Confusion Factors Research Articles

Impact of SLGT2 inhibitors treatment initiation on the reduction of atrial and ventricular arrhythmias in patients with implanted cardiac defibrillator

Abstract Introduction Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) have been associated with improved prognosis in patients with heart failure; however, their impact on atrial arrhythmic (AA) and ventricular arrhythmic (VA) events is not fully understood. Methods Retrospective multicentric study of heart failure patients with implantable cardiac defibrillator device (ICD) from 2015 to 2020 with or without cardiac resynchronization therapy (CRT) receiving SGLT2 inhibitors. Device-registered arrhythmic events were analyzed and compared in two time periods for each patient: one year before and one year after starting SGLT2i. Relevant VA were defined as the occurrence of any sustained VT (SVT) (>30 seconds), ventricular fibrillation (VF), or appropriate therapy (antitachycardia pacing or shock). All VA included all the relevant VA and the occurrence of non-sustained ventricular tachycardia (NSVT). AA included atrial fibrillation (AF) burden, and episodes of more than 24 hour of AF. Results A total of 195 patients (66.8 [61.3-73.1] years, 18.5% women) were included. A reduction was observed in the percentage of patients with any VA (pre: 52.3% vs post: 30.3%; P < 0.001) and clinically relevant VA (excluding NSVT) (pre: 21.5% vs post 8.7%; P < 0.001) in the post-SGLT2i period. There was also a reduction in the number of episodes per patient/year of NSVT (pre: 2 (1-5) vs post: 1 (0-2); P < .001), and SVT (pre: 1 (1-3) vs post: 0 (0-2); p = 0.046). This protective effect was also observed after controlling confusion factors (Any VA: OR 0.35 (0,24-0,50); p<0.001 and relevant VA: OR 0.30 (0,17-0,52); p<0.001). However, no differences were observed in the prevalence of AA (24.7% vs 18.8%; P = 0.117) or the burden of atrial fibrillation (pre: 0% (0-0.1) vs post 0% (0-0); p = 0.097). Conclusions Following the initiation of SGLT2i treatment, a reduction in the percentage of patients with relevant VA was observed. However, this effect was not observed for AA.Figure 1Figure 2

HRU-Net: High-Resolution Remote Sensing Image Road Extraction Based on Multi-Scale Fusion

Road extraction from high-resolution satellite images has become a significant focus in the field of remote sensing image analysis. However, factors such as shadow occlusion and spectral confusion hinder the accuracy and consistency of road extraction in satellite images. To overcome these challenges, this paper presents a multi-scale fusion-based road extraction framework, HRU-Net, which exploits the various scales and resolutions of image features generated during the encoding and decoding processes. First, during the encoding phase, we develop a multi-scale feature fusion module with upsampling capabilities (UMR module) to capture fine details, enhancing shadowed areas and road boundaries. Next, in the decoding phase, we design a multi-feature fusion module (MPF module) to obtain multi-scale spatial information, enabling better differentiation between roads and objects with similar spectral characteristics. The network simultaneously integrates multi-scale feature information during the downsampling process, producing high-resolution feature maps through progressive cross-layer connections, thereby enabling more effective high-resolution prediction tasks. We conduct comparative experiments and quantitative evaluations of the proposed HRU-Net framework against existing algorithms (U-Net, ResNet, DeepLabV3, ResUnet, HRNet) using the Massachusetts Road Dataset. On this basis, this paper selects three network models (U-Net, HRNet, and HRU-Net) to conduct comparative experiments and quantitative evaluations on the DeepGlobe Road Dataset. The experimental results demonstrate that the HRU-Net framework outperforms its counterparts in terms of accuracy and mean intersection over union. In summary, the HRU-Net model proposed in this paper skillfully exploits information from different resolution feature maps, effectively addressing the challenges of discontinuous road extraction and reduced accuracy caused by shadow occlusion and spectral confusion factors. In complex satellite image scenarios, the model accurately extracts comprehensive road regions.

Abstract 95: Vehicle Fleet is Associated With Hospitalizations for Oncological Treatment and Surgery in Brazil: A Cross-Sectional Study

Abstract Purpose: Vehicles are a giant source of carcinogenic substances, given the fact they power up by the combustion of gasoline, gas, or even ethanol, which can be harmful on a daily basis. Thus, our objective is to ascertain if the vehicle fleet in a region is related to its hospitalizations for oncological treatment and surgery. We expect that the vehicle fleet is directly related to oncological treatment and surgical procedures. Methods: A cross sectional study was designed using data collected from the DATASUS database, related to the number of hospitalizations for oncological treatment and surgery among Brazilian macro regions and states in the period of 2008 to 2021. It was then correlated with the vehicle fleet data of each macro region and state of July 2021 released by the Secretaria Nacional de Trânsito, federal institution that manages vehicle fleets in Brazil. Motorcycles, trailers, automobiles, trucks, tractors and buses are considered in this analysis. Pearson correlation test was performed using the Graphpad Prism software. P<0.05 was defined as significant. Results: Brazil’s vehicle fleet amounts to 113,406,884 vehicles. The Southeast region has the biggest fleet, as well as the highest number of hospitalizations, followed by south, northeast, central-west, and north, respectively. São Paulo has the most vehicles, 31,920,712, and also the highest number of hospitalizations, accounting for 24.3% of the total. At the same time, Amazonas showed the lowest vehicle fleet (228,731) as well as oncological hospitalizations (6,373). Pearson correlation was statistically significant considering states (p<0.0001, R²=0,9516) and macro regions (p=0,0038, R²=0,9574). Conclusion: These results suggest that the fleet is directly related to oncological surgical procedures and treatment. Data from this study can help public policies to take further decisions on investments in collective transport and transition to electric powered vehicles. It is important to note that this is a cross-sectional study, which can only light up hypotheses, not ascertain causality and there may be factors of confusion, such as southeast being the most developed and richest region, capable of a higher number of diagnoses. Citation Format: Lucas Kieling, Pedro Antonio Paludo Menna Barreto, Laura Tibola Marques da Silva, Rafaela de Andrade, Luiza Seixas de Sá Beltramo, Gabriele Eckerdt Lech, Fernando Azambuja, Arthur Minas Alberti, Pedro Arthur Zimmer Silveira. Vehicle Fleet is Associated With Hospitalizations for Oncological Treatment and Surgery in Brazil: A Cross-Sectional Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 95.

Cryptic diversity in a saline Mediterranean pond: the role of salinity and temperature in the emergence of zooplankton egg banks

Mediterranean endorheic wetlands are strongly affected by local meteorological events, so they undergo frequent unpredictable disturbances, such as episodes of high salinity or desiccation. In this context, salinity and temperature may be crucial for determining the structure of zooplankton communities and regional biodiversity, since they may trigger the hatching of egg bank in different ways. The goal of this study is to assess the combined role of these two variables on the zooplankton assemblage emerging from the egg bank. We hypothesize that temperature and salinity affect the community structure in a non-linear way, that is, both factors interact and modify the magnitude of their effects. We performed a laboratory factorial design where the same sediment was incubated under different thermal and salinity conditions, reducing the potential effects of other possible confusion factors. Community structure was described by measuring cumulative abundances, species composition, richness, and diversity. Our results showed that the community structure was strongly determined by salinity at all experimental temperatures. In contrast, the magnitude of the temperature effect depended on salinity. The high variability among replicates when salinity and temperature increased suggests that climate change might lead to unpredictable patterns of the community emerging from the egg bank.

COVID-19 상황을 경험한 미술치료사의 만다라를 통한 자기 돌봄에 관한 자전적 내러티브 탐구

The purpose of this study is to understand the experience and meaning of social and psychological changes experienced by art therapists infected with the COVID-19 virus through artistic narrative inquiry methods. The study period was total 16 months from January 2020 to April 2021, and the art therapist worked on mandara painting during the period focusing on the contents of 12 paintings related to the COVID-19 virus or including psychological confusion factors. The Mandara work, which began as part of self-care for emotional recovery and balance of work and personal life, unfolds with psychological flow and displays data collected by the time, place, and spatial meaning based on the five-step format of the narrative proposed by Connolly and Clandin. The results of this study are first, during the COVID-19 situation, the art therapist’s mandara work led to an experience of emotional circulation by expressing an internal world of freedom while minimizing negative factors of exposure to external risks through artistic activities in personal space. Second, during the COVID-19 situation, the art therapist’s self-care work had a positive effect on the control of psychological balance as he was given the opportunity to recognize and reflect on his feelings of meeting through his paintings and stories. Therefore, it can be seen that the mandara art therapy work can be a method of self-care in relieving the confusion from mental conflicts in social disaster situations, further maintaining life as an art therapist, coping with crises, and recovering.

Macronutrient intake is not associated with cardiovascular risk assessed by Coronary Calcium Score, but dietary fiber showed a significantly inverse relationship

Evidence of impact of dietary factors on development of coronary artery calcification remains uncertain. The objective of the study was to evaluate the association between the intake carbohydrates, proteins, total fats, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), trans fatty acids (TFA) cholesterol and fiber with cardiovascular risk. Cross-sectional analysis from 181 dyslipidemic patients. The Coronary Calcium Score (CCS) was used to measure cardiovascular risk. 24-hour recalls were applied and the Multiple Source Method was used to adjust dietary variability. The mean values of the cardiovascular risk categories were compared by analysis of variance, using ANOVA and Kruskal-Wallis. Tukey's post-test was used for multiple analyzes. Simple and multiple binary logistic regression, was used as a measure of association between nutrient intake and cardiovascular risk. Age, male gender, comorbidities and drug treatment were significantly prevalent in those with CCS>100. The average total energy intake was 1315.6 kcal. Total energy and macronutrient intake were higher among men (p < 0.05). No significant results were found regarding the association between cardiovascular risk and macronutrient intake. Fiber intake was inversely associated with cardiovascular risk, regardless of confusion factors (OR:0.918; 95% CI:0.845-0.999; p=0.047). The resultes that there was no association between nutrientes analyzed to cardiovascular risk assessed by CCS. However, the increase of dietary fiber intake in 1 g/day has been shown to reduce the of future cardiovascular events in 8.2% among individuals in the highest risk category. Therefore, we strongly recommend that fiber intake be encouraged.

한국 노인의 신체활동 참여 유형과 제2형 당뇨 위험의 관계 분석

This study aimed to investigate the association of physical activity type and type 2 diabetes in elderly. The data from the 2016-2020 Korea National Health and Nutrition Examination Survey(KNHANES) were used. The subjects were 5,811 elderly aged 65 to 79 years. Subjects were classified as Inactivity group, Aerobic exercise group, resistance exercise group and Combined exercise group based on physical activity type. Logistic regression was used to estimate the odd ratios (ORs) and confidence intervals (CIs) of type 2 diabetes risk according to the physical activity type. As a result of analysis, after adjustment factors of confusion, resistance exercise group and combined exercise group had significantly lower risks of type 2 diabetes(OR, .791; 95% CI, .638-.930; p=.032 and OR, .715; 95% CI, .556-.919; p=.009) compared with the Inactivity group(OR, 1). The results of this study suggest the importance of participating in resistance training as a method for the prevention of type 2 diabete in the elderly in Korea.

Security and Privacy Protection of Internet of Vehicles Consensus Algorithm Based on Wireless Sensors

Due to its large network scale, open communication environment, unstable wireless network, and other characteristics, it is extremely vulnerable to attacks and causes security problems, resulting in the collapse of the Internet of Vehicles system. The application of the Internet of Vehicles is becoming more and more extensive, but there are still problems such as information security and privacy leakage in the Internet of Vehicles. Through the analysis of the security threats and privacy protection requirements faced by the Internet of Vehicles system, this paper mainly studies information security, vehicle identity privacy, and location privacy in the process of Internet of Vehicles wireless communication. Therefore, it is urgent to conduct research on the information security and privacy protection issues of the Internet of Vehicles. This paper discusses the research on the security and privacy protection of the consensus algorithm for the Internet of Vehicles based on wireless sensors, compares and analyzes the wireless sensor data privacy protection protocols based on sharding technology, Tongtai encryption technology, and perturbation technology, and selects an optimized Kalman consensus filter. The algorithm is applied to the node information exchange of the sensor network, and two filters (low pass and band pass) are used to unify the observations and covariance of the network. Estimation of the sensor network state with and without data packet loss, the effect of system estimation error under different packet loss rates, data privacy protection algorithm performance, vehicle network data communication volume, and confusion factors on algorithm efficiency and the node energy consumption was compared and analyzed. Based on the application of wireless sensors, the estimation error and inconsistency estimation error of the algorithm in this paper finally converge to about 0.5, and both can maintain good stability and have good robustness. In addition, the communication volume of the algorithm in this paper is about 30% of the SCPDA algorithm. The Kalman consensus filtering algorithm reduces the amount of confusing data sent, improves privacy protection, and also achieves lower communication overhead.

Efficacy of Thin and Ultrathin Descemet Stripping Automated Endothelial Keratoplasty and Influence of Graft Thickness on Postoperative Outcomes: Systematic Review and Meta-analysis

To conduct a systematic review and meta-analysis on the efficacy of thin and ultrathin Descemet stripping automated endothelial keratoplasty (T-DSAEK and UT-DSAEK, with graft thickness <130 and <100 µm, respectively), depending on graft thickness. Systematic review and meta-analysis. PubMed, Cochrane Library, Embase, ClinicalTrials.gov, and ScienceDirect databases were searched until October 1, 2021. We computed random-effect meta-analysis on postoperative outcomes of T/UT-DSAEK, stratified by graft thickness (<80 μm, 80-100 μm, and 100-130 μm). The main postoperative outcome was visual acuity (logarithm of the minimum angle of resolution [logMAR]). Secondary outcomes were pachymetry (μm), endothelial cell count (cell/mm2), spherical equivalent (diopter [D]), rebubbling rate (%), and rejection rate (%). Meta-regressions compared postoperative outcomes depending on graft thickness and search for putative confusion factors. We included 47 articles for a total of 2141 eyes of 2040 patients. T/UT-DSAEK globally improved visual acuity (effect size=-0.38 logMAR [95% confidence interval {CI} -0.46 to -0.30 logMAR]), without difference depending on graft thickness. Overall, pachymetry improved (-60.6 µm [95% CI -101 to -19.7 µm]), endothelial cell count decreased (-1039 cells/mm2 [95% CI -1209 to -868 cells/mm2), spherical equivalent resulted in a hyperopic shift (0.74 D [95% CI -0.50 to 1.97 D), the graft rejection rate was 0.2% (95% CI -0.1% to 0.4%), and the rebubbling rate was 8.7% (95% CI 6.8%-10.5%). Grafts >100 μm induced a hyperopic shift. Metaregressions did not demonstrate differences between the 3 groups (<80 μm, 80-100 μm, or 100-130 μm) in any outcomes. All T/UT-DSAEK thickness groups provided similar visual acuity, pachymetry, endothelial cell count, rejection rate, and rebubbling rate regardless of graft thickness. A hyperopic shift was induced by grafts >100 μm.

Displaced posterior pelvic ring fractures treated with an unlocking closed reduction technique: Prognostic factors associated with closed reduction failure, reduction quality, and fixation failure

PurposesThis study aimed to evaluate the clinical effect of the unlocking closed reduction technique (UCRT) for the displaced posterior pelvic ring fractures and to analyze the factors associated with failure of closed reduction and fixation. Patients and methodsData from patients admitted with displaced posterior pelvic ring fractures initially treated with the URCT from July 2017 to January 2020 were extracted. Clinical and radiological factors including fracture classification, interval days from injury to surgery, number of screws, and type of fixation for the posterior pelvic ring were analyzed to evaluate their correlation with closed reduction failure, reduction quality, and fixation failure. Then a logistic regression model was used for statistical analysis to eliminate confusion factors. ResultsNinety-seven patients with displaced posterior pelvic ring fractures were followed for a mean of 1.7 years after surgery. Successful closed reduction and percutaneous fixation were achieved for 89 patients (91.8%), of which 82 patients (92.1%) achieved an excellent or good reduction. Closed reduction failure which converted to open reduction was recorded for eight patients (8.2%). AO/OTA type C3 fracture (p = 0.036) and osteoporosis (p = 0.012) were significant factors for closed reduction failure. Excellent was recorded for 76 patients (78.4%) and acute (1-21 days) interval days from injury to surgery was an associated factor for reduction quality. For AO/OTA type C1 fractures, no more than two short screws (unilateral iliosacral screws) or a single long screw (transiliac-transsacral screws) were independent prognostic factors of fixation failure (p = 0.026). ConclusionsDisplaced posterior pelvic ring fractures treated with the UCRT are associated with excellent/ good radiological results. However, in patients with AO/OTA type C3 pelvic fracture and osteoporosis, the backup plan of open reduction should be routinely prepared. The patient should be brought to the operating room within three weeks to get a good reduction result. Two long screws or one long screw combined with two short screws are required to create a strong construct for AO/OTA type C1 pelvic fractures.

Matrix Programing Style for I/O Stream Expression between External Software in Engineering Work

At a business process, it has a work that to make a final data create step by step by some software. At the almost cases, these software use a unique input and output data (s) and format. In these days, a work to make the input and output data (s) and format by the operator become extremely hard, because kind of software and data size getting to grow.It's not so hard a thing to make the input data (s) and format automatically. But there's no way to management that add and/or delete software, modification of software running sequence. Thus it's one of the factors of work confusion and constitutes a limiting factor of an automatic design system. This paper supplies a new matrix style programing language and software for the I/O stream expression between external software. Note that, data create functions are supplied by external software, thus these process aren't included in it.

Radial global strain by cardiac magnetic resonance imaging predicts arrhythmic outcomes in hypertrophic cardiomyopathy

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Hypertrophic cardiomyopathy (HCM) is a relatively prevalent condition associated with arrhythmic events and sudden cardiac death. Several tools are currently available to identify which HCM patients are at risk of developing these events. Purpose We aimed to evaluate the association of Tissue Tracking strain analysis by cardiac magnetic resonance (CMR) and the development of arrhythmic events in patients with HCM. Methods We prospectively analyzed 136 consecutive patients with HCM diagnosis (established according to current clinical practice guidelines) from January 2006 to October 2017. Every routine 24 hours ECG-monitoring test was registered and looked for sustained or non-sustained ventricular tachycardia (any VT). CMR studies were performed following our predefined CMR protocol for HCM with 1.5T magnets. Cine images were obtained with standard, retrospectively gated, steady-state free-precession (SSFP) sequences in 2, 3 and 4 chambers views and in 10–15 contiguous short-axis slices covering the ventricles from the base to the apex, with breath holding. The strain evaluation was performed by a commercially available Tissue Tracking analysis software, manually defining the endocardial border in short axis, 4, 3 and 2 chambers views and, after verifying adequate identification of the different structures, running the strain analysis (Figure 1, displaying myocardium identification by the strain analysis software). Results Mean follow-up was 49 ± 45 months. Mean age was 61 ± 15 years old (p for the comparation between the group with arrhythmic and the group without arrhythmic events 0.212) and 31% of patients were women (p 0.420). Mean ejection fraction was 69 ± 9.21% (p 0.223) and mean HCM-SCD (hypertrophic cardiomyopathy sudden cardiac death) risk score was 2.20 ± 1.34 (p &amp;lt;0.001). Median percentage of total myocardium showing late gadolinium enhancement (LGE) was 0.61 (interquartile range 2.9; p 0.170). Mean global radial strain (GRS) was 26.23 ± 8.78% (p &amp;lt;0.001). 21 VT episodes were recorded during follow-up. GRS showed an area under de ROC curve of 0.75 predicting VT during follow-up, selecting the value of 27% as the best sensitivity/specificity cutoff point. Statistically significant differences were not found when analyzing global circumferential strain (GCS) and global longitudinal strain (GLS) as VT predictors after adjusting for possible confusion factors (GRS, GCS and GLS distributions depicted in Figure 2). A binary GRS ≥27%/&amp;lt;27% variable was included in a logistic regression model adjusted by age, percent of total myocardium mass showing LGE and HCM-SCD risk score. Significantly more arrhythmic events were found to occur in patients with a GRS &amp;lt;27% (OR 7.33; 95% confidence interval 1.07 – 50.41; p 0.043) after adjusting by age, percent of total myocardium mass showing LGE, and HCM-SCD risk score Conclusions A GRS value of &amp;lt;27% on CMR appears to be a good predictor of worse arrhythmic prognosis in patients with HCM.

Self-Reported Hearing Loss and Associated Factors in Older Adults at a Memory Clinic.

Purpose The prevalence of dementia has increased in recent years and, along with hearing loss, can negatively impact the health of older adults. The purpose of this retrospective cross-sectional study was to establish self-reported hearing loss and associated factors in older adults at a memory clinic. Method Researchers conducted a retrospective cross-sectional study on factors associated with self-reported hearing loss (i.e., lifestyle, general health, cognition, functional capacity). Data were taken from medical records of older adults (≥ 60 years old) who received care between 2017 and 2018 at a memory clinic located at the Southern Santa Catarina University in Brazil. Analysis included the Pearson chi-squared test and logistic regression, estimation of the crude and adjusted odds ratios (OR), with respective confidence intervals of 95%. Results Researchers analyzed the medical records of 257 older adults and verified a prevalence of 13.2% of these adults with self-reported hearing loss. There was a higher prevalence of the outcome (i.e., self-reported hearing loss) in older adults who reported tinnitus (35.2%), those with mild cognitive impairment (14.7%), and those who were sedentary (19.2%). After adjustment for confusion factors, tinnitus (OR = 4.63; p = .019) and sedentarism (OR = 2.89; p = .029) were still associated with the outcome. Conclusions Tinnitus and sedentarism were associated with hearing loss in older adults receiving care at a memory clinic. As a public health issue, presbycusis needs to be included in the health planning and health promotion agendas, with effective control, prevention, and treatment measures.

P474 Postoperative infectious complications in patients with Inflammatory Bowel Disease: experience of a tertiary center

Abstract Background Patients with Inflammatory Bowel Disease (IBD) are at increased risk of postoperative infectious complications (PIC). There are few studies and conflicting data regarding the risk factors involved in these patients. The aim of this study was to investigate the incidence of infectious complications and postoperative mortality in patients with IBD who underwent intestinal surgery, as well as describe the characteristics of our population and identify possible risk factors. Methods Retrospective study on patients with Inflammatory Bowel Disease (Crohn’s disease (CD) and Ulcerative Colitis (UC)) treated in “Virgen de las Nieves” University Hospital between January 2019 and December 2020. Patients who underwent small bowel or colorectal surgery were included. Information regarding demographic and clinical data, procedures, treatments and surgical outcomes were collected. Clinical outcomes documented were postoperative infectious complications and in-hospital mortality. Descriptive inferential were carried out. Results 36 patients were included (47.2% male, median age 44.9 years). All the characteristics of our sample are detailed in Figures 1 and 2. Regarding surgical outcomes, 7 patients developed PIC (6 surgical site infection (SSI) and 1 multiple infections including pneumonia, candidemia and SSI). The features of these patients are detailed in Figures 3 and 4. Conclusion Postoperative infectious complications after intestinal surgery are an important cause of morbi-mortality in CD and UC patients. Identifying risk factors early, could help reduce the incidence of these complications. Seven patients (19,4%) in our sample developed PIC, mostly SSI. All of them diagnosed of CD, which explains the greater need of surgery in them compared to patients with UC. These patients had more severe disease: penetrating pattern (B3 according to Montreal Classification) and ileocolonic location (L3). Most patients were receiving immunosuppressive treatments by the time of surgery, especially biological treatments. The median time of evolution of the disease was high, describing a profile of disease more advanced. Our efforts should be determined to early prevention and treatment of modifiable risk factors during the perioperative period. In order to achieve this aim, further research is needed, with prospective, multicenter and wider population studies, trying to control any confusion factors. Finally, we would like to highlight the need of studies analyzing UC population, as most of them focus on patients with CD.

The intraindividual co-occurrence of anxiety and hope in procrastination episodes during exam preparations: An experience sampling study

Previous studies have shown that students procrastinate during exam preparation phase. Until now, only a few studies have investigated emotions that accompany academic procrastination in real-life situations. Further, there is a lack of studies that investigate the co-occurrence of both positive and negative emotions during procrastination episodes although both emotions can co-occur and interact within a person. We therefore examined how within-person experiences of exam-related emotions (i.e., anxiety and hope), learning-related confusion, and between-person factors (i.e., trait procrastination, gender, age, semester, and relevant exam) relate to state procrastination of learning during preparations for a relevant end-of-semester exam. A total of N = 93 students participated in an experience sampling procedure for 10 days prior to the relevant exam. As expected, multilevel logistic regression analyses showed that state procrastination was associated with higher anxiety, lower hope, and higher trait procrastination. The association between hope and state procrastination was weaker when anxiety was higher. Confusion and demographic variables had no significant relationship with state procrastination. Interestingly, these emotional experiences related to state procrastination were not comparable to delay per se suggesting that the two phenomena are distinct. Our research highlights the dynamic interplay of anxiety and hope during procrastination episodes.

Science in service of theology: Gender and sexual orientation

By reflecting on sexuality, gender and gender roles, this article compared the contributions of two sources: one from the medical sciences and one from theology. These publications paved the way for an informed theological reflection on the ministry of people from an LGBT orientation. The motivation for this article was McHugh and Mayer’s statement that science offers limited answers to gender matters and that help should be sought from the humanities. The interdisciplinary nature of the research challenged us to consider non-theological data and to formulate our theological convictions better. An integrative literature review was used as research method and key research concepts included sex, gender and what influences these predispositions. The findings were analysed and synthesised and presented in a way that posed new questions for future research. It encouraged us to make informed decisions when offering theological responses to sex and gender. The inability of the natural sciences to identify causative factors of gender confusion opened the door to the humanities. It afforded theology an opportunity to engage with other sciences while addressing sex and gender from a faith perspective. This article presented a broad multi-disciplinary understanding of gender and sexual orientation and paved the way for theological reflection that is scientifically sound. Shifting our focus from causative to environmental factors in gender research was a profitable endeavour. Our first responsibility as religious practitioners is not to protect truth and condemn behaviour at the cost of people, but to liberate people to share in the fulness of life. Contribution: This article promoted collaboration between theology and the natural sciences on matters of gender and sexual orientation. It was found that there is room for theology to investigate the role that environmental factors play in this regard. This approach corresponds with the aim of In die Skriflig / In Luce Verbi to promote multi-disciplinary research where religious studies engage with social sciences, human sciences, or even natural sciences.

Awareness of Nurses’ Working in Health Centers and Health Offices Regarding Communication Skills

Background: The lack of effective communication can lead to misunderstanding, poor performance,interpersonal conflict, ineffective program development, medical mistakes, and many otherundesirable outcomes. This study aimed to assess awareness of nurses’ working in health centersand health offices regarding communication skills. Research design: A descriptive research designwas utilized to conduct this study. Setting: The study was conducted in all health centers and healthoffices in Benha City. Sampling: Convenient sample was used in study which included all thenurses’ work at health centers and health offices in Benha City, the total number of nurses were 124nurses. Tools: Three tools were used in this study: I- A structured interviewing questionnaire toassess nurses’ socio- demographic characteristics, nurses’ knowledge regarding communication skillsand factors affecting nurses’ skills regarding communication. II-The second tool: Likert scale toassess nurses’ attitude regarding communication skills III-The third tool: Observational checklist toassess skills of nurses regarding communication. Results: More than two fifths of studied nursingaged 45 years or more with the mean age 41.97±9.88 years, more than two thirds of nurses had goodknowledge about communication skills, the most factors highly affected communication skills werephysiological factors of internal confusion, factors enhancing in communication and the principles toovercome communication barrier, more than three quarters of studied nurses had positive attitudetoward personal communication and had satisfactory skills about communication. Conclusion: Therewas a statistically significant relation between nurses’ total knowledge with their socio- demographiccharacteristics regarding their marital status and work setting, there was a statistically significantrelation between nurses’ total skills score and their socio- demographic characteristics regarding theirmarital status. There were highly positive correlation between total knowledge with total factors ofstudied nurses and there was no a statistically relation with total skills and total attitude.Recommendation: Develop and implement health educational program for nurses at health centersand health offices to improve nurses’ knowledge and practice regarding communication skills andbooklets should be available and distributed in all health care centers to all nurses about thecommunication and ways to over comes the barriers faced

Czech adaptation of the Brunel Mood States for adolescent athletes

The Brunel Mood States is a 24-items long questionnaire (formerly referred to as the Profile of Mood States for Adolescents POMS-A) used to capture emotional profile of an individual. It has been used in various settings including sport psychology, where it is considered a valid indicator for overtraining syndrome. The aim of this study was to develop the Czech adaptation of BRUMS and verify its psychometric properties in adolescent athletes. The data were collected from a sample of 246 participant (50.8% females; age range 14-19 years). Confirmatory factor analysis was used to evaluate original six-dimensional structure (with factors of Depression, Tension, Confusion, Anger, Fatigue, and Vigor). Even though this model showed acceptable fit to the data, Depression and Tension factors were empirically indistinguishable. Therefore, we proposed and verified alternative five-factor model with these two factors collapsed. Measurement invariance across gender was assessed using the Multiple Indicators Multiple Causes (MIMIC) model. Although three items showed signs of differential item functioning, the Czech adaptation of the instrument can in general be considered a measurement invariant.

Part 1: Outcome of Posterior Pelvic Ring Injuries and Associated Prognostic Factors - A Five-Year Retrospective Study of One Hundred and Sixty Five Operated Cases with Closed Reduction and Percutaneous Fixation.

The aim of this study was to evaluate: 1. the outcome of pelvic ring fractures treated by closed reduction and percutaneous fixation, 2. the prognostic factors associated with a poor quality reduction, 3. the prognostic factors associated with ilio-sacral screws misplacement and 4. the prognostic factors associated with nonunion. Data from medical charts for all patients admitted with unstable posterior pelvic ring injuries from 2009 to 2013 were extracted. A total of 165 patients with a mean age of 40years were included. One hundred and five patients were reviewed at a mean of 32months of follow-up. The prognostic factors analyzed were clinical and radiological factors. Tile B and Tile C pelvic ring fractures were compared and analyzed separately. Then specific statistical analysis was performed using a logistic regression model to eliminate confusion factors. An excellent or good clinical result was achieved for 94 patients (90%). An excellent or good reduction was achieved for 141 patients (85%). Nonunion rate, smoking patients, bad reductions, age of patients and ISS score were significantly higher in Tile C group. To eliminate confusion factors we used a multivariate analysis logistic regression model. Only unstable vertical bilateral posterior injuries (Tile C2 and C3) were independent prognostic factors for unsatisfactory reduction (p= 0.001; OR = 4.72; CI 95% [2.08-16.72]). Screw misplacement was recorded for 30 patients (16%) and sacral dysmorphia was an associated prognostic factor (p= 0.0001; OR = 15.6; CI95% [3.41-98.11]). Nonunion was recorded for ten patients (6%) and smoking was an associated prognostic factor (p= 0.01, OR = 5.12; CI95% [1.1-24.1]). Posterior pelvic ring fractures treated by closed reduction and percutaneous fixation are associated with excellent/good clinical results if excellent/good reduction and bone healing are achieved without screw misplacement. Bilateral unstable vertical posterior pelvic ring injuries, and sacral dysmorphia are risk factors for bad quality reduction and screw misplacement respectively.

Prevalence of low back pain in young Brazilians and associated factors: Sex, physical activity, sedentary behavior, sleep and body mass index.

Low back pain (LBP) has become increasingly common, but the prevalence of this complaint and associated factors in young people remains controversial. This study aimed to identify the prevalence of LBP and to explore the existence of associated factors (sex, physical activity, sedentary lifestyle, sleep, body mass index and waist circumference). This study considered all complaints of the lumbar region (acute or chronic) as LBP, which can irradiate to the backside and legs, lasting a minimum of 24 hours. Youngsters aged 15 to 18 years from a school in the south of Brazil were evaluated. Descriptive statistics was used, in particular Chi-square, Mann-Whitney U tests and binary logistic regression. A significance level of p< 0.05 was adopted. A total of 330 youngsters answered a questionnaire and had their anthropometric measurements measured (response rate 84%). The prevalence of LBP in the present was 30%, quarterly 63% and throughout life 77%. There was a significant association between LBP and sex: girls have an increased risk of LBP in the last three-month period (PR = 1.3, 95% CI 1.06-1.56) and throughout life (PR = 1.2, 95% CI 1.04-1.43). The practice of physical activities was also associated with LBP, but as a protection factor in the present and in the last three-month period (PR = 0.7, 95% CI 0.47-0.90). Physical education at school has demonstrated a protective factor regarding LBP throughout life (PR = 0.9, 95% CI 0.77-0.97). Most of the students did not comply with recommendations related to sleep and time spent doing activities in front of a screen, and no association of these factors with LBP was detected. This exposure (physical activity, sleep time, sedentarism) did not present significant association with LBP when adjusted by the confusion factors (sex, age, BMI). Youngsters reported a high prevalence of LBP. Girls were at greater risk of LBP than boys. It is recommended that prevention strategies focus on the practices of physical activities and scholar physical education. No association of LBP with sedentary lifestyle (TV and computer use time, sleep time), anthropometric measures and sleeping duration was observed.