Pituitary adenomas are benign brain tumors that pose a heavy burden on patients worldwide. However, the local burden of disease is yet to be established due to scarcity of data. In line with this, this study aims to present the challenges and gaps in the treatment of pituitary adenomas in the Philippines. A scoping review of available relevant literature on epidemiology, clinical experience with treatment, health financing, and healthcare delivery system based on the Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines extension for Scoping Reviews was conducted. The scarcity of updated local clinical data, inequity of distribution of resources, inadequate government support, and lack of affordable diagnostic testing, medications and neurosurgical procedures are the factors that hinder provision of adequate care of pituitary adenomas in the Philippines. There are notable treatment gaps in the management of pituitary adenomas in the Philippines, which may be addressed by strengthening universal healthcare. Strategies to address these gaps were proposed, including improving public-private insurance coverage, increasing manpower, enhancing accessibility to resources, and spreading more awareness.

The maximal prime gaps upper bound problem is one of the major mathematical problems to date. The objective of the current research is to develop a standard which will aid in the understanding of the distribution of prime numbers. This paper presents theoretical results which originated with a researchin the subject of the maximal prime gaps. the document presents the sharpest upper bound for the maximal prime gaps ever developed. The result becomes the Supremum bound on the maximal prime gaps and subsequently culminates with the conclusive proof of the Firoozbakht's Hypothesis No 30. Firoozbakht's Hypothesis implies quite a bold conjecture concerning the maximal prime gaps. In fact it imposes one of the strongest maximal prime gaps bounds ever conjectured. Its truth implies the truth of a greater number of known prime gaps conjectures, simultaneously, the Firoozbakht's Hypothesis disproves a known heuristic argument of Granville and Maier. This paper is dedicated to a fellow mathematician, the late Farideh Firoozbakht.

Cultural tourism in Tanzania presents a diverse tapestry of traditions, varied ethnic groups, and historical accounts. This article aims to pinpoint areas for further exploration in the cultural tourism sector of Tanzania and analyze their potential impacts. The study conducted a systematic review of the literature following established inclusion criteria as well as the Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines. A total of 21 articles focused on Tanzania Cultural Heritage Tourism from sources such as Google Scholar and web databases were examined, revealing several research gaps, including theoretical, contextual and methodological aspects. Furthermore, the research offers insights into theoretical implications and recommends avenues for future studies that could advance the field by addressing these knowledge gaps providing valuable direction to new researchers interested in exploring these specific areas as well as practitioners seeking a comprehensive understanding of various aspects related to Tanzania's cultural heritage tourism

This study investigates the multifaceted aspects of 21st century teaching and identifies gaps in current educational practices. The researcher employed a qualitative approach, utilizing interviews, observations, and document analysis. Grounded in a theoretical framework emphasizing student-centered pedagogy, technology integration, and innovative instructional strategies, the study involved a diverse sample of 30 participants, including teachers, students, and administrators. Rigorous measures were implemented to ensure validity and reliability, such as researcher triangulation and member checking. The findings revealed significant gaps in areas such as student engagement, digital literacy, and pedagogical innovation. These findings are discussed in relation to existing literature, highlighting the implications for educational practice and the urgent need for educational transformation. The study's limitations include the small sample size and its focus on a specific educational context. Future research should explore the identified gaps using different methodologies and extend the investigation to other educational settings. The study contributes to the growing body of knowledge on 21st century teaching, providing valuable insights for educators, policymakers, and researchers aiming to promote effective and transformative teaching practices in the modern era.

Various studies on the physical characteristics of the canopy gaps in tropical and subtropical regions but that in the mangrove swamp forest in Malaysia is little known. The objectives of this study are to assess the canopy gaps physical characteristics (size, form, direction), to assess the changes in soil physical characteristics and microenvionment in and around the canopy gaps. Five canopy gaps were selected formed by lightning strikes, gaps size and shapes were determined using the portable Global Positioning System and photographic images were analysed using ForestCrown. Result shows that canopy gap opening has increased the total light reaching the forest floor, changed the canopy gap microenvironment. Strong correlation between canopy opening percentage and temperature of gaps explains the changes of canopy gaps characteristics. These changes have contributed to new seedling germination, regeneration and maintaining the canopy gap dynamics.

In the research, we studied the typical functional plant traits and life forms of plants that colonize forest gaps. In the research, we analysed functional plant traits of plant species growing on five forest gaps in the Dinaric fir-beech forest in Slovenia. The forest gaps were created as a result of natural disturbances. We selected 18 functional plant traits, whose values were obtained from the BiolFlor database. With the help of the JUICE program, we calculated the frequency of its occurrence on individual forest gap for each functional plant trait. Then we calculated Sperman's correlation coefficient at p<0.05, between the occurrence of individual functional plant traits and single forest gap. We found out that forest gaps are mainly colonized by perennials and herbaceous perennials and hamephytes. These are plant species that begin to flower in June and July, bloom for two or three months and are pollinated by insects, mainly hover flys and wild bees. Characteristic of colonizing plant species is also that, in addition to reproducing by seeds and spores, they also reproduce vegetatively. Besides that, birds and forest mammals are the vectors of fruit and seed dispersal of colonizing plant species.

This qualitative research examines the quality assurance practices in private school institutions in Iligan City during the first semester of 2020-2021. The study involves interviews with 30 school administrators and document analysis to uncover key themes and sub-themes. The findings reveal the significance of clear policies, professional development for teachers, stakeholder engagement, assessment strategies, and technology utilization in quality assurance. The study also identifies challenges such as the need for standardized assessment procedures, limited resources for professional development, and the integration of technology. Moreover, it emphasizes the importance of adaptability and flexibility in the face of changing educational landscapes, particularly during the COVID-19 pandemic. Recommendations for further research include conducting a comparative analysis between private and public school institutions, investigating the long-term impacts of the pandemic on quality assurance, and exploring innovative strategies for online and blended learning environments. The paper concludes by highlighting the importance of addressing challenges and embracing new perspectives in quality assurance to improve the overall quality of education. The implications of the study emphasize the need for comprehensive quality assurance frameworks that encompass all aspects of education and the importance of ongoing evaluation and improvement. Ultimately, this qualitative research article contributes valuable insights for private school institutions and educational policymakers to enhance their quality assurance practices and provide better educational experiences for students.

Indigenous Peoples in Canada have shown great strength and resilience in maintaining their cultures and ways of life to date in the face of settler colonialism. Centering the water crises within Indigenous sovereignty and self-determination, we explore the impacts these crises are having on community members. Particularly, the continuous failure of the Canadian government to end the water crises in remote Indigenous communities, Star Blanket Cree Nation, is investigated in this paper. What implications have these water governance gaps had on Indigenous Peoples’ sovereignty and self-determination? We adopted an Indigenist theoretical framework to guide the study. Additionally, a community-based participatory research approach was adopted. To achieve our research goals of investigating the implications of the current water crises for Indigenous sovereignty and self-determination, specific methods of sharing circles were used to gather knowledge from community members, Elders, and knowledge keepers. The research findings strongly highlight the strength and resilience shown by remote Indigenous communities in the face of the current water crises and continuous government failure. Solving the current water crises will involve remote Indigenous communities taking charge of their own water governance through Indigenous-led water governance systems. Additionally, taking steps to rebuild trust through genuine reconciliation will be key. Therefore, listening to remote Indigenous communities and taking collaborative action is fundamental.

The aim of this paper is to optimize thickness variation function of simply supported and cantilever beams, in terms of maximizing gaps between chosen neighboring frequencies and analyze obtained results. The optimization results are examined in terms of achieving the objective function (related to eigenproblem), but also in terms of their dynamics stiffness (forced vibrations excited by point harmonic load). In the optimization process, a Genetic Algorithm was used. Problems related to structural dynamics were solved by FEM implementation into the algorithm. Sample results were presented, and the developed algorithm was analyzed in terms of result convergence by examining several variable parameters. The authors demonstrated the validity of applying the described optimization tool to the presented problems. Conclusions were drawn regarding the correlation between stiffness and mass distribution in the optimized beams and the natural frequency modes in terms of which they were optimized.

The Density Wave Theory, which aims to explain the formation of spiral arms in disc galaxies, has been subject to discussion. According to this theory, at the co-rotation circle, the rotational velocity of the density waves or spiral arms matches that of the galactic matter. Consequently, this alignment should impede the formation of new stars within this co-rotation circle, leading to the presence of dark or dim gaps within the spiral arms. Additionally, the theory predicts the occurrence of the front side trail effect in the inner region of the co-rotation circle and the rear side trail effect in the outer region. However, despite these expectations, no such spiral patterns have been observed, prompting the need for revision or reconsideration of the Density Wave Theory.

The German health authorities' guidelines for medical devices in 2012 highlighted the importance of cleaning ultrasound probes, emphasizing their validation and reliability. In addition to automated and validated options, alternative manual methods such as wipe disinfection have gained traction due to their independence from additional hardware. The study examines the effectiveness of manual disinfection methods, specifically the cleaning process, addressing concerns raised by the Robert Koch Institute regarding the lack of validation for wipe disinfection of semi-critical devices. The EQUINOS colored wipe disinfection kit identified wetting gaps in all cleanings across four probes tested. The results indicate significant challenges in ensuring complete surface wetting, particularly in complex body parts such as clip-on areas and shapes for additional biopsy attachments, suggesting that manual methods alone may not adequately mitigate the risk of infection transmission (p value .001). The study concludes that while manual disinfection methods are a viable alternative to automated reprocessing, there is a critical need for enhanced training and potentially the development of more effective manual disinfection techniques or colored wipes to ensure patient safety and compliance with healthcare hygiene standards.

This article examines the diagnosis of the Agricultural Innovation System (SIA) in the department of Tolima, Colombia, as part of a project led by the Colombian Ministry of Agriculture and Rural Development and the Technological University of Pereira (TUP), which also evaluated the National Agricultural Innovation System (NAIS) in regions such as Chocó, Bolívar, and Meta. A methodology was used that involved a survey with 58 questions on a Likert scale to 300 participants, evaluated with congruence and relevance indexes, identifying key variables in the operation of the Agricultural Innovation System (AIS). A survey was also applied to actors of the National Innovation System for Higher Education in Agriculture, A survey was also applied to map the participating actors in the regional agricultural innovation systems of Tolima to identify gaps in extension, innovation, development, sustainability, ICT, education and training. Among the conclusions, it stands out that the associativity subsystem presents the lowest lag and is close to a score of two on the scale of gaps, evaluation carried out among the five subsystems including extension, ICT, environmental aspects, and pub-lic policy. The department of Tolima shows low performance in innovation and ICT, while the extension is less lagging. In Chaparral there is a general lag, with innovation being the worst evaluated subsystem. Rovira obtains high scores in most subsystems, although innovation and ICT have lower scores. At the national and regional levels, innovation is low, and articulation among NARS actors is insufficient, which highlights the need to promote good practices, strategies, and projects.

$\beta$-decay is one of the key factors to understand the $r$-process and evolution of massive stars. The Gamow-Teller (GT) transitions drive the $\beta$-decay process. We employ the proton-neutron quasiparticle random phase approximation (pn-QRPA) model to calculate terrestrial and stellar $\beta$-decay rates for 50 top-ranked nuclei possessing astrophysical significance according to a recent survey \cite{Nab21}. The model parameters of the pn-QRPA model effect the predicated results of $\beta$-decay. The current study investigates the effect of nucleon-nucleon pairing gaps on charge-changing transitions and the associated $\beta$ decay rates. Three different values of pairing gaps, namely TF, 3TF and 5TF, were used in our investigation. It was concluded that both GT strength distributions and half-lives are sensitive to pairing gap values. The 3TF pairing gap scheme, in our chosen nuclear model, resulted in best prediction with around 80$\%$ of the calculated half-lives within a factor 10 of the measured ones. The 3TF pairing scheme also led to calculation of biggest $\beta$-decay rates in stellar matter.

Acute low back pain (LBP) stands as a leading cause of activity limitation and work absenteeism, and its associated healthcare expenditures are expected to become substantial when acute LBP develops into a chronic and even refractory condition. Therefore, early intervention is crucial to prevent progression to chronic pain whose management is particularly challenging and for which the most effective pharmacological therapy is still controversial. Current guideline treatment recommendations vary and are mostly driven by expertise with opinion differing across different interventions. Thus, it is difficult to formulate evidence-based guidance when relatively few randomized clinical trials did explore the diagnosis and management of LBP while employing different selection criteria, statistical analyses, and outcome measurements. This narrative review aims to provide a critical appraisal of current acute LBP management by discussing the unmet needs and areas of improvement from bench-to-bedside and proposes multimodal analgesia as the way forward to attain an effective and prolonged pain relief and functional recovery in patients with acute LBP.

Background: Misconceptions and knowledge gaps about antibiotic use contribute to inappropriate antibiotic use and antimicrobial resistance. Aim: Identifying and prioritizing misconceptions and knowledge gaps about antibiotic use from a healthcare professionals’ perspective. Methods: A modified Delphi study of two rounds with an expert meeting. A literature search was conducted to create statements about misconceptions and knowledge gaps about antibiotic use. These were rated by healthcare professionals from five EU countries representing general practice, out-of-hour services, nursing homes, and pharmacies. Consensus was achieved if ≥80% of the participants rated 4+ on a five-point Likert scale during the second Delphi round. Results. In total, 44 misconceptions were identified through the literature search within four themes: 1) antimicrobial resistance in general, 2) use of antibiotics in general, 3) use of antibiotics for respiratory tract infections, and 4) use of antibiotics for urinary tract infections. Consensus was reached for more than half of the statements within each setting. Conclusions. Experts from different settings and nationalities acknowledge that multiple misconceptions and knowledge gaps can contribute to inappropriate use of antibiotics in the community. These results provide valuable information to use in educational campaigns for patients and healthcare professionals to improve the use of antibiotics.

The presented study demonstrates the bi-sensor approach suitable for rapid and precise up-to-date mapping of forest canopy gaps for the larger spatial extent. The approach makes use of UAV RGB images on smaller areas for highly precise forest canopy mask creation. Sentinel-2 was used as a scaling platform for transferring information from UAV to a wider spatial extent. The various approaches of the improvement of the predictive performance were examined: (I) the highest R2 of the single satellite index was up to 0.57, (II) the highest R2 using multiple features obtained from the single date, S-2 image was 0.624 and, (III) the highest R2 on the multi-temporal set of S-2 images, was 0.697. Satellite indices such as ARVI, IPVI, NDI45, PSSRa, MCARI, CI, RI, and NDTI were the dominant predictors in most of the ML algorithms. The more complex ML algorithms such as SVM, Random Forest, GBM, XGBoost, and Catboost that provided the best performance on the training set exhibited weaker generalization capabilities. Therefore, a simpler and more robust Elastic Net algorithm was chosen for the final map creation.

This research paper aims to explicate the complex issue of the Riemann's Hypothesis and ultimately presents its elementary proof. The method implements one of the binomial coefficients, to demonstrate the maximal prime gaps bound. Maximal prime gaps bound constitutes a comprehensive improvement over the Bertrand's result, and becomes one of the key elements of the theory. Subsequently, implementing the theory of the primorial function and its error bounds, an improved version of the Gauss' offset logarithmic integral is developed. This integral serves as a Supremum bound of the prime counting function Pi(n). Due to its very high precision, it permits to verify the relationship between the prime counting function Pi(n) and the offset logarithmic integral of Carl Gauss. The collective mathematical theory, via the Niels F. Helge von Koch equation, enables to prove the RIemann's Hypothesis conclusively.

Forest canopy gaps are important for the ecosystem dynamics. Depending on tree species, small canopy openings might be also associated to intra-crown porosity and to space between crowns. Yet, little is known on the relationships between the fine-scaled pattern of canopy openings and biodiversity features. This research explored the possibility of i)- mapping forest canopy gaps from a very high resolution orthomosaic (10 cm), processed from a versatile imaging platform such as unmanned aerial vehicles (UAV), ii)- to derive patch metrics that can be tested as covariates of variables of interest for forest biodiversity monitoring. This is attempted in a test area of 240 ha covered by temperate deciduous forest types in Central Italy and containing 50 forest inventory plots of about 530 m². Correlation and linear regression techniques were used to explore relationships between patch metrics and understorey (density, development and species diversity) or forest habitat biodiversity variables (density of micro-habitat bearing trees, vertical species profile, tree species diversity). The results revealed that small openings in the canopy cover (75% smaller than 7 m²) can be faithfully extracted from UAV RGB imagery, using the red band and contrast split segmentation. Highest correlations were observed in the mixed forest (beech and turkey oak), while beech forest had the poorest ones and turkey oak forest displayed intermediate results. Moderate to strong linear relationships were found between gap metrics and understorey variables in mixed forest type, with adjusted R² from linear regression ranging from 0.52 to 0.87. Equally good results, in the same forest types, were observed for forest habitat biodiversity variables (0.52<adjusted R²<0.79) with highest values found for density of trees with microhabitats and vertical species profile. In conclusion, this research highlights that UAV remote sensing can potentially provide covariate surfaces of variables of interest for forest biodiversity monitoring, conventionally collected in forest inventory plots. By integrating the two sources of data, these variables can be mapped over small forest areas with satisfactory levels of accuracy, at a much higher spatial resolution than would be possible by field-based forest inventory solely.

Vibration suppression in a field of frequencies and the creation of band gaps which do not allow the propagation of the waves is studied in this paper by means of microstructures designed through topology optimization. Topology optimization is formulated in frequency domain. Band gap design is based on Floquet-Bloch theory and genetic optimization. The result is appealing in view of modern 3D printing techniques.