bluuebunny/crossref_metadata_2025 huggingface dataset:
Holistic nursing care practice and associated factors among nurses in public hospitals of Wolaita zone, South Ethiopia
Authors: Ambushe Selamawit Ataro , Awoke Nefsu , Demissie Birhanu Wondimeneh , Tekalign Tiwabwork
Published: October 2023

Background

Holistic nursing care is an approach to patient care that takes into account the physical, social, spiritual, and psychological needs of the patient. Providing holistic care has been found to be an effective way to prevent diseases and death, as well as improve the quality of healthcare provided to patients. However, despite its perceived benefits, many nurses lack experience with holistic care and only focus on patients’ physical needs, treating them as biological machines while ignoring their spiritual, mental, and social needs. Therefore, this study aimed to assess the practice of holistic nursing care and its associated factors among nurses.

Methods

A hospital-based cross-sectional study was conducted among 422 sampled Nurses working in public hospitals in Wolaita Zone. Systematic random sampling was applied to select the study participants. A self-administered, pretested questionnaire was used to collect the data. The collected data were entered into Epi Data version 4.6 and analyzed using SPSS version 25. Binary and multivariable logistic regression analyses were used to identify factors associated with holistic nursing care practice. Statistical significance was declared at a p-value less than 0.05. The strength of the association was indicated by the AOR and 95% CI.

Result

The study found that the overall practice of holistic nursing care was 21%. Nurses with a diploma in nursing (AOR: 0.28; 95% CI: 0.11, 0.71), nurses working in a hospital with no continuous in-service learning (AOR: 0.39; 95% CI: 0.20, 0.76), nurses with a poor relationship with patients (AOR: 0.31; 95% CI: 0.16, 0.58), and nurses with poor knowledge of holistic nursing care practice (AOR: 0.41; 95% CI: 0.21, 0.7) were factors associated with a lower likelihood of practicing holistic nursing care.

Conclusion

This study found that the practice of holistic nursing care among nurses working in public hospitals in the Wolaita Zone was low. Level of education, the unit of work, continuous in-service learning, the nurse-patient relationship, and the knowledge of nurses were factors associated with holistic nursing care. The provision of in-service training and the creation of trusting, positive relationships were suggested to improve the practice of holistic nursing care.
Healthcare professional and manager perceptions on drivers, benefits, and challenges of telemedicine: results from a cross-sectional survey in the Italian NHS
Authors: Antonacci Grazia , Benevento Elisabetta , Bonavitacola Sveva , Cannavacciuolo Lorella , Foglia Emanuela , Fusi Giulia , Garagiola Elisabetta , Ponsiglione Cristina , Stefanini Alessandro
Published: October 2023

Background

The Covid-19 pandemic provided new challenges and opportunities for patients and healthcare providers while accelerating the trend of digital healthcare transformation. This study explores the perspectives of healthcare professionals and managers on (i) drivers to the implementation of telemedicine services and (ii) perceived benefits and challenges related to the use of telemedicine across the Italian National Health Service.

Methods

An online cross-sectional survey was distributed to professionals working within 308 healthcare organisations in different Italian regions. Quantitative and qualitative data were collected through a self-administered questionnaire (June-September 2021). Responses were analysed using summary statistics and thematic analysis.

Results

Key factors driving the adoption of telemedicine have been grouped into (i) organisational drivers (reduce the virus spread-80%; enhance care quality and efficiency-61%), (ii) technological drivers (ease of use-82%; efficacy and reliability-64%; compliance with data governance regulations-64%) and (iii) regulatory drivers (regulations’ semplification-84%). Nearly all respondents perceive telemedicine as useful in improving patient care (96%). The main benefits reported by respondents are shorter waiting lists, reduced Emergency Department attendance, decreased patient and clinician travel, and more frequent patient-doctor interactions. However, only 7% of respondents believe that telemedicine services are more effective than traditional care and 66% of the healthcare professionals believe that telemedicine can’t completely substitute in-person visits due to challenges with physical examination and patient-doctor relationships. Other reported challenges include poor quality and interoperability of telemedicine platforms and scarce integration of telemedicine with traditional care services. Moreover, healthcare professionals believe that some groups of patients experience difficulties in accessing and using the technologies due to socio-cultural factors, technological and linguistic challenges and the absence of caregivers.

Conclusions

Respondents believe that telemedicine can be useful to complement and augment traditional care. However, many challenges still need to be overcome to fully consider telemedicine a standard of care. Strategies that could help address these challenges include additional regulations on data governance and reimbursements, evidence-based guidelines for the use of telemedicine, greater integration of tools and processes, patient-centred training for clinicians, patient-facing material to assist patients in navigating virtual sessions, different language options, and greater involvement of caregivers in the care process.
Enhanced antidepressant effects of BDNF-quercetin alginate nanogels for depression therapy
Authors: Xu Dong , Gao Li-Na , Song Xu-Jiao , Dong Qin-Wei , Chen Yi-Bing , Cui Yuan-Lu , Wang Qiangsong
Published: October 2023

Background

Brain-derived neurotrophic factor (BDNF) with neuronic development and function is a promising therapeutic agent for treating depressive disorder, according to the neurotrophin hypothesis. However, the delivery of BDNF into the brain is not easy as these large protein molecules cannot efficiently cross the blood-brain barrier (BBB) and easily suffer oxidative damage in vivo. Therefore, the quercetin-based alginate nanogels (quercetin nanogels) loaded with BDNF have been developed, which could efficiently bypass the BBB via the nose-to-brain pathway and protect BDNF from oxidative damage, providing an effective route for the therapy of depressive disorders by intranasal delivery.

Results

Quercetin nanogels exhibited uniform size distribution, excellent biocompatibility, and potent antioxidant and anti-inflammatory activities. Quercetin nanogels in the thermosensitive gel achieved sustained and controlled release of BDNF with non-Fick’s diffusion, exhibited rapid brain distribution, and achieved nearly 50-fold enhanced bioavailability compared to oral quercetin. Quercetin nanogels as a therapeutic drug delivery carrier exerted antidepressant effects on reserpine-induced rats, effectively delivered BDNF to reverse despair behavior in stress-induced mice, and exhibited antidepressant effects on chronic mild unpredictable stimulation (CUMS) rats. These antidepressant effects of BDNF-Quercetin nanogels for CUMS rats are associated with the regulation of the glutamatergic system, PI3K-Akt, and BDNF-TrkB signaling pathway.

Conclusions

In this study, we provide a promising strategy for brain delivery of BDNF for treating depressive disorders, effectively achieved through combining quercetin nanogels and intranasal administration.
Racial/ethnic differences in receipt of naloxone distributed by opioid overdose prevention programs in New York City
Authors: Nolen Shayla , Trinidad Andrew J. , Jordan Ashly E. , Green Traci C. , Jalali Ali , Murphy Sean M. , Zang Xiao , Marshall Brandon D. L. , Schackman Bruce R.
Published: October 2023

Introduction

We evaluated racial/ethnic differences in the receipt of naloxone distributed by opioid overdose prevention programs (OOPPs) in New York City (NYC).

Methods

We used naloxone recipient racial/ethnic data collected by OOPPs from April 2018 to March 2019. We aggregated quarterly neighborhood-specific rates of naloxone receipt and other covariates to 42 NYC neighborhoods. We used a multilevel negative binomial regression model to assess the relationship between neighborhood-specific naloxone receipt rates and race/ethnicity. Race/ethnicity was stratified into four mutually exclusive groups: Latino, non-Latino Black, non-Latino White, and non-Latino Other. We also conducted racial/ethnic-specific geospatial analyses to assess whether there was within-group geographic variation in naloxone receipt rates for each racial/ethnic group.

Results

Non-Latino Black residents had the highest median quarterly naloxone receipt rate of 41.8 per 100,000 residents, followed by Latino residents (22.0 per 100,000), non-Latino White (13.6 per 100,000) and non-Latino Other residents (13.3 per 100,000). In our multivariable analysis, compared with non-Latino White residents, non-Latino Black residents had a significantly higher receipt rate, and non-Latino Other residents had a significantly lower receipt rate. In the geospatial analyses, both Latino and non-Latino Black residents had the most within-group geographic variation in naloxone receipt rates compared to non-Latino White and Other residents.

Conclusions

This study found significant racial/ethnic differences in naloxone receipt from NYC OOPPs. We observed substantial variation in naloxone receipt for non-Latino Black and Latino residents across neighborhoods, indicating relatively poorer access in some neighborhoods and opportunities for new approaches to address geographic and structural barriers in these locations.
Evidence of autoinflammation as a principal mechanism of myocardial injury in SARS-CoV-2 PCR-positive medical examiner cases
Authors: Hammond Margo E. , Christensen Erik D. , Belenky Michael , Snow Gregory L. , Shah Kevin , Hammond M. Elizabeth H.
Published: October 2023

Background

Disease from Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) remains the seventh leading cause of death in the United States. Many patients infected with this virus develop later cardiovascular complications including myocardial infarctions, stroke, arrhythmia, heart failure, and sudden cardiac death (20–28%). The purpose of this study is to understand the primary mechanism of myocardial injury in patients infected with SARS-CoV-2.

Methods

We investigated a consecutive cohort of 48 medical examiner cases who died with PCR-positive SARS-CoV-2 (COVpos) infection in 2020. We compared them to a consecutive cohort of 46 age- and sex-matched controls who were PCR-negative for SARS-CoV-2 (COVneg). Clinical information available at postmortem examination was reviewed on each patient. Formalin-fixed sections were examined using antibodies directed against CD42 (platelets), CD15 (myeloid cells), CD68 (monocytes), C4d, fibrin, CD34 (stem cell antigen), CD56 (natural killer cells), and myeloperoxidase (MPO) (neutrophils and neutrophil extracellular traps(NETs)). We used a Welch 2-sample T-test to determine significance. A cluster analysis of marker distribution was also done.

Results

We found a significant difference between COVpos and COVneg samples for CD42, CD15, CD68, C4d, fibrin, and MPO, all of which were significant at p < 0.001. The most prominent features were neutrophils (CD15, MPO) and MPO-positive debris suggestive of NETs. A similar distribution of platelets, monocytes, fibrin and C4d was seen in COVpos cases. Clinical features were similar in COVpos and COVneg cases for age, sex, and body mass index (BMI).

Conclusion

These findings suggest an autoinflammatory process is likely involved in cardiac damage during SARS-CoV-2 infection. No information about clinical cardiac disease was available.
Plant regeneration through somatic embryogenesis in cell suspensions of Cenchrus ciliaris L.
Authors: Goyal Shipra , Chatterjee Vijaya , Kulkarni Vishvas M. , Bhat Vishnu
Published: October 2023

Background

This study aims to establish cell suspension culture, its maintenance and induction of somatic embryogenesis, and in vitro plant regeneration in Cenchrus ciliaris L. Suspension cultures are relatively homogenous cell lines facilitating uniform access to nutrition. These are ideal sources of competent cells for genetic transformation.

Results

Callus was initiated by culturing immature inflorescences of Cenchrus ciliaris cv. IGFRI-3108 on Murashige and Skoog (MS) medium containing 3 mg l−1 2,4-dichlorophenoxyacetic acid (2,4-D) and 0.5 mg l−1 6-benzylaminopurine (BAP) with 30 g l−1 sucrose. Cell suspension cultures were established in liquid MS medium using an inoculum size of 10 g l−1. These were maintained to achieve embryogenic cell/regeneration competent cultures. Growth curve analysis and a subculture interval of 20 days were determined to harvest cells at the end of the exponential phase. The cell doubling time was found to be 11 days. Somatic embryogenesis was accomplished in MS medium containing 1 mg l−1 2,4-D, 1 mg l−1 BAP along with growth adjuvants, 300 mg l−1 casein hydrolysate, 400 mg l−1 glutamine and 300 mg l−1 proline. The highest number (16 ± 3.78/per inoculum) of shoots regenerated on this medium. The elongation and rooting of shoots were recorded on basal MS and ½ MS media, respectively. Rooted plants were successfully transferred to pots containing a Soilrite and cocopeat mixture in a 3:1 proportion for 3–4 weeks and later successfully acclimatized in the greenhouse with a 60% survival rate. The genetic fidelity of 12 regenerated plants was analysed using RAPD primers that were genetically identical to the mother plant.

Conclusion

Cell suspension culture-based in vitro plant regeneration of C. ciliaris involved the establishment, maintenance and progression of somatic embryogenesis during shoot and root development. The inherent limitation of callus-mediated in vitro plant regeneration reducing the regeneration potential due to the aging of the calli has been overcome.
The impact of higher protein dosing on outcomes in critically ill patients with acute kidney injury: a post hoc analysis of the EFFORT protein trial
Authors: Stoppe Christian , Patel Jayshil J. , Zarbock Alex , Lee Zheng-Yii , Rice Todd W. , Mafrici Bruno , Wehner Rebecca , Chan Man Hung Manuel , Lai Peter Chi Keung , MacEachern Kristen , Myrianthefs Pavlos , Tsigou Evdoxia , Ortiz-Reyes Luis , Jiang Xuran , Day Andrew G. , Hasan M. Shahnaz , Meybohm Patrick , Ke Lu , Heyland Daren K.
Published: October 2023

Background

Based on low-quality evidence, current nutrition guidelines recommend the delivery of high-dose protein in critically ill patients. The EFFORT Protein trial showed that higher protein dose is not associated with improved outcomes, whereas the effects in critically ill patients who developed acute kidney injury (AKI) need further evaluation. The overall aim is to evaluate the effects of high-dose protein in critically ill patients who developed different stages of AKI.

Methods

In this post hoc analysis of the EFFORT Protein trial, we investigated the effect of high versus usual protein dose (≥ 2.2 vs. ≤ 1.2 g/kg body weight/day) on time-to-discharge alive from the hospital (TTDA) and 60-day mortality and in different subgroups in critically ill patients with AKI as defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria within 7 days of ICU admission. The associations of protein dose with incidence and duration of kidney replacement therapy (KRT) were also investigated.

Results

Of the 1329 randomized patients, 312 developed AKI and were included in this analysis (163 in the high and 149 in the usual protein dose group). High protein was associated with a slower time-to-discharge alive from the hospital (TTDA) (hazard ratio 0.5, 95% CI 0.4–0.8) and higher 60-day mortality (relative risk 1.4 (95% CI 1.1–1.8). Effect modification was not statistically significant for any subgroup, and no subgroups suggested a beneficial effect of higher protein, although the harmful effect of higher protein target appeared to disappear in patients who received kidney replacement therapy (KRT). Protein dose was not significantly associated with the incidence of AKI and KRT or duration of KRT.

Conclusions

In critically ill patients with AKI, high protein may be associated with worse outcomes in all AKI stages. Recommendation of higher protein dosing in AKI patients should be carefully re-evaluated to avoid potential harmful effects especially in patients who were not treated with KRT.

Trial registration: This study is registered at ClinicalTrials.gov (NCT03160547) on May 17th 2017.
Characterization of briquettes developed from banana peels, pineapple peels and water hyacinth
Authors: Mibulo Tadeo , Nsubuga Denis , Kabenge Isa , Wydra Kerstin D.
Published: October 2023

Background

Uganda’s energy relies heavily on biomass sources. This dependence on biomass for household and commercial purposes, driven largely by population increase, poses pressure on natural resources, such as forests. This study investigates the usage of some of the country’s largely produced agricultural wastes for the production of biofuels.

Methods

Pineapple peels (PP), banana peels (BP) and water hyacinth (WH_Eichhornia crassipes (Mart.) Solms) were used for generation of both carbonized and uncarbonized briquettes. Physical properties and calorific values for the developed briquettes were determined through thermogravimetric analysis and using a bomb calorimeter.

Results

Pineapple peel carbonized briquettes had the highest calorific value (25.08 MJ/kg), followed by a composite of banana peels and pineapple peels (22.77 MJ/kg). The moisture content for briquettes ranged from 3.9% to 18.65%. Uncarbonized briquettes had higher volatile matter (ranging between 62.83% and 75.1%) compared to carbonized briquettes (ranging between 22.01% and 24.74%). Uncarbonized briquettes had a shorter boiling time (ranging between 27 and 36 min for 2.5 L of water) compared to carbonized briquettes (ranging between 26 and 41 min). Bulk density was highest in uncarbonized BP briquettes (1.089 g/cm3) and compressive strength was highest with carbonized BP + PP (53.22 N/mm2). When using water hyacinth alone, the produced carbonized briquettes show low calorific values (16.22 MJ/kg). However, the calorific values increased when they were mixed with banana (20.79 MJ/kg) or pineapple peels (20.55 MJ/kg).

Conclusions

The findings revealed that agricultural wastes could be used to augment the energy sources pool to protect the environment and create social stability in the community.
Sleep disturbance increases the risk of severity and acquisition of COVID-19: a systematic review and meta-analysis
Authors: Shafiee Arman , Jafarabady Kyana , Rajai Shahryar , Mohammadi Ida , Mozhgani Sayed-Hamidreza
Published: October 2023

Background

Understanding the association between sleep quality and COVID-19 outcomes is crucial for effective preventive strategies and patient management. This systematic review aims to evaluate the impact of sleep quality as a risk factor for acquiring COVID-19 infection and the severity of the disease.

Methods

A comprehensive search of electronic databases was conducted to identify relevant studies published from the inception of the COVID-19 pandemic which was 31st of December 2019 until 30 April 2023. Studies investigating the relationship between sleep quality and COVID-19 infection, or disease severity were included. Random effect meta-analysis was performed with odds ratios (OR) and their 95% confidence intervals (95% CI) as effect measures.

Results

Out of the initial 1,132 articles identified, 12 studies met the inclusion criteria. All studies were observational studies (cohort, case–control, and cross-sectional). The association between sleep quality and COVID-19 infection risk was examined in 6 studies, The results of our meta-analysis showed that participants with poor sleep quality showed a 16% increase regarding the risk of COVID-19 acquisition (OR 1.16; 95% CI 1.03, 1.32; I2 = 65.2%, p = 0.02). Our results showed that participants with poor sleep quality showed a 51% increase in the incidence of primary composite outcome (OR 1.51; 95% CI 1.25, 1.81; I2 = 57.85%, p < 0.001). The result of our subgroup analysis also showed significantly increased risk of mortality (RR 0.67; 95% CI 0.50, 0.90; I2 = 31%, p = 0.008), and disease severity (OR 1.47; 95% CI 1.19, 1.80; I2 = 3.21%, p < 0.001) when comparing poor sleep group to those with good sleep quality.

Conclusion

This study highlights a significant association between poor sleep quality and an increased risk of COVID-19 infection as well as worse disease clinical outcomes.
Is There Just One Type of Multisport Pathway? A Scoping Review of Multisport Engagement in Early Athlete Development
Authors: Ramsay Gillian , Mosher Alexandra , Baker Joseph
Published: October 2023

Multisport engagement is positioned as the antithesis to specialization within youth development pathways. However, different terms are used to describe the multisport pathway, which may create confusion regarding what the pathway should look like. This review investigated all published research examining the multisport pathway, with a focus on terminology, and how different terms have led to varying interpretations of this research. Four databases were searched for all peer reviewed studies published up until December 2021. All included papers were full text, in English, and focusing on multisport athlete engagement. In total, 1974 abstracts were screened for inclusion eligibility, resulting in 82 articles included within this review. General results showed most studies are empirical (71%,n = 58) and looked at athlete development pathways using retrospective questionnaires aimed at investigating the specific pathway to sporting excellence. However, despite the consensus that multisport athletes play many sports in their lifetime, there is little investigation into when and the level of intensity (play versus practice) at which these sports are being played. Further, inconsistencies in the terminology used to describe this pathway have made it difficult to understand potential mechanisms that lead to any positive or negative effects. It is recommended that differences between the key terms ofdiversificationandsamplingare clarified and should not be regarded as synonymous as they may represent different paths within multisport development based on varying levels of intensity of play and practice.
Potential application of foveal structural measurements in treatment decision for retinopathy of prematurity: an OCT-based study
Authors: Bazvand Fatemeh , Salari Farhad , Barzi Navid Hasani , Ghassemi Fariba , Maleki Anahid , Dastjani Farahani Afsar , Imani Fooladi Marjan , Taleghani Naeeme Taslimi , Shariati Maryam Khoshnoud , Harper C. Armitage , Mehrabi Bahar Mohammadreza
Published: October 2023

Purpose

To investigate foveal changes in infants with ROP not requiring treatment(nROP) and ROP infants needing treatment (tROP) using a handheld SD-OCT device.

Method

We performed horizontal SD-OCT scans through the fovea in 156 eyes of 81 infants diagnosed with ROP. Foveal immaturity indices including the presence of inner retinal layers (IRL), absence of foveal outer nuclear layers widening (ONL) and attenuation of hyperreflective outer segment layers (OS), presence and type of cystoid macular edema (CME), epiretinal membrane (ERM), foveal pit depth (FPD), foveal pit width (FPW) and central foveal thickness (CFT) were calculated. The multivariate logistic regression model was used to predict the need for treatment based on OCT measurements.

Results

The shape of the foveolar pit was not significantly different among tROP and nROP groups (P-value = 0.287, Chi-square test). IRL extrusion was incomplete in both tROP and nROP groups (P-value = 0.0.41, Chi-square test). Nevertheless, the presence of thicker IRL was more frequent in the nROP group in comparison with the tROP group (100% vs.64.8%, P-value = 0.001). CME was observed in 29% of eyes in the tROP group and 40% of eyes in the nROP group; however, this difference was not statistically significant (P-value = 0.32, Chi-square test). ERM was detected in 15 (75%) and 84 (65.6%) eyes in the nROP and tROP groups, respectively (P-value = 0.39, Chi-square test). Multivariate logistic regression analyses showed that the need for treatment was significantly associated with gestational age (GA), CFT and FPD (P-values 0.001 and 0.002 respectively).

Conclusions

This study demonstrated GA, foveal pit depth and the central foveal thickness could accurately predict the need for treatment with sensitivity, specificity, and diagnostic accuracy of 97%, 65% and 91.7% respectively.
Prevalence and determinants of anxiety, depression and comorbid anxiety–depression symptoms among adolescents in Ebola-affected zones
Authors: Cénat Jude Mary , Dromer Elisabeth , Mistry Shruti , Villarreal Daniela Gonzalez , Moshirian Farahi Seyed Mohammad Mahdi , Dalexis Rose Darly , Darius Wina Paul , Bukaka Jacqueline , Balayulu-Makila Oléa , Luyeye Noble , Derivois Daniel , Rousseau Cécile
Published: October 2023

Background

Ebola virus disease (EVD) has been shown to be associated with poor mental health in affected zones. However, no study has yet explored its impact on adolescents’ mental health.

Aims

This study aimed to assess the prevalence and risk factors associated with depression and anxiety symptoms among adolescents in EVD-affected areas in the Equateur Province of the Democratic Republic of the Congo during the COVID-19 pandemic.

Method

A provincial sample of adolescents aged 12–17 years (M = 14.84, s.d. = 1.49) living in the 18 urban and rural areas affected by the 2018 EVD outbreak completed a two-wave longitudinal survey. Surveys assessed symptoms of depression and anxiety, exposure to Ebola, social support and sociodemographic information.

Results

A total of 490 participants completed the baseline and follow-up surveys, 50% of whom were female. Elevated and worsened depressive symptoms were observed among participants from the baseline (56.94%) to the follow-up (91.43%; z = −11.37, P < 0.001), whereas anxiety symptoms decreased from the baseline (36.33%) to follow-up (24.90%; z = 4.06, P < 0.001). The final generalised estimating equation model showed that anxiety symptoms decreased over time (B = −3.92, P < 0.001), while depression symptoms increased (B = 4.79, P < 0.001). Stigmatisation related to Ebola positively predicted anxiety (B = 5.41, P < 0.001) and depression symptoms (B = 0.4452, P = 0.009). Social support negatively predicted anxiety (B = −1.13, P = 0.004) and depression (B = −0.98, P < 0.001) symptoms but only moderated the association between stigmatisation and depression symptoms (B = −0.67, P < 0.001).

Conclusions

Most adolescents living in EVD-affected areas experience mental health issues. Stigmatisation related to EVD and living in urban areas are the most consistent predictors of mental health problems. Nevertheless, social support remains a protective factor for depression and anxiety symptoms and a necessary resource for building resilience.
The role of gender as a barrier to the professional development of psychiatrists
Authors: Kilic Ozge , Riecher-Rössler Anita , Galderisi Silvana , Gorwood Philip , Frangou Sophia , Pinto da Costa Mariana
Published: October 2023

Background

Despite efforts toward greater gender equality in clinical and academic psychiatry in recent years, more information is needed about the challenges in professional development within psychiatry, and how these may vary with gender.

Methods

A cross-sectional 27-item online survey was conducted with psychiatrists and psychiatric trainee members of the European Psychiatric Association.

Results

A total of 561 psychiatrists and psychiatric trainees from 35 European countries participated representing a response rate of 52.8% for women and 17.7% for men from a total sample of 1,580. The specific challenges that women face in their professional development fall into two categories. One comprised women’s negative attitudes concerning their abilities in self-promotion and networking. The other identified environmental barriers related to lack of opportunity and support and gender discrimination. Compared to men, women reported higher rates of gender discrimination in terms of professional advancement. Women were less likely to agree that their institutions had regular activities promoting inclusion, diversity, and training to address implicit gender bias. Working in high-income countries compared to middle-income countries relates to reporting institutional support for career progression.

Conclusions

These findings are an open call to hospital leaders, deans of medical schools, and department chairs to increase efforts to eradicate bias against women and create safer, inclusive, and respectful environments for all psychiatrists, a special call to women psychiatrists to be aware of inner tendencies to avoid self-promotion and networking and to think positively and confidently about themselves and their abilities.
Paraproteinemic Neuropathies
Authors: Beydoun Said R. , Darki Leila
Published: October 2023

OBJECTIVE

Coexistence of polyneuropathy and gammopathy is a common but potentially challenging situation in clinical practice. This article reviews the clinical, electrophysiologic, and hematologic phenotypes of the paraproteinemic neuropathies and the diagnostic and treatment strategies for each.

LATEST DEVELOPMENTS

Advances in our understanding of the underlying pathophysiology of various paraproteinemic neuropathies and their corresponding phenotypes have identified potential new therapeutic targets. Therapeutic strategies to diminish anti–myelin-associated glycoprotein (MAG) IgM antibodies have shown partial and inconsistent efficacy; however, antigen-specific immune therapy is being investigated as a novel treatment to remove the presumably pathogenic anti-MAG antibody. Advances in genetic and cell signaling studies have resulted in the approval of Bruton tyrosine kinase inhibitors for Waldenström macroglobulinemia. Monoclonal antibodies are being investigated for the treatment of light chain amyloidosis.

ESSENTIAL POINTS

Early recognition and treatment of underlying plasma cell disorders improves clinical outcomes in patients with paraproteinemic neuropathy. Despite significant progress, our knowledge regarding underlying mechanisms for paraproteinemic neuropathy is still limited. Clinicians’ awareness of clinical phenotypes, electrophysiologic hallmarks, and hematologic findings of the different paraproteinemic neuropathies is crucial to promptly identify and treat patients and to avert misdiagnosis. Multidisciplinary collaboration among specialists, including neurologists and hematologists, is paramount for the optimal treatment of these patients with overlapping conditions.
Enhancing Diabetes Care in LMICs: Insights from a Multinational Consensus
Authors: Miranda Jose Carlos , Raza S. Abbas , Kolawole Babatope , Khan Jahanzeb Kamal , Alvi Atiba , Ali Fariha Sadiq , Chukwudi Ejim Emmanuel , Ram Nanik , Oluwatoyin Amira
Published: October 2023

The International Cardio-Metabolic Forum held a plenary session to establish a multinational consensus on the challenges faced in diabetes management within lower-middle-income countries (LMICs) and their potential solutions. Stakeholders, including patients, family/caretakers, healthcare professionals, and healthcare policymakers & organizations, participated in discussions. The audience of 280 doctors from different countries (Pakistan, Qatar, Sri Lanka, Kenya, Myanmar, Georgia, Nigeria, Philippines, Uzbekistan, Iraq, Tanzania, Cambodia, Kazakhstan, South Sudan and Libya) was divided into 4 groups led by Group Leaders to represent each stakeholder group. Questionnaires addressing key challenges and solutions specific to each group were used to facilitate consensus development. Participants voted on relevant options based on their clinical experience. SLIDO software was used for polling, generating separate results for each group. The insights shared by healthcare professionals highlighted the importance of improving medication accessibility and cost-effectiveness for patients, emphasizing the need for adherence to treatment plans and lifestyle modifications. The significance of balanced nutrition with low glycemic index food for enhancing quality of life was recognized. Caregivers of diabetic patients with comorbidities face increasing demands for care, particularly in relation to age-related milestones. Healthcare professionals emphasized the challenges posed by cultural beliefs and health awareness, underscoring the importance of teamwork and early referral for managing comorbidities. Healthcare policymakers need to focus on disease education, awareness programs, screening guidelines, and advocacy for community and clinical screening. By addressing these challenges, a more comprehensive and effective approach to diabetes management can be achieved in LMICs, ultimately improving outcomes for individuals with diabetes.

doi: https://doi.org/10.12669/pjms.39.7.8881

How to cite this: Miranda JC, Raza SA, Kolawole B, Khan JK, Alvi A, Ali FS, et al . Enhancing Diabetes Care in LMICs: Insights from a Multinational Consensus. Pak J Med Sci. 2023;39(7):1899-1906. doi: https://doi.org/10.12669/pjms.39.7.8881

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.
Το σαξόφωνο στην Ελλάδα
Authors: Σωτηριάδης Θεόφιλος
Published: October 2023

Ο θεματικός κατάλογος της εργασίας αυτής παρουσιάζει με τρόπο συστηματικό 819 έργα, 274 Ελλήνων, Κυπρίων και συνθετών της Διασποράς που είναι καταγεγραμμένα σε μουσικό κείμενο, σε οποιαδήποτε διανομή περιλαμβάνεται σαξόφωνο (ορχηστρικά, σόλο, κονσέρτα κ.ά.) και αφορούν κυρίως την έντεχνη μουσική χωρίς χρονικό και τοπικό περιορισμό. Ο κατάλογος δεν περιλαμβάνει έργα που είναι γραμμένα υπό τη μορφή «οδηγών» μελωδικών και αρμονικών κινήσεων ή διέπονται κυρίως από την τέχνη του αυτοσχεδιασμού. Συγκροτήθηκε από τη σκοπιά του εκτελεστή-παιδαγωγού και απευθύνεται κυρίως σε εκτελεστές-παιδαγωγούς προκειμένου να τους κατευθύνει στην επιλογή του προτιμητέου μουσικού υλικού. Για κάθε έργο παρουσιάζονται βασικές κατηγορίες δεδομένων, βαθμός δυσκολίας, αντιστοιχία εκπαιδευτικού επιπέδου στην Ελλάδα και εκπαιδευτικοί στόχοι που εκπορεύονται από την υφολογική ανάλυση του έργου και τις ερμηνευτικές πρακτικές του σαξοφώνου, καθιστώντας έτσι τον κατάλογο χρηστικό εργαλείο για τον παιδαγωγό. Επίσης, περιλαμβάνονται διαθέσιμοι οπτικοακουστικοί σύνδεσμοι, στοιχεία έκδοσης / επικοινωνίας με τους δημιουργούς, επίσημη δισκογραφική παραγωγή με αναφορά και στους εκτελεστές και πλήθος στατιστικών αναλύσεων. Ενδιαφέρον παρουσιάζουν οι βιντεοσκοπημένες συνεντεύξεις συνθετών, ως αυθεντικές μαρτυρίες της σχέσης και αισθητικής των δημιουργών με το σαξόφωνο. Τέλος, στα παραρτήματα παρουσιάζονται συγκεντρωτικοί πίνακες με βάση τον ρόλο που διαδραματίζει το σαξόφωνο στη διανομή της ενορχήστρωσης σε συνάρτηση με τη φόρμα και το είδος της μουσικής το οποίο εκπροσωπεί (σόλο, ντουέτα, κονσέρτα, συμφωνική μουσική, μουσικό θέατρο, πολυμεσικό έργο κ.λπ.). Στη διατριβή συγκαταλέγεται κι ένα κεφάλαιο που πραγματεύεται την ιστορία του σαξοφώνου στην ελληνική και κυπριακή επικράτεια. Ο συγγραφέας επιχειρεί να ιχνηλατήσει τις απαρχές εμφάνισης του οργάνου στην περιοχή, να περιγράψει τη δράση του και να εντοπίσει τους συντελεστές της διαδρομής του, ακολουθώντας το νήμα του χρόνου σύμφωνα με τις εναλλαγές της αισθητικής της κάθε εποχής.
Cortical auditory potentials and cognitive potentials in individuals with and without vestibular dysfunction
Authors: Kumar Kaushlendra , S Krishnapriya , Ebenezer Anupriya , Kalaiah Mohan Kumar , D Deviprasad
Published: October 2023

Background: Among individuals with vestibular dysfunction, the loss of vestibular sensory information is found to alter cognitive abilities that coordinate spatial and non-spatial information. P300 is an event-related potential commonly used to assess cognitive processing. The aim of the present study was to compare the latency and amplitude of cortical auditory evoked potential and P300 between individuals with vestibular dysfunction and individuals with no vestibular dysfunction. Methods: Forty adults with a mean age of 40.5 ± 13.07 participated in the study. Group I included 20 adults diagnosed with vestibular dysfunction and group II included 20 age-matched adults with no vestibular dysfunction. The P300 was recorded from the electrode site Cz and Pz. It was elicited using pure-tones in odd-ball paradigm. The latency and amplitude of peaks P1, N1, P2, and N2 of the cortical auditory evoked potential and the P300 were measured. Results: Significant amplitude difference was observed in cortical potentials at Cz and Pz. The P300 was present only in 70% of individuals with vestibular dysfunction compared to 100% among individuals with no vestibular dysfunction. The mean amplitude of the P300 was slightly larger in group 1 compared to group 2 and the mean latency of the P300 was similar in both groups. However, the difference in amplitude of the P300 between groups was not statistically significant. Conclusions: Knowing the cognitive function of individuals with vestibular dysfunction enables planning vestibular rehabilitation therapy, which enhances the quality of life in these individuals by improving their vestibular and cognitive functions.
Game on: Can gamification enhance productivity?
Authors: Rahiman Habeeb Ur , Kodikal Rashmi , Suresh Sucharitha
Published: October 2023

Background: Research suggests that gamification can increase work engagement by providing employees with a sense of autonomy, competence, and relatedness, and by creating a fun and engaging work environment. Gamification is designed to increase consumer and employee engagement and see that they holistically collaborate to achieve a shared vision. The concept of gamification is as old as learning itself, just that the use of the terminology “Gamification” is of a recent origin. Methods: This article focuses on the impact of gamification in various organizations and simultaneously sees its relationship with job engagement and productivity. A primary investigation was done to determine the nexus between the various variables and data collection from 400 respondents working in various fraternities of the economy from both public and private domains from countries in the Gulf region. The structural equation model and SPSS has been inferred to analyse the results. Results: The study results show that variable such as perceived adoption and usefulness in the gamified system is significantly associated with job engagement. Similarly, employee’s recognition and perceived motivation have a positive impact on productivity. The study identified job engagement mediating factor to enhance organisational productivity in a gamified system. Conclusion: The effectiveness of gamification in enhancing work engagement may depend on factors such as the design of the gamification system, the preferences and motivations of individual employees, and the organizational culture and goals. The findings have significant implications for insight into how employees in the service sector are aware of the gamified working environment and react to the system through work engagement and productivity.
Prevalence, serovars, and risk factors associated with the presence of Salmonella in pork sold in public markets in Quito, Ecuador
Authors: Vinueza-Burgos Christian , Hidalgo-Arellano Luis , Gómez-Coronado Carlos , Medina-Santana José Luis , Cevallos-Almeida María
Published: October 2023

Background: Salmonella enterica are bacteria that include more than 2,500 serovars. Most of these serovars have been linked to human foodborne illnesses, mainly related to poultry and pigs. Thus, these animals are considered the reservoirs of many Salmonella serovars and strains related to antibiotic resistance. This study aimed to determine the prevalence, serovars, β-lactam resistance genes, and the risk factors associated with Salmonella enterica in pork commercialized in open markets of Quito city. Methods: For this, 165 pork meat samples were taken from municipal markets in three areas in the city. These samples were microbiologically processed following the ISO 6579-2014 standardized method. The polymerase chain reaction (PCR) test was used to identify Salmonella serotyping and resistance genes. Strains not identified by PCR were typed by the Kauffman White Le Minor scheme. A multivariate analysis was performed to identify risk factors associated with the presence of the microorganism. Results: Salmonella prevalence in pork was 9.1%. Identified serovars were 4, [5], 12: i:- (53.3%), Infantis (33.3%), and Derby (13.4%). Furthermore, the β-lactam resistance genes bla CTX-M-65 could be identified in three S. infantis isolates. Multivariate analysis showed that temperature (above 8°C) and cutting surfaces (wood) presented significant association values. Conclusions: This research represents the first report of several epidemiological aspects of Salmonella in pork in Ecuador.
Carbon footprint of Nepalese healthcare system: A study of Dhulikhel Hospital
Authors: Adhikari Bikash , Dangal Ambika , Pandey Sushila , Thapa Bijay , Joshi Ashim , Baral Bivek
Published: October 2023

Background: Though direct greenhouse gas emissions cannot be observed in health care sectors, there can exist indirect emissions contributing to global climate change. This study addresses the concept of the carbon footprint and its significance in understanding the environmental impact of human activities, with a specific emphasis on the healthcare sector through gate-to-gate (GtoG) life cycle assessment. Transportation, energy consumption, and solid waste generated by hospitals are the primary sources of carbon emissions. Methods: Different standards, guidelines and parameters were used to estimate emissions from both the primary and secondary data. All steps and sub-steps involved in GtoG were accessed and analyzed within the standard ISO 14040:44 guideline. An extensive review of existing literature was carried out for the evaluation and verification of secondary data. Results: The total carbon footprint of generators, electricity consumption, transportation activities, LPG cylinders, PV systems was found to be 58,780 kg-CO2-eq/yr, 519,794 kg-CO2-eq/yr, 272,375 kg-CO2-eq/yr, 44,494 kg-CO2-eq/yr, 35,283 kg-CO2-eq/yr respectively and the emissions from non-biodegradable solid waste was found to be 489,835 kg-CO2/yr. Local air pollutants such as PM10, CO, SO2, NOX, and VOCs generated by generators and transportation were also estimated. The CH4 emissions from liquid waste were 1177.344 kg CH4/BOD yr, and those from biodegradables were 3821.6954 kg CH4/yr. Conclusions: Healthcare professionals and policymakers can take action to reduce the sector's carbon footprint by implementing best practices and encouraging sustainable behavior. This study can be taken as foundation for further exploration of indirect emissions from healthcare sectors not only in Nepal but also in south Asian scenario.
A Circularly Polarized Antenna for UHF Satellite Communication Applications
Authors: Chitambara Rao K. , Lakshmun M. , Nataraj D. , Vinutna Ujwala G. , Chakradha K. S.
Published: October 2023

There is a tremendous demand for antennas with very broad bandwidth and gain so that one antenna can cover the entire frequency range of the satellite communication applications, which are rapidly expanding with the current technology for diverse platforms. Helical antennas are ideal for these applications due to their distinctive qualities such as circular polarization, wide bandwidth, excellent gain, and low-profile conformability. For transmitting and receiving applications, which comprise frequency ranges of 240MHz to 270MHz and 290MHz to 320MHz, respectively. A new design of circularly polarized double-wire helical antenna employing the butterfly approach has been created in this study. An antenna was designed, simulated, analyzed, and fabricated before being experimentally measured for important parameters such as axial ratio, gain, 3dB beamwidth, and voltage standing wave ratio.
Development of an artificial neural network for ECG classification
Authors: Kireeva Kseniya , Korobova Lyudmila Lyudmila Anatol'evna , Arapov Denis
Published: October 2023

The paper presents a solution to the problem of developing an artificial neural network for classifying electrocardiograms in order to identify a patient's cardiovascular diseases. A literary review of the use of artificial neural networks for use in medicine in the determination of various cardiac pathologies in the condition of patients has been carried out. The most significant six parameters of the heart rhythm have been determined, which can be used in neural network modeling of the state of the human cardiovascular system. An analysis of the capabilities of well-known commercial programs for the classification of electrocardiograms was carried out, their advantages and disadvantages were identified. The capabilities of modern devices for taking cardiograms are described with an indication of the accuracy of their measurements. A study of three different structures of the desired neural network was carried out and the best option was chosen. The software package is made in Python in the Pycharm 2023.1 environment. The network was trained on the basis of the error backpropagation algorithm, the Adam method served as an optimizer. The standard deviation of the network output signal from the standard was used as a criterion. The Softmax function used in the output layer is used to convert the output of neurons into probabilities. Thus, a neural mathematical model for detecting heart diseases has been developed, which has low system requirements for a computer, which can be used to develop software for wearable electronics. An artificial neural network has the following metric: accuracy - 90%, sensitivity - 90%, specificity - 10%.
Development of a mathematical model for optimizing the process of training cadets of law enforcement agencies in higher educational institutions as a complex system
Authors: Sumin Viktor , Dubrovin A. , Rodin S. , Zolnikov V.
Published: October 2023

This article discusses the problem of developing a mathematical model to describe the process of training cadets of law enforcement agencies in higher educational institutions, which are a complex system. Currently, reality places high demands on the qualifications and personal qualities of law enforcement officers, which in turn requires the relevant educational organizations to carry out advanced professional training of specialists. The functioning of higher educational institutions of law enforcement agencies is influenced by objective and subjective factors. To this end, in order to increase the efficiency of managerial decision-making in the process of training cadets of law enforcement agencies in higher educational institutions, it is proposed to use a mathematical model of training and education of a group of cadets, developed on the basis of the method of operations research, specifically the theory of Markov random processes that occur during continuously changing time and use discrete states of the system. The mathematical model of training and education of a group of cadets in its functioning uses streams of events that have the properties of stationarity and ordinariness. The process of transition from one state to another is described in the form of a marked graph of states with a transition probability density. Setting the intensity of the event flows will allow you to find the limiting probabilities and predict the states in which the study group is located. This approach will reduce the level of subjectivity of university staff and will allow structuring and optimizing the process of assessing the level of knowledge of cadets.