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Candida albicans is the primary etiological agent of vulvovaginal candidiasis (VVC), a widespread fungal infection affecting millions of women worldwide. Although often self-limiting, VVC can become recurrent or severe, significantly impacting quality of life. The pathogenesis of C. albicans is driven by key virulence factors, including hyphal transformation, biofilm formation, and immune evasion, which all facilitate persistence and resistance to host defenses. Epidemiological data indicate that up to 75% of women experience at least one episode of VVC, with 5–10% developing recurrent vulvovaginal candidiasis. The condition typically presents with vaginal itching, burning, erythema, edema, and an abnormal discharge. Diagnosis relies on both clinical presentation and microbiological confirmation; however, misdiagnosis remains common due to symptom overlap with other vaginal infections and conditions in general. Azole antifungals remain the cornerstone of treatment; however, increasing resistance (particularly in non-albicans Candida species) poses substantial therapeutic challenges. Consequently, the emergence of antifungal-resistant strains underscores the need for novel treatment strategies, including probiotics and natural antifungal agents. Preventive measures—including maintaining vaginal microbiota balance, avoiding unnecessary antibiotic usage, and improving hygiene practices—play a pivotal role in reducing disease burden due to C. albicans. Given the rising incidence of VVC and the burden of recurrent cases, further research is essential to develop targeted therapeutic interventions. This comprehensive review highlights the evolving epidemiology, pathogenesis, and clinical challenges of C. albicans-associated VVC, emphasizing the need for improved diagnostic strategies, alternative therapeutic approaches, and targeted preventive measures to reduce disease burden and enhance patient outcomes. Full article

Core mathematics courses are fundamental to the academic success of engineering students in higher education. These courses equip students with skills and knowledge applicable to their specialized fields. However, first-year engineering students often face significant challenges in mathematics due to a range of factors, including insufficient preparation, mathematics anxiety, and difficulty connecting theoretical concepts to real-life applications. The transition from secondary to tertiary mathematics remains a key area of educational research, with ongoing discussions about effective pedagogical approaches for teaching engineering mathematics. This study utilized a belief survey to gain general insights into the attitudes of first-year mathematics students towards the subject. In addition, it employed the activity theory framework to conduct a deeper exploration of the experiences of first-year engineering students, aiming to identify contradictions, or “tensions,” encountered within a flipped-classroom learning environment. Quantitative data were collected using surveys that assessed students’ self-reported confidence, competence, and knowledge development. Results from Friedman’s and Wilcoxon’s Signed-Rank Tests, conducted with a sample of 20 participants in 10 flipped-classroom sessions, statistically showed significant improvements in all three areas. All of Friedman’s test statistics were above 50, with p-values below 0.05, indicating meaningful progress. Similarly, Wilcoxon’s Signed-Rank Test results supported these findings, with p values under 0.05, leading to the rejection of the null hypothesis. The qualitative data, derived from student questionnaire comments and one-to-one interviews, elucidated critical aspects of flipped-classroom delivery. The analysis revealed emerging contradictions (“tensions”) that trigger “expansive learning”. These tensions encompassed the following: student expectation–curriculum structure; traditional versus novel delivery systems; self-regulation and accountability; group learning pace versus interactive learning; and the interplay between motivation and anxiety. These tensions are vital for academic staff and stakeholders to consider when designing and delivering a first-year mathematics course. Understanding these dynamics can lead to more effective, responsive teaching practices and support student success during this crucial transition phase. Full article

Diabetes is a chronic and complex pathological syndrome that includes a series of disorders and imbalances, whose first characterization is hyperglycemia, although, as it is a multifactorial phenomenon, it requires risk reduction strategies beyond glycemic control. Continuous education and support for diabetes self-management are essential to prevent acute complications and reduce the risk of long-term complications. Therefore, the guidelines for the treatment of diabetes emphasize the importance of lifestyle changes, including a reduced-calorie diet and increased physical activity. However, for many people, these changes can be difficult to maintain in the long term and eventually they must resort to pharmacological treatment that in most cases requires the combined use of two or more antidiabetic drugs with different mechanisms of action. This review explores the different pharmacological agents, authorized and used therapeutically, for the control of diabetes, especially type 2 diabetes, and analyzes the development strategies of multi-target agents whose effects, through distinct mechanisms and by acting on more than one receptor, could represent a promising alternative in the treatment of a multifactorial disease such as diabetes. As regards therapeutic uses, from metformin to glucose transporter inhibitors (SGLT2i), the potential mechanisms of action, pharmacological and clinical effects, safety, and use in therapeutics are described, presenting, as far as reasonably possible, diverse comparisons between them. In conclusion, although metformin remains the first-line agent for the treatment of type 2 diabetes, the choice of a second-line agent depends on several factors, in particular the cardiovascular risk profile, weight, and renal function of the patient; moreover, the ideal pharmacological treatment, although expected and desired, has in fact not been achieved so far, and physicians must consider not only the glycemic efficacy of the agent but also all the other potential benefits, balanced by the possible adverse effects. Compounds modulating multiple signaling pathways are a promising approach to manage this multifactorial disorder, with the primary objective of maintaining the therapeutic efficacy observed in several clinical studies, alongside reducing adverse effects, the main reason for the discontinuation of developments, to levels that enable a favorable risk–benefit balance. Full article

The gas desorption behavior of coal is a key basis for guiding gas parameter determination, optimizing gas extraction, and preventing gas-related disasters. Coal in mine working faces typically exhibits a mixed particle size distribution. However, research on the gas desorption behavior of mixed-size coal samples and comparative studies with single-sized samples remains insufficient. This study employed a self-developed experimental system for the multi-field coupled seepage desorption of gas-bearing coal to conduct comparative experiments on gas desorption behavior between single-sized and mixed-size coal samples. Systematic analysis revealed significant differences in their desorption and diffusion patterns: smaller particle sizes and higher proportions of small particles correlate with greater total gas desorption amounts and higher desorption rates. The desorption process exhibits distinct stages: the initial desorption amount is primarily influenced by the particle size, while the later stage is affected by the proportion of coal samples with different particle sizes. The desorption intensity for both single-sized and mixed-size samples decays exponentially over time, with the decay rate weakening as the proportion of small particles decreases. The gas diffusion coefficient decays over time during desorption, eventually approaching zero, and increases as the proportion of small particles rises. Conversely, the gas desorption attenuation coefficient increases with a higher proportion of fine particles. Based on the desorption laws of coal samples with single and mixed particle sizes, this study can be applied to coalbed gas content measurements, emission prediction, and extraction design, thereby providing a theoretical foundation and technical support for coal mine operations. Full article

Background: The COVID-19 pandemic significantly disrupted patterns of physical activity and participation in mass sporting events, with recreational runners in Latin America among the most affected. In Colombia, pre-existing inequalities in access to sport further exacerbated these impacts. Nevertheless, evidence on post-COVID-19 impact and recovery experiences among regional runners remains limited. Objective: We examined the sociodemographic profiles, athletic experience, and perceptions of COVID-19-related impact and recovery among participants in the 2023 Medellín Marathon, and to assess differences by educational attainment, employment status, age group, and geographic origin. Methods: A cross-sectional descriptive study was undertaken involving 2486 registered marathon runners. An ad hoc questionnaire assessed COVID-19 symptoms and sequelae, perceived respiratory and physical limitations, fears associated with group exercise, and self-reported recovery. Analyses included descriptive statistics, bivariate comparisons and one-way ANOVA tests. Results: Older participants, retirees and those with lower educational levels reported significantly greater COVID-19 impact, longer recovery periods and higher perceived physical and respiratory limitations. In contrast, younger runners and those with a college education showed more complete physical recovery and attributed protective benefits, such as improved cardiorespiratory function and a lower incidence of respiratory symptoms, to their training. Additionally, runners originating from smaller municipalities and other Latin American countries reported higher levels of impact and lower perceptions of recovery. Conclusions: Post-COVID-19 effects among marathon runners are not uniform but vary according to sociodemographic and contextual factors. These findings underscore the importance of tailored support and readaptation strategies—particularly for vulnerable subgroups—to ensure their safe and equitable return to mass endurance events. Full article

In this paper, we report how digital resources support engineering students in the early stages of mathematical modelling within a Challenge-Based Education (CBE) course. The study was conducted in a second-year engineering course involving mathematics, physics, and ethics. Through a case study of two student teams, we analyze how a digital curriculum resource—specifically, a dashboard designed for feedback and progress monitoring—helped students identify, define, and begin modelling a real-world problem related to crowd flow on train platforms. Using the instrumental approach, we examined the dual processes of instrumentation (integration of resources) and instrumentalization (adaptation and repurposing of tools). Results show that the Dashboard played a central role in fostering self-regulated learning, interdisciplinary collaboration, and the iterative refinement of guiding questions. Students used data analysis, simulations, and modelling techniques to build and validate mathematical representations in answer to the guiding questions. Our findings contribute to ongoing discussions on how mathematics education in engineering can be enhanced through activity-based learning and targeted use of digital tools. We argue that digital feedback systems like dashboards can bridge the gap between abstract mathematical content and its meaningful application in engineering contexts, thus fostering engagement, autonomy, and authentic learning. Full article

Accurate and real-time environmental perception is essential for the safe and efficient execution of deep-sea mining operations. Semantic segmentation of forward-looking sonar (FLS) images plays a pivotal role in enabling environmental awareness for deep-sea mining vehicles (DSMVs), but remains challenging due to strong acoustic noise, blurred object boundaries, and long-range semantic dependencies. To address these issues, this study proposes DSM-Seg, a novel hybrid segmentation architecture combining Convolutional Neural Networks (CNNs) and Receptance Weighted Key-Value (RWKV) modeling. The architecture integrates a Physical Prior-Based Semantic Guidance Module (PSGM), which utilizes sonar-specific physical priors to produce high-confidence semantic guidance maps, thereby enhancing the delineation of target boundaries. In addition, a RWKV-Based Global Fusion with Semantic Constraints (RGFSC) module is introduced to suppress cross-regional interference in long-range dependency modeling and achieve the effective fusion of local and global semantic information. Extensive experiments on both a self-collected seabed terrain dataset and a public marine debris dataset demonstrate that DSM-Seg significantly improves segmentation accuracy under complex conditions while satisfying real-time performance requirements. These results highlight the potential of the proposed method to support intelligent environmental perception in DSMV applications. Full article

Background: Self-directed lifestyle modifications are essential for managing symptoms in individuals diagnosed with irritable bowel syndrome (IBS). This study incorporated longitudinal multi-omics profiling to estimate the mechanisms underlying responses to a nurse-led person-centered self-management intervention in young adults with IBS. Methods: This pre-post study was nested within a 12-week parent randomized controlled trial (NCT03332537). Biospecimens (stool and blood) and clinical outcomes were collected at baseline and post-intervention. Symptoms were assessed using the Brief Pain Inventory and PROMIS^® short forms. Host transcriptomic profiling was performed using RNA sequencing, and gut microbial composition was analyzed via 16S rRNA sequencing. Host transcriptomic co-expression and microbial co-abundance modules were identified via weighted gene co-expression network analysis. Associations between multi-omics modules and symptoms were evaluated using linear mixed-effect models. Results: Among the 20 participants, most were non-Hispanic (75%), White (75%), and female (65%). The intervention significantly reduced self-reported pain severity (p = 0.019) and pain interference (p = 0.013). Decreased associations were observed between pain phenotypes and a microbial module enriched in core metabolic pathways (interference: β = –4.7, p < 0.001; severity: β = –2.4, p = 0.02). Anxiety strengthened associations with host transcriptomic cellular energy metabolism pathways post-intervention (p < 0.05). The intervention attenuated associations between fatigue, sleep disturbance, and immune–inflammatory transcriptomic and microbial adaptation modules (p < 0.05). Conclusions: Findings suggest that the IBS self-management intervention induces symptom-specific biological responses, implicating distinct host–microbe pathways. Larger longitudinal studies are warranted to validate these omics-based symptom signatures. Full article

(1) Aims: This review aims to investigate whether screen-based simulated learning experiences improve on traditional teaching strategies to bridge the theory–practice gap for biomedical scientists and enhance the readiness to practice of graduates. (2) Methods: This review adheres to the systematic–narrative hybrid literature review strategy with the scope of review defined according to Cochrane guidelines for systematic reviews. To identify the potentially relevant literature, the PUBMED, CINAHL, and Web of Science bibliographic databases were searched using the identified keywords from January 2020 to February 2025. Thematic analysis of the resultant literature was conducted in line with the Braun and Clarke framework. (3) Results: The original search and analysis of the online databases returned 45 papers. Collectively these sources explore global perspectives on biomedical science education, training, and professional practice. These include the identification of core competencies that may contribute to the theory–practice gap for biomedical scientists, as well as educational interventions that aim to address them. The poor quality of existing research on simulation-based learning, mostly from academic settings, makes it challenging to apply the findings to professional practice. This limitation is primarily due to an overreliance on self-reported data and perceived learning gains rather than direct, objective evaluations of competence. Future studies should focus on objective, validated outcome measures and longitudinal follow-up to assess real-world impacts and learning transfer. (4) Conclusions: Simulation-based learning experiences have the potential to address aspects of the theory–practice gap for biomedical scientists, but the current evidence base reflects a lack of understanding regarding specific targets and strategies for its design, evaluation, and integration in this context. There is a need for more robust evidence that evaluates their impacts on readiness to practice. This need is hindered by a lack of research directly investigating the impact of simulation-based teaching and training interventions in clinical settings. Full article

Aiming at the nonlinear, nonstationary, and multiscale fluctuation characteristics of wind speed series, this study proposes a wind speed-forecasting framework that integrates multi-resolution turbulence intensity features and a Transformer-based hybrid neural network. Firstly, based on multi-resolution turbulence intensity and stationary wavelet transform (SWT), the original wind speed series is decomposed into eight pairs of mean wind speeds and turbulence intensities at different time scales, which are then modeled and predicted in parallel using eight independent LSTM sub-models. Unlike traditional methods treating meteorological variables such as air pressure, temperature, and wind direction as static input features, WaveNet, LSTM, and TCN neural networks are innovatively adopted here to independently model and forecast these meteorological series, thoroughly capturing their dynamic influences on wind speed. Finally, a Transformer-based self-attention mechanism dynamically integrates multiple outputs from the four sub-models to generate final wind speed predictions. Experimental results averaged over three datasets demonstrate superior accuracy and robustness, with MAE, RMSE, MAPE, and $R^2$ values around 0.65, 0.87, 23.24%, and 0.92, respectively, for a 6 h forecast horizon. Moreover, the proposed framework consistently outperforms all baselines across four categories of comparative experiments, showing strong potential for practical applications in wind power dispatching. Full article

Physical hazards are the most common source of health effects among waste recyclers, frequently leading to worker injuries. South Africa’s formal buy-back centres (BBCs) have emerged as key nodes in the recycling chain, yet the burden of non-fatal workplace injuries among BBC recyclers is not characterised. We conducted a cross-sectional study at ten BBCs in Johannesburg, enrolling 160 waste recyclers (median age 32 years; 55.6% female). A structured, interviewer-led questionnaire captured workers’ characteristics and self-reported injuries in the past six months. Robust Poisson regression was fitted to determine associations with frequent workplace injury. Overall, 69.4% of participants reported at least one injury. Cuts and lacerations (67.6%) and sprains or muscle strains (39.6%) predominated. Each additional year of age raised the risk of frequent workplace injury by 1% (adjusted relative risk [aRR] 1.01; 95% CI 1.00–1.02), each extra hour worked per day by 22% (aRR 1.22; 95% CI 1.04–1.42), and presence of hearing or vision problems by 45% (aRR 1.45; 95% CI 1.14–1.83). Targeted interventions—such as work hour regulation, sensory-friendly accommodations, and comprehensive, fit-focused PPE programs—are needed to reduce injury risk in this vulnerable workforce. Full article

Background: This paper provides the first national analysis of antimicrobial use (AMU) of oral and parenteral dosages in Bangladesh, as well as biannual trends for the years from 2019 to 2023. It also analyzes the effect of the COVID-19 pandemic on AMU. Methods: AMU was analyzed in accordance with the WHO Anatomical Therapeutic Chemical classification and defined daily doses per 1000 inhabitants per day methodology. Data on antimicrobial medicine dispatched from manufacturers’ central warehouse was collected and categorized based on the WHO’s Access, Watch, and Reserve (AWaRe) classification. Findings: This AMU surveillance demonstrates an increase in the use of antimicrobial medicines from 2021 to 2022, and in 2023, it decreased, with our national AMU surveillance data indicating that cefixime and azithromycin were the most consumed antibiotics during this period. Most antibiotics used in Bangladesh are broad-spectrum ‘Watch’-category antibiotics. Among oral antibiotics, 50 to 67% are from the ‘Watch’-category. When considering only parenteral antibiotics, 70 to 91 % fall under the ‘Watch’-category. Third-generation cephalosporin consumption has been found to be higher than second- and first-generation cephalosporins. The oral antimicrobials are more commonly used than parenteral ones. AMU notably increased during the COVID-19 pandemic, especially in the case of systemic antibacterial use. Conclusions: To achieve the global target of 70% use of Access category antibiotics by 2030, the use of Watch-group antibiotics, like cefixime, azithromycin, ciprofloxacin, levofloxacin, and ceftibuten, needs to be reduced through investing in and strengthening stewardship programs and eliminating self-medication in Bangladesh. The findings of this study provide useful information to policymakers to tackle AMR in Bangladesh. Full article

To promote the sustainable development of urban smart transportation systems, this study constructs a structural equation model (SEM) based on the Technology Acceptance Model (TAM), incorporating extended variables including social influence, environmental awareness, privacy concerns, and service similarity to investigate users’ behavioral intentions toward Mobility as a Service (MaaS). The research systematically examines key factors influencing user adoption behavior and their underlying mechanisms, providing theoretical foundations and practical guidance for optimizing MaaS system design and policy making. Using SEM as the core analytical framework, this study employs mediation analysis, moderation analysis, and multigroup comparison to empirically examine the direct and indirect effects among variables, as well as group heterogeneity. Data were collected through an online questionnaire survey, with Analysis of Variance (ANOVA) applied to identify the differential impacts of demographic and travel behavior characteristics on users’ intentions and related psychological constructs, thereby supporting precise user segmentation and evidence-based policy interventions. Key findings include the following: (1) Social influence, ease of use, and environmental awareness boost MaaS adoption, while privacy concerns hinder it. (2) Freelancers/self-employed weaken the positive effects of usefulness, ease of use, and social influence on adoption. (3) Service similarity and ease of use effects vary significantly between single-mode and multimodal commuters. The findings extend the theoretical boundaries of TAM and provide both theoretical and practical support for the development of sustainable urban transportation systems. Full article

Micellar or mycelial membranes from medicinal mushrooms are self-growing fibrous polymeric biocomposites that are biocompatible, biodegradable, cost-effective, and environmentally friendly. In this study, the cultivation process for the medicinal mushrooms Ganoderma lucidum and Pleurotus ostreatus has been optimized via submerged cultivation to maximize growth and promote the formation of micellar membranes with high water-absorption capacity. Optimal growth conditions were achieved at an alkaline pH in a medium containing malt extract for G. lucidum, while for P. ostreatus, these were in a glucose-enriched medium. The hydrophilic underside of the micellar membranes led to a high-water uptake capacity. These membranes exhibited a broad spectrum of functional groups, thermal stability with decomposition temperatures above 260 °C, and a fibrous and porous structure. The micellar membranes from both mushrooms were additionally functionalized with mango peel extract (MPE), resulting in a uniform and gradual release profile, which is an important novelty. They also showed successful antimicrobial activity against Escherichia coli and Staphylococcus aureus growth. MPE-functionalized micellar membranes are, therefore, innovative biocomposites suitable for various biomedical applications. As they mimic the extracellular matrix of the skin, they are a promising material for tissue engineering, wound healing, and advanced skin materials applications. Full article

Background/Objectives: This study examines individual perceptions of national healthcare system efficiency before and after the COVID-19 pandemic across 18 countries grouped into three clusters (the Anglo-world, Europe, East Asia). This paper aims to identify the demographic, socioeconomic, health-related, and macroeconomic healthcare drivers of public assessments, and explain changes in attitudes between 2011–2013 and 2021–2023. Methods: Using individual-level data from the International Social Survey Programme (ISSP) for 2011–2013 and 2021–2023, logistic regression models of perceived healthcare inefficiency are estimated. In addition, the Oaxaca–Blinder decomposition model is adopted in order to decompose the assessment gap between the two periods. Models include a range of individual demographic and socioeconomic characteristics and national healthcare controls (healthcare expenditure, potential years of life lost). Results: Health-related factors, especially self-assessed health and trust in doctors, consistently emerge as predictors of more favourable evaluations across regions and periods. Higher national healthcare expenditure is associated with more positive public views and is the single largest contributor to the improved assessments in 2021–2023. Demographic and socioeconomic variables show smaller regionally and temporally heterogeneous effects. Decomposition indicates that both changes in observed characteristics (notably, expenditure and trust) and unobserved behavioural, cultural, or institutional shifts account for the gap in public healthcare assessments between the two time periods. Conclusions: Public assessments of healthcare systems are primarily shaped by individual health status, trust in providers, and national spending rather than differential demographic and socioeconomic traits. Therefore, policymakers should couple targeted investments in the healthcare sector in order to address adequately public healthcare needs, and strengthen doctor–patient relationships in order to sustain public support. Future research should focus on disentangling the cultural and behavioural pathways influencing healthcare attitudes. Full article