Concord University

High-quality research is essential to enhance the delivery and outcomes of supportive care for patients with cancer. In this review, we discuss key challenges and potential solutions for conducting supportive care clinical trials in oncology. Structural barriers to supportive care research include limited infrastructure and investigators, insufficient funding, a paucity of foundational research, and a lack of standardized terminologies. Process barriers involve challenges in patient recruitment and retention, intervention design, control selection, and outcome assessments. Recognition of these barriers enables the development of targeted strategies to overcome them. Encouragingly, there is growing awareness of the importance of supportive care among investigators, clinicians, patients, and healthcare administrators, leading to an increase in research activity, funding, and publications. Research centers and professional organizations dedicated to supportive care are actively building capacity and fostering collaboration. Additionally, innovative study designs, personalized outcome measures, and multicenter research networks offer promising strategies to enhance both the quantity and quality of clinical trials. Through interdisciplinary collaborations, we can continue to strengthen the infrastructure and refine the processes in supportive care trials. These efforts will help build a robust evidence base and ultimately improve outcomes for patients with cancer.

Shear zone systems exposed in the crystalline rocks of Colorado record Proterozoic deformation episodes documenting strain partitioning, reactivation, and the progressive tectonic evolution of SW Laurentia. These structures, and their equivalents throughout the American southwest, provide insight into the structural evolution of the North American craton, and inform tectonic models for an active, but challenging to decipher period in Earth's history. NE-SW trending mylonitic bands record regional fold formation and establishment of sub-vertical D 1 /D 2 shear zones occurred during the successive ca. 1720 to 1600 Ma Yavapai and Mazatzal orogenies, and D 3 /D 4 reactivation of these structures during the ∼1450 to 1300 Ma Picuris Orogeny. The shallowly-dipping Slide Lake Shear Zone (SLSZ), in Colorado's Sawatch Range, is adjacent to the steeply dipping Homestake Shear Zone (HSZ), allowing for comparison between high and low angle faulting in mid-crustal positions associated with the long-lived Laurentin orogenic margin throughout the Proterozoic. Both structures record similar deformational conditions and bulk NW-SE verging kinematics. Newly obtained in- situ electron microprobe monazite U-Th-Pb geochronology and trace element geochemistry constrain the timing and nature of SLSZ activity, allowing direct comparison to established HSZ activity. Core domains in a steeply dipping segment of the SLSZ record mineral growth during the Yavapai Orogeny (D 1 ) at ca. 1700 ± 14 Ma, and support continued SLSZ activation during the Mazatzal Orogeny (D 2 ). Low-angle segments preserve deformation associated with the Mesoproterozoic Picuris Orogeny (D 3 /D 4 ) at ca. 1450 to 1300 Ma. The age progression of the SLSZ parallels the structural evolution of the HSZ, indicating that sub-horizontal, transtensional, D 3 /D 4 slip on the SLSZ was coeval with sub-vertical, transpressional, D 3 /D 4 slip on the HSZ. Cumulatively, the existing structural and newly established temporal history of the HSZ-SLSZ system are interpreted to indicate that oblique extensional and compressional strain were competing in the middle crust within the Laurentian interior during the Picuris Orogeny, lending credence to models of plateau-style crustal thickening and collapse during this event.

This study examined the disconnect between perceived needs of tourism stakeholders and available support structures in West Virginia. It focused on identifying sources of tourism development assistance and stakeholder perceptions of the role of Convention and Visitors Bureaus (CVBs). Although tourism scholarship offers robust conceptual frameworks, these models have not translated into practical tools for practitioners, leaving stakeholders uncertain about where to seek guidance. Using convenience and snowball sampling, a survey was administered to 187 tourism professionals across the state, exploring their relationships with businesses, support organizations, CVBs, policymakers, educators, and communities. Findings revealed that most respondents did not perceive having a strong support system for tourism-related questions or needs. This reflects a broader systemic issue: tourism is rarely understood as a holistic, interdependent ecosystem. While theory emphasizes integrated systems, stakeholder comprehension and application remain limited. Encouragingly, initiatives such as the Tourism Ecosystem Sub-Committee show promise for fostering collaboration.

Driven by media rights, international fans and diversified revenue sources, the global sports industry is running in a major financial transformation. This article explores the potential of tokenization of real-world assets (RWA) supported by blockchain technology to completely transform sports financing and valuation. Although RWA tokenization has advantages such as enhancing liquidity, reducing transaction costs, improving transparency and global accessibility, it also faces key challenges such as regulatory uncertainty, legal enforceability and interoperability issues. Traditional valuation methods, which based on revenue, market and assets. Despite they are still widespread, but they have limitations in dealing with intangible assets and cross-border transactions. This study concludes with RWA tokenization with its transformative potential, integrating RWA tokenization into the sports industry requires further research, a standardized framework, and regulatory coordination to achieve widespread adoption.

ABSTRACT In today’s educational landscape, in-service teachers (IST) should strive to find ways that allow students to expand upon their social and emotional skills. The act of sacrificial listening (SL) has the potential to build understanding between unfamiliar voices. Building upon the knowledge surrounding this specific act of listening, this arts-based qualitative case study used solicited audio diaries to investigate an IST’s understanding of SL, including its key components and their experiences resulting from applying SL during morning meetings. Findings from audio diaries and final interviews with the IST demonstrate how SL corresponds to and builds on several existing theories related to education. The use of SL within morning meetings provided students with opportunities to make connections, strengthen relationships, interact with different cultures, and SL was found to have the ability to be featured in a variety of content areas.

In recent years, the mechanical artificial hearts are widely used in surgery ought to the medical demands. Although the use of mechanical artificial hearts is widespread worldwide and has been clinically proven for many years, current technology is still not sufficient to permanently preserve the heart. With current technology, reliable recovery after transplantation cannot be achieved and patients must continue to struggle to maintain heart function. Valves are therefore the main cause of artificial heart failure, and the choice of valve type is time-consuming. On this basis, this study will discuss the principle as well as the state-of-art facilities of heart valve. According to the analysis, valves, especially mitral and aortic valves (bioprosthetic and purely mechanical), can be further developed and their advantages and disadvantages are obvious. In addition, the limitations as well as the prospects for the devices are discussed accordingly. Overall, these results shed light on guiding further exploration of artificial heart valve development.

China faces the challenge of balancing economic growth while meeting carbon emission reduction targets. This essay analyzes current Chinese government policies aimed at reducing emissions, including supply-side reforms, renewable energy subsidies, and awareness campaigns. It argues these policies have limitations, such as only temporary emissions reductions from supply cuts, high costs of subsidies, and lack of infrastructure to support consumer adoption of electric vehicles. To improve outcomes, the essay recommends implementing a carbon tax or cap-and-trade system, choosing the optimal policy based on demand elasticities. It also suggests subsidizing a transition from coal to electricity for heating in rural areas. In conclusion, modifying existing policies and implementing new market-based and technological solutions can help China achieve its twin goals of reducing emissions while maintaining economic growth. The essay provides a thoughtful analysis of the issues and policy trade-offs China faces in balancing environmental sustainability and development.

In response to the spread of COVID-19 in Quanzhou on 13th March, 2022, a number of schools, including kindergartens, primary schools, junior/senior high schools and universities implemented online teaching.In this context, this study explores the impact of online education on students and their parents in Secondary School S in Quanzhou, Fujian Province, China.Some studies found that online education broke the traditional control model of offline classroom teaching, and that both teachers and students had more autonomy [1].However, this study shows that online teaching only gives students more autonomy in learning space, but puts more pressure on their long learning time and online tasks submission.The study highlights the impact of online education on students performance and mental health, as well as the impact on parents.

ABSTRACTSacred lotus (Nelumbo nucifera) has been utilized as a food, medicine, and spiritual symbol for nearly 3,000 years. The medicinal properties of lotus are largely attributed to its unique profile of benzylisoquinoline alkaloids (BIAs), which includes potential anti-cancer, anti-malarial and anti-arrhythmic compounds. BIA biosynthesis in sacred lotus differs markedly from that of opium poppy and other members of the Ranunculales, most notably in an abundance of BIAs possessing the (R)-stereochemical configuration and the absence of reticuline, a major branchpoint intermediate in most BIA producers. Owing to these unique metabolic features and the pharmacological potential of lotus, we set out to elucidate the BIA biosynthesis network inN. nucifera. Here we show that lotus CYP80G (NnCYP80G) and a superior ortholog from Peruvian nutmeg (Laurelia sempervirens;LsCYP80G) stereospecifically convert (R)-N-methylcoclaurine to the proaporphine alkaloid glaziovine, which is subsequently methylated to pronuciferine, the presumed precursor to nuciferine. While sacred lotus employs a dedicated (R)-route to aporphine alkaloids from (R)-norcoclaurine, we implemented an artificial stereochemical inversion approach to flip the stereochemistry of the core BIA pathway. Exploiting the unique substrate specificity of dehydroreticuline synthase from common poppy (Papaver rhoeas) and pairing it with dehydroreticuline reductase enabledde novosynthesis of (R)-N-methylcoclaurine from (S)- norcoclaurine and its subsequent conversion to pronuciferine. We leveraged our stereochemical inversion approach to also elucidate the role ofNnCYP80A in sacred lotus metabolism, which we show catalyzes the stereospecific formation of the bis-BIA nelumboferine. Screening our collection of 66 plantO-methyltransferases enabled conversion of nelumboferine to liensinine, a potential anti-cancer bis-BIA from sacred lotus. Our work highlights the unique benzylisoquinoline metabolism ofN. nuciferaand enables the targeted overproduction of potential lotus pharmaceuticals using engineered microbial systems.