bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-efficacy beliefs and expectations during an Emergency Medicine Clerkship
Authors: Cevik Arif Alper , Cakal Elif Dilek , Alao David , Elzubeir Margret , Shaban Sami , Abu-Zidan Fikri
Published: January 2022

Background

Undergraduate emergency medicine (EM) training is important because all medical graduates are expected to have basic emergency knowledge and skills regardless of their future speciality. EM clerkship should provide opportunities to improve not only knowledge and skills but also the self-efficacy of learners. This study aims to evaluate the expectations, opinions, and self-efficacy beliefs of medical students during a 4-week mandatory EM clerkship.

Methods

This study used a prospective longitudinal design with quantitative and qualitative survey methods. It includes final year medical students of the 2015–2016 academic year. Voluntary de-identified pre- and post-clerkship surveys included 25 statements. The post-clerkship survey included two open-ended questions asking participants to identify the best and worst three aspects of EM clerkship. Responses were analysed to determine themes or commonalities in participant comments indicative of the EM clerkship learning experiences and environment.

Results

Sixty-seven out of seventy-nine (85%) students responded to both pre- and post-clerkship surveys. Medical students’ expectations of EM clerkships’ effect on knowledge and skill acquisition were high, and a 4-week mandatory EM clerkship was able to meet their expectations. Medical students had very high expectations of EM clerkships’ educational environment. In most aspects, their experiences significantly exceeded their expectations (p value < 0.001). The only exception was the duration of clerkship, which was deemed insufficient both at the beginning and at the end (p value: 0.92). The students perceived that their self-efficacy improved significantly in the majority of basic EM skills and procedures (p value < 0.001). Emergent qualitative themes in the study also supported these results.

Conclusion

This study showed that a 4-week mandatory EM clerkship increased medical students' perceived self-efficacy in basic emergency management skills. The EM clerkship met students' expectations on knowledge and skill acquisition, and exceeded students’ expectations on educational environment.
Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
Authors: Price Delyth , Edwards Michelle , Davies Freya , Cooper Alison , McFadzean Joy , Carson-Stevens Andrew , Cooke Matthew , Dale Jeremy , Evans Bridie Angela , Harrington Barbara , Hepburn Julie , Siriwardena Aloysius Niroshan , Snooks Helen , Edwards Adrian
Published: January 2022

Background

Patient experience is an important outcome and indicator of healthcare quality, and patient reported experiences are key to improving quality of care. While patient experience in emergency departments (EDs) has been reported in research, there is limited evidence about patients’ specific experiences with primary care services located in or alongside EDs. We aim to identify theories about patient experience and acceptability of being streamed to a primary care clinician in an ED.

Methods

Using theories from a rapid realist review as a basis, we interviewed 24 patients and 106 staff members to generate updated theories about patient experience and acceptability of streaming to primary care services in EDs. Feedback from 56 stakeholders, including clinicians, policymakers and patient and public members, as well as observations at 13 EDs, also contributed to the development of these theories, which we present as a programme theory.

Results

We found that patients had no expectations or preferences for which type of clinician they were seen by, and generally found being streamed to a primary care clinician in the ED acceptable. Clinicians and patients reported that patients generally found primary care streaming acceptable if they felt their complaint was dealt with suitably, in a timely manner, and when clinicians clearly communicated the need for investigations, and how these contributed to decision-making and treatment plans.

Conclusions

From our findings, we have developed a programme theory to demonstrate that service providers can expect that patients will be generally satisfied with their experience of being streamed to, and seen by, primary care clinicians working in these services. Service providers should consider the potential advantages and disadvantages of implementing primary care services at their ED. If primary care services are implemented, clear communication is needed between staff and patients, and patient feedback should be sought.
Examining the association between loneliness and emergency department visits using Canadian Longitudinal Study of Aging (CLSA) data: a retrospective cross-sectional study
Authors: Chamberlain Stephanie A. , Savage Rachel , Bronskill Susan E. , Griffith Lauren E. , Rochon Paula , Batara Jesse , Gruneir Andrea
Published: January 2022

Background

Loneliness is a public health concern and its influence on morbidity and mortality are well documented. The association between loneliness and emergency department visits is less clear. Further, while sex and gender-related factors are known to be associated with loneliness and health services use, little research looks at the relationship by gender. Our study aimed to estimate the association between loneliness and emergency department use in the previous 12 months. We aimed to determine if this association differed based on gender identity and gender-related characteristics.

Methods

We used a retrospective cohort study design to analyze population-based survey data from the Canadian Longitudinal Study on Aging (CLSA). We analysed data from the baseline and follow-up 1 survey respondents (2015-2018) from both the tracking (telephone interviews) and comprehensive (in-home data collection) cohorts (n=44816). Loneliness was assessed using a dichotomous measure (lonely/not lonely) from a validated scale. Emergency department visits were dichotomous (yes/no) by self-reported emergency department use in the 12 months prior to the survey date. Multivariable logistic regression analyses using analytic weights examined the association between loneliness and emergency department visit, controlling for other demographic, social, and health related factors.

Results

We identified 44,413 respondents to the baseline and follow-up 1 survey. The prevalence of loneliness in our sample was 23.1% (n=10263). Of those who had been to the emergency department in the previous year, 27.2% (n=2793) were lonely. Lonely respondents had higher odds of an emergency department visit (aOR: 1.13, 95% CI: 1.05-1.21), adjusted for various demographic and health factors. Loneliness was associated with emergency department visits more so in women (aOR: 1.15, 95% CI: 1.05-1.25) than in men (aOR: 1.10, 95% CI: 0.99-1.22).

Conclusions

In our study, loneliness was associated with emergency department visits in the previous 12 months. When our analysis was disaggregated by gender, we found differences in the odds of emergency department visit for men, women, and gender-diverse respondents. The odds of ED visit were higher in women than men. These findings highlight the general importance of identifying loneliness in both primary care and hospital. Care providers in ED need resources to refer patients who present in this setting with health issues complicated by social conditions such as loneliness.
Self-reported olfactory and gustatory dysfunctions in COVID-19 patients: a 1-year follow-up study in Foggia district, Italy
Authors: Fortunato Francesca , Martinelli Domenico , Iannelli Giuseppina , Milazzo Marica , Farina Umberto , Di Matteo Gabriella , De Nittis Rosella , Ascatigno Leonardo , Cassano Michele , Lopalco Pier Luigi , Prato Rosa
Published: January 2022

Background

From the initial stages of the pandemic in early 2020, COVID-19-related olfactory and gustatory dysfunctions have been widely reported and are emerging as one of the most frequent long-term sequelae of SARS-CoV-2 infection. However, data regarding the long-term recovery of the sense of smell and taste are lacking. This study aimed to characterize the evolution up to one year after the diagnosis of self-reported olfactory and gustatory dysfunctions in COVID-19 cases.

Methods

Based on the data of the active surveillance platform of the Apulia region, Italy, we selected the residents of Foggia district who were confirmed positive for SARS-CoV-2 from March 1st to June 16th, 2020, and home-quarantined with paucisymptomatic-to-mild clinical presentation. Self-reported olfactory and gustatory dysfunctions were recorded at baseline through a survey of dichotomous questions. The evolution of these symptoms at approximately one year was prospectively assessed via telephone by the validated sino-nasal outcome test 22 (SNOT-22, Italian version).

Results

Among the 1,175 COVID-19 cases notified in the Foggia district during the first epidemic wave, 488 had paucisymptomatic-to-mild clinical presentation. Of these, 41.2% (n = 201, 95% confidence interval [CI] 36.8–45.7%) reported at least one sensory dysfunction. A total of 178 to 201 (88.5%) patients agreed to participate in the follow-up survey. According to the SNOT-22 results, the persistence of a sensory dysfunction was observed in the 29.8% (n = 53, 95% CI 23.2–37.1%) of them. Particularly, loss of smell persisted in 25.8% (n = 46, 95% CI 19.6–32.9%), loss of taste in 21.3% (n = 38, 95% CI 15.6–28.1%), loss of both in 17.4% (n = 31, 95% CI 12.2–23.8%) of participants in the follow-up. The rates of full recovery increased over time: from 59% at 30 days to 71.9% at 90 days for the sense of smell; from 61.3% at 30 days to 74.7% at 90 days for the sense of taste.

Conclusions

The persistence of COVID-19-related olfactory and gustatory dysfunctions up to 12 months after the disease onset in a noteworthy proportion (approximately 3 out of 10) of patients with paucisymptomatic-to-mild clinical presentation deserves further investigations due to its possible pathophysiological implications and impact on the quality of life.
Comparison of different sepsis scoring systems and pathways: qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in bacteraemic and non-bacteraemic patients presenting to the emergency department
Authors: Sparks Rebecca , Harada Arisa , Chavada Ruchir , Trethewy Christopher
Published: January 2022

Background

Bacteraemia is associated with high morbidity and mortality, with delayed antibiotic treatment associated with poorer outcomes. Early identification is challenging, but clinically important. Multiple scoring systems have been developed to identify individuals in the broader categories of sepsis. We designed this study to assess the performance of existing scoring systems and pathways—CEC SEPSIS KILLS pathway (an Australian sepsis care package), quick sequential organ failure score (qSOFA), systemic inflammatory response syndrome (SIRS) and the Shapiro criteria.

Methods

This was a retrospective cohort study performed in two metropolitan hospitals in NSW, consisting of adult patients (> 18 years) with positive blood cultures containing a true pathogen and patients matched by age without positive blood cultures. Performance (sensitivity, specificity, and mortality prediction) of recognised sepsis and bacteraemia criteria and pathways—qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in the first 4 h following ED triage was assessed.

Results

There were 251 patients in each cohort. Sepsis-related mortality was higher in the bacteraemic group (OR 0.4, p = 0.03). Of the criteria studied, the modified Shapiro criteria had the highest sensitivity (88%) with modest specificity (37.85%), and qSOFA had the highest specificity (83.67%) with poor sensitivity (19.82%). SIRS had reasonable sensitivity (82.07%), with poor sensitivity (20.72%). The CEC SEPSIS pathway sensitivity of 70.1% and specificity of 71.1%. The SEPSIS KILLS was activated on only 14% of bacteraemic patients.

Conclusion

The performance of all scoring systems and pathways was suboptimal in the identification of patients at risk of bacteraemia presenting to the emergency department.
The role of women's traditional gender beliefs in depression, intimate partner violence and stress: insights from a Spanish abbreviated multicultural measure
Authors: Rovira Montse , Lega Leonor , Suso-Ribera Carlos , Orue Izaskun
Published: January 2022

Background

Research on traditional gender beliefs has highlighted their psychological impact and social implications for women. The purpose of this study was twofold. First, we aimed to adapt and validate the Spanish version of the Multicultural O’Kelly Women’s Beliefs Scale. Next, we explored its sources of validity evidence in relation to intimate partner violence, stress, and depression. Based on the Rational Emotive Behavior Therapy framework, traditional gender beliefs were expected to be associated with higher levels of intimate partner violence, stress and depression. We also expected to obtain a psychometrically-sound factor structure of the Multicultural O’Kelly Women’s Beliefs Scale.

Methods

A sample of Spanish women (N = 322) completed the Multicultural O’Kelly Women’s Beliefs Scale, the Beck’s Depression Inventory II, the Modified Conflict Tactics Scale, and the Stress Perceived Scale. To test the psychometric properties of the Multicultural O’Kelly Women’s Beliefs Scale we implemented exploratory and confirmatory factor analyses and an analysis of the area under the curve.

Results

Regarding the psychometric properties of the scale, statistical analysis revealed a one-factor dimensionality (Global traditionalism) and supported a reduction of items in the original instrument. The abbreviated version (eight items) obtained the best fit indices. Considering the association between traditional gender beliefs and psychological outcomes, we found that traditional gender beliefs were associated with increased severity of stress, depressive symptoms and reciprocal verbal aggression.

Conclusion

The Spanish adaptation of the Multicultural O’Kelly Women’s Beliefs Scale provided a very short, psychometrically robust and clinically relevant measure of traditional gender beliefs. In addition to the association between traditional gender beliefs and mental health outcomes, an important finding was the relationship between traditional gender beliefs and intimate partner violence. Our scale might be used in clinical settings by helping women to identify their traditional gender beliefs and replace them by healthy and goal-oriented beliefs, which would also contribute in achieving a more egalitarian society.
Health practitioners’ perceptions of structural barriers to the identification of intimate partner abuse: a qualitative meta-synthesis
Authors: Hudspeth Naomi , Cameron Jacqui , Baloch Surriya , Tarzia Laura , Hegarty Kelsey
Published: January 2022

Background

Health care practitioners (HCPs) play a critical role in identifying and responding to intimate partner abuse (IPA). Despite this, studies consistently demonstrate a range of barriers that prevent HCPs from effectively identifying and responding to IPA. These barriers can occur at the individual level or at a broader systems or organisational level. In this article, we report the findings of a meta-synthesis of qualitative studies focused on HCPs’ perceptions of the structural or organisational barriers to IPA identification.

Methods

Seven databases were searched to identify English-language studies published between 2012 and 2020 that used qualitative methods to explore the perspectives of HCPs in relation to structural or organisational barriers to identifying IPA. Two reviewers independently screened the articles. Findings from the included studies were analysed using Thomas and Hardin’s method of using a thematic synthesis and critiqued using the Critical Appraisal Skills Program tool for qualitative studies and the methodological component of the GRADE-CERQual.

Results

Forty-three studies conducted in 22 countries informed the review. Eleven HCP settings were represented. Three themes were developed that described the structural barriers experienced by HCPs: The environment works against us (limited time with patients, lack of privacy); Trying to tackle the problem on my own (lack of management support and a health system that fails to provide adequate training, policies and response protocols and resources), Societal beliefs enable us to blame the victim (normalisation of IPA, only presents in certain types of women, women will lie or are not reliable).

Conclusion

This meta-synthesis highlights the need for structural change to address these barriers. These include changing health systems to enable more time and to improve privacy, training, policies, and referral protocols. On a broader level IPA in health systems is currently not seen as a priority in terms of global burden of disease, mortality and morbidity and community attitudes need to address blaming the victim.
Zinc transporter ZIP12 maintains zinc homeostasis and protects spermatogonia from oxidative stress during spermatogenesis
Authors: Zhu Xinye , Yu Chengxuan , Wu Wangshu , Shi Lei , Jiang Chenyi , Wang Li , Ding Zhide , Liu Yue
Published: January 2022

Background

Overwhelming evidences suggest oxidative stress is a major cause of sperm dysfunction and male infertility. Zinc is an important non-enzymatic antioxidant with a wide range of biological functions and plays a significant role in preserving male fertility. Notably, zinc trafficking through the cellular and intracellular membrane is mediated by specific families of zinc transporters, i.e., SLC39s/ZIPs and SLC30s/ZnTs. However, their expression and function were rarely evaluated in the male germ cells. The aim of this study is to determine and characterize the crucial zinc transporter responsible for the maintenance of spermatogenesis.

Methods

The expression patterns of all 14 ZIP members were characterized in the mouse testis. qRT-PCR, immunoblot and immunohistochemistry analyses evaluated the ZIP12 gene and protein expression levels. The role of ZIP12 expression was evaluated in suppressing the sperm quality induced by exposure to an oxidative stress in a spermatogonia C18–4 cell line. Zip12 RNAi transfection was performed to determine if its downregulation altered cell viability and apoptosis in this cell line. An obese mouse model fed a high-fat-diet was employed to determine if there is a correlation between changes in the ZIP12 expression level and sperm quality.

Results

The ZIP12 mRNA and protein expression levels were higher than those of other ZIP family members in both the mouse testis and other tissues. Importantly, the ZIP12 expression levels were very significantly higher in both mice and human spermatogonia and spermatozoa. Moreover, the testicular ZIP12 expression levels significantly decreased in obese mice, which was associated with reduced sperm zinc content, excessive sperm ROS generation, poor sperm quality and male subfertility. Similarly, exposure to an oxidative stress induced significant declines in the ZIP12 expression level in C18–4 cells. Knockdown of ZIP12 expression mediated by transfection of a ZIP12 siRNA reduced both the zinc content and viability whereas apoptotic activity increased in the C18–4 cell line.

Conclusions

The testicular zinc transporter ZIP12 expression levels especially in spermatogonia and spermatozoa are higher than in other tissues. ZIP12 may play a key role in maintaining intracellular zinc content at levels that reduce the inhibitory effects of rises in oxidative stress on spermatogonia and spermatozoa viability during spermatogenesis which help counteract declines in male fertility.
Individualized luteal phase support after fresh embryo transfer: unanswered questions, a review
Authors: ZHAO Jing , HAO Jie , LI Yanping
Published: January 2022

Background

Luteal phase support (LPS) is an important part of assisted reproductive technology (ART), and adequate LPS is crucial for embryo implantation. At present, a great number of studies have put emphasis on an individualized approach to controlled ovarian stimulation (COS) and endometrium preparation of frozen- thawed embryo transfer (FET); However, not much attention has been devoted to the luteal phase and almost all ART cycles used similar LPS protocol bases on experience.

Main body

This review aims to concisely summarize individualized LPS protocols in fresh embryo transfer cycles with hCG trigger or GnRH-a trigger. The PubMed and Google Scholar databases were searched using the keywords: (luteal phase support or LPS) AND (assisted reproductive technology or ART or in vitro fertilization or IVF). We performed comprehensive literature searches in the English language describing the luteal phase support after ART, since 1978 and ending in May 2019. Recent studies have shown that many modified LPS programs were used in ART cycle. In the cycle using hCG for final oocyte maturation, the progesterone with or without low dose of hCG may be adequate to maintain pregnancy. In the cycle using GnRH-a for trigger, individualized low dose of hCG administration with or without progesterone was suggested. The optimal timing to start the LPS would be between 24 and 72 h after oocyte retrieval and should last at least until the pregnancy test is positive. Addition of E2 and the routes of progesterone administration bring no beneficial effect on the outcomes after ART.

Conclusions

Individualized LPS should be applied, according to the treatment protocol, the patients’ specific characteristics, and desires.
What’s happening where when SARS-CoV-2 infects: are TLR7 and MAFB sufficient to explain patient vulnerability?
Authors: Englmeier Ludwig , Subburayalu Julien
Published: January 2022

The present COVID-19 pandemic has revealed that several characteristics render patients especially prone to developing severe COVID-19 disease, i.e., the male sex, obesity, and old age. An explanation for the observed pattern of vulnerability has been proposed which is based on the concept of low sensitivity of the TLR7-signaling pathway at the time of infection as a common denominator of vulnerable patient groups.

We will discuss whether the concept of established TLR-tolerance in macrophages and dendritic cells of the obese and elderly prior to infection can explain not only the vulnerability of these two demographic groups towards development of a severe infection with SARS-CoV-2, but also the observed cytokine response in these vulnerable patients, which is skewed towards pro-inflammatory cytokines with a missing interferon signature.
The challenges of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in low-middle income countries and possible cost-effective measures in resource-limited settings
Authors: Duma Zamathombeni , Chuturgoon Anil A. , Ramsuran Veron , Edward Vinodh , Naidoo Pragalathan , Mpaka-Mbatha Miranda N. , Bhengu Khethiwe N. , Nembe Nomzamo , Pillay Roxanne , Singh Ravesh , Mkhize-Kwitshana Zilungile L.
Published: January 2022

Diagnostic testing for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection remains a challenge around the world, especially in low-middle-income countries (LMICs) with poor socio-economic backgrounds. From the beginning of the pandemic in December 2019 to August 2021, a total of approximately 3.4 billion tests were performed globally. The majority of these tests were restricted to high income countries. Reagents for diagnostic testing became a premium, LMICs either cannot afford or find manufacturers unwilling to supply them with expensive analytical reagents and equipment. From March to December 2020 obtaining testing kits for SARS-CoV-2 testing was a challenge. As the number of SARS-CoV-2 infection cases increases globally, large-scale testing still remains a challenge in LMICs. The aim of this review paper is to compare the total number and frequencies of SARS-CoV-2 testing in LMICs and high-income countries (HICs) using publicly available data from Worldometer COVID-19, as well as discussing possible interventions and cost-effective measures to increase testing capability in LMICs. In summary, HICs conducted more SARS-CoV-2 testing (USA: 192%, Australia: 146%, Switzerland: 124% and Canada: 113%) compared to middle-income countries (MICs) (Vietnam: 43%, South Africa: 29%, Brazil: 27% and Venezuela: 12%) and low-income countries (LICs) (Bangladesh: 6%, Uganda: 4% and Nigeria: 1%). Some of the cost-effective solutions to counteract the aforementioned problems includes using saliva instead of oropharyngeal or nasopharyngeal swabs, sample pooling, and testing high-priority groups to increase the number of mass testing in LMICs.
Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum
Authors: Damschroder Laura J. , Reardon Caitlin M. , Opra Widerquist Marilla A. , Lowery Julie
Published: January 2022

Background

The challenges of implementing evidence-based innovations (EBIs) are widely recognized among practitioners and researchers. Context, broadly defined as everything outside the EBI, includes the dynamic and diverse array of forces working for or against implementation efforts. The Consolidated Framework for Implementation Research (CFIR) is one of the most widely used frameworks to guide assessment of contextual determinants of implementation. The original 2009 article invited critique in recognition for the need for the framework to evolve. As implementation science has matured, gaps in the CFIR have been identified and updates are needed. Our team is developing the CFIR 2.0 based on a literature review and follow-up survey with authors. We propose an Outcomes Addendum to the CFIR to address recommendations from these sources to include outcomes in the framework.

Main text

We conducted a literature review and surveyed corresponding authors of included articles to identify recommendations for the CFIR. There were recommendations to add both implementation and innovation outcomes from these sources. Based on these recommendations, we make conceptual distinctions between (1) anticipated implementation outcomes and actual implementation outcomes, (2) implementation outcomes and innovation outcomes, and (3) CFIR-based implementation determinants and innovation determinants.

Conclusion

An Outcomes Addendum to the CFIR is proposed. Our goal is to offer clear conceptual distinctions between types of outcomes for use with the CFIR, and perhaps other determinant implementation frameworks as well. These distinctions can help bring clarity as researchers consider which outcomes are most appropriate to evaluate in their research. We hope that sharing this in advance will generate feedback and debate about the merits of our proposed addendum.
Incidence and risk factors of in-stent restenosis after percutaneous coronary intervention in patients from southern China
Authors: Li Mingrui , Hou Jingyuan , Gu Xiaodong , Weng Ruiqiang , Zhong Zhixiong , Liu Sudong
Published: January 2022

Background

In-stent restenosis (ISR) remains a challenge for coronary artery disease (CAD) patients who undergo percutaneous coronary intervention (PCI) with stents, and risk factors for ISR are controversial. This study aimed to investigate the incidence and risk factors of ISR in patients from southern China.

Methods

In this retrospective study, patients diagnosed as acute coronary syndromes (ACS) and underwent successful PCI with drug-eluting stent (DES) and conducted a follow-up coronary angiography in Center for Cardiovascular Diseases of Meizhou People’s Hospital at the period of January 1st, 2016 to January 1st, 2021 were included for analysis. The clinical and angiographic factors were compared between patients in ISR ( +) and ISR (−) groups. The association between variables and ISR was evaluated by multivariate logistic regression model.

Result

A total of 341 ACS patients who had been installed at least 1 stent were included in this study. The follow-up time was 34.2 ± 17.2 months. During the follow-up period, 62 (18.2%) patients experienced ISR, and the average time for ISR was 32.8 months; the incidence of ISR for left main coronary artery, left anterior descending coronary artery, left circumflex artery coronary artery and right coronary artery were 6.7%, 20.9%, 19.4% and 14.4%, respectively; left ventricular ejection fraction (LVEF), stent number, stent type, statin therapy, antiplatelet therapy were significantly different between patients in ISR ( +) and ISR (−) group. Multivariate logistic analysis suggested that LVEF and stent number were significantly correlated with ISR.

Conclusion

Our study revealed the incidence and risk factors of ISR in patients from southern China. Our data suggested that LVEF and stent number were independent risk factors associated with ISR.
Incidence and factors associated with postoperative delirium in patients undergoing transurethral resection of bladder tumor
Authors: Nakatani Shohei , Ida Mitsuru , Wang Xiaoying , Naito Yusuke , Kawaguchi Masahiko
Published: January 2022

Background

Postoperative delirium is an important complication after surgery, including urological surgery. This study evaluated the incidence of postoperative delirium and its associated factors after transurethral resection of bladder tumor in adult patients.

Methods

Patients aged ≥20 years who underwent elective transurethral resection of bladder tumor under general anesthesia from April 2016 to November 2020 were included. Patient demographic and intraoperative data, including the administration of 5-aminolevulinic acid and hypotension, defined as a mean arterial pressure value < 60 mmHg, were evaluated. The primary outcome was the incidence of postoperative delirium assessed using a chart-based method. The factors associated with postoperative delirium were explored using multiple logistic regression analysis. Postoperative lengths of stay between patients with and without postoperative delirium were compared using the Mann–Whitney U-test.

Results

Of 324 eligible patients with a median age of 76, 26 patients experienced postoperative delirium, with an incidence rate of 8.0% (95% confidence interval, 5.06–10.9). Age (odds ratio 1.13, 95% confidence interval 1.05–1.22, p = 0.001) and body mass index (odds ratio 0.83, 95% confidence interval 0.71–0.97, p = 0.02) were associated with postoperative delirium. Postoperative length of stay between patients with or without postoperative delirium was not significantly different (6 vs 6 days, p = 0.18).

Conclusions

The incidence of postoperative delirium after transurethral resection of bladder tumor under general anesthesia in this study was 8.0%. Older age and low body mass index were associated with development of postoperative delirium.
Subchorionic hematoma and pregnancy outcomes in patients with threatened miscarriage
Authors: Naz Sumaira , Irfan Sheikh , Naru Tahira , Malik Ayesha
Published: January 2022

Objective: To compare maternal and perinatal outcomes in patients with threatened miscarriage with or without subchorionic hematoma (SCH) at a tertiary care hospital.

Methods: This retrospective cohort study was conducted at Aga Khan University Hospital. The study included 200 patients of <20 weeks singleton pregnancy with threatened miscarriage from January 2016 till December 2018. These patients were divided into two groups based on the presence (study group) or absence of subchorionic hematoma (control) on ultrasound imaging. Baseline demographic data, and obstetric outcomes were compared for the two groups.

Results: The incidence of subchorionic hematoma was observed to be 30.5% (61/200). Most of the patients of SCH and non SCH groups presented in first trimester. Age and BMI were similar for both groups however there were more multigravida patients in the SCH group (63% versus 46.7%, P=0.12). A higher number of patients in the SCH group ended up in spontaneous miscarriage in contrast to patients with no SCH (13% versus 6.1%, P=0.07) and also had a greater proportion of small for gestational age (SGA) babies (8.9% versus 3.9%) though no statistical significance was observed. There were more preeclamptic patients in SCH group as compared to non SCH group (4.8% versus 0.7%) and the trend was statistically significant (P=0.05). However, no significant correlation of hematoma size and adverse pregnancy outcomes was found in SCH group.

Conclusion: Our study shows that women with threatened miscarriage having SCH are at a higher risk of having preeclampsia and SGA and hence these pregnancies warrant greater surveillance.

doi: https://doi.org/10.12669/pjms.38.3.4283

How to cite this:Naz S, Irfan S, Naru T, Malik A. Subchorionic hematoma and pregnancy outcomes in patients with threatened miscarriage. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4283

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The Digi-Image Age and the Issue of Genericization of Truth in the Context of Comparative Religion
Authors: Öztürk Ali
Published: January 2022

With digitalism, humanity entered a new age—the digital metaphysical period. Significant distinctions from previous epochs mark this period. Indeed, digitalism produces a transformation in every field via its specified applications, resulting in the creation of a new natural cosmos and a new human species. Unarguably, in addition to all its productions, the field in which digitalism most excels, owing to its inherent nature, is the adoption of an imaginary state of being as a database. This field, which we might refer to as the digi-image, has a significant impact on fields that can be changed into imaginary productions, such as belief, mystification, value, and culture, as well as the process of change in general. This study is a comparative and theoretical study of the new role that faiths, beliefs, and civilizations will play due to digital image transformation.
Socio-formative Pedagogical Counseling: Professionalization and Improvement of Teaching Practice in Compulsory Education in Northern Mexico
Authors: Acosta Haydeé Parra , Lerma Perla Briselda Cordero , Loya José López
Published: January 2022

Technical and pedagogical counseling as accompaniment benefits teachers’ development. However, there are information gaps on the specific impact of counseling with a socio-formative approach on both professionalization and the improvement of teaching practice. The objective is to analyze the relationship between these three elements. A cross-sectional study with a quantitative approach was employed. A validated questionnaire was applied to a representative sample of 212 teachers. The information analysis was carried out through statistics: descriptive, correlational, and linear regression, whose level of significance was: <.01-. 05. Teachers consider that technical and pedagogical counseling from socio-formation fosters the development of an ethical life project, promotes problem solving in their educational practice, collaborative work, metacognition, and entrepreneurship (92.78 ± 14.3). The correlational analysis showed a significant relationship between socio-formative pedagogical technical counseling and teaching practice, the latter of which was enhanced by the former. In the linear regression analysis, the best model of pedagogical technical counseling is made from socio-formation, which predicts a 71% improvement of teaching practice. As a result, this form of counseling benefits both professionalization and teaching practice through metacognition.
Genetic diversity and morphological variation of Pinus gerardiana along the environmental gradient from Zhob, Balochistan, Pakistan
Authors: Gul Janat , Saeed Shazia , Ahmed Alia , Laghari Saad ullah khan , Basit Abdul , Rehman Abdul , Zahid Muhammad
Published: January 2022

Abstract.  Gul J, Saeed S, Ahmed A, Leghari SK, Basit A, Rehman A, Khan MZ. 2021. Genetic diversity and morphological variation of Pinus gerardiana along the environmental gradient from Zhob, Balochistan, Pakistan. Nusantara Bioscience 13: 121-128. Pinus gerardiana, an evergreen gymnosperm, is an economically- and ecologically valuable tree found in the Takhte Suleman Mountain Range, Zhob northeastern edge of the Balochistan, Pakistan. The present study is based on the assessment of the impact of environmental gradients with special reference to altitudinal gradient and soil variables on morphological, phytochemicals and genetic variation of P. gerardiana. A total of 27 genotypes of P. gerardiana were collected from the three elevation zones ranging from 2000 - 3500 m above sea level. The genetic diversity was assessed by combined markers, the random amplified polymorphic DNA (RAPD) and the Inter Simple Sequence Repeat (ISSR). Polymorphic bands analyzed the data to generate a dendrogram, based on the unweighted pair group method with arithmetic mean (UPGMA). Morphological characters assessed the morphological characters. Phytochemicals were investigated; the total phenolic content and total flavonoid contents were estimated and compared amongst all accessions. Our results revealed variations along altitudinal gradients and related to soil characteristics. The populations at the Middle altitude zone have greater diversity than populations at lower and higher altitudes. The resulting altitudinal variation can be attributed to various geographical and environmental conditions. These results can help in conservation and cultivation of this economically important tree.
Antibacterial activity of Jatropha tanjorensis leaf extracts against bacteria associated with wound infections from the clinical setting
Authors: BABAYEMI OLAWALE OLADEJO , OKE EBENEZER AYODELE , BAYODE MICHAEL TOSIN
Published: January 2022

Abstract. Babayemi OO, Oke EA, Bayode MT. 2021. Antibacterial activity of Jatropha tanjorensis leaf extracts against bacteria associated with wound infections from the clinical setting. Nusantara Bioscience 13: 260-267. The use of microbial agents to treat infectious wounds based on ethnobotanical knowledge is still minimal. Antibacterial activity of Jatropha tanjorensis J.L.Ellis & Saroja leaf crude extracts and commercial antibiotics were evaluated against bacterial isolates associated with wound samples using agar well diffusion and disc diffusion techniques, respectively. Phytochemical analysis of the sections was carried out using standard methods. Saponin (58 mg/g) was the highest phytochemical in the methanol extract while flavonoid (0.1 mg/g) was the lowest percentage in the coldwater extract. Methanol extract had had the highest Zone of Inhibition (ZOI) of 33 mm against Staphylococcus aureus coagulase-positive, while the lowest ZOI (5 mm) against S. aureus coagulase-positive was obtained from cold water extract. Methanol extract resulted in the highest ZOI ranging from 16 mm to 17 mm against Escherichia coli while the lowest ZOI was obtained from coldwater extract (3-4 mm). The highest Minimum Inhibitory Concentration (MIC) value of all extracts (100 mg/mL) was obtained against P. aeruginosa while the lowest MIC value was obtained against coagulase-positive S. aureus (12.5 mg/mL). All extracts contain Octadecanoic acid, n-hexadecanoic acid, and phytol. The study's outcome revealed that methanol extract had the highest inhibitory activity against bacteria isolated from wound samples compared to other crude extracts and ciprofloxacin. Jatropha tanjorensis could be used as a potent herbal remedy to reduce the adverse effects of wound infection.
Plant-extract-mediated biosynthesis of silver nanoparticles using Eleutherine americana bulb extract and its characterization
Authors: MANULLANG JULINDA ROMAULI , NUGROHO RUDY AGUNG , ROHMAH MIFTAKHUR , RUDIANTO RUDIANTO , QORYSUCHI AMANDA
Published: January 2022

Abstract. Manullang JR, Nugroho RA, Rohmah M, Rudianto, Qorysuchi A. 2021. Plant-extract-mediated biosynthesis of silver nanoparticles using Eleutherine americana bulb extract and its characterization. Nusantara Bioscience 13: 247-254. The plant-based biosynthesis of nanoparticles has gained increasing momentum due to being lower in cost and eco-friendly. This study aimed to biosynthesize nanoparticles from the bulb ethanolic extract of Eleutherine americana (Aubl.) Merr. ex K.Heyne (Ea-AgNPs), then characterize Ea-AgNPs and determine their phytochemical content and antioxidant capacity. The Ea-AgNPs were synthesized using ethanolic extract of E. americana bulb along with various concentrations of AgNO3 (0.5-4 mM). The Ea-AgNPs were then characterized using UV-VIS spectroscopic, Scanning Electron Microscopy/ Energy Dispersive X-ray (SEM/EDX), Transmission Electron Microscopy (TEM), X-ray Powder Diffractometry (XRD), and Fourier-Transform Infrared Spectroscopy (FTIR) techniques. The results indicated that E. americana can be used to reduce AgNO3 to synthesize Ea-AgNPs, indicated by color change, and had optimum UV/VIS spectra at 400 nm. The FTIR analysis found that Ea-AgNPs showed peaks at 2919, 2850, 1586, and 1031 cm1, containing several important biocompounds. Additionally, the XRD results found an amorphous Ea-AgNP peak with maximum intensity and proportion of silver occurring at 24 Theta. The particle size distribution curve of Ea-AgNPs showed a size of 105 nm. Furthermore, SEM/EDX analysis revealed an optical absorption characteristic peak at 3 keV. The EDX examination revealed three signals: a strong signal from the C atom (70.99 %), an O atom (28.95 %), and Ag atom (0.06 %). The TEM imaging also showed the characteristics of Ea-AgNPs. Some phytochemicals such as flavonoids, tannins, alkaloids, and saponins were found in Ea-AgNPs, with IC50 values of 45.30 ppm.
THE IMAGE OF THE FUTURE OF RUSSIA AS A BASIS FOR POSITIVE CIVIC IDENTIFICATION
Authors: Maximova Svetlana G. , Atyasova Natalia Yu. , Surtaeva Olga V. , Shakhova Ekaterina V.  , Spirina Anastasiya S.
Published: January 2022

The article presents the results of a study of civic identity, on the one hand, and an analysis of the images of modern and future Russia existing in the social representations of Russians, on the other hand. A sociological survey was conducted in four regions of the Russian Federation: Altai Krai, Voronezh Oblast, Kaliningrad Oblast, and Khabarovsk Krai. The authors examine the relationship between civic identity and the image of the country. According to the results of the study, the images of modern and future Russia are presented, which exist in the minds of residents of four regions of the country. Based on the analysis of the data obtained, the presence of similar images of modern Russia, predominantly with negative characteristics, is ascertained. In the perceptions of the inhabitants of the studied regions, there are different images of the future of Russia: an unambiguous positive image, a predominantly positive image, an ambivalent image and a depressive image.
Detection of seed vigour differences in Festuca sinensisseed lots
Authors: Munyaneza Venuste , Chen Dali , Hu Xiaowen
Published: January 2022

The selection of high vigour seeds significantly affects stand establishment and initial plant growth, particularly in harsh environments. Several tests, including standard germination (SG), seed vigour index (SVI), germination under water and temperature stress conditions, radicle
emergence (RE) counts, accelerated ageing (AA) and electrical conductivity (EC), were applied to evaluate the vigour of 12 seed lots of Festuca sinensis. The SG showed that all seed lots attained high germination ranging from 86 to 96%; no significant correlation was observed between
SG and seedling emergence (SE) in field experiments over two years (2020 and 2021). The RE count at 88 hours, germination (15°C and -0.2 MPa) were the most correlated with SE (r = 0.881 and 0.851, respectively, P < 0.01), followed by AA (42°C for 48 hours) and SVI
(0.836 and 0.753, respectively, P < 0.01). Thus, RE counts at 88 hours, germination (15°C and -0.2 MPa), SVI and AA (42°C for 48 hours) accurately detect vigour difference of F. sinensis seed lots and provide similar data to those for SE in the field.
Prevención de infecciones asociadas a la atención de salud: conocimientos y prácticas en médicos residentes
Authors: Yagui Moscoso Martin , Vidal-Anzardo Margot , Rojas Mezarina Leonardo , Sanabria Rojas Hernán
Published: January 2022

Objetivos. Determinar el nivel de conocimientos y prácticas sobre las medidas de prevención de las infecciones asociadas a la atención de salud (IAAS) y sus factores asociados en médicos residentes ingresantes 2018 de una universidad de Lima, Perú. Métodos. Estudio transversal en el cual se aplicó un cuestionario validado a 171 médicos residentes. Las variables estudiadas fueron edad, sexo, tiempo como profesional, capacitaciones previas, procedencia, tipo de universidad de procedencia, entre otras. Resultados. 52% de los participantes fueron de sexo femenino, el 49% tenía 2 o menos años de tiempo como profesional médico, el 49% provenía de una universidad del interior del país, solo el 34% ocupó una vacante cautiva y el 71,9% tuvo capacitaciones previas sobre medidas de prevención de IAAS. El 83% de los médicos residentes ingresantes estudiados mostró poco conocimiento sobre medidas de prevención de las IAAS mientras que el 68,4% mostró prácticas no adecuadas sobre medidas de prevención de las IAAS.El ingreso a una especialidad de medicina estuvo asociado a un menor riesgo de tener poco conocimiento (OR: 0,32, IC 95%: 0,11-0,93). El mayor tiempo como profesional se relacionó a un menor riesgo de tener prácticas inadecuadas (OR: 0,936, IC 95%: 0,89-0,99). Conclusiones. Existe un bajo nivel de conocimientos sobre medidas de prevención de IAAS y una elevada proporción de los residentes ingresantes 2018 tuvo prácticas no adecuadas sobre medidas de prevención de IAAS. Se observó que el tipo de especialidad fue un factor asociado al nivel de conocimientos y el tiempo de experiencia profesional fue un factor asociado al tipo de práctica.
ANÁLISE DA MOBILIDADE INTERURBANA NO BRASIL POR MEIO DE UMA MATRIZ ORIGEM DESTINO DE DADOS DA TELEFONIA MÓVEL
Authors:   Universidade de Brasília, SILVA LEANDRO RODRIGUES ,   Programa de Pós Graduação em Arquitetura e Urbanismo, DE PAULA RUBEM OLIVEIRA ,   Universidade de Brasília; Programa de Pós Graduação em Arquitetura e Urbanismo, YAMASHITA YAEKO ,   Universidade de Brasília; Programa de Pós Graduação em Arquitetura e Urbanismo, SILVA LUIZ NOBERTO BRANQUINHO ,   LUCA – Telefônica Data Unit S/A
Published: January 2022

Interurban mobility from a systemic and integrated perspective is not much studied in Brazil. It comprises the movements that take place between cities, with the objective of meeting non-daily needs, through different modals of transport and different dimensions of administrative management. The use of a big data with mobile phone information in Brazil, modeling techniques and the crossing with secondary data from different sources, allowed an unprecedented overview at this mobility, and exposes how this integrated vision can contribute to the improvement of the planning. The results demonstrate a distinct mobility for different Brazilian locations. The accessibility offered to the population presents regional differences, and the data indicate that the more than 2 billion individual trips made annually considered different parameters for their travel and modal choices, in addition to the cost and time of transportation. Intercity transportation by car is the majority (58%), mainly due to the limited supply of services and infrastructure in other modes (just 1% of domestic connections have more than one mode of transportation offered). However, air transport (25%) and road transport by bus (17%) have a significant contribution to the modal division of transport production.