bluuebunny/crossref_metadata_2025 huggingface dataset:
Relation of 91 Circulating Inflammatory Proteins to Nonalcoholic Fatty Liver Disease: A Two‐Sample Mendelian Randomisation Study
Authors: Wu Xiaodong , Song Yanhong , Wu Shuodong
Published: December 2024

Increasingly, emerging research evidence has demonstrated that nonalcoholic fatty liver disease (NAFLD) is a disease closely associated with systemic inflammation. However, the specific upstream inflammatory factors engaged in the pathogenesis of NAFLD remain unclear. Our study aimed to identify the inflammatory regulators causally associated with NAFLD pathogenesis through Mendelian randomisation. A two‐sample Mendelian randomisation method was applied to analyse the causal association between 91 circulating inflammatory proteins and NAFLD. Data on circulating inflammatory proteins were derived from samples of European ancestry (14,824 samples) and NAFLD data were obtained from the FinnGen consortium (2025 cases and 284,826 controls). Instrumental variables were selected from the genetic variance and F‐statistics were calculated to avoid bias. We adopted the random‐effects inverse variance weighting (IVW) method as our primary analytical approach. Supplementary analyses were also implemented, including weighted median, MR‐Egger and weighted mode. Moreover, we conducted pleiotropy and heterogeneity analyses to validate the accuracy of the findings. The application of Mendelian randomisation analysis identified four inflammatory factors that might be causally associated with NAFLD at the genetic level. Elevated levels of eotaxin (or = 1.27, 95% CI: 1.05–1.53, p = 0.014), osteoprotegerin (OPG) (or = 1.29, 1.03–1.60, p = 0.023) and TNFRSF9 (or = 1.32, 95% CI: 1.06–1.64, p = 0.014) may be causally related to an increasing risk of NAFLD. Conversely, heightened leukaemia inhibitory factor (LIF) levels (or = 0.63, 0.44–0.92, p = 0.016) were linked to a lower risk of NAFLD onset. There was no causal relationship between levels of other circulating inflammatory proteins and NAFLD. Our analysis uncovered four upstream inflammatory factors genetically associated with the pathogenesis of NAFLD. These results highlight the potential involvement of inflammation in NAFLD, which provides partial insights for further research in this field in the future.
Efficacy of Therapeutic Hypothermia During Transport of Newborns With Perinatal Hypoxic‐Ischaemic Encephalopathy: Experience From Newborn and Paediatric Transport Service, New South Wales
Authors: McLean Lucia , Dalrymple Hannah , Sasidharan Lekshmi , Grant Trish , Browning Carmo Kathryn
Published: December 2024

Aim

To examine the efficacy of current non‐servo‐based cooling methods used by NETS NSW in treating hypoxic ischaemic encephalopathy (HIE) with therapeutic hypothermia (TH) in neonatal retrieval.

Methods

A retrospective observational study of infants treated with TH for HIE retrieved by NETS NSW from January 2017 to June 2020 inclusive. Primary outcomes were the proportion of neonates achieving TH within 6 h of life and maintaining temperature in a therapeutic range.

Results

82 patients were included in analysis. Mean gestational age (GA) was 39 weeks (IQR 38–40) and mean birthweight (BW) 3297 g (SD 607 g). 68 infants (82.9%) were passively cooled while 14 (17.1%) were cooled with gel packs. 20 infants (21.4%) had rectal temperature monitoring before retrieval. 45 infants (55.6%) reached TH within 6 h of birth. Only 56 infants (68.3%) reached TH during retrieval. Of these infants, 45 (80.4%) had subsequent temperatures outside the therapeutic range.

Conclusions

Infants receiving TH through non‐servo‐controlled methods are commonly exposed to temperature instability and overcooling. Introduction of servo‐controlled cooling devices is required to improve care and management of perinatal HIE in retrieval.
Biocontrol Potential of Bacillus velezensisZF‐10 Inhibiting Potato Virus Y and Promoting Growth of Tobacco Plant
Authors: Ying Yufeng , Zhang Nuoni , Li Bin , Liu Dongyang , Zhang Qiang , Yang Zhao , An Derong , Hao Xingan
Published: December 2024

The viral disease caused by potato virus Y (PVY) poses a serious threat to tobacco plants worldwide. In this study, Bacillus velezensis ZF‐10, isolated from Panzhihua, China, exhibited an effective inhibitory effect against PVY. The presence of B. velezensis ZF‐10 significantly reduced the accumulation of PVY to 25.4% in plants and lowered the disease index to 15.23. Moreover, the infiltration of B. velezensis ZF‐10 on leaves of tobacco resulted in an increase in reactive oxygen species (ROS) and enhanced defence enzyme activity, leading to a decrease in malondialdehyde (MDA) accumulation and ultimately improving the tolerance of tobacco plants to PVY infection. Additionally, in a greenhouse environment, B. velezensis ZF‐10 promoted the growth of tobacco plants. Furthermore, B. velezensis ZF‐10 was found to exhibit activities such as ammonia production, cellulase, protease and siderophore production, and the ability to solubilise insoluble phosphates in soil. As a novel plant growth‐promoting bacterium (PGPB), B. velezensis ZF‐10 not only effectively suppressed the occurrence of PVY disease and enhanced tobacco growth but also demonstrated potent antifungal properties against various phytopathogens that cause diseases in tobacco plants and other crops. In conclusion, B. velezensis ZF‐10 is a potential biocontrol agent against PVY infection a supporter of plant growth for tobacco plant.
Interventions Intended to Improve the Well‐Being at Work of Nurses Working in Care Settings for Older People—A Systematic Review
Authors: Wiisak Johanna , Suikkala Arja , Leino‐Kilpi Helena , Stolt Minna , Suhonen Riitta , Koskinen Sanna
Published: December 2024

Introduction

Nurses' well‐being at work (WAW) is important for overall health care outcomes. Nurses often navigate complex roles, contending with time constraints, ethical challenges and societal undervaluation, underscoring the necessity of addressing their WAW.

Methods

The aim of this systematic review was to analyse the interventions that potentially improve nurses' WAW in care settings for older people. The ultimate goal is to provide an understanding of this field and advance the development of WAW interventions. We performed a systematic review which was registered in PROSPERO and conducted according to PRISMA guideline. We conducted a comprehensive literature search across five scientific databases and one platform in February 2023.

Results

Out of 5975 records, we included 21 full‐text articles in the review. Interventions were typically complex and focused on (a) nurses' health, (b) nursing care, (c) care facilities and (d) management. Interventions resulted in a range of outcomes on the (a) physical, (b) psychosocial and (c) environmental dimensions of WAW, with most interventions leading to positive outcomes, albeit with instances of negative and neutral results.

Conclusions

Interventions focusing on nurses' health or care facilities can be promising to improve WAW of nurses working in care settings for older people. Interventions aimed at improving the WAW have focused on various aspects. Despite the mainly positive outcomes, some interventions can also compromise nurses' WAW.

Implications for Practice

Strategies and interventions aimed at improving nurses’ WAW are needed in practice as nurses’ WAW is crucial in recruiting to and retaining nurses in care settings for older people. Promoting WAW also contributes to the quality of care for older people and the provision of ethically high‐quality health services.

Trial Registration

The review protocol was registered in the International Prospective Register of Systematic Reviews, PROSPERO (CRD42023399478)
Tolerance to insect herbivory increases with progressing plant development
Authors: Gols R.
Published: December 2024

Plants can sustain various degrees of damage or compensate for tissue loss by regrowth without significant fitness costs. This tolerance to insect herbivory depends on the plant's developmental stage during which the damage is inflicted and on how much tissue is removed.

Plant fitness correlates, that is, biomass and germination of seeds, were determined at different ontogenetic stages, vegetative, budding, or flowering stages of three annual brassicaceous species exposed to feeding by Pieris brassicae caterpillars at different intensities.

Fitness costs decreased with progressive ontogenetic stage at which damage was inflicted. Feeding on meristem tissues on vegetative and budding plants limited the plant's ability to fully compensate for tissue loss, whereas feeding on flowers resulted in full compensation or overcompensation in Sinapis arvensis and Brassica nigra. Herbivory promoted germination of seeds in the following year, thereby causing a shift in relative contribution to the next year's generation at the expense of contributing to the long‐lived seed bank. Herbivory intensity affected fitness correlates of B. nigra and to a lesser extent of Sisymbrium officinale, but not of S. arvensis, demonstrating that even closely related plant species can differ in their specific responses to herbivory and that these can differently affect reproductive output.

In terms of fitness costs, annual plant species can be quite resilient to herbivory. However, the extent to which they tolerate tissue loss depends on the ontogenetic stage that is under attack. Seed persistence in the soil has been proposed as a bet‐hedging strategy of short‐lived species to increase long‐term fitness. Herbivore‐induced changes in seed germination can result in a shift in the relative contribution of seeds to the seed bank and next year's generation.
Recognition of Novel KIR2DL1*0040135, KIR2DL1*112, KIR2DL1*0040136, KIR3DL1*0010122 Alleles From India
Authors: Agarwal Disha , Sharma Gaurav , Khadwal Alka , Malhotra Pankaj
Published: December 2024

Novel KIR alleles KIR2DL1*0040135, KIR2DL1*112, KIR2DL1*0040136 and KIR3DL1*0010122, were identified using next‐generation sequencing.
Kaempferol promotes flap survival by inhibiting ferroptosis and inflammation through network pharmacology and in vivo experiments
Authors: Wang An , Yang Jialong , Deng Jiapeng , Wang Kaitao , Chen Guodong , Lin Dingsheng
Published: December 2024

Skin flap transplantation is a primary method for wound repair; however, postoperative skin flap necrosis remains a significant challenge. Kaempferol, a flavonol abundant in various foods, exhibits diverse pharmacological effects. This study investigated the potential targets of kaempferol for treating skin flap ischemia–reperfusion (I/R) injury through network pharmacology and molecular docking, followed by in vivo validation. Using SwissTargetPredict, PubChem, SymMap V2, and GeneCards databases, 174 potential target proteins of kaempferol were identified. KEGG and GO enrichment analyses, performed using R software, indicated that kaempferol promotes skin flap survival by modulating ferroptosis, TNF‐α, and NF‐κB signalling pathways. Molecular docking demonstrated stable binding between kaempferol and key proteins, including SIRT1 and NRF2. In vivo, a McFarlane skin flap model was established in Sprague–Dawley rats. Kaempferol treatment improved flap survival, enhanced perfusion areas and distal arteriole visualisation, and increased blood flow in the flap. Furthermore, kaempferol reduced neutrophil infiltration, alleviated oxidative stress, improved mitochondrial morphology and function, and inhibited the release of proinflammatory cytokines. Western blot and immunofluorescence analyses confirmed that kaempferol inhibited ferroptosis and inflammation while promoting flap survival. Mechanistically, kaempferol was found to activate SIRT1‐mediated HMGB1/TLR4/NF‐κB and NRF2/SLC7A11/GPX4 pathways, thereby promoting skin flap survival and mitigating I/R injury.
Primary classical seminoma of the testis with rhabdoid differentiation
Authors: Ueda Yasuo , Shimoyama Hideaki , Takeyama Nobuyuki , Ogawa Takafumi
Published: December 2024

Rhabdoid differentiation is an indicator of poor prognosis that is often seen in renal cell carcinoma; however, it is also rarely seen in non-renal tumours. Therefore, pathologists should carefully review this finding and report. This report describes the first case of a seminoma of testicular origin that developed rhabdoid differentiation.
Spatial associations between measures of public transportation and diabetic foot ulcer outcomes in the state of Georgia: 2016–2019
Authors: Vanasse Lauren T , Chang Howard H , D'Souza Rohan , Ali Mohammed K , Waller Lance , Schechter Marcos C
Published: December 2024

Introduction

There are limited data regarding the associations between public transportation reliance, availability, and diabetic foot ulcer (DFU)-related amputations.

Research design and methods

We used visit-level data from the Georgia 2016–2019 Healthcare Cost and Utilization Project database and obtained transportation variables from open sources. Using Bayesian spatial-temporal models, we assessed the associations between transportation and DFU-related amputations within each quartile of poverty status indicators at the ZIP code tabulation area (ZCTA) level. We used the proportion of adults who use public transportation to commute, distance to nearest transit stop, and per capita expense on public transportation as proxies for public transportation reliance, availability, and both, respectively.

Results

Of 114 606 DFUs, 21 388 (19%) were associated with a major or minor amputation. Among ZCTAs at the highest income quartile, reduced amputation risk was associated with the proportion of adults who use public transportation to commute to work (relative risk (RR)=0.29, 95% CI 0.09 to 0.97 per IQR increase of 1.13%) and per capita expense on public transportation (RR=0.78, 95% CI 0.63 to 0.78 per IQR increase of 6 cents). In metropolitan Georgia, a 1 IQR (261 m) increase in distance to the nearest transit stop was associated with lower amputation risk among ZCTAs at the lowest income quartile (RR=0.47, 95% CI 0.26 to 0.85).

Conclusion

In Georgia, public transportation reliance and availability are protective against DFU-related amputations in high-income but not among low-income ZCTAs. Reducing disparities in DFU-related amputations requires interventions to mitigate transportation barriers to care.
Differential impact of lifestyle factors on 2-hour glucose values in individuals with type 2 diabetes: potential for more personalized interventions
Authors: Snel Tim , Krone Tanja , Kamstra Regina J M , Eggink Hannah M , Pijl Hanno , de Graaf Albert A , de Hoogh Iris M
Published: December 2024

Introduction

Lifestyle determinants of 2-hour glucose concentration in people with type 2 diabetes and interindividual differences need to be identified.

Research design and methods

38 participants with type 2 diabetes, treated with lifestyle advice and/or metformin, tracked their physical activity, sleep and dietary intake, while continuously monitoring interstitial glucose concentrations for 11 periods of four consecutive days each. A linear mixed-effects model was used to quantify the effect of sleep, stress, current glucose, carbohydrate intake and exercise on glucose levels 2 hours later.

Results

The final model identified carbohydrate intake (grams) in the past 5 min as well as in the past 30 min, sleep duration during the previous night (hours) and physical activity (metabolic equivalents) over the past 12 hours as significant fixed effects that influenced glucose concentrations 2 hours later. In addition, carbohydrate intake in the past 5 and past 30 min, and physical activity in the past and future 30 min were included as random or individualized effects. Although carbohydrate intake led to increased glucose concentrations in 2 hours in all individuals, the magnitude of this effect varied between individuals. The physical activity on glucose concentrations in 2 hours varied among individuals as well, in terms of magnitude and in terms of direction (showing either increase or decline).

Conclusions

Carbohydrate intake, sleep and physical activity at specific points in time have both fixed as well as individualized effects on glucose concentrations 2 hours later in individuals with type 2 diabetes. Interindividual differences in glycemic response to lifestyle components call for personalized advice in the management of type 2 diabetes.
Implementation Mapping of Integrated Cost Management Concepts with the Phases of Product Development
Authors: Tirkaamiana Dean , Basuksi Satrio Samudro Aji
Published: December 2024

The alteration in the business environment is always dynamic, and the companies must respond to these issues. It is necessary for the management to always be conscious of the prevailing condition, especially in the cost aspect. Cost aspect is substantial for profit-oriented companies to lead to the profit as optimum as possible. Therefore, the cost management is requisite in order to manage cost in the proper manner. Cost management is considered as one of the essential tools to enhance the competitiveness of business potential. Through a well-defined cost management system, man-agement is capable to acquire accurate information which pro-spective to be exploited for decision-making instruments and con-trol the internal business process entirely. Many studies have been conducted to provide a more appropriate and proper cost man-agement system for the companies. The current development in-cludes integrating cost management with Kaizen, Target Cost Modeling, Target Value Design, Cost Effectiveness Analysis, and even with the Monte Carlo Simulation in order to accommodate the uncertainty factor in the cost. Therefore, this paper provides an overview related to the cost management implementation by mapping those current development into the modified Generic Product Development framework.
Learning Preferences and Academic Outcomes: Insights from Franciscan-Managed Schools
Authors: Cutillas Anesito L. , Lebosada Jr. Juanito O.
Published: December 2024

This study examines the relationship between learning preferences and academic performance among third-year high school students in two Franciscan-managed schools in Negros Oriental, Philippines. Using the Felder-Silverman Learning Style Model and a descriptive research design, the profiles and preferences of 120 students were analyzed across four dimensions. Pearson’s correlation revealed a significant relationship between gender and academic performance, with females outperforming males, while family size and income showed no significant impact. The sensing/intuitive learning style exhibited a weak but positive relationship with academic outcomes, highlighting the need for differentiated instructional strategies. The findings advocate for gender-sensitive and adaptive teaching approaches to enhance student engagement and holistic development in Franciscan-managed
schools.
Cyberloafing and Organizational Citizenship Behavior as Correlates of Performance: Towards an Enhanced Evaluation Tool
Authors: Ortiz Ma. Arjean L.
Published: December 2024

This study examines the interplay between cyberloafing, Or-ganizational Citizenship Behavior (OCB), and employee perfor-mance. Cyberloafing, defined as personal use of company internet during work hours, and OCB, comprising voluntary behaviors that enhance organizational effectiveness, are analyzed as predictors of job performance. The research aims to develop an Enhanced Productivity Evaluation Tool (EPET) to assess the impact of these behaviors on performance outcomes.Using a quantitative approach, data were collected via surveys from employees across multiple industries. The study emphasizes the identification of least indicators in three cyberloafing catego-ries: browsing-related activities, non-work-related email usage, and interacting behaviors, as well as in two OCB dimensions: or-ganizational (OCBO) and personal (OCBP). Statistical analyses were conducted to explore correlations between these behaviors and performance metrics.Findings reveal a nuanced relationship: while certain cyberloaf-ing behaviors detract from productivity, others have negligible or even positive impacts under specific conditions. Strong OCB, how-ever, consistently correlates with higher performance levels. These insights underline the importance of a balanced evaluation of em-ployee behavior.This research provides a novel framework for organizations to assess employee productivity comprehensively, accounting for both adverse and beneficial behaviors. The resulting EPET offers a practical tool to enhance organizational performance evaluation and decision-making processes.
Development and Use of Game-Based Instructional Materials for Teaching Science, Technology, and Society to College Students
Authors: Balic Allan Gregy Villanueva , De Gracia Rommel Selda
Published: December 2024

This study developed and evaluated game-based instructional ma-terials to enhance learning in the college-level subject, Science, Tech-nology, and Society (STS). Using an action research approach, the study addressed the limitations of traditional teaching methods by introducing the "ALLAN Star Card," inspired by Bingo, and the "Amaz-ing Challenge," modeled after the game show Who Wants to Be a Mil-lionaire. These tools were designed to promote student engagement, critical thinking, and active participation. The research included 30 first-year BS Agribusiness students from Bayambang Polytechnic Col-lege, selected through purposive sampling. Pre- and post-tests were administered to assess the effectiveness of the materials, alongside evaluations using the LRMDS Non-Print Instructional Materials Tool. The instructional materials received a "Very Satisfactory" rating, with an average content quality score of 3.81 (SD = 0.13). However, areas such as technical quality and user control required further improve-ment, particularly in minimizing technical issues and enhancing user interaction.Results from the pre-test (M=6.9, SD=2.81) and post-test (M=10.47, SD=3.31) revealed a significant improvement in student performance, confirming the efficacy of game-based methods in boosting academic achievement. These findings align with prior re-search on the advantages of gamification in education. Recommenda-tions for improvement include addressing grammatical errors, reduc-ing lifeline usage, and implementing time constraints for activities. The study concludes that game-based instructional materials effec-tively enhance learner engagement and academic performance in higher education.
Entrepreneurial Intent of Filipino Undergraduate Health Sciences Stu-dents: A Descriptive Cross-Sectional Study
Authors: Angeles Raul G.
Published: December 2024

This quantitative study, grounded in Ajzen’s (1991) Theory of Planned Behavior (TPB), investigates the entrepreneurial inten-tions of Filipino undergraduate health sciences students using a descriptive cross-sectional research design. The study involved 820 respondents from various health sciences programs in North Luzon, Philippines, who completed an online survey. Demographic characteristics and entrepreneurial intent were assessed through a researcher-designed Demographic Profile Questionnaire (DPQ) and the Individual Entrepreneurial Intent Scale (IEIS) established by Thompson (2009). This study adopts a positivist view, empha-sizing objectivity, consistency, and replicability through statistical methods. The findings reveal that the undergraduate health sci-ences students demonstrate a “good” level of entrepreneurial in-tentions, with a notable significant variation observed between those who have taken business-related courses and those who have not, with the former exhibiting higher intent. Other factors, such as age, gender, and marital status, did not show significant differences in entrepreneurial intentions, suggesting that educa-tional experiences play a more critical role than personal charac-teristics. The study recommends educational strategies and poli-cies, such as curricular enhancement towards entrepreneurial ed-ucation in health sciences education, to foster innovation and en-courage healthcare entrepreneurship. Overall, this research con-tributes to the expanding literature on entrepreneurship; however, like other studies, it has limitations. Therefore, future research directions are offered.
Exploring the Value of Philosophy in Curriculum Implementation in Physical Education: A Scoping Review
Authors: M. Luprandado Rowen Jr. , Sazon Pauline Jane C. , Agrano Junique O. , Zapata Kyla Marie C. , Gania Mary Joy C. , Pansuelo Chinie A. , Rodriguez Maria Monica Y. , Fernandez Paula Mae Q.
Published: December 2024

Educational philosophy provides a strong pillar of support and guidance to an institution. The scoping review aims to examine the significance of educational philosophies to curriculum implementation in Physical Education. The purpose was to provide a comprehensive overview of other relevant literature to identify gaps and observe existing cases related to this review. Additionally, it explores how these theoretical-based approaches influence the selection of content, teaching pedagogy, and preferred learning styles to deliver instructions effectively. Arksey and O’Malley’s (2005) five-stage framework was employed for a comprehensive and transparent process. Moreover, the study covered a criterion for inclusion and exclusion studies. The researchers selected articles from 1998 to 2024 that focused on the accuracy and consistency of the scope and material and underwent a rigorous evaluation to identify peer-reviewed papers. Further, the references list was manually searched and extracted from Google Scholar. The results indicate that educational philosophies are the common basis of reflection on how certain curriculum content should be properly implemented. Though learning contents might vary, teachers could still find an effective way to sustain the demands of learners providing substantial experiences in academic pursuit.
Project Double Barrel: Crime Rate and Experiences of the Implementers in the Municipality of Diplahan, Zamboanga Sibugay
Authors: Precillas Antonette F. , Pallega Rowell B.
Published: December 2024

This study aimed to determine the crime rate in the Municipality of Diplahan, Zamboanga Sibugay in the calendar years 2013-2015 and 2016-2018. Specifically, this study described the index and non-index crimes prior to and during the implementation of the project double barrel and whether significant differences existed on the crime profiles prior to and during the project. It also aimed to identify the experiences encountered by the imple-menters of the project under CMC 16 2. 2016. Archived data were taken from police blotters and crime statistics given by the PNP Personnel in Diplahan Police Station and employed the qualita-tive design using in-depth interview to generate and explore the experiences of the PNP Personnel and Barangay Captains before and during the implementation of the project. Thematic analysis was then applied to generate codes and themes that described the experiences of the participant-interviewees. Findings re-vealed the decrease in index crimes, which include serious of-fenses like murder, theft, and robbery, suggests an improvement in public safety. The heightened police presence and visibility likely acted as a deterrent to violent and property crimes, con-tributing to a more secure environment in public areas. There is a need for a multifaceted approach to improving law enforce-ment's effectiveness and ethical standards in addressing drug-related crimes. Integration of advanced technologies and en-hanced coordination among agencies to improve operations and monitoring capabilities and collaboration with external organi-zations focuses on rehabilitation and prevention, while inde-pendent oversight mechanisms and regular reviews are also needed to ensure accountability, transparency, and continuous improvement of policies and drug related operations. Stronger collaboration between police, local governments, NGOs, and health organizations is also necessary to reinforce community-based rehabilitation efforts and preventive measures. Providing mental health support for officers is equally important, as it im-proves their well-being, reduces burnout, and fosters ethical de-cision-making under high-pressure situations. Comprehensive training for officers is vital to prepare them for the complexities of the drug campaign, improving operational effectiveness and promoting accountability within the force.
School Administrators’ Leadership Competencies and Teachers’ Resilience During Covid-19 Pandemic
Authors: Hostallero Michael Ballon , Cabal Esmen M.
Published: December 2024

This study investigated the relationship between school adminis-trators’ leadership competencies and teachers’ resilience during the COVID-19 pandemic in the Zone 1 Division of Zambales for the school year 2020-2021. Using a descriptive research design, data were gathered from 136 randomly selected principals and teachers through a questionnaire. Results indicated that the school admin-istrators were rated "Excellent" in the leadership dimensions of managing change, solving problems, taking risks, setting vision, and demonstrating ethics and integrity. Similarly, teachers were assessed as "Excellent" in the resilience dimensions of self-awareness, realism, keeping calm under stress, empathy, and self-control. No significant difference was found in the perceptions of the school administrators and teachers regarding the administra-tors’ leadership competencies. However, a significant difference was observed in the perceptions of teachers' resilience. The study further revealed a positive high correlation between administra-tors’ leadership competencies and teachers’ resilience. Based on these findings, it was recommended that school heads continue to employ democratic principles, embrace new ideas, and adapt to change while maintaining ethical integrity. Moreover, strengthen-ing the partnership between school administrators and teachers is essential in achieving the school’s vision and objectives. Future researchers are encouraged to conduct parallel studies to validate these results and support the development of effective leadership practices.
Implementation of Phil-Iri Program and English Competence in Oral Read-ing of Grade 6 Pupils
Authors: Plotado Uniqcca L.
Published: December 2024

This study explored the implementation of the Phil-IRI Program and its impact on the English oral reading competence of Grade 6 pupils in public elementary schools in San Marcelino, Zambales, Philippines. Using a descriptive-correlational approach with 557 pupils and 26 teachers in the district of San Marcelino, Zambales, it assessed oral reading competence levels before and after the program's implementation. Results showed that most pupils were at the instructional level pre-implementation but demonstrated significant improvements post-implementation. The findings highlight the value of regular reading assessments and interventions in addressing reading comprehension challenges. The study recommends ongoing evaluation of reading programs and professional development for teachers to enhance literacy outcomes and instructional effectiveness.
Achieving Productivity in the New Normal: Teachers’ Work Productivity in Public Secondary Schools Division of Zambales
Authors: De Guzman Marie Fe D , Blanco Martha Jelle D.
Published: December 2024

This study described the level of teachers’ work productivity em-ployed in the thirteen Districts of DepEd Division of Zambales. The present study was conducted during the third quarter of the school year 2022-2023. The research design is descriptive; quantitative in interpretation using inferential statistics for data analysis; and utilized survey questionnaire as main research instrument. The school heads are male middle aged adults, master's degree holders, and served in the profession for two and a half decades as Princi-pals I and IV. The teachers are female young adults, baccalaureate degree holders with master’s units and served in the teaching pro-fession for a decade as Teacher I. The school heads strongly agreed that the level of teachers’ work productivity was high on school and community engagement primarily taking other roles as teach-er, responsibilities in school, and with colleagues while the teach-ers strongly agreed that the level of their work productivity was high on instructional planning and delivery mostly on identifying the learning objectives and how these can be achieved by the learners. The ANOVA computation revealed a no significant differ-ence in the described level of teachers’ work productivity when grouped according to school head and teacher respondents’ pro-file. An Enhancement Program was designed and proposed aimed to help improve the work productivity of teachers which can po-tentially increase overall school performance and output.
An Assessment of Transformational Leadership of School Heads and Its Relationship to the School Climate
Authors: Santos Orlando R. , Caparas Laurenne Anne R. , Medina Arnold B. , Cabrera Wendell C.
Published: December 2024

Attaining high levels of learning outcomes has been the core of school management, operations, and teaching. Correspondingly, various programs, projects, and activities of the Department of Education (DepEd) aimed toward the recovery and enhancement of learning, and ultimately the holistic development of the youth have been implemented every academic year. Some of the key factors for pupils' learning and holistic development are the provision of a positive school climate and the leadership style of the school heads. Hence, this review paper looked into the existing literature for the given key variables and identified the research gap and future research perspectives. The findings showed that there is a significant relationship between idealized influence, inspirational motivation, and personal consideration. As assessed in all the domains of transformational practices of school heads as highly observed, meanwhile, intellectual stimulation does not significantly influence the school climate thus, much effort is required from the school heads to inspire and motivate the teachers to attain higher performance of the students. This paper hopes to contribute to the potential research undertakings in the locale and provide clarity about how transformational leadership impacts school climate which ultimately leads to positive learning outcomes.
Sequence‐Dependent Repolarization Is Modulated by Endogenous Action Potential Duration Gradients Rather Than Electrical Coupling in Ventricular Myocardium
Authors: Blair Grace A. , Depman Madeline , Adams William P. , Maisonneuve Rowan O. , Hoeker Gregory S. , Weinberg Seth H. , Poelzing Steve
Published: December 2024

Background

Previous studies suggest the relationship between activation time (AT) and action potential duration (APD) in the heart is dependent on electrotonic coupling, but this has not been directly tested. This study assessed whether acute changes in electrical coupling, or other determinants of conduction or repolarization, modulate APD heterogeneity.

Methods and Results

Langendorff‐perfused guinea pig hearts were epicardially paced and optically mapped after treatment with the gap junction uncoupler carbenoxolone, ephaptic uncoupler mannitol, ephaptic enhancer dextran 2MDa, sodium channel inhibitor flecainide, or rapid component of the delayed rectifier potassium channel inhibitor E4031. SD of APD and the AT–APD slope and coefficient of determination were quantified as metrics of APD heterogeneity. SD of APD increased with carbenoxolone, mannitol, and altered activation sequence. The AT–APD slope was insensitive to carbenoxolone, mannitol, dextran, flecainide, or E4031 but changed in response to activation sequence. The coefficient of determination did not change with carbenoxolone; decreased with mannitol, E4031, and activation sequence; but increased with dextran and flecainide. APD heterogeneity changes were dependent on whether the estimation used SD of APD or the AT–APD relationship. The pacing stimulus increased APD at the site of stimulation, revealing a confounding stimulus effect on APD within the measurement area. Simulations predict that the stimulus artifact and endogenous APD gradients are stronger determinants of APD heterogeneity than AT.

Conclusions

APD dependence on conduction is relatively small. Furthermore, APD heterogeneity within a mapping field of view is dependent on endogenous gradients, the stimulus artifact, and the experimental approach, rather than electrical coupling.
Proton Pump Inhibitors Use in Patients With Ischemic Stroke on Dual Antiplatelet Therapy at Low Risk of Upper Gastrointestinal Bleeding
Authors: Baik Minyoul , Jeon Jimin , Heo Seok‐Jae , Kim Jinkwon , Yoo Joonsang
Published: December 2024

Background

Current guidelines lack recommendations regarding the use of proton pump inhibitors (PPIs) for preventing upper gastrointestinal bleeding (UGIB) among patients at low risk for UGIB treated with dual antiplatelet therapy for ischemic stroke (IS). Our objective was to assess the effectiveness of PPIs in lowering the risk of significant UGIB in this patient group.

Methods and Results

A retrospective cohort study was conducted involving patients at low risk for UGIB admitted for IS between 2014 and 2018 and treated with dual antiplatelet therapy. The study used a nationwide claims database in Korea. The primary end point was significant UGIB during 12 months after IS. To evaluate the risk of significant UGIB based on PPI use, we performed a multivariable Cox regression analysis. Subgroup analyses and propensity score matching analysis were conducted for validation. Among 96 722 patients with IS at low risk for UGIB who were on dual antiplatelet therapy (mean age, 67.0 years; men: 63.0%), 16 084 (16.6%) were treated with PPIs. During 12 months of follow‐up, 325 patients experienced significant UGIB, and 479 experienced any UGIB. PPI use was associated with a reduced risk of significant UGIB (hazard ratio, 0.63 [95% CI, 0.45–0.89];
P
=0.009). This association was consistent in the subgroup and propensity score matching analyses.

Conclusions

In patients with IS receiving dual antiplatelet therapy, PPI use reduced the risk of significant UGIB by 37% on average, even among low‐risk patients. However, the use of PPIs in this patient group was limited, highlighting the need for additional prospective studies.
Hyperkalemia and the Risks of Adverse Cardiovascular Outcomes in Patients With Chronic Kidney Disease
Authors: Agiro Abiy , Mu Fan , Cook Erin , Greatsinger Alexandra , Chen Jingyi , Zhao Angela , Louden Elaine , Colman Ellen , Desai Pooja , Chertow Glenn M.
Published: December 2024

Background

This real‐world evidence study compared risks of cardiovascular events in hospital settings among patients with chronic kidney disease (CKD) with and without hyperkalemia.

Methods and Results

Adults with CKD stages 3b/4 with and without hyperkalemia were identified from Optum's deidentified Market Clarity Data (January 2016–August 2022). Patients with hyperkalemia were exact and propensity score matched to patients without hyperkalemia. The index date was the first CKD stage 3b/4 diagnosis with ≥1 hyperkalemia diagnosis and ≥1 serum potassium >5.0 mmol/L in the preceding 12 months (baseline) for patients with hyperkalemia and a randomly selected CKD stage 3b/4 diagnosis for controls. Cardiovascular composite end points included major adverse cardiovascular events plus (a composite end point of all‐cause mortality, myocardial infarction, stroke, or heart failure) and cardiac arrhythmias (a composite end point of new onset atrial fibrillation and other atrial and ventricular arrythmias), all in the hospital setting. We compared cardiovascular events between cohorts using cause‐specific Cox proportional hazards regression. The study included 5301 matched pairs in the analysis of major adverse cardiovascular events plus and 5564 in the analysis of arrhythmia. Cardiovascular events were more likely among patients with hyperkalemia relative to those without hyperkalemia, with the risk of major adverse cardiovascular events plus increased by 32% (23%–40%) and the risk of arrhythmia increased by 59% (44%–75%; both
P
<0.001).

Conclusions

Among patients with CKD stages 3b/4, patients with hyperkalemia experienced significantly higher risks of major adverse cardiovascular events and arrhythmia in hospital settings relative to patients without hyperkalemia.
Diagnostic Accuracy of Computational Fluid Dynamics‐Based Fractional Flow Reserve Derived From Coronary Angiography: The ACCURATE Study
Authors: Jiang Jun , Hu Yumeng , Li Changling , Dong Liang , Xu Jian , Tang Lijiang , Jiang Wenbing , Du Changqing , Jiang Xuejun , Lyu Yongnan , Leng Xiaochang , Li Chengguang , Koo Bon‐Kwon , Xiang Jianping , Ge Junbo , Wang Jian’an
Published: December 2024

Background

Although fractional flow reserve (FFR) is the contemporary standard to detect hemodynamically significant coronary stenosis, it remains underused for the need of pressure wire and hyperemic stimulus. Coronary angiography‐derived FFR could break through these barriers. The aim of this study was to assess the feasibility and performance of a novel diagnostic modality deriving FFR from invasive coronary angiography (AccuFFRangio) for coronary physiological assessment.

Methods and Results

The ACCURATE (Angiography‐Derived Fractional Flow Reserve for Functional Evaluation of Coronary Artery Disease) study was a prospective, multicenter study conducted at 5 centers. Patients who had at least 1 lesion with a diameter stenosis of 30% to 90% were eligible. AccuFFRangio was measured on site in real time and compared with invasive FFR measurements in a blinded fashion. Primary end point was the diagnostic accuracy of AccuFFRangio in identifying functional relevant lesions. Between November 2020 and June 2021, pairwise analyses of AccuFFRangio and FFR were performed in 304 coronary arteries. AccuFFRangio showed good correlation (
r
=0.89;
P
<0.001) and agreement (mean difference: 0.01±0.06) with FFR. The diagnostic accuracy was 95.07% (95% CI, 91.99%–97.21%), which were significantly exceeded the prespecified target value (
P
<0.001). The sensitivity, specificity, and area under the receiver operating characteristic curve of 95.83% (95% CI, 89.67%–98.85%), 94.71% (95% CI, 90.73%–97.33%), and 0.972 (95% CI, 0.947–0.988), respectively.

Conclusions

AccuFFRangio derived from coronary angiography alone has high diagnostic accuracy, sensitivity, and specificity compared with FFR. AccuFFRangio bears the potential for increasing the adoption of functional assessment of coronary artery stenosis and improving the use of physiological guided decision‐making.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04814550.
Echocardiographic Changes Following Surgical Myectomy in Severely Symptomatic Obstructive Hypertrophic Cardiomyopathy: Insights From the SPIRIT‐HCM Study
Authors: Desai Milind Y. , Szpakowski Natalie , Tower‐Rader Albree , Bittel Barb , Fava Agostina , Ospina Susan , Xu Bo , Thamilarasan Maran , Mentias Amgad , Smedira Nicholas G. , Popovic Zoran B.
Published: December 2024

Background

In obstructive hypertrophic cardiomyopathy, myectomy improves symptoms, quality of life, and left ventricular (LV) outflow tract gradients. We prospectively evaluated the temporal changes in various echo parameters after myectomy.

Methods and Results

In 173 adults with obstructive hypertrophic cardiomyopathy (53±10 years, 63% men) who underwent myectomy between March 2017 and June 2020, clinical and blinded echo assessment (before and at 12±6 months follow‐up) was performed prospectively (SPIRIT‐HCM [Quality of Life and Functional Capacity Following Septal Myectomy in Obstructive Patients With Hypertrophic Cardiomyopathy]). Changes in echocardiographic parameters (left atrial volume index,
E
/
e
′, LV outflow tract gradients, along with average LV global longitudinal strain on apical 2‐, 3‐, and 4‐chamber views and regional LV strain from apical 4‐chamber view) were measured in 126 patients. There was significant improvement in left atrial volume index (−6.9 mL/m
2
[95% CI, 4–9.7]),
E
/
e
′ (−2.9 [95% CI, −2.7 to −4.1]) and peak LV outflow tract gradient (−94 mm Hg [95% CI −87 to −100]) from baseline to follow‐up (both
P
<0.001). There was no improvement in basal (0.91% [95% CI, −0.15 to 1.97],
P
=0.09) and midseptal (−0.98% [95% CI, −1.93 to 0.02],
P
=0.05) LV strain, worsening in apical septal strain (−4.5% [95% CI, −5.9 to −3.0],
P
<0.001) and an improvement in LV free wall strain (2.3% [95% CI, 0.67–3.9],
P
<0.001), with no change in overall LV‐global longitudinal strain (0.47% [95% CI, −0.43 to 1.37],
P
=0.30). There was no correlation between change in LV‐global longitudinal strain and change in 6‐minute walk time (r=0.12,
P
=0.24) or Kansas City Cardiomyopathy Questionnaire summary score change (r=0.02,
P
=0.85), whereas it was significantly associated with change in
E
/
e
′ (r=0.29,
P
=0.003).

Conclusions

In patients with obstructive hypertrophic cardiomyopathy, myectomy improved various echocardiography parameters at 1‐year; however, LV‐global longitudinal strain remained unchanged.

Registration

URL:
https://clinicaltrials.gov
; Unique identifier: NCT03092843.
Atherothrombotic Outcomes After Sodium‐Glucose Cotransporter 2 Inhibitors Versus Dipeptidyl Peptidase‐4 Inhibitors in Patients With Type 2 Diabetes: A Territory‐Wide Retrospective Cohort Study
Authors: Ng Pauline Yeung , Ng Andrew Kei‐Yan , Ip April , Sin Wai Ching , Yiu Kai‐Hang
Published: December 2024

Background

This study compared the risks of atherothrombotic major adverse cardiovascular events in patients with type 2 diabetes taking SGLT2 (sodium‐glucose cotransporter 2) inhibitors to those taking DPP‐4 (dipeptidyl peptidase‐4) inhibitors.

Methods and Results

All adult patients (≥18 years of age) with type 2 diabetes and newly prescribed with SGLT2 inhibitors or DPP‐4 inhibitors across all public hospitals in Hong Kong between January 2015 and December 2019 were included. Patients were propensity matched in a 1:1 ratio using a caliper distance of 0.2 without replacement. The primary outcome was atherothrombotic major adverse cardiovascular events as a composite outcome of cardiovascular mortality, nonfatal stroke, and nonfatal myocardial infarction. Time‐to‐first event analysis was conducted using a univariable Cox proportional hazards model. Primary and secondary analyses were repeated using stabilized inverse probability weighting and propensity score adjustment in the complete case cohort. A total of 20 642 patients (10 321 SGLT2 inhibitors versus 10 321 DPP‐4 inhibitors) were included in the final analysis. The mean age was 59±11 years, and 13 142 (63.7%) were men. The median follow‐up period was 2.9 years. The use of SGLT2 inhibitors was associated with a significant reduction in atherothrombotic major adverse cardiovascular events (453 [4.4%] versus 719 [7.0%]; hazard ratio, 0.64 [95% CI, 0.57–0.72];
P
<0.001) compared with DPP‐4 inhibitors. SGLT2 inhibitors were independently associated with reduced all‐cause mortality, cardiovascular mortality, stroke, myocardial infarction, and incident dialysis (all
P
values <0.001).

Conclusions

SGLT2 inhibitors in patients with diabetes were independently associated with reduction in atherothrombotic major adverse cardiovascular events, all‐cause mortality, cardiovascular mortality, myocardial infarction, stroke, and incident dialysis, compared with DPP‐4 inhibitors.