Background: Persistent infection with oncogenic human papillomavirus (HPV) is the necessary cause of almost all cervical cancers and contributes to several other anogenital and oropharyngeal malignancies. In Morocco, HPV vaccination was introduced into the National Immunization Program in October 2022, making healthcare professional’s key actors in vaccine communication and recommendation. Objective: To assess knowledge, attitudes, and practices (KAP) regarding HPV infection and vaccination among healthcare professionals and healthcare students in Morocco, and to identify factors associated with vaccine recommendation. Methods: A cross-sectional study was conducted among healthcare professionals and healthcare students in Morocco. A systematic questionnaire was used to examine knowledge, attitudes, practices, and perceived barriers to HPV vaccination. A composite knowledge score (0-100) was derived. We studied factors associated with knowledge and systematic recommendation of the HPV vaccine by multivariable linear and logistic regression, respectively. Results: A total of 205 participants were included, among them 67.3% were health care professionals and 32.7% students. The awareness about HPV was quite high (98.5%), while the mean composite knowledge score was 65.8 ± 14.1. There were major gaps in HPV DNA-based screening (19.0%) and knowledge on HPV vaccination in the Moroccan National Immunization Program (52.7%). Only 5.9% reported being vaccinated and 51.2% systematically advocated immunization for girls aged 9–14 years. The most important perceived hurdles were lack of information (87.8%), fear of adverse effects (62.0%) and perceived lack of need (58.0%). Higher knowledge was independently linked with systematic endorsement of vaccination (aOR=1.026, 95% CI 1.005-1.048; p=0.015). Conclusion: Although knowledge and attitudes toward HPV are generally favorable among Moroccan healthcare professionals and students, important gaps persist in practice. Strengthening education on HPV-related diseases, screening strategies, and vaccine safety may improve recommendation practices and support national cervical cancer prevention efforts.

Against national digital-driven educational strategies, college English for non-English majors is troubled by fragmented resources, homogeneous teaching and limited personalized feedback. Targeting first-year non-English students, this study develops a knowledge-graph-enabled smart curriculum for General English. Combining top-down and bottom-up strategies, a two-tier knowledge graph is established: an ontology knowledge layer sorted from syllabus-centered five-skill knowledge points, and a data-resource layer built upon MOOC and SPOC resources on the Chaoxing Fanya platform. Based on a “teacher-student-machine” interactive framework, this paper presents the full-cycle teaching workflow covering pre-class guidance, in-class interaction and post-class adaptive push. Integrating ideological-political education and power-industry materials, this two-year research uses case studies. Pilot results show knowledge-graph visualization clarifies implicit links between language knowledge points, supports adaptive recommendation and multi-dimensional formative assessment. It offers feasible references for digital transformation of college foreign-language courses.

The increasing number of adults receiving orthodontic treatment has made bonding to pre-existing ceramic restorations a routine clinical challenge. The objective of this narrative review is to explain how ceramic composition determines surface conditioning and to translate the available evidence into material-specific protocols for orthodontic attachment bonding. Glass-matrix ceramics contain a silica-rich phase that can be selectively etched with hydrofluoric acid and chemically coupled with silane. Polycrystalline ceramics, particularly zirconia, lack an etchable glass phase; therefore, airborne-particle abrasion or tribochemical silica coating combined with a phosphate-monomer primer is generally more appropriate. Resin-matrix ceramics require a conservative protocol selected according to their ceramic and polymer content. Laser conditioning can increase surface roughness, but results depend strongly on the ceramic, wavelength, energy, and irradiation settings; excessive energy may cause microcracking, thermal damage, or phase transformation. Across ceramic groups, the goal is not to maximize bond strength, but to obtain a durable bond that tolerates orthodontic loading and still permits safe debonding without damaging the restoration. Current evidence remains dominated by laboratory studies with heterogeneous ageing and testing methods. Clinicians should first identify the ceramic, use the least destructive effective pretreatment, add the appropriate chemical coupling agent, and follow material- and manufacturer-specific instructions.

Leisure time is an important aspect of daily life that contributes greatly to people’s mental well-being and quality of life. Traditional games, often considered as the conventional recreational leisure activities of children and youth, have historically played an important role in cultural transmission and holistic development. However, due to technological developments, urbanization, and the development of visual media, outdoor games and other traditional means of leisure have declined significantly. Despite this shift, Indian traditional games continue to offer substantial benefits, including physical growth, cognitive enhancement, creativity, cultural literacy, and social cohesion. The study aims to explore and document a few common prevailing Indian traditional games, with an emphasis on their structure, cultural significance, and potential developmental contribution to children. Employing a descriptive thematic research design, data were collected via extensive review of literature, including academic publications, books, websites, and digital repositories. Based on the available data collected from secondary sources, it was observed that throughout history, traditional games and sports have served as fundamental expressions of human creativity, spontaneity, amusement, motor learning, community bonding, leadership, and emphasized physical and mental health benefits. Traditional games, often seen as unique to specific regions, reveal striking similarities across cultures. Many games are played globally under different names, shaped by local customs but maintaining core mechanics. The modern generation prefers technology-based games over indigenous ones; consequently, some traditional games are on the verge of extinction, while others have been transformed into mainstream sports, and a few still exist in their original form, predominantly practiced by rural and semi-urban children. Additionally, certain traditional games have been preserved as part of cultural heritage and are performed during religious festivals. The research also highlights the role of traditional games in advancing inclusivity and sustainability, as they require minimal resources such as simple, low-cost, lightweight tools; utilize local surroundings as play areas; and follow unwritten, simple, and flexible rules, thereby promoting enjoyment and participation beyond competition, making them easily accessible. In conclusion, Indian traditional games are an important, sustainable, and culturally rich means of having fun in a manner which is beneficial for the holistic development of children. Furthermore, it was observed that various Indian traditional games, ranging from physical skill, strategy, memory, rhythmic, and verbal skills, have an important impact on developing the minds, cognitive and motor skills, leadership qualities, cooperativeness, and cultural awareness of children. Their revitalization¬¬ through parental engagement, community initiatives, school curricula, governmental support, and inclusive sports policies can position them as meaningful, recreational, value-based alternatives to digital leisure.

Diabetic foot is a severe complication of diabetes, the management of which depends on the microbiological profile and antibiotic resistance patterns. This study aimed to describe the bacteriological profile and antibiotic susceptibility of the isolated bacteria. A retrospective study conducted from 2019 to 2025 at the Mohamed V Military Training Hospital in Rabat included 100 patients hospitalised for diabetic foot infection. Clinical and bacteriological data, along with antibiograms, were analysed. The study population was predominantly male (80%; M/F sex ratio = 4), with a mean age of 68.2 years. Among the 125 isolates identified, Gram-negative bacilli predominated (50.4%), followed by Gram-positive cocci (46.4%). The main species isolated were Staphylococcus aureus (18.4%), Klebsiella pneumoniae (13.6%), Proteus mirabilis (11.2%), Enterococcus faecalis (9.6%) and Pseudomonas aeruginosa (8.8%). Among the Staphylococcus aureus strains, 17.4% were methicillin-resistant (MRSA). Among Enterobacteriaceae, 16.0% were producers of extended-spectrum beta-lactamases (ESBL), and a single isolate was a carbapenemase producer. Multidrug-resistant strains of Pseudomonas aeruginosa were observed in 27.3% of cases. By documenting the local bacterial flora and resistance burden, this study highlights the high prevalence of multidrug-resistant pathogens in diabetic foot infections, demonstrating the essential need to adapt empirical antibiotic regimens to regional epidemiology and systematically guide targeted therapy using antibiogram results. Keywords: Antibiogram, antibiotic therapy, bacterial resistance, bacteriological profile, diabetic foot, extended-spectrum beta-lactamases, infection, Staphylococcus aureus.

Background: Giant cell fibroma is a relatively uncommon benign fibrous lesion of the oral cavity, frequently seen in the 2nd and 3rd decades of life. It is often asymptomatic but may require removal for functional or esthetic reasons. Case Presentation: A 5-year-old female patient presented with a localized gingival growth in the Lower Anterior region for 2 Months. Clinical and radiographic evaluation followed by biopsy confirmed the diagnosis of giant cell fibroma. The lesion was excised using electrocautery under local anesthesia. Management and Outcome: The procedure was uneventful with minimal bleeding. Histopathological examination confirmed the diagnosis. Postoperative healing was satisfactory with no recurrence at 7-day and 3 Month follow-up. Conclusion: Electrocautery is an effective and minimally invasive modality for excision of giant cell fibroma in pediatric patients, offering advantages such as reduced bleeding and better patient compliance.

Global concerns regarding patient safety are especially pertinent in today’s highly multicultural healthcare environment. Communication, decision making, and treatment adherence are influenced by culture. Miscommunication, lack of compliance with treatment plans, and higher risks for adverse events occur when there are differences in language, belief systems regarding health and wellness, and health-related practices among patients and healthcare workers (Divi et al., 2007; Flores, 2006; Schyve, 2007; Richardson et al., 2019). The development of transcultural nursing rooted in cultural competence provides an effective framework to provide culturally congruent and patient-centered care to help meet the needs of this population (Campinha-Bacote, 2011; Purnell, 2013). This integrative review is intended to explore the current literature related to the impact of transcultural nursing on enhancing patient safety within a variety of healthcare settings. A comprehensive search of four major electronic databases (PubMed, CINAHL, Scopus, and Google Scholar) was performed utilizing keywords associated with transcultural nursing, patient safety, and diversity. Articles published from January 1, 2010 through December 31, 2025 were included in the search results. Twenty-two peer-reviewed articles that addressed all three components (transcultural nursing, patient safety, and diversity) were selected for analysis using thematic synthesis and critical appraisal. Results showed that having cultural competence significantly enhances communication, decreases medical errors, increases treatment adherence, improves patient satisfaction, and builds trust between patients and their healthcare providers (Beach et al., 2005; Truong et al., 2014; Jongen et al., 2018; Kaihlanen et al., 2019; Govere & Govere, 2016). Three broad categories were identified based on the findings: (a) barriers to communication; (b) beliefs and practices relative to health and wellness; (c) cultural competence training; and (d) the relationship between cultural competence and patient safety outcomes. Additionally, subcategories included organizational support for cultural competence initiatives and cultural competence training programs at the educational level (Douglas et al., 2014; Seeleman et al., 2015; Jeffreys, 2016). Based upon the findings of this study, it appears that transcultural nursing plays a crucial role in ensuring both quality care and patient safety. Therefore, integrating cultural competence into clinical practice and the educational system, as well as incorporating cultural competence into healthcare policy, will be important steps toward providing safe, equitable, high-quality healthcare services (Alizadeh & Chavan, 2016; Degrie et al., 2017; Stubbe, 2020).

Background and Objective: Staphylococcus aureus is a major human pathogen responsible for a wide range of clinical infections. While aminoglycoside antibiotics are vital for treating staphylococcal infections, resistance to these agents is an increasing global concern. This study aimed to determine the prevalence of aminoglycoside-modifying enzyme genes [aph-3 and armA] in clinical isolates of S. aureus from various hospitals in Khartoum State. Materials and Methods: A cross-sectional study was conducted between May and August 2022. Seventy-two [72] S. aureus isolates were obtained from clinical specimens, including wound swabs, blood, and aspirated fluids. The isolates were identified using standard biochemical tests. Antimicrobial susceptibility testing for amikacin and gentamicin was performed using the disk diffusion method. All 72 isolates were analyzed via multiplex polymerase chain reaction [PCR] to detect the presence of the aph-3 and armA resistance genes. Results: Of the 72 S. aureus isolates, 35 [48.6%] were positive for at least one resistance gene. Specifically, the aph-3 gene was detected in 34 [47.2%] isolates [including one isolate carrying both genes], while the armA gene was detected in 2 [2.8%] isolates. Phenotypic resistance was found to be higher for amikacin than for gentamicin. Statistical analysis showed no significant association between the presence of these genes and patient gender, age, or specimen type [p > 0.05]. Conclusion: This study concludes that the aph-3 gene is the predominant aminoglycoside resistance marker among S. aureus isolates in Khartoum State. The low prevalence of the armA gene suggests it is currently a less common mechanism in this region. The high frequency of resistance to amikacin underscores the need for continuous molecular surveillance to guide effective antimicrobial therapy.

Antibiotic contamination in aquatic ecosystems drives the dissemination of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs). While heterogeneous photocatalysis using metal-free porous organic polymers (POPs) and covalent organic frameworks (COFs) offers a sustainable remediation strategy, current literature predominantly focuses on parent pollutant disappearance rather than fundamental degradation bottlenecks. This review critically addresses this gap by evaluating the inherent molecular trade-offs governing COF/POP design, the mechanistic pathways of real-water matrix interference, and the ecotoxicity of transformation products. Furthermore, we provide a critical Life Cycle Assessment (LCA) and Techno-Economic Analysis (TEA) perspective on synthesis versus performance, concluding with a standardized reporting checklist to guide future research toward practical, pilot-scale implementation.

Leaks and misuse of banking customer personal data in Indonesia are increasingly common along with the acceleration of digital transformation. Although Law Number 27 of 2022 concerning Personal Data Protection (PDP Law) has been passed, the burden of proving fault still often presents a challenge for customers as the injured party. This study aims to analyze the urgency of implementing the principle of strict liability as a legal protection instrument for customers in cases of personal data misuse by banking institutions. The research method used is a normative juridical approach with a statutory approach and a conceptual approach. The results show that the application of the principle of fault liability in the highly regulated banking industry is no longer relevant due to information asymmetry and the complexity of information technology systems. Adopting the principle of strict liability holds banks accountable for any failure to protect data without requiring customers to prove fault on their part. The implementation of this principle is expected to encourage banking institutions to maximize cybersecurity standards while providing legal certainty and redress for customers more effectively and efficiently.

Industrial production systems face disruptions caused by machine failures, material delays, workforce shortages, and changing production requirements. Conventional scheduling and maintenance practices often operate separately, limiting coordinated responses to changing operational conditions. This study proposes a Digital Twin enabled adaptive production and asset coordination framework that integrates machine degradation, Remaining Useful Life (RUL), workforce capacity, material availability, and disruption states within a virtual production environment. A co-simulation layer represents machine workforce interactions, while an adaptive multi-objective scheduling layer considers makespan, schedule deviation, energy consumption, material waste, recovery time, and operating cost. An Adaptive Twin-Reinforcement Learning (ATRL) layer incorporates carbon and waste considerations into disruption recovery decisions. A hierarchical edge cloud architecture supports local schedule repair and cloud-based policy updates. The framework is evaluated through synthetic simulation scenarios involving machine failures, demand surges, supply delays, workforce shortages, and simultaneous resource disruptions. Results show that the proposed framework reduces makespan from 120 h to 94 h and recovery time from 34 h to 17 h compared with static scheduling. Lower energy consumption and material waste are also observed across the evaluated scenarios. The findings indicate that Digital Twin-based adaptive coordination can support resilient production planning, asset management, sustainability-aware recovery, and operational decision-making under dynamic industrial conditions.

There is concrete evidence of cults that continued to be practiced despite their official prohibition. If human sacrifices were known in Jewish antiquity and if practices can persist in marginal groups, then the blood libels may be explained as the occasional detection, on the part of Christian communities, of a practice that had survived in certain marginal or heretical Jewish groups, or that had been transformed into an esoteric ritual. The veracity or falsity of this hypothesis cannot be determined with certainty, and therefore, the assertion that all blood libels are false is as unproven as the assertion that some are true. In Gaza there occurs a slow and almost daily sacrifice of the population: continuous immolation of civilians, structurally analogous to the herem of ancient Israel. Here we present the full text of the third edition of Jewish Morality and the Blood Mystery written by Theodor Fritsch (Athanasius Fern). It is enlarged with many additions.

Desertion, a novel by Abdulrazak Gurnah, has been widely noted for its insightful examination of colonial history and its impact on individual lives. Within this novel, the central female character, Rehana, has a destiny that is very closely connected to space. Using Rehana as its focus, this study seeks to explore the memory predicament and reconstruction pathways of marginalized women within a postcolonial context. Utilizing a close reading methodology and drawing on Gabriel Zoran’s spatial narrative theory, this research undertakes an analysis structured around three key dimensions: topographical space, textual space, and chronotopic space. The findings reveal that Rehana’s spatial mobility enables her to transition from being “abandoned” to actively “abandoning,” thereby achieving memory reconstruction. This transformation underscores the subjectivity of marginalized women and provides a significant framework for comprehending individual memory predicaments and identity reconciliation within a postcolonial context.

Background: Eclampsia is associated with substantial maternal morbidity and mortality, while the optimal mode of delivery remains uncertain because available evidence is conflicting. Therefore, the present study was undertaken to compare maternal outcomes according to mode of delivery among women with eclampsia. Methods: This cross-sectional observational study was conducted at the Eclampsia Ward, Department of Gynecology and Obstetrics, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from April 20 to October 20, 2015. A total of 100 women with antepartum eclampsia were enrolled through purposive sampling. Data were collected using a semi-structured questionnaire and analyzed using SPSS to compare maternal outcomes according to mode of delivery. Ethical approval, institutional permission, and informed consent were obtained. Results: Among 100 women with eclampsia, 55 (55.0%) had vaginal and 45 (45.0%) caesarean delivery. Demographic and clinical characteristics were largely comparable (p>0.05), except urinary albumin distribution (p=0.034). Maternal morbidity (45.5% vs. 37.8%) and mortality (5.5% vs. 2.2%) were higher after vaginal delivery. ICU referral was significantly higher following vaginal delivery (29.1% vs. 8.9%; p=0.012), while major organ and postpartum complications did not differ significantly (p>0.05). Of four maternal deaths, three followed vaginal delivery and one followed caesarean section. Conclusion: Vaginal delivery was associated with greater maternal morbidity and ICU requirement among women with eclampsia, highlighting the importance of individualized delivery planning based on maternal and fetal condition.

Background: Occupational burnout is a psychological response to chronic workplace stress and is particularly prevalent among nurses due to the high demands of the healthcare environment. In Saudi Arabia, nursing burnout is a growing concern, warranting targeted investigation. Aim/objective: To assess the prevalence of occupational burnout and examine its association with demographic and work-related factors among nurses at King Abdulaziz Hospital, Eastern Province, Saudi Arabia. Methods: The study included 295 purposively selected nurses. Data were collected using two instruments: a self-administered questionnaire covering demographic and work-related characteristics, and the Oldenburg Burnout Inventory (OLBI). Statistical analysis involved chi-square tests and binary logistic regression to identify predictors of burnout. Results: High overall burnout was reported by 8.1% of participants, with 26.8% experiencing high exhaustion and 23.0% high disengagement. Inadequate staffing was significantly associated with burnout (OR = 6.91, p = .001). Working in inpatient units showed a marginal association (p = .054). No other demographic or work-related factors were significantly associated. Conclusions: While the overall prevalence of high burnout was relatively low, a considerable proportion of nurses reported symptoms of exhaustion and disengagement. Perceived inadequate staffing emerged as the strongest predictor of burnout. Interventions such as optimizing nurse staffing levels and integrating stress management into nursing education are essential to mitigate burnout risk.