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05). Based on these results, it was expected that rosemary extracts were effective for improving the mental energy and sleep quality of work-age men with poor mental health.Clinical competencies consisting of skills, knowledge, and communication techniques should be acquired by all medical graduates to optimize healthcare quality. However, transitioning from observation to hands-on learning in clinical competencies poses a challenge to medical students. The aim of this study is to evaluate the impact of a novel interactive multimedia eBook curriculum in clinical competency training. selleck products Ninety-six medical students were recruited. Students in the control group (n = 46) were taught clinical competencies via conventional teaching, while students in the experimental group (n = 50) were taught with conventional teaching plus interactive multimedia eBooks. The outcomes of clinical competencies were evaluated using Objective Structured Clinical Examination (OSCE) scores, and feedback on their interactive eBook experiences was obtained. In the experimental group, the average National OSCE scores were not only higher than the control group (214.8 vs. 206.5, p less then 0.001), but also showed a quicker improvement when comparing between three consecutive mock OSCEs (p less then 0.001). In response to open-ended questions, participants emphasized the importance of eBooks in improving their abilities and self-confidence when dealing with 'difficult' patients. Implementing interactive multimedia eBooks could prompt a more rapid improvement in clinical skill performance to provide safer healthcare, indicating the potential of our innovative module in enhancing clinical competencies.In 2008, the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (PedIMMPACT) published a consensus statement that recognized the dearth of research surrounding the topic of children's satisfaction with acute pain management. This review of published literature will summarize what is known about the topic of children's satisfaction with pain management, identify current gaps in the knowledge, and provide direction for future research in this critical area. Including children in the decision-making process as soon as they are developmentally able is a concept that is the fundamental basis for seeking assent and more active roles within healthcare decisions for children. It is the responsibility of adults to provide them with increasing opportunities for self-evaluation and more independent management of their healthcare, encouraging the development of children into adults. As clinicians and researchers, it is our prerogative to support the maturation of children by building effective methods to communicate their satisfaction with acute pain treatment and healthcare. Children's satisfaction with acute pain management is not well studied and further research is needed for the development of inclusive, developmentally appropriate measures of satisfaction for our pediatric patients.Neuroparacoccidioidomycosis (NPCM) is a rare and severe clinical presentation of paracoccidioidomycosis (PCM). We performed a retrospective cohort study at the Evandro Chagas National Institute of Infectious Diseases (INI/Fiocruz), a reference center for PCM in the state of Rio de Janeiro, Brazil. All cases of PCM admitted to the INI/Fiocruz from January 2007 to December 2019 were reviewed. Eight (3.9%) among 207 patients met the diagnostic criteria for NPCM. The mean age was 44.6 years and the malefemale ratio was 71. All cases presented multifocal disease, 5 (62.5%) the chronic form and 3 (37.5%) the acute/subacute form. All patients presented the pseudotumoral pattern and 6 (75.0%) had multiple lesions in the cerebral hemispheres. Seizures and motor symptoms were the most frequent clinical manifestations (50.0%, each). The treatment of choice was sulfamethoxazole/trimethoprim (SMZ-TMP) and fluconazole, in association (87.5%). Most patients responded well to the treatment. Sequela and death occurred in one (12.5%) patient, each.Intensification of agricultural practices leads to a loss of floral resources and drives pollinator decline. Extensive agricultural practices are encouraged in Europe and contribute to the preservation of biodiversity. We compared three agricultural landscapes without extensive farming practices with three adjacent landscapes containing organic crops and extensively managed grasslands in Belgium. Nectar resource availability and plant-pollinator interactions were monitored from April to June. Flower density per plant species and plant-pollinator interactions were recorded in different landscape elements. In April, the main nectar resources were provided by linear elements such as hedgerows and forest edges. Nectar production peaked in May, driven by intensive grasslands and mass-flowering crops. Occurrence of extensive grasslands and organic crops significantly alleviated the nectar resource gap observed in June. Our results underscore the importance of maintaining landscape heterogeneity for continuous flower resources and highlight the specific role of extensive grasslands and organic crops in June.As energy efficiency (EE) is a key performance indicator for the future wireless network, it has become a significant research field in communication networks. In this paper, we consider multi-cell multi-carrier non-orthogonal multiple access (MCMC-NOMA) networks and investigate the EE maximization problem. As the EE maximization is a mixed-integer nonlinear programming NP-hard problem, it is difficult to solve directly by traditional optimization such as convex optimization. To handle the EE maximization problem, we decouple it into two subproblems. The first subproblem is user association, where we design a matching-based framework to perform the user association and the subcarriers' assignment. The second subproblem is the power allocation problem for each user to maximize the EE of the systems. Since the EE maximization problem is still non-convex with respect to the power domain, we propose a two stage quadratic transform with both a single ratio quadratic and multidimensional quadratic transform to convert it into an equivalent convex optimization problem.