BACKGROUND The C-MIC II trial demonstrated benefits of 6 months of cardiac microcurrent (C-MIC) therapy in patients with non-ischemic heart failure with reduced ejection fraction (HFrEF). The prospective C-MIC II Follow-Up Study evaluates safety and efficacy outcomes post-device deactivation. METHODS Primary safety-related endpoints included all-cause, cardiovascular and device-related mortality and hospitalizations and adverse events (AEs). Secondary efficacy-related endpoints included changes in left ventricular ejection fraction (LVEF), Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS), 6-minute walk distance (6MWD), New York Heart Association (NYHA) class and device reactivation rate. Here, we report 12-month results comparing the 6-month time-point (at the end of active therapy) with the 18-month time-point (12 months post-deactivation). RESULTS Of 32 eligible patients, 31 (97%) were enrolled. At 12 months post-device deactivation, 3 patients (10%) were hospitalized and 1 died (3%); none were device-related. One device-related AE occurred and resolved completely. Improvements in LVEF (vs pre-implantation: +6%; 95% CI 5-8; p<0.0001) and KCCQ-OSS (vs pre-implantation: +43 points; 95% CI 36-49; p<0.0001) were sustained and unchanged from 6 months (LVEF: -0.1%; 95% CI -2-2; p=0.87; KCCQ-OSS:-2; 95% CI -8-4; p=0.49). The 6MWD remained improved (vs pre-implantation: +150 m; 95% CI 109-191; p<0.0001), with a modest decrease (-31 m; 95% CI -56- -7; p=0.013) from 6 months. Improvements in NYHA class (≥1-class improvement in 77% patients) were sustained. Three (10%) patients required device reactivation. CONCLUSION Among patients previously treated with C-MIC device, improvements in LVEF, 6MWD, NYHA class and KCCQ-OSS were sustained, with a favorable safety profile 12 months post-deactivation.

Darts is a precision-based sport that requires a high level of motor control, coordination, and psychological stability. The aim of this review paper is to synthesize current scientific knowledge on the determinants of performance in darts, with a focus on motor skills, biomechanics, and psychological factors. A narrative review methodology was used, drawing from studies in motor control, sport psychology, and skill acquisition. The findings suggest that successful darts performance depends on fine motor control, movement consistency, visual–motor coordination, and mental focus. Psychological factors such as concentration, anxiety regulation, and self-confidence play a crucial role in performance under pressure. Additionally, deliberate practice and repetition are essential for skill acquisition. This review highlights the importance of integrating physical and psychological training in darts.

Kinesiology, as the scientific study of human movement, has undergone substantial conceptual and structural changes over the past decades. According to Mraković, kinesiology is defined as an empirical, experimentally based science that studies the laws, principles, and patterns of controlled and purposeful physical activity and its effects on the human organism. This definition highlights the scientific and systematic nature of the discipline. The aim of this review paper is to examine the development of kinesiology in the 21st century, with particular emphasis on its paradigm shift from a practice-oriented field toward an interdisciplinary scientific discipline. The analysis is based on foundational and contemporary literature, including empirical and systematic studies . The findings suggest that kinesiology has evolved into a comprehensive field integrating biological, social, and behavioural sciences. Modern kinesiology focuses on health, performance, and human development, addressing global challenges such as physical inactivity and chronic disease. The discipline is increasingly recognised as a central scientific framework for understanding human movement in the 21st century. The review further demonstrates that the future development of kinesiology will depend on interdisciplinary collaboration, methodological standardization, international scientific cooperation, and the integration of emerging technologies such as wearable sensors, artificial intelligence, motion analysis systems, and precision exercise medicine. These developments position kinesiology as a central scientific discipline for addressing contemporary challenges in health, human performance, and physical activity across the lifespan.

The aim of this study was to assess the possible adverse effects of different dietary regimens—namely diets based onbakery products and meat products—on erythrocytes, their morphology, erythrocyte indices, platelets, leukocytes, andthe leukogram in rats during late puerperium. A monotonous diet may affect the hematological profile and potentiallycause pathophysiological disorders. The study included 18 clinically healthy rats in the late puerperal period, divided intothree groups of six animals each: a group fed meat products (Group M), a group fed bakery products (Group H), and acontrol group (Group K) that consumed standard pelleted rodent feed. All groups of rats were fed their respective dietsseparately for a period of 49 days. At the end of the experimental period, hematological blood analyses were performed.Statistically significant differences (p < 0.05) were found among the groups for the parameters MCV, MCH, and PLT. It wasalso established that HCT, HGB, MCV, and MCH values in the experimental bakery-product group (H) were lower than boththe physiological reference intervals and the corresponding values in the control group (K). Moderate anulocytosis wasobserved, accompanied by hypochromic erythrocytes of reduced volume. Regarding the experimental group that consumedprocessed meat products, the results indicated the presence of hypochromic anemia, as evidenced by decreasedHGB, MCV, and MCH values. Examination of peripheral blood smears revealed the presence of poikilocytotic erythrocyteforms, namely echinocytes, with a notable percentage occurrence (14.05%) within microscopic fields of view. A diet basedon bakery products led to changes in hematological parameters, resulting in the development of iron-deficiency anemia.Furthermore, prolonged consumption of meat products contributed to the development of hypochromic anemia and suggestedpossible impairment of kidney function. This study demonstrated that rats during the late puerperal period are notimmune to the adverse effects of a monotonous meat-based diet nor to a monotonous diet consisting of bakery products.

Background: Technological changes and the demand for digital-based financial services have driven the gold pawn industry in Indonesia to undertake innovative governance and regulatory transformations to address the public's need for safe, fast, and transparent access to financing. Methods: This study uses a normative legal research approach that analyzes the synchronization of regulations, corporate governance principles, and harmonization of legal norms related to the digital gold pawn business by applying legal document analysis. Findings: The study results show that the implementation of digitalization expands the reach of services and improves operational efficiency. However, regulatory synchronization, data security, transaction validity, and consumer protection remain key challenges that require continuous policy adaptation. Conclusion: Strengthening adaptive governance and responsive regulatory updates are key to maintaining public trust in digital gold pawn services. Collaboration between regulators, industry players, and public education is crucial to support financial inclusion and protect public interests. Novelty/Originality of this article: This study offers a comprehensive analysis of the harmonization of regulations for the gold pawn business in the digital era, highlighting the need for legal protection and technology-based governance strategies, and emphasizing the relevance of digital literacy for the sustainability of the pawn industry in Indonesia.

The increasing complexity of Internet of Things (IoT) environments requires adaptive mechanisms for efficient service allocation across distributed infrastructures. Existing approaches are often focused on specific optimization algorithms or isolated Quality of Service (QoS) parameters, lacking a unified framework for decision-making across IoT, Fog/Edge, and Cloud layers. This paper proposes a modular QoS-aware decision-making framework that integrates QoS profiles, key performance indicators (KPIs), utility functions, and multi-criteria decision-making mechanisms to support both static and dynamic service allocation. The framework considers service execution latency, energy consumption, network throughput, and network coverage as decision criteria and enables adaptive balancing of conflicting QoS requirements. Its applicability is demonstrated through a smart transportation use case involving multiple service allocation scenarios across CRU, Fog, and Cloud infrastructures. The results confirm that different allocation strategies exhibit distinct QoS trade-offs and demonstrate the suitability of the proposed framework for adaptive and resource-efficient service allocation in layered IoT architectures.

Large‐scale assessments such as the Trends in International Mathematics and Science Study (TIMSS) provide valuable opportunities to examine factors associated with academic achievement across educational contexts. Using TIMSS 2023 data from Bosnia and Herzegovina, this study examined the association between teacher job satisfaction and students' mathematics achievement while controlling for socioeconomic status (SES) and gender. Data were analyzed using three‐level hierarchical linear modeling to account for the nested structure of students within classrooms and schools. Mathematics achievement was represented by the five TIMSS plausible values, and parameter estimates were pooled using Rubin's rules. Results showed that both individual and school‐level SES were strong positive predictors of mathematics achievement, while boys scored slightly higher than girls. School socioeconomic composition emerged as the strongest predictor in the models. Teacher job satisfaction showed a small but statistically significant positive association with achievement after controlling for socioeconomic factors and school climate indicators. In contrast, perceptions of safe and orderly schools and school emphasis on academic success were not significantly associated with achievement. These findings highlight the importance of socioeconomic context in shaping educational outcomes while suggesting that teacher job satisfaction may represent an additional factor associated with students' mathematics achievement.

Geometric morphometrics has created a significant field in the study of skeletal variation in veterinary osteology by providing a robust framework for investigating shape variation. This technique allows for the analysis of anatomical structures in a variety of biological contexts. This review examines the extant literature, demonstrating how dietary consistency and biomechanical structure significantly shape and often lead to intergenerational morphological changes. The investigation further explores the function of locomotion strategies, including habitat preference and diversity, in the context of the skeletal system. The merits of geometric morphometric analysis are evident in its capacity to facilitate species identification and close relative discrimination in scenarios where conventional methods encounter constraints. The utilisation of geometric morphometric analysis offers distinct advantages in ontogenetic studies, allometric scaling in morphology, and the consideration of developmental constraints. Additionally, it provides a framework for investigating sexual dimorphism and variations in shape across varied species and anatomical regions. From a clinical and welfare perspective, geometric morphometrics provides a powerful framework for orthopaedic surgical planning, detection of pathological changes, phenotyping in animal models, and translational research. Finally, the integration of artificial intelligence (AI)-powered automation and high-resolution imaging is also being reviewed in studies. These developments position geometric morphometrics as an indispensable method for integrating form, function, and health in veterinary research.

Digital technology is now embedded in mathematics classrooms across most school systems, yet the pedagogical question of how such technology should be used to support mathematical learning remains unsettled. Quantitative syntheses report effects ranging from negligible to substantial, large-scale international assessments frequently associate school technology use with weaker mathematical performance, and teacher-level studies show that availability of tools rarely translates into changes in mathematical practice. This critical narrative review examines the state of knowledge on mathematics teaching methodology in digitally mediated settings and develops an integrated pedagogical framework for meaningful technology integration. The review draws on peer-reviewed literature identified through structured searching of open scholarly databases and indexes, supplemented by backward and forward citation searching and by examination of authoritative institutional reports. Evidence was appraised for design adequacy, duration, outcome validity, sample representativeness and consistency with independent findings, and was synthesised thematically rather than study by study. Four critical findings emerge. Aggregate effect estimates are dominated by short, small, researcher-implemented studies, and the largest reported effects cluster in precisely those conditions. Tool-class comparisons show that effects depend on the epistemic function a tool performs rather than on its technical sophistication. Correlational evidence from international assessments cannot be read as evidence of harm, because usage measures conflate remediation, compensation and pedagogy. Teacher enactment, rather than tool provision, is the principal determinant of whether digital mediation alters mathematical activity. The proposed framework organises integration around mathematical purpose, instrumental orchestration, representational congruence, epistemic authority, feedback calibration and equity by design, and distinguishes propositions that are well supported from those that remain conjectural. Generative artificial intelligence intensifies rather than resolves these questions, because it relocates the production of mathematical justification. Priorities for research include longer classroom-embedded trials, process-sensitive outcome measures, and studies that treat teacher orchestration as a manipulated variable rather than as background noise.

This paper explores how generative AI (GAI) may complement, extend or selectively assume information-based functions traditionally associated with human tour guiding in self-guided tourism experiences (SGE). It presents a new framework for GAI-driven SGE, highlighting three central aspects: personalization, real-time support and contextual relevance. To map the relationship between GAI, on-site information-seeking behavior and SGE, we adapted a structured approach based on MacInnis' (2011) framework for explicating (descriptive) conceptual contributions. By utilizing GAI's features, the study shows how GAI may improve tourist independence and convenience. The paper also evaluates the limitations of GAI, particularly its difficulty in replicating the emotional connections, cultural understanding and narrative immersion that human guides provide. Through a comparison with traditional guided tours, the research discusses the consequences of adopting GAI for tourists, service providers and destination management organizations (DMOs). Ethical issues, including data privacy concerns and the potential for cultural inaccuracies, are also explored, along with proposed strategies for responsible implementation. This work lays the groundwork for future studies and real-world applications, offering insights into how GAI may make tourism more adaptable, inclusive and sustainable. While the paper focuses on how GAI may support or selectively assume specific information-based functions of guiding, we recognize that tour guiding is also a form of embodied, relational, and regulated labor that extends beyond the scope of this conceptual framework.

Biliary tract cancers (BTCs) are aggressive malignancies associated with a poor prognosis. Although molecular profiling is recommended to guide therapeutic decision-making, real-practice data on the prevalence and prognostic significance of genomic alterations in European BTC cohorts remain limited. This retrospective cohort study characterized the molecular landscape of BTCs in a Belgian real-practice setting and evaluated its prognostic relevance. Patients with BTC who underwent informative molecular testing as part of routine diagnostics at Antwerp University Hospital between 2016 and 2024 were included. Demographic, clinical, and molecular data were extracted from electronic health records. Survival outcomes were analyzed using Kaplan-Meier methods and Cox proportional hazards regression. Among 224 included patients, genomic alterations were identified in 59.4% of tumors, with clear subtype-specific patterns. IDH1 mutations (17.3%) and FGFR2 fusions (13.9%) were exclusively observed in intrahepatic cholangiocarcinoma, KRAS mutations were most prevalent in extrahepatic cholangiocarcinoma (42.9%), and ERBB2 amplification was enriched in gallbladder cancer (16.7%). Co-occurring alterations were present in 7.8% of cases. KRAS mutation was the most frequent alteration overall (20.4%) and remained significantly associated with worse overall survival in multivariate analysis adjusted for tumor subtype and tumor stage (HR = 1.54, 95% CI: 1.03-2.31, p = 0.04). Although 32.6% of tumors harbored a potentially actionable alteration, only 31.6% of eligible patients received matched targeted therapy. These findings underscore the clinical value of routine molecular profiling in BTC and highlight its importance for identifying therapeutic opportunities in clinical practice.