12th December Research Articles

Kampania podhalańska I Brygady Legionów Polskich (listopad-grudzień 1914)

THE PODHALE CAMPAIGN BY THE 1ST BRIGADE OF THE POLISH LEGIONS (NOVEMBER-DECEMBER 1914)The article describes an episode from the battles fought in the first year of World War I between the Russian army entering West Galicia and the Austro-Hungarian army defending Krakow. Polish military units organised by Józef Piłsudski within the Austro-Hungarian army, organised into the 1st Infantry Regiment, also took part in the battles conducted from 23 November to 12 December. The Legionnaires' task was to halt the Russian advance, which was approaching Kraków in the second half of November that year. The 1st Infantry Regiment of the Polish Legions was attached to the Hungarian corps commanded by General Gyul Nagy which was to attack the Russian troops heading for Kraków from the south-west. The legionnaires, who were then in the village of Zawoja in difficult terrain conditions, with no artillery of their own and limited supplies, not only managed to stop the Russian advance, but also began to drive the Russian troops out of the areas they had occupied. Of particular note were two major battles at Limanowa and Marcinkowice, which Józef Piłsudski's subordinates had to fight at the time. The campaign ended with the entry of legionary troops into Nowy Sącz on 12th December 1914.

Diagnostic Accuracy of Transabdominal Ultrasound in the Diagnosis of Ectopic Pregnancy Taking Transvaginal Ultrasound as the Gold Standard

Background: The diagnostic accuracy of transabdominal ultrasound in the diagnosis of ectopic pregnancy has rarely been studied in our population. Hence, the study has been planned. Objective: This study aimed to determine the accuracy of transabdominal ultrasound in the diagnosis of ectopic pregnancy, transvaginal ultrasound was used as the gold standard. Materials and Methods: This cross-sectional study was carried out at the Department of Radiology, Northwest General & Research Centre, Peshawar, from 12th June 2022 until 12th December 2022. Patients aged 15--45 years presenting with signs and symptoms of ectopic pregnancy were enrolled. Transabdominal ultrasound was performed, and the diagnostic accuracy was compared with that of transvaginal ultrasound to determine the diagnostic accuracy. The data were analysed via SPSS version 25. Results: A total of 143 patients were enrolled. The mean age of the patients was 30.01±5.518 years. The majority of the patients were aged less than 30 years (n = 84, 58.7%). The sensitivity, specificity, PPV, NPV and accuracy of transabdominal ultrasound were 93.9%, 100.0%, 100.0%, 57.8% and 94.4%, respectively. Conclusion: The clinical spectrum of ectopic pregnancy is very wide. Transabdominal ultrasound is a useful noninvasive diagnostic tool for the diagnosis of ectopic pregnancy.

Hydro-thermal conditions and their impact on irradiance and hygro-thermal use efficiency of wheat in central Punjab

The experiments were conducted to develop indices to provide critical insights into crop phenology and yield responses of wheat to thermal and moisture conditions during rabi 2021-22 and 2022-23 at PAU, Ludhiana, Punjab. The wheat variety Unnat PBW was sown on three dates (D1: 27th October, D2: 17th November, D3: 8th December) under three irrigation regimes (I1: irrigations at CRI, Jointing, 50% Flowering, Soft dough stages, I2: irrigations at CRI, Flag leaf emergence, soft dough stage, I3: irrigations at Jointing, Soft dough stage). Results revealed that the crop sown on 27th October acquired maximum number of calendar days and various heat indices viz. growing degree days (GDD), solar thermal degree days (STDD) and hygrothermal units (HGTU) for attaining physiological maturity while 8th December sown crop resulted in lowest accumulation. However, late sown crop was observed to accumulate more STDD. Wheat sowing before 17th November resulted in higher grain yield and energy use efficiencies. Four irrigations at critical stages took highest GDD, STDD and HGTU for attaining maturity which was at par with two irrigations. Application of four irrigations resulted in significantly higher yield and energy use efficiencies. Similar performance of three irrigations was observed when irrigation was not skipped at anthesis stage.

The association between health literacy and quality of life of patients with type 2 diabetes mellitus: A cross-sectional study.

Health literacy-driven interventions in patients with type 2 diabetes have been found to play an important role in achieving glycemic control and enhancing diabetic self-management outcomes. The present study aimed to examine the role of health literacy as a predictor of quality of life among diabetic patients in Jordan. This cross-sectional study enrolled 400 Type 2 diabetic patients visiting the endocrinology department at the outpatient clinic at Al Basheer Hospital in Amman, Jordan. The data were collected between 1st of August and 28th of December 2023, using the validated Jordanian Diabetic Health Literacy Questionnaire and the EuroQol-5D tool. A quantile regression analysis was conducted to explore the factors associated with health-related quality of life among the study participants. This study included 68.8% females, with a median age of 58 (50-64) years. The median EQ5-D index score was 0.66 (0.41-0.78). Findings from regression analysis indicated as patients' age increased, their quality of life scores significantly decreased (-0.004, 95%CI (-0.006, -0.001), p = 0.002). Additionally, higher JDHLQ scores were significantly associated with higher EQ5-D scores (0.012, 95% CI (0.006-0.018), p<0.001). Moreover, patients with only an elementary education had significantly lower EQ5-D scores compared to those with a postgraduate education (-0.106, 95%CI (-0.190, -0.023), p = 0.013). The findings of the present study emphasize the importance of including health literacy assessments and interventions in the diabetes care plans of patients in Jordan.

Interventions to reduce opioid use for patients with chronic non-cancer pain in primary care settings: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to assess interventions to reduce opioid use for patients with chronic non-cancer pain (CNCP) versus usual care or active controls in primary care settings. In this registered study (PROSPERO: CRD42022338458), we searched MEDLINE, Embase PsycInfo, CINAHL, and Cochrane Library from inception to December 28th 2021, and updated on Dec 14th 2023 for randomized controlled trials (RCTs) and cohort studies with no restrictions. Methodological quality was assessed using the Cochrane Risk of Bias tool for RCTs and Newcastle Ottawa Scale for cohort studies. Primary outcomes included mean reduction in morphine equivalent daily dose (reported as mean differences [MDs] mg/day; 95% confidence intervals [95%CIs]) and/or opioid cessation proportion. Secondary outcomes were mean changes in pain severity (reported as standardized mean difference [SMDs]; 95%CIs) and (serious) adverse events. Meta-analyses were performed using random-effects models. We identified 3,826 records, of which five RCTs (953 participants) and five cohort studies (901 participants) were included. Overall, opioid dosage was significantly reduced in intervention groups compared to controls (MD: -28.63 mg/day, 95%CI: -39.77 to -17.49; I2 = 31.25%; eight studies). Subgroup analyses revealed significant opioid dose reductions with mindfulness (MD: -29.36 mg/day 95%CI: -40.55 to -18.17; I2 = 0.00%; two trials) and CBT-based multimodalities (MD: -41.68 mg/day; 95%CI: -58.47 to -24.89; I2 = 0.00%; two cohort studies), respectively, compared to usual care. No significant differences were observed in opioid cessation (Odds ratio: 1.10, 95%CI: -0.48 to 2.67, I2 = 58.59%; two trials) or pain severity (SMD: -0.13, 95%CI: -0.37 to 0.11; I2 = 33.51%; three trials). Adverse events were infrequently examined, with withdrawal symptoms commonly reported. The studied interventions were effective in reducing opioid dosage for people with CNCP in primary care. They highlighted the importance of multidisciplinary collaboration. Large-scale RCTs measuring the long-term effects and cost of these interventions are needed before their implementation.

EP334 - What does ERAS mean to foundation doctors?

Abstract Aims To quantify the Enhanced Recovery After Surgery (ERAS) protocol knowledge of foundation doctors on the general surgical rotation from August 2023 to December 2023. ERAS protocol has decreased recovery time, length of stay, complications, and readmission rates. [1] ERAS protocol can be categorised into 5 domains: diet, pre-operative medications including bowel preparation, post-operative medications including nutritional drinks, mobilisation, and discharge. Foundation doctors should be aware of the details within ERAS protocol. Methods Survey questions were devised alongside a senior registrar to probe foundation doctors understanding of ERAS protocol. The questions were either single best answer questions out of 5 or had multiple correct answers. Foundation doctors who worked on general surgery between 2nd August 2023 and 5th December 2023 undertook this survey, carried out from 6th December 2023 to 28th January 2024. There were 10 respondents to the survey, out of 21 foundation doctors. Results Out of 10 surveys, foundation doctors correctly answered 47% of questions, with scores ranging from 36% to 57%. On further sub analysis the lowest scoring domains were mobilisation (21%), medication (post-op) (23%), and medication (pre-op) (50%). Conclusions Foundation doctors should have more knowledge of the ERAS protocol to improve the quality of patient care. Our proposed method of improving this involves presenting study findings and the ERAS protocol to foundation doctors at the next departmental Clinical Governance meeting, alongside ERAS nurses and senior team members. We aim to re-audit to identify whether an ERAS induction makes a difference to their understanding of ERAS.

Characteristics of paediatric injuries as predictors of 24-hour disposition from the Emergency Department of a teaching hospital in Southwestern Uganda

BackgroundPaediatric injuries are among the leading causes of morbidity and mortality globally, especially in low- and middle-income countries. We aimed to characterize paediatric injuries as predictors of disposition from Mbarara Regional Referral Hospital Emergency Department (ED) Southwestern Uganda. MethodsThis was a prospective cohort study done from 12th December 2022 to 31st March 2023. We described the characteristics of injuries sustained by children and evaluated the predictors of 24-hour disposition from the ED using logistic regression. ResultsOf the 160 children followed up, 64.4% were male with a median age of 7 years, brought in with road traffic accidents (RTAs) (40.6%) and falls (35.6%) as the commonest mechanism of injury. Over half of the patients were triaged as yellow (urgent); polytrauma and head injuries were the top injury patterns. The majority (45.6%) of the children were admitted to the inpatient surgical ward. Only 1.9% and 5.0% ended up in intensive care unit (ICU) and died (to mortuary), respectively. The median time to disposition was 8 h and 14% stayed in the ED beyond 24-hours. Patients who needed more intensive initial treatment, including additional medications or interventions, were significantly more likely to be admitted to the ward (AOR= 5.3, 95%CI: 2.0-13.0, p <0.01). ConclusionPaediatric injuries were caused mainly by RTAs and presenting with polytrauma and head injuries. Most patients were disposed of to the inpatient surgical ward within 24 h with severe KTS and initial management being strongest predictors of admission. These findings can be used to tailor quick risk stratification and decision-making tools and improve ED disposition of paediatric injuries in Low- and Middle- income countries.

Do psychological treatments for PTSD in children and young people reduce trauma-related appraisals? A systematic review and meta-analysis

Research is increasingly highlighting the role of negative trauma-related appraisals in child and adolescent post-traumatic stress disorder (PTSD). The cognitive model of PTSD claims that an essential mechanism of treatment is a reduction in these appraisals. The current systematic review with meta-analysis investigated the extent to which psychological treatments for PTSD reduce negative trauma-related appraisals in children and adolescents. Four databases (PsycINFO, Medline Complete, CINAHL Complete and PTSDpubs) were searched on the 11–12th December 2022. The Risk of Bias 2 (ROB-2) tool was used to assess for risk of bias. Thirteen studies were included in this review, comprising 937 child and adolescent participants. Using a random effects model to perform the meta-analysis, a medium pooled effect size for the effect of current treatments on trauma-related appraisals was found (g = −.67, 95% CI [-.86, −.48]). There was only a moderate level of heterogeneity between studies (I2 = 44.4%), increasing the confidence with which these findings can be interpreted. These results indicate that psychological treatments for child and adolescent PTSD significantly reduce negative trauma-related appraisals. However, it is important to note that no trial included in the review was categorised as having low risk of bias.

Forensic age estimation of adolescents using computed tomography of the clavicles.

In forensic age estimation, CT imaging of the clavicles is used to determine an age over completed 21years. If ossification of the medial clavicular epiphysis is complete, young men are assumed to be over 21years of age. The aim of this study is to check the statistical parameters (specificity, predictive probability) for the characteristic "completed ossification of the medial clavicles". 285 male patients who, for various reasons, received a chest CT at the Medical Center of the University of Freiburg between 1st December 2019 and 6th December 2022 were screened for the study, of whom 203 patients were included in the study. The stage of clavicular ossification was classified as stage 1 - 5 according to Schmeling. While 70 out of 71 patients under 21years of age were correctly estimated to be under 21years of age, there was one patient whose ossification on one side was classified as stage 4 and who would therefore have been estimated to be over 21years of age. If only subjects whose ossification stage was the same on both sides are included, the specificity of the test method is 100% and the positive predictive probability is 100%. If patients for whom only one side is stage 4 are also included, the specificity is 98.6%. Thus, only the complete and symmetrical ossification of both clavicles (stage 4 according to the Schmeling classification) in a standardised thin-layer CT can be classified as a reliable indicator of an age over 21years in young men. In the case of asymmetric ossification of the medial clavicles (stage 4 is not reached on one side), false positive evaluations and the incorrect assumption of an age over 21years can occur.

Report on the 2nd international molecular biosciences PhD and postdoc conference 2023: The emerging challenge - environmental impacts on human health.

The 2nd International FEBS-IUBMB-ENABLE Molecular Biosciences PhD and Postdoc Conference was held from 23rd to 25th November 2023 in Cologne, Germany. Over 240 participants from 31 different countries came together at the University of Cologne to follow the two-day scientific symposium and the career day. This year's topic was "The emerging challenge - environmental impacts on human health". In four different sessions, eight renowned keynote speakers presented their current research. By offering flash and short talks, 39 participants were able to present their work in front of a big audience. Scientific exchange and networking were encouraged during the two poster sessions, during breaks, and the conference dinner. On the Career Day, a career fair was held and participants could attend workshops as well as career chats to improve their job prospects. The success of the series will be continued during the next conference edition: "Artificial Intelligence - Reshaping biomedical and healthcare research", which will take place 4th to 6th December 2024 in Singapore.

Associations between recorded loneliness and adverse mental health outcomes among patients receiving mental healthcare in South London: a retrospective cohort study

PurposeLoneliness disproportionately affects people with mental disorders, but associations with mental health outcomes in groups affected remain less well understood.MethodA cohort of patients receiving mental healthcare on 30th June 2012 was assembled from a large mental health records database covering a south London catchment area. Recorded loneliness within the preceding 2 years was extracted using natural language processing and outcomes were measured between 30th June 2012 until 30th December 2019, except for survival which applied a censoring point of 6th December 2020 according to data available at the time of extraction. The following mental healthcare outcomes: (i) time to first crisis episode; (ii) time to first emergency presentation; (iii) all-cause mortality; (iv) days active to service per year; and (v) face-to-face contacts per year.ResultsLoneliness was recorded in 4,483 (16.7%) patients in the study population and fully adjusted models showed associations with subsequent crisis episode (HR 1.17, 95% CI 1.07–1.29), emergency presentation (HR 1.30, 1.21–1.40), days active per year (IRR 1.04, 1.03–1.05), and face-to-face contacts per year (IRR 1.28, 1.27–1.30). Recorded loneliness in patients with substance misuse problems was particularly strongly associated with adverse outcomes, including risk of emergency presentation (HR 1.68, 1.29–2.18) and mortality (HR 1.29, 1.01–1.65).ConclusionPatients receiving mental healthcare who are recorded as lonely have a higher risk of several adverse outcomes which may require a need for higher service input.

Sapovirus: an emerging pathogen in kidney transplant recipients?

PurposeDiarrhea is an important cause of morbidity and mortality in immunocompromised patients. After including sapovirus to the viral gastroenteritis screening of our institution’s laboratory, we noticed an increase in sapovirus infections among kidney transplant recipients. Therefore, we assumed former gastrointestinal tract infections with unidentified pathogens could have been caused by sapovirus. To better understand the characteristics of a sapovirus infection in a high-risk group we initiated this study.MethodsOver a period of 6 months, all transplant recipients with diarrhea and later identified viral/unknown pathogens were included. Kidney function, levels of immunosuppressants and c-reactive protein, acid–base balance, onset of symptoms and time of hospitalization were analyzed.ResultsAmong 13 hospitalized kidney transplant recipients sapovirus was detected in four patients, while in the remaining nine, three were diagnosed with norovirus, one with cytomegalovirus, one with inflammatory bowel disease and in four patients no pathogen was identified. Even though statistically not significant, creatinine levels at admission tended to be higher in sapovirus patients (median: sapovirus: 3.3 mg/dl (1.3; 5.0), non-sapovirus: 2.5 mg/dl (1.1; 4.9), p = 0.710). Also, Tacrolimus levels showed the same trend (sapovirus: 13.6 ng/ml (12.9; 13.6), non-sapovirus: 7.1 ng/ml (2.6; 22.6), p = 0.279). On discharge creatinine levels improved equally in both groups (sapovirus: 1.7 mg/dl (1.4; 3.2), non-sapovirus: 2 mg/dl (1.0; 3.6), p = 0.825).ConclusionIn high-risk patients, early symptomatic treatment remains crucial to protect the transplant`s function. In our cohort all patients recovered well. Larger cohorts and longer follow-up times are needed to detect the long-term consequences and a potential need for further research regarding specific treatment.Trial registrationThe study has been registered on DRKS (trialsearch.who.int), Reg. Nr. DRKS00033311 (December 28th 2023).

A phase I open-label, dose-escalation study of NUC-3373, a targeted thymidylate synthase inhibitor, in patients with advanced cancer (NuTide:301)

Purpose5-fluorouracil (5-FU) is inefficiently converted to the active anti-cancer metabolite, fluorodeoxyuridine-monophosphate (FUDR-MP), is associated with dose-limiting toxicities and challenging administration schedules. NUC-3373 is a phosphoramidate nucleotide analog of fluorodeoxyuridine (FUDR) designed to overcome these limitations and replace fluoropyrimidines such as 5-FU.Patients and methodsNUC-3373 was administered as monotherapy to patients with advanced solid tumors refractory to standard therapy via intravenous infusion either on Days 1, 8, 15 and 22 (Part 1) or on Days 1 and 15 (Part 2) of 28-day cycles until disease progression or unacceptable toxicity. Primary objectives were maximum tolerated dose (MTD) and recommended Phase II dose (RP2D) and schedule of NUC-3373. Secondary objectives included pharmacokinetics (PK), and anti-tumor activity.ResultsFifty-nine patients received weekly NUC-3373 in 9 cohorts in Part 1 (n = 43) and 3 alternate-weekly dosing cohorts in Part 2 (n = 16). They had received a median of 3 prior lines of treatment (range: 0–11) and 74% were exposed to prior fluoropyrimidines. Four experienced dose-limiting toxicities: two Grade (G) 3 transaminitis; one G2 headache; and one G3 transient hypotension. Commonest treatment-related G3 adverse event of raised transaminases occurred in < 10% of patients. NUC-3373 showed a favorable PK profile, with dose-proportionality and a prolonged half-life compared to 5-FU. A best overall response of stable disease was observed, with prolonged progression-free survival.ConclusionNUC-3373 was well-tolerated in a heavily pre-treated solid tumor patient population, including those who had relapsed on prior 5-FU. The MTD and RP2D was defined as 2500 mg/m2 NUC-3373 weekly. NUC-3373 is currently in combination treatment studies.Trial registrationClinicaltrials.gov registry number NCT02723240. Trial registered on 8th December 2015. https://clinicaltrials.gov/study/NCT02723240.

Effect of Sowing Date on Growth and Yield of Different Carrot Varieties (Daucus carota L.)

A study was conducted at Agriculture and Forestry University, Rampur, Chitwan, from October 2019 to March 2020 to evaluate the effect of sowing date on the growth and yield of four different carrots (Daucus carota L.) varieties. The experimental treatments were three different sowing dates (19th October, 13th November, and 8th December) and four varieties (New Kuroda, Nepa Dream, SK3, and Taki) which constituted 12 treatments. The experiment was set up using a randomized complete block design with three replications. The results revealed that sowing dates and varieties significantly influenced the growth and yield of carrots. But interaction effect was not significant. Maximum plant height, number of leaves per plant, leaf length, leaf breadth, canopy diameter, root length (15.37 cm), root diameter (2.74 cm), and fresh root weight (133 g) were obtained with Nepa Dream variety. Similarly, the highest plant height, number of leaves per plant, leaf breadth, canopy diameter, root diameter (3.27 cm), root length (16.23 cm), and fresh root weight (162.60 g) was obtained with first sowing (19th October) which might be due to favorable condition available during the growing condition and also early sowing possibly attributed to maximum photosynthesis with longer growth period than the later sowing. The combined effect of sowing date and varieties was significant with the number of leaves per plant, cortex diameter, and core-to-cortex ratio. So based on the results of the experiment, Nepa Dream sown on 19th October was economically better for the optimum yield and quality production in Chitwan, Nepal.

The risk of acute disseminated encephalomyelitis (ADEM) following covid-19 vaccination in England: A self-controlled case-series analysis

ABSTRACT Acute disseminated encephalomyelitis (ADEM) has been identified as an Adverse Event of Special Interest in the COVID-19 vaccine programme due to its long-standing temporal association with a wide range of other vaccines. Case reports of ADEM shortly following COVID−19 vaccination have now been documented. There were 217 ADEM admissions in 215 individuals in the period 8th December 2020 to 31st March 2023. An increased risk of ADEM following the first dose of ChAdOx1 vaccine was observed (relative incidence (RI) = 3.13, 95% Confidence Interval (CI) [1.56–6.25]) with a vaccine attributable risk of 0.39 per million doses. When doses 1 and 2 were combined this increased risk remained just significant (1.96 [95%CI 1.01–3.82]). No significant increased risk was observed with any other vaccine or dose. This small, elevated risk after the first dose of ChAdOx1-S vaccine demonstrates how large national electronic datasets can be used to identify very rare risks and provides reassurance that any risk of ADEM following the ChAdOx1-S COVID-19 vaccination is extremely small. Given the rarity of this risk, further studies in settings with access to data on large populations should be carried out to verify these findings.

Faktor-Faktor Yang Berhubungan Dengan Kunjungan K4 Ibu Hamil Di Puskesmas Lubuk Buaya Tahun 2023

An antenatal care visit is a visit of a pregnant woman to a health worker as early as possible since she must trust her to get antenatal care services. An assesment of the implementation of antenatal care services can be done by looking at the coverage of K1 and K4. This study was conducted in Lubuk Buaya Primary Health Centre at december 28th 2022- February 20th2023 with a cross sectional design. Thirty nine sample was taken by total population technique to all pregnant women who give birth in Lubuk Buaya Primary Health Centre. Data was collected use questionnaire, processed data and analyzed by univariate and bivariate. Results of this study found 23.5% respondents did not have complete visit, 12.5% respondents had a low level of knowledge, 56.4% respondents have negative attitude, and 33.3% respondents did not have husband’s support. Statistical analysis shows correlation between complete visit (p&lt;0.05) with knowledge (p=0.007) and husband’s support (p=0.039) and no correlation with attitude (p=0.052). We can conclude that there is a correlation between knowledge and family support with complete visit coverage. However, there is no correlation between attitude and complete visit.

“It is because the treatment of this lady is a cascade”: Accumulation of delays and the occurrence of obstetric emergencies in an urban maternity unit in Tanzania

ObjectiveTo explore healthcare workers’ and women's experiences of providing and seeking childbirth care in a busy urban maternity facility in Tanzania. DesignA qualitative study with observations, in-depth interviews, and informal conversations, using thematic network analysis. SettingThis study was conducted in a busy urban maternity unit in Dar es Salaam, Tanzania which is a low-resource setting with a need to improve childbirth care. ParticipantsSix frontline healthcare providers and four hospital managers from the facility, along with six postpartum women who gave birth at the facility. FindingsDelays were observed throughout the childbirth care cascade, encompassing various stages. During antenatal care, timely provision of care was hindered by a high patientto-provider ratio, resulting in inadequate monitoring of risk factors. At the onset of labor, women delayed seeking care, sometimes, attempting a trial of labor after a previous Caesarean section. Within the facility, delays in care decision-making and patient management were evident due to insufficient resources. The accumulation of these delays over time influenced the quality of care provided and challenged the management of obstetric emergencies at the study facility. Key conclusionsThe study findings show that delays are prevalent throughout the entire childbirth care cascade. The accumulation of these delays over time has influenced the quality of care provided at the facility and increased the vulnerability of women experiencing obstetric emergencies. To effectively address the imperative of reducing maternal mortality in low-resource settings, it is essential to develop appropriate interventions that span the entire spectrum of childbirth care. Additionally, further research is needed to delve into the complexities of care decision-making and the quality of care delivered within urban maternal facilities. Implications for practiceOur findings stress the need for comprehensive childbirth interventions and contextspecific guidelines to address challenges across the care cascade, particularly in lowresource settings. Urgent attention is required to prioritize care during patient triage and address systemic challenges within the healthcare system to improve birth outcomes and ensure effective facility-based care provision.Trial registration number: NCT04685668Date of initial trial registration: December 28th, 2020

Implementing digital respiratory technologies for people with respiratory conditions: A protocol for a scoping review.

The value of 'data-enabled', digital healthcare is evolving rapidly, as demonstrated in the COVID-19 pandemic, and its successful implementation remains complex and challenging. Harmonisation (within/between healthcare systems) of infrastructure and implementation strategies has the potential to promote safe, equitable and accessible digital healthcare, but guidance for implementation is lacking. Using respiratory technologies as an example, our scoping review process will capture and review the published research between 12th December 2013 to 12th December 2023. Following standard methodology (Arksey and O'Malley), we will search for studies published in ten databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, Scopus, IEEE Xplore, CABI Global Health, and WHO Medicus. Our search strategy will use the terms: digital health, respiratory conditions, and implementation. Using Covidence, screening of abstracts and full texts will be undertaken by two independent reviewers, with conflicts resolved by a third reviewer. Data will be extracted into a pilot-tested data extraction table for charting, summarising and reporting the results. We will conduct stakeholder meetings throughout to discuss the themes emerging from implementation studies and support interpretation of findings in the light of their experience within their own networks and organisations. The findings will inform the future work within the ERS CONNECT clinical research collaboration and contribute to policy statements to promote a harmonised framework for digital transformation of respiratory healthcare.

The Hidden Impact of Covid-19 on Memory: Disclosing Subjective Complaints.

A significant body of research has suggested that the contraction of SARS-CoV-2 may cause memory impairment, even in the months following recovery. In this regard, studies suggest that COVID-19 predominantly targets structures and cortices within the temporal lobe, and the hippocampus, a critical brain structure for memory and spatial navigation.The purpose of this study was to investigate the potential impact of the COVID-19 pandemic on subjective memory complaints, which represent an individual's perception of subtle changes in memory in the absence of an objective memory impairment. to explore how the COVID-19 pandemic may affect subjective memory complaints, we incorporated ad hoc self-reported measures of subjective memory complaints, the "Subjective Memory Complaints Questionnaire" (SMCQ) and the "Prospective and Retrospective Memory Questionnaire" (PRMQ), in our cross-sectional study. Both measures referred to two periods: the pre-pandemic period (T0) and the moment of survey administration (T1) (December 28th, 2021, to February 6th, 2022). 207 Italian participants accessed the survey, out of which 189 participants were included in the final sample. The majority of the participants were females, and their age ranged from 55 to 65 years. The study revealed a significant increase in the total PRMQ score at T1 compared to T0 (p = 0.02). However, no significant differences were found between PRMQ and SMCQ scores of COVID-19-negative individuals and those who tested positive for COVID-19 in the last 12 months from the date of completing the survey. McNemar's test showed a statistically significant increase in the score of item 1 ("Do you think that you have a memory problem?" (p = 0.016) and item 10 ("Do you lose objects more often than you did previously") (0.019) of the SMCQ, while for the PRMQ, significant increases were found in several individual items. our study suggests that subjective memory complaints increased during the pandemic, potentially due to the compound effects of stress and social isolation, rather than solely due to COVID-19 infection. Although a marginal association between COVID-19 and reported prospective memory issues was detected, further investigation is warranted to understand its persistent effects.

MAPPING TOEFL PREDICTION SCORE RESULT BASED ON CEFR STANDARD AND TEST TAKERS’ PREPARATION PATTERN

TOEFL Prediction score can also be seen as the benchmark of English Language Competence of the institution. This study looked into the types of preparation and the length of preparation and TOEFL Preparation Score result. The data were collected from 2 sources: online survey and the score compilation record from Pusat Studi Bahasa (PSB) Unpatti. There were 702 respondents to the survey which was distributed from November 9th to December 28th 2022. The respondents were TOEFL Prediction test-takers from Unpatti Ambon, PSDKU Aru, PSDKU MBD, and general Public. The result from the data analysis shows that 87.5% of test-taker have some sort of preparation before the test, the most common type of preparation is self-study (85,5%), and the most common length of preparation taken by test-takers is on average 1 week (70,5%). Lastly, overall test score indicated that majority of test takers (71.65%) were in A2 level and 26.64% were in A1 level based on CEFR. This suggested that 89.9% the graduates (test-takers) may be failing when competing in the world of job seeking and scholarship hunting.