strategies, guiding the development of novel targeted therapies, and enhancing patient outcomes. However, standardization of assay methodologies and consensus on clinical response metrics are imperative to unlock the full potential of ctDNA in the management of B-NHL. Prospective validation of ctDNA in clinical trials is necessary to establish its role as a complementary decision aid. Full article

Emotional labor is a crucial yet often overlooked aspect of effective leadership. To address this, the current study adopts the Emotion as Social Information (EASI) model as a theoretical framework to investigate the influence of leaders’ emotional labor and perceived appropriateness on employees’ emotional labor. A two (leaders’ emotional labor strategies: surface acting vs. deep acting) by two (perceived appropriateness: appropriate vs. inappropriate) between-subjects experiment was designed with a sample of 120 front-line service employees from hotels in Shanghai. The results showed that regardless of whether the perception of a leader’s surface acting was deemed appropriate or not, employees tended to perform surface acting, while the impact of the perceived appropriateness regarding the leader’s deep acting was different, wherein an appropriate display of deep acting by the leader significantly influenced employees to engage in deep acting themselves. The managerial implications and limitations of the findings are also discussed. Full article

Probiotic microorganisms are used in a variety of food supplements and medical formulations to promote human health. In periodontal therapy, probiotics are mainly used in the form of gels, tablets or rinses that often tend to leak from the periodontal pocket, resulting in a strongly reduced therapeutic effect. In this pilot in vitro study, we present biodegradable alginate-based particles as an alternative, highly efficient system for a periodontal delivery of probiotic bacteria to the inflammation site. For this purpose, Lactococcus (L.) lactis was encapsulated using a standardized pump-controlled extrusion-dripping method. Time-dependent bacterial release in artificial saliva was investigated over 9 days. The effect of freeze drying was explored to ensure long-term storage of L. lactis-loaded particles. Additionally, the particles were bound to dentin surface using approved bioadhesives and subjected to shear stress in a hydrodynamic flow chamber that mimics the oral cavity in vitro. Thus, round particles within the range of 0.80–1.75 mm in radius could be produced, whereby the diameter of the dripping tip had the most significant impact on the size. Although both small and large particles demonstrated a similar release trend of L. lactis, the release rate was significantly higher in the former. Following lyophilization, particles could restore their original shape within 4 h in artificial saliva; thereby, the bacterial viability was not affected. The attachment strength to dentin intensified by an adhesive could resist forces between 10 and 25 N/m². Full degradation of the particles was observed after 20 days in artificial saliva. Therefore, alginate particles display a valuable probiotic carrier for periodontal applications that have several crucial advantages over existing preparations: a highly stable form, prolonged continuous release of therapeutic bacteria, precise manufacturing according to required dimensions at the application site, strong attachment to the tooth with low risk of dislocation, high biocompatibility and biodegradability. Full article

Due to the present worldwide economic development, there is an increasing need to follow the financial health of companies in individual sectors to avoid possible decline and bankruptcy. The goal of this contribution is to find out the influence of the pandemic on the economic situation in the mining industry as the primary sector, in connection with the construction industry as the secondary sector. The research is carried out through economic and financial indicators, which mostly influence the potential crisis of companies. The results show that the mining industry and construction sectors managed to avoid the heavy decline and bankruptcy of certain organizations in the industries. Such results can be used for forecasting and modeling the socio-economic development of regions and countries. The growth of the analyzed industries could contribute to the sustainable development in the country. Full article

The main subject of the current review is a specific subtype of headache, which is related to shunt over-drainage and slit ventricle syndrome, in pediatric patients harboring an implanted shunt device for the management of hydrocephalus. This clinical entity, along with its impairment regarding the quality of life of the affected individuals, is generally underestimated. This is partly due to the absence of universally agreed-upon diagnostic criteria, as well as due to a misunderstanding of the interactions among the implicated pathophysiological mechanisms. A lot of attempts have been performed to propose an integrative model, aiming at the determination of all the offending mechanisms of the shunt over-drainage syndrome, as well as the determination of all the clinical characteristics and related symptomatology that accompany these secondary headaches. This subcategory of headache, named postural dependent headache, can be associated with nausea, vomiting, and/or radiological signs of slim ventricles and/or subdural collections. The ultimate goal of our review is to draw clinicians’ attention, especially that of those that are managing pediatric patients with permanent, long-standing, ventriculoperitoneal, or, less commonly, ventriculoatrial shunts. We attempted to elucidate all clinical and neurological characteristics that are inherently related to this type of headache, as well as to highlight the current management options. This specific subgroup of patients may eventually suffer from severe, intractable headaches, which may negatively impair their quality of daily living. In the absence of any other clinical condition that could be incriminated as the cause of the headache, shunt over-drainage should not be overlooked. On the contrary, it should be seriously taken into consideration, and its management should be added to the therapeutic armamentarium of such cases, which are difficult to be handled. Full article

This review article aims to provide an up-to-date overview of the main determinants of consumers’ acceptance of novel foods (new foods and ingredients) in the EU with emphasis on product’s intrinsic properties (sensory characteristics) and individual factors (socio-demographics, perceptive, psychological) by adopting a systematic approach following the PRISMA methodology. Case studies on terrestrial (i.e., insects, cultured meat and other animal origin products, plant-based food including mushrooms, plant-based analogues, pulses, and cereals) and aquatic systems (i.e., algae and jellyfish) are included focusing on age-related and cross-national differences in consumer acceptance of novel foods and ingredients. General trends have emerged that are common to all the novel foods analysed, regardless of their aquatic or terrestrial origin. Aspects such as food neophobia, unfamiliarity, and poor knowledge of the product are important barriers to the consumption of novel foods, while healthiness and environmental sustainability perception are drivers of acceptance. Sensory properties are challenging for more familiar ingredients such as plant-based food (e.g., novel food made by pulses, mushrooms, cereals and pseudocereals). Results are discussed in terms of feasibility of introducing these products in the EU food systems highlighting strategies that can encourage the use of new ingredients or novel foods. Full article

There is no practical and at the same time objective colour system available for describing cultivated roses (Rosa L. cultivars). For this reason, a new colour classification system was developed which is colorimetrically balanced and appropriate for algorithmic colour identification; however, it is also suitable for field-work. The system is based on the following colorimetric criteria: (A) Each colour category is characterised by a measured petal colour in the CIE L*a*b* standard as the centroid of the category. (B) The CIEDE2000 colour differences between the adjacent centroid colours are limited (5 < ΔE₀₀ < 7). (C) The maximal colour difference between the measured colours in a category is also limited (to 12.12 ΔE₀₀). (D) A measured petal colour can only be classified into an existing category if the colour difference from the centroid colour of the given category is less than 5.81 ΔE₀₀, otherwise a new category is required. (E) A category is only considered non-redundant if it has at least one measured petal colour that cannot be classified elsewhere. (F) The classification of the petal colours is based on the least colour difference from the centroid colours. As a result, 133 colour categories were required for describing all the 8139 petal colours of the rose cultivars of the Budatétény Rose Garden (Hungary). Each colour category has the following parameters: standardised colour name, the colorimetric parameters of the centroid, grouping, RHS colour chart coding, and reference cultivars, which are described in the article. Full article

Environmental degradation leads to an unsustainable food system. In addition to this issue, the consumption of foods that improve people’s health and well-being is recommended. One of the alternatives is undoubtedly the use of by-products of winemaking, namely in the form of grape pomace flour (GPF). To verify the benefits of using the Touriga Nacional and Arinto (Vitis vinifera L.) flour varieties, analytical determinations were made to identify and quantify different components. In terms of nutritional characterization, the Touriga Nacional GPF showed results that indicate better nutritional quality than the Arinto GPF. The Touriga Nacional and Arinto samples had protein contents of 10.13% and 8.38%, polyunsaturated fatty acids of 6.66% and 5.18%, soluble dietary fiber of 14.3% and 1.7%, and insoluble dietary fiber of 55.1% and 46.4%, respectively. The anthocyanins, proanthocyanidins, and flavonols presented in samples were detected by HPLC-DAD/ESI-MS. Atomic absorption spectrometry revealed elevated concentrations of certain elements in Touriga Nacional compared to Arinto, with the former showing higher levels of aluminum (130 mg/kg) and iron (146 mg/kg) against the latter’s Al (120 mg/kg) and Fe (112 mg/kg) content. GPF could become a valuable ingredient due to its nutritional quality and high content of various polyphenols. Full article

The Preboreal (11.75–10.70 ka BP) is still the least paleogeographically studied time interval in the central part of the East European Plain. High-resolution multi-proxy studies of lacustrine sediments at the Seltso site located in the Desna River floodplain (Dnieper River basin) were conducted. Radiocarbon dating, loss-on-ignition determination, sedimentological and palynological studies and identification of Non-Pollen Palynomorphs in lacustrine sediments allow us to reconstruct changes in vegetation caused by rapid warming at the Younger Dryas–Holocene boundary, short-term climatic fluctuations within the Preboreal and subsequent resumption of warming. Initial Preboreal warming reached its maximum at about 11.5 ka BP when a relatively dry continental climate existed. Between 11.4 and 11.2 ka BP, a short-term cooling corresponding to the Preboreal Oscillation in Greenland occurred, as indicated by a significant reduction of woody vegetation and expansion of open plant communities. In the Late Preboreal, approximately 11.2–10.7 ka BP, warming resumed, which was accompanied by a decrease in the climate continentality. Comparison with high-resolution lithological and palynological data from eight reliably dated sections of the central East European Plain indicates that in northwestern and central Europe, the impact of the Preboreal Oscillation cooling on the vegetation and the lake ecosystems’ development was probably somewhat stronger. Full article

Background: Traditional gel-based (wet) electrodes for biopotential recordings have several shortcomings that limit their practicality for real-world measurements. Dry electrodes may improve usability, but they often suffer from reduced signal quality. We sought to evaluate the biopotential recording properties of a novel mixed ionic–electronic conductive (MIEC) material for improved performance. Methods: We fabricated four MIEC electrode form factors and compared their signal recording properties to two control electrodes, which are electrodes commonly used for biopotential recordings (Ag-AgCl and stainless steel). We used an agar synthetic skin to characterize the impedance of each electrode form factor. An electrical phantom setup allowed us to compare the recording quality of simulated biopotentials with ground-truth sources. Results: All MIEC electrode form factors yielded impedances in a similar range to the control electrodes (all <80 kΩ at 100 Hz). Three of the four MIEC samples produced similar signal-to-noise ratios and interfacial charge transfers as the control electrodes. Conclusions: The MIEC electrodes demonstrated similar and, in some cases, better signal recording characteristics than current state-of-the-art electrodes. MIEC electrodes can also be fabricated into a myriad of form factors, underscoring the great potential this novel material has across a wide range of biopotential recording applications. Full article

The rise of e-commerce has significantly impacted consumer shopping habits, resulting in profit loss for traditional supply chains. In response to intense competition, numerous companies have transitioned their business models to embrace dual-channel configurations, seeking to captivate customers and increase their market share. Nonetheless, research on decentralized dual-channel supply chain configurations is scarce and predominantly concentrates on single-period pricing. This paper addresses this gap by employing Stackelberg’s game theory to investigate the multi-periodic pricing and remanufacturing decisions within a decentralized dual-channel supply chain with reverse logistics, specialized in the manufacturing and sales of pharmaceutical products. Moreover, this work considers that the online channel pays a sales commission to the pharmacy in return for the provided after-sales services, aiming to incorporate the aspect of sharing revenues. A mathematical formulation is proposed in a multi-periodic environment allowing us to simultaneously maximize the total profits of the manufacturer, the pharmacy and the online channel, by optimizing the pricing and remanufacturing strategies. Numerical analyses examine the customer purchasing preference’s effect on the demand and pricing decisions of each channel, the impact of the collection cost on the optimal remanufacturing strategy, and assess the break-even point of the total profits generated in both channels according to the sales commission. This study’s novelty lies in employing Stackelberg’s game theory to develop a mathematical formulation for the multi-periodic pricing and remanufacturing problem within a decentralized dual-channel supply chain, incorporating a sales commission between both distributors. Full article

Spina bifida includes a spectrum of different neural tube defects. Myelomeningocele is the most serious type and is associated with a risk of paralysis and sensory dysfunction below the affected level, bladder/bowel dysfunction, brain dysmorphology, and impaired health-related quality of life (HRQoL). The aim of this study was to describe the establishment of linguistic, content and face validity of the Swedish version of a Quality-of-Life Assessment for children (QUALAS-C, n = 10 items), teenagers (QUALAS-T, n = 10 items) and adults with spina bifida (QUALAS-A, n = 15 items) based on the original US English versions. The process included close collaboration with the original instrument developer and complied with international standards on patient-reported outcome measurements. The procedure includes forward translation, expert and patient/parent review and reconciliation, back translation, back translation review and cognitive debriefing interviews with 16 people with spina bifida aged 8 to 33, providing them with the possibility of evaluating the clarity, adequacy, and comprehensiveness of QUALAS-C, QUALAS-T and QUALAS-A, respectively. The interviews lasted a median of 15 min (range 8–16) for QUALAS-C, 10 min (range 9–15) for QUALAS-T and 24 min (range 9–38) for QUALAS-A. Four main issues/topics needed attention and discussion after both the forward and back translation. Following the back translation review, all issues were resolved. The patient feedback revealed recognition of the HRQoL issues included in QUALAS, and also difficulties in understanding some questions. After the patients’ evaluation, four items were reworded for clarity. No study participant reported a wish to add to or remove questions from QUALAS. Hence, the Swedish versions of QUALAS became conceptually equivalent to the original US English versions and achieved linguistic, content and face validity. While empowering the voices of people with spina bifida, these results also enable their HRQoL to be properly assessed in research and clinical care in Sweden and in international studies. Full article

B-cell lymphomas (BCL) is the most frequent hematological cancer in dogs. Treatment typically consists of chemotherapy, with CHOP-based protocols. However, outcome remains generally poor, urging the exploration of new therapeutic strategies with a targeted approach. Myc transcription factor plays a crucial role in regulating cellular processes, and its dysregulation is implicated in numerous human and canine malignancies, including canine BCL (cBCL). This study aims to evaluate the efficacy of indirectly inhibiting Myc in cBCL using BI2536 and MZ1 compounds in two in vitro models (CLBL-1 and KLR-1201). Both BI2536 and MZ1, alone and combined, affected cell viability in a significant concentration- and time-dependent manner. Western Blot revealed an upregulation of PLK1 expression in both cell lines upon treatment with BI2536, in association with a reduction in c-Myc protein levels. Conversely, MZ1 led to a decrease in its primary target, BRD4, along with a reduction in c-Myc. Furthermore, BI2536, both alone and in combination with MZ1, induced larger transcriptomic changes in cells compared to MZ1 alone, primarily affecting MYC target genes and genes involved in cell cycle regulation. These data underscore the potential role of Myc as therapeutic target in cBCL, providing a novel approach to indirectly modulate this molecule. Full article

(1) Objectives: A divergence in self- and preceptor-evaluations of clinical skills has been noted during Advanced Pharmacy Practice Experiences (APPEs). The goal of this study was to determine the domains of overestimation of clinical skills by students during their APPE rotations. (2) Methods: Preceptor-assigned grades for APPE rotations from 2017–2022 were analyzed to identify instances of letter grade B or lower. The self- and preceptor-evaluations of APPE rotation were compared to determine the domains of divergence in evaluation between students and preceptors. (3) Results: Between 2017 and 2022, 305 student APPE rotations were graded as B or lower (~14%) by the preceptors. A statistically significant difference was noted between self- and preceptor-assigned letter grades across all practice settings including ambulatory patient care, community pharmacy, general medicine patient care, hospital/health system pharmacy, and special population patient care APPE rotations. In addition, examining the self- and preceptor evaluation rubric for these rotations revealed a statistically significant overestimation of clinical skills by students in all 9 domains of APPE evaluation. Finally, the divergence in the rating of clinical skills between student- and preceptor evaluation was found to be highest in the domains of planning and follow-up of patient care, disease knowledge, and communication with patients. (4) Conclusions: Students who fail to exhibit exemplary practice readiness during APPEs tend to overestimate their clinical skills in all domains of APPE evaluation. The results from our study support the need for additional avenues to assist in the identification of deficits in student learning before APPEs to increase their self-awareness (metacognition). Full article

Background/Objective: To ensure that implants are able to support prosthetic rehabilitation, a stable and functional union between the bone and the implant surface is crucial to its stability and success. To increase bone volume and density and excel bone-implant contact, a novel drilling method, called osseodensification (OD), was performed. To assess the effectiveness of the osseodensification drilling protocol versus the conventional surgical technique on implant stability. Methods: Bone Level Tapered Straumann implants were placed side-by-side with both OD and subtractive conventional drilling (SD) in 90 patients from CESPU—Famalicão clinical unit. IT was measured using a manual torque wrench, and the Implant stability quotient (ISQ) value was registered using the Osstell^® IDX. Results: According to the multifactorial ANOVA, there were statistically significant differences in the mean IT values due to the arch only (F(1.270) = 4.702, p-value = 0.031 < 0.05). Regarding the length of the implant, there were statistically significant differences in the mean IT in the OD group (p = 0.041), with significantly lower mean IT values for the Regular implants compared to the Long. With respect to the arch, the analyses of the overall ISQ values showed an upward trend in both groups in the maxilla and mandible. High levels of IT also showed high ISQ values, which represent good indicators of primary stability. Conclusions: OD does not have a negative influence on osseointegration compared to conventional subtractive osteotomy. Full article