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Martial arts tourism is a form of cultural, sports and educational tourism that requires special recognition; particularly important is knowledge about martial arts. The sources of this practical knowledge are especially high-ranking masters. The scientific problem raised here involves the issue of high-ranking martial arts teachers taking trips for their own studies (to acquire knowledge and skills) and teaching others. Some of the questions addressed include how often the trips occur (single, sporadic, or multiple, regular), what their effects are, and what their meaning is—in the opinion of these experts. The “Martial Arts Tourism” questionnaire was addressed to N = 12 people, masters/teachers of high-rank in martial arts (level 7–10 dan/toan) who live and teach in Europe and the USA, but come from Europe. They are the holders of the highest degrees in Chinese, Japanese and Korean styles. Further questions were asked through direct correspondence. The collected statements were usedby means of qualitative analysis—as in the method of ‘expert courts’/’competent judges’. The respondents in most cases undertook trips from Europe to East Asia for their own learning. They teach themselves mainly in their own countries and in Europe. Stays rarely lasted over two weeks. The respondents are convinced of the legitimacy of this type of trip, and believe that the trips are very helpful on the way to mastery. None of the respondents mentioned the material forms of cultural heritage pertaining to martial arts as motives for the trips. Therefore, the ability to visit historic places is a marginal concern. The trips were directly linked to a career path and self-improvement in martial arts, learning or teaching.

Background. This study investigates the values embedded in Chinese Wushu and Japanese Budō within contemporary contexts, with a focus on practitioners’ perceptions and internalization of these values. It explores how cultural heritage influences value preferences and motivations among martial arts practitioners.Materials and Methods. The research is based on a survey of 648 martial arts practitioners from Europe and East Asia. The study analyzes cultural influences, value preferences, and motivations, examining how these factors shape the practitioners’ understanding and practice of martial arts.Results. The findings indicate that Chinese martial arts practitioners prioritize humility [68.2%] and righteousness [47.5%], values deeply rooted in Confucian ideals. In contrast, Japanese martial arts practitioners emphasize loyalty [31.8%] and perseverance [42.9%], reflecting Bushidō principles. Additionally, 37.2% of respondents identified the balance between body and spirit as their primary life value, highlighting the universal appeal of martial arts in promoting holistic development. The study also reveals that training frequency, duration, and proficiency significantly influence value preferences [p < 0.05].Conclusions. This study underscores the role of martial arts as bridges between cultural heritage and modern practices. They contribute to personal growth, social cohesion, and cross-cultural dialogue. Future research should further investigate the evolving roles of martial arts in global contexts and their impact on mental and social well-being.

Controlling the intensity of emitted light and charge current is the basis of transferring and processing information 1 . By contrast, robust information storage and magnetic random-access memories are implemented using the spin of the carrier and the associated magnetization in ferromagnets 2 . The missing link between the respective disciplines of photonics, electronics and spintronics is to modulate the circular polarization of the emitted light, rather than its intensity, by electrically controlled magnetization. Here we demonstrate that this missing link is established at room temperature and zero applied magnetic field in light-emitting diodes 2 , 3 , 4 , 5 , 6 – 7 , through the transfer of angular momentum between photons, electrons and ferromagnets. With spin–orbit torque 8 , 9 , 10 – 11 , a charge current generates also a spin current to electrically switch the magnetization. This switching determines the spin orientation of injected carriers into semiconductors, in which the transfer of angular momentum from the electron spin to photon controls the circular polarization of the emitted light 2 . The spin–photon conversion with the nonvolatile control of magnetization opens paths to seamlessly integrate information transfer, processing and storage. Our results provide substantial advances towards electrically controlled ultrafast modulation of circular polarization and spin injection with magnetization dynamics for the next-generation information and communication technology 12 , including space–light data transfer. The same operating principle in scaled-down structures or using two-dimensional materials will enable transformative opportunities for quantum information processing with spin-controlled single-photon sources, as well as for implementing spin-dependent time-resolved spectroscopies. The helicity of light from a light-emitting diode can be electrically controlled by spin–orbit torque effects, enabling a seamless integration of magnetization dynamics with photonics.

Pembrolizumab is active in head and neck squamous cell carcinoma (HNSCC), with programmed cell death ligand 1 (PD-L1) expression associated with improved response. KEYNOTE-048 was a randomised, phase 3 study of participants with untreated locally incurable recurrent or metastatic HNSCC done at 200 sites in 37 countries. Participants were stratified by PD-L1 expression, p16 status, and performance status and randomly allocated (1:1:1) to pembrolizumab alone, pembrolizumab plus a platinum and 5-fluorouracil (pembrolizumab with chemotherapy), or cetuximab plus a platinum and 5-fluorouracil (cetuximab with chemotherapy). Investigators and participants were aware of treatment assignment. Investigators, participants, and representatives of the sponsor were masked to the PD-L1 combined positive score (CPS) results; PD-L1 positivity was not required for study entry. The primary endpoints were overall survival (time from randomisation to death from any cause) and progression-free survival (time from randomisation to radiographically confirmed disease progression or death from any cause, whichever came first) in the intention-to-treat population (all participants randomly allocated to a treatment group). There were 14 primary hypotheses: superiority of pembrolizumab alone and of pembrolizumab with chemotherapy versus cetuximab with chemotherapy for overall survival and progression-free survival in the PD-L1 CPS of 20 or more, CPS of 1 or more, and total populations and non-inferiority (non-inferiority margin: 1·2) of pembrolizumab alone and pembrolizumab with chemotherapy versus cetuximab with chemotherapy for overall survival in the total population. The definitive findings for each hypothesis were obtained when statistical testing was completed for that hypothesis; this occurred at the second interim analysis for 11 hypotheses and at final analysis for three hypotheses. Safety was assessed in the as-treated population (all participants who received at least one dose of allocated treatment). This study is registered at ClinicalTrials.gov, number NCT02358031. Between April 20, 2015, and Jan 17, 2017, 882 participants were allocated to receive pembrolizumab alone (n=301), pembrolizumab with chemotherapy (n=281), or cetuximab with chemotherapy (n=300); of these, 754 (85%) had CPS of 1 or more and 381 (43%) had CPS of 20 or more. At the second interim analysis, pembrolizumab alone improved overall survival versus cetuximab with chemotherapy in the CPS of 20 or more population (median 14·9 months vs 10·7 months, hazard ratio [HR] 0·61 [95% CI 0·45–0·83], p=0·0007) and CPS of 1 or more population (12·3 vs 10·3, 0·78 [0·64–0·96], p=0·0086) and was non-inferior in the total population (11·6 vs 10·7, 0·85 [0·71–1·03]). Pembrolizumab with chemotherapy improved overall survival versus cetuximab with chemotherapy in the total population (13·0 months vs 10·7 months, HR 0·77 [95% CI 0·63–0·93], p=0·0034) at the second interim analysis and in the CPS of 20 or more population (14·7 vs 11·0, 0·60 [0·45–0·82], p=0·0004) and CPS of 1 or more population (13·6 vs 10·4, 0·65 [0·53–0·80], p<0·0001) at final analysis. Neither pembrolizumab alone nor pembrolizumab with chemotherapy improved progression-free survival at the second interim analysis. At final analysis, grade 3 or worse all-cause adverse events occurred in 164 (55%) of 300 treated participants in the pembrolizumab alone group, 235 (85%) of 276 in the pembrolizumab with chemotherapy group, and 239 (83%) of 287 in the cetuximab with chemotherapy group. Adverse events led to death in 25 (8%) participants in the pembrolizumab alone group, 32 (12%) in the pembrolizumab with chemotherapy group, and 28 (10%) in the cetuximab with chemotherapy group. Based on the observed efficacy and safety, pembrolizumab plus platinum and 5-fluorouracil is an appropriate first-line treatment for recurrent or metastatic HNSCC and pembrolizumab monotherapy is an appropriate first-line treatment for PD-L1-positive recurrent or metastatic HNSCC. Merck Sharp & Dohme.

The Brazilian Organization for Crohn's Disease and Colitis (GEDIIB) established a national registry of inflammatory bowel disease (IBD). The aim of the study was to identify clinical factors associated with disease severity in IBD patients in Brazil. A population-based risk model aimed at stratifying the severity of IBD based on previous hospitalization, use of biologics, and need for surgery for ulcerative colitis (UC) and Crohn’s Disease (CD) and on previous complications for CD. A total of 1179 patients (34.4 ± 14.7y; females 59%) were included: 46.6% with UC, 44.2% with CD, and 0.9% with unclassified IBD (IBD-U). The time from the beginning of the symptoms to diagnosis was 3.85y. In CD, 41.2% of patients presented with ileocolic disease, 32% inflammatory behavior, and 15.5% perianal disease. In UC, 46.3% presented with extensive colitis. Regarding treatment, 68.1%, 67%, and 47.6% received biological therapy, salicylates and immunosuppressors, respectively. Severe disease was associated with the presence of extensive colitis, EIM, male, comorbidities, and familial history of colorectal cancer in patients with UC. The presence of Montreal B2 and B3 behaviors, colonic location, and EIM were associated with CD severity. In conclusion, disease severity was associated with younger age, greater disease extent, and the presence of rheumatic EIM.

Hosting the Olympic Games may result in learning skills and add educational value for the host region. Based on the legacy framework proposed by Koenigstorfer et al., the current study examines the Olympic legacy on personal experiences, training/information, networking, and skill development of teachers. The case study was conducted in the context of Rio 2016 Olympic Games, and data were collected among teachers who attended the Transforma Program, through an online questionnaire (n = 617). The results of a structural equation model indicate that the Olympic legacy measured through four factors contributed positively to the educational development of teachers as well as to their Olympic knowledge. This study reveals the importance of Olympic education, arguing that when Olympism is embedded into educational practices, positive consequences can occur and contribute to positive education legacy.

The objective of this study was to analyze the perceived barriers to dual career success and athletic identity of student-athletes according to disability type and level of professionalization. The final sample consisted of 203 student-athletes with disabilities from five European countries. The questionnaires used were ESTPORT, EBBS and AIMS. Depending on disability type, it was found that student-athletes with hearing and physical impairment showed the highest difficulty in reconciling sports and studies (p = 0.001); that student-athletes with a hearing impairment showed the highest score in the barrier ‘the cost of education is high’ (p = 0.023); that student-athletes with a physical impairment had the highest scores in the barrier ‘Exercise tires me’ (p = 0.013); that student-athletes with cerebral palsy showed the highest scores in the barrier ‘I do not have enough university/educational institution support’ (p = 0.014) and ‘Exercise facilities do not have convenient timetables for me’ (p = 0.001). Depending on sports professionalization level, semi-professional student-athletes showed the highest values in the barrier ‘the university/educational institution is far from my training center’ (p = 0.040); while professional student-athletes had the highest score in the barrier ‘exercise takes too much time from family responsibilities’ (p = 0.034). In most of the variables related to identity as athletes, professional student-athletes showed the highest values, followed by semi-professional athletes (p = 0.043- < 0.001). In conclusion, the self-perception of barriers is quite relevant, with differences arising from disability type and level of professionalization, whereas the identity as an athlete is only different according to the level of professionalization.

Hantaviruses are rodent-borne Bunyaviruses that infect the Arvicolinae, Murinae, and Sigmodontinae subfamilies of Muridae. The rate of molecular evolution in the hantaviruses has been previously estimated at approximately 10[sup]-7 nucleotide substitutions per site, per year (substitutions/site/year), based on the assumption of codivergence and hence shared divergence times with their rodent hosts. If substantiated, this would make the hantaviruses among the slowest evolving of all RNA viruses. However, as hantaviruses replicate with an RNA-dependent RNA polymerase, with error rates in the region of one mutation per genome replication, this low rate of nucleotide substitution is anomalous. Here, we use a Bayesian coalescent approach to estimate the rate of nucleotide substitution from serially sampled gene sequence data for hantaviruses known to infect each of the 3 rodent subfamilies: Araraquara virus (Sigmodontinae), Dobrava virus (Murinae), Puumala virus (Arvicolinae), and Tula virus (Arvicolinae). Our results reveal that hantaviruses exhibit short-term substitution rates of 10[sup]-2 to 10[sup]-4 substitutions/site/year and so are within the range exhibited by other RNA viruses. The disparity between this substitution rate and that estimated assuming rodent-hantavirus codivergence suggests that the codivergence hypothesis may need to be reevaluated. [PUBLICATION ABSTRACT]

Hosting the Olympic Games may result in learning skills and add educational value for the host region. Based on the legacy framework proposed by Koenigstorfer et al. (2019), the current study examines the Olympic legacy on personal experiences, training/information, networking and skill development of teachers. The case study was conducted in the context of Rio 2016 Olympic Games, and data were collected among teachers who attended the Transforma Program, through an online questionnaire (n = 617). The results of a structural equation model indicate that the Olympic legacy measured through four factors contributed positively to the educational development of teachers as well as to their Olympic knowledge. This study reveals the importance of Olympic Education, arguing that when Olympism is embedded into educational practices, positive consequences can occur and contribute to positive education legacy.

Transgender and gender diverse people (TGD) have specific healthcare needs and struggles with access barriers that should be addressed by public health systems. Our study aimed to address this topic in the Brazilian context. A hospital and web-based cross-sectional survey built with input from the medical and transgender communities was developed to assess TGD healthcare needs of and access barriers in two Brazilian states. Although services that assist this population have existed in Brazil since the 1990s, TGD have difficulty accessing these services due to discrimination, lack of information and a policy design that does not meet the needs of TGD. A history of discrimination was associated with a 6.72-fold increase in the frequency of health service avoidance [95% CI (4.5, 10.1)]. This article discusses the urgent necessity for adequate health policies and for the training of professionals regarding the needs of Brazilian TGD.