Management Group Research Articles

ART conceptions: timing of delivery and the risk of hypertensive disorders of pregnancy

Research questionAre there differences in the rates of hypertensive disorders of pregnancy among in vitro fertilization (IVF) patients who underwent induction of labor at 39 weeks compared to those who were managed expectantly? DesignThis is a retrospective cohort study of 1,176 low-risk singleton pregnancies conceived following IVF with no contraindications to vaginal delivery. Two groups were constructed: elective induction of labor from 39 weeks 0 days to 39 weeks 6 days (n=234) versus expectant management (n=942). Main outcome measure was the incidence of hypertensive disorders of pregnancy. Secondary outcome was the rate of cesarean delivery. Sub-analyses were performed within fresh and frozen embryo transfer groups. ResultsHypertensive disorders of pregnancy developed in 8.1% of patients in the induction of labor group and in 12.4% in the expectant management group (P=.06). This difference was attenuated after controlling for potential confounders (P=.28). For frozen embryo transfers, the unadjusted odds of hypertensive disorders of pregnancy were significantly lower with induction of labor compared to expectant management (P=.02) and after adjusting for confounders, the odds ratio neared significance (P=.09). For fresh transfers, there was no difference in the odds of hypertensive disorders of pregnancy between the two groups. The odds of delivering via cesarean section were higher in the induction of labor group, in the total population and in sub-analyses. ConclusionOverall, in IVF conceived pregnancies, induction of labor when compared to expectant management was not associated with a lower incidence of hypertensive disorders of pregnancy, it was however, associated with a higher rate of cesarean delivery.

Web-Based Warfarin Management (Alfalfa App) Versus Traditional Warfarin Management: Multicenter Prospective Cohort Study.

Poor anticoagulation management of warfarin may lead to patient admission, prolonged hospital stays, and even death due to anticoagulation-related adverse events. Traditional non-web-based outpatient clinics struggle to provide ideal anticoagulation management services for patients, and there is a need to explore a safer, more effective, and more convenient mode of warfarin management. This study aimed to compare differences in the quality of anticoagulation management and clinical adverse events between a web-based management model (via a smartphone app) and the conventional non-web-based outpatient management model. This study is a prospective cohort research that includes multiple national centers. Patients meeting the nadir criteria were split into a web-based management group using the Alfalfa app or a non-web-based management group with traditional outpatient management, and they were then monitored for a 6-month follow-up period to collect coagulation test results and clinical events. The effectiveness and safety of the 2 management models were assessed by the following indicators: time in therapeutic range (TTR), bleeding events, thromboembolic events, all-cause mortality events, cumulative event rates, and the distribution of the international normalized ratio (INR). This national multicenter cohort study enrolled 522 patients between June 2019 and May 2021, with 519 (99%) patients reaching the follow-up end point, including 260 (50%) in the non-web-based management group and 259 (50%) in the web-based management group. There were no observable differences in baseline characteristics between the 2 patient groups. The web-based management group had a significantly higher TTR than the non-web-based management group (82.4% vs 71.6%, P<.001), and a higher proportion of patients received effective anticoagulation management (81.2% vs 63.5%, P<.001). The incidence of minor bleeding events in the non-web-based management group was significantly higher than that in the web-based management group (12.1% vs 6.6%, P=.048). Between the 2 groups, there was no statistically significant difference in the incidence of severe bleeding and thromboembolic and all-cause death events. In addition, compared with the non-web-based management group, the web-based management group had a lower proportion of INR in the extreme subtreatment range (17.6% vs 21.3%) and severe supertreatment range (0% vs 0.8%) and a higher proportion in the treatment range (50.4% vs 43.1%), with statistical significance. Compared with traditional non-web-based outpatient management, web-based management via the Alfalfa app may be more beneficial because it can enhance patient anticoagulation management quality, lower the frequency of small bleeding events, and improve INR distribution.

Axillary management and long-term oncologic outcomes in breast cancer patients with clinical N1 disease treated with neoadjuvant chemotherapy

BackgroundLow false negative rates can be achieved with sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients with clinical N1 (cN1) disease. We examined changes in axillary management and oncologic outcomes in BC patients with cN1 disease receiving NAC.MethodsBC patients with biopsy proven cN1 disease treated with NAC were selected from our institutional cancer registry (2014–2017). Patients were grouped by axillary management, axillary lymph node dissection (ALND), SLNB followed by ALND, or SLNB alone. Univariable and multivariable survival analysis for recurrence-free survival (RFS) and overall survival (OS) were performed.Results81 patients met inclusion criteria: 31 (38%) underwent ALND, 25 (31%) SLNB + ALND, and 25 (31%) SLNB alone. A SLN was identified in 45/50 (90%) patients who had SLNB. ALND was performed in 25/50 (50%) patients who had SLNB: 18 for a + SLNB, 5 failed SLNB, and 2 insufficient SLNs. 25 patients had SLNB alone, 17 were SLN- and 8 SLN+. In the SLNB alone group, 23/25 (92%) patients received adjuvant radiation (RT). 20 (25%) patients developed BC recurrence: 14 distant (70%), 3 local (15%), 2 regional + distant (10%), and 1 contralateral (5%). In the SLNB alone group, there was 1 axillary recurrence in a patient with a negative SLNB who did not receive RT. Univariable survival analysis showed significant differences in RFS and OS between axillary management groups, ALND/SLNB + ALND vs. SLNB alone (RFS: p = 0.006, OS: p = 0.021). On multivariable survival analysis, worse RFS and OS were observed in patients with TNBC (RFS: HR 3.77, 95% CI 1.70–11.90, p = 0.023; OS: HR 8.10, 95% CI 1.84–35.60, p = 0.006).ConclusionsSLNB alone and RT after NAC in BC patients with cN1 disease who have negative SLNs at surgery provides long-term regional disease control. This analysis provides support for the practice of axillary downstaging with NAC and SLNB alone.

Neonatal Riga-Fede disease: A systematic review of 84 cases collected over 120 years

Background: Traumatic ulceration of the tongue due to congenital teeth is known as Riga-Fede disease (RFD). The literature on RFD consists largely of anecdotal case reports, thereby lacking valid clinical recommendations. While managing a newborn with RFD complicated by Ludwig’s angina, this knowledge gap was recognized. Therefore, this systematic review was conducted to gain insight into the optimal management and the possible complications of RFD. Methods: A literature search was conducted using PubMed, Google Scholar, and Science Direct, supplemented with African Journals Online, Indmed, and manual searches. Papers published between 1900 and July 2023 in any language were retrieved. Neonates with natal or neonatal teeth and ulceration of the oral mucosa were included. Papers with incomplete data and review articles were excluded. Results: A total of 84 newborns with RFD from 62 published reports (including the case reported herein) were analyzed. Most of the reports were from the Indian subcontinent, and the frequency of reporting has increased since the year 2000. Tongue ulceration in all cases was due to mandibular incisors. There was no significant difference in the median duration of healing between the tooth extraction group (14 days) and the conservative management group (18 days). There was only a very weak positive correlation between the duration of symptoms and healing time, which was statistically insignificant. Conclusion: Healing of mucosal ulcers in RFD is often protracted and does not appear to be influenced by the duration of symptoms or by the modality of treatment. Extraction of the offending teeth is more common (75% of cases) than conservative management, such as grinding (ameloplasty) or resin capping of teeth. RFD is mostly a benign disorder; however, serious complications such as meningitis, Ludwig’s angina, and soft tissue abscesses can rarely occur with Staphylococcus aureus infections.

Assessing the Relevance of Non-molecular Prognostic Systems for Myelodysplastic Syndrome in the Era of Next-Generation Sequencing.

The Molecular International Prognostic Scoring System (IPSS-M) has improved the prediction of clinical outcomes for myelodysplastic syndromes (MDS). The Artificial Intelligence Prognostic Scoring System for MDS (AIPSS-MDS), based on classical clinical parameters, has outperformed the IPSS, revised version (IPSS-R). For the first time, we validated the IPSS-M and other molecular prognostic models and compared them with the established IPSS-R and AIPSS-MDS models using data from South American patients. Molecular and clinical data from 145 patients with MDS and 37 patients with MDS/myeloproliferative neoplasms were retrospectively analyzed. Prognostic power evaluation revealed that the IPSS-M (Harrell's concordance [C]-index: 0.75, area under the receiver operating characteristic curve [AUC]: 0.68) predicted overall survival better than the European MDS (EuroMDS; C-index: 0.72, AUC: 0.68) and Munich Leukemia Laboratory (MLL) (C-index: 0.70, AUC: 0.64) models. The IPSS-M prognostic discrimination was similar to that of the AIPSS-MDS model (C-index: 0.74, AUC: 0.66) and outperformed the IPSS-R model (C-index: 0.70, AUC: 0.61). Considering simplified low- and high-risk groups for clinical management, after restratifying from IPSS-R (57% and 32%, respectively, hazard ratio [HR]: 2.8; P=0.002) to IPSS-M, 12.6% of patients were upstaged, and 5% were downstaged (HR: 2.9; P=0.001). The AIPSS-MDS recategorized 51% of the low-risk cohort as high-risk, with no patients being downstaged (HR: 5.6; P<0.001), consistent with most patients requiring disease-modifying therapy. The IPSS-M and AIPSS-MDS models provide more accurate survival prognoses than the IPSS-R, EuroMDS, and MLL models. The AIPSS-MDS model is a valid option for assessing risks for all patients with MDS, especially in resource-limited centers where molecular testing is not currently a standard clinical practice.

Home Care Services in the Last Year of Life by Type of Care Management.

Care management of home-based long-term care is vital for community-dwelling older adults. Regarding care planning, which is a part of care management, appropriate care plans according to individual conditions are extremely important for older adults to continue living independently in their familiar environment for as long as possible. We compared the use of care services in the last year of life between advanced and conventional care management. The results showed that among the older adults with a care-need level of 3, 4, or 5, the advanced care management group had a significantly higher rate of use of home-visit nursing services than the conventional care management group. These differences could be attributed to differences in the care planning knowledge, experience, and the training environment of the care managers' offices.

Work ethic, cultural impact and perceived performance – innovative insights from three countries

PurposeThis study aims to examine the relationship between work ethics and organizational performance and investigate the influence of respondents’ career stages on their work ethic among British, United Arab Emirates (UAE) and Serbian nations.Design/methodology/approachThis research is based on a survey of British, UAE and Serbian managers, whose task was to assess the dimensions of the multidimensional work ethic profile (MWEP) and organizational performance. Since the MWEP does not analyze work ethics in the context of religion, it is deemed the most suitable instrument for this study because it analyzes work ethics among the three cultures that practice different religions.FindingsThe results revealed that national culture impacts work ethics. British managers place greater value on the wasted time, self-reliance and morality dimensions of work ethics. Serbian managers prefer the leisure and delay of gratification dimensions, while UAE managers value hard work ethics more than the other two groups of managers. The study also shows that respondents’ career stage influences their work ethic, and a significant relationship exists between different dimensions of work ethics and organizational performance in all three nations.Originality/valueThis study contributes to the theory by analyzing work ethic and its relationship with organizational performance and respondents’ career stages in three nations that share business interests. It addresses a research gap by comparing work ethics in developed, developing and a country in socio-economic transition.

Intraoperative goal-directed fluid management and postoperative brain edema in patients having high-grade gliomas resections: a randomized trial.

Patients with high-grade gliomas often have severe brain edema. Goal-directed fluid management protects neurological function, but whether reduces postoperative brain edema remains unknown. Patients having elective resection of supratentorial malignant gliomas were randomly assigned to goal-directed versus routine fluid management. Patients assigned to goal-directed management group were given 3mL kg-1 hydroxyethyl starch solution when stroke volume variation exceeded 15% for 5 minutes. Fluid was managed per routine by attending anesthesiologists in reference patients. The primary outcome was cerebral edema volume after surgery as assessed by computerized tomography. A total of 480 eligible patients were randomly assigned to the goal-directed (n = 240) or the routine fluid management group (n = 240). The amounts of crystalloid (5.4 vs. 7.0ml kg-1 hour-1, P < 0.001), colloid (1.1 vs. 1.7ml kg-1 hour-1, P < 0.001), and overall fluid balance (0.3 vs. 1.9ml kg-1 hour-1, P < 0.001) were significantly lower in goal-directed fluid management. There was no significant difference in postoperative brain edema volume between groups (36.0cm3 vs. 38.9cm3, mean difference: 0.18cm3, 95% CI: -5.7 to 5.9). Goal-directed patients had lower intraoperative dural tension (risk ratio: 0.63, 95% CI: 0.50 to 0.80, P < 0.001). There was no significant difference in Karnofsky Performance Status between the two groups at 30 days after surgery. Goal-directed fluid therapy substantially reduced intravenous fluid volumes, but did not reduce postoperative brain edema in patients having brain tumor resections.

Outcomes of advanced care management in home-based long-term care: A retrospective population-based observational study

BackgroundIn home-based long-term care, care management aims to facilitate the independence of community-dwelling older adults and mitigate the escalation of their care needs. We examined the association between the types of care management (advanced vs. conventional) and the progression of care needs among recipients with moderate care needs and compared care services offered in care plans between care management types. MethodsA retrospective, population-based observational study was conducted in Tsukuba City in Japan. The individual-level secondary data from the suburban municipal government was collected between May 2015 and March 2019. The primary outcome was the progression of care-need levels certificated in Japanese long-term care insurance. The exposure variable was advanced care management. First, we conducted propensity-score matching to adjust for differences in recipient characteristics. Second, we performed Kaplan–Meier survival analyses and log-rank tests, with the outcome measure being the progression of care-need levels. Third, Pearson's chi-square tests were performed to compare care services for recipients of advanced vs. conventional care management. ResultsOf the 1010 long-term care recipients, we selected 856 propensity score-matched recipients receiving advanced or conventional care management. The proportions of four-year cumulative progression-free survival in the groups receiving advanced and conventional care management were 82.2 % and 78.5 %, respectively (p = .69). The proportions of the groups with advanced and conventional care management were 17.1 % and 23.8 % using home-help services (p < .05), and 4.0 % and 8.2 % using community-based day care services (p < .05), respectively. ConclusionsAdvanced care management in home-based long-term care was not associated with a slowing of the progression of care needs among older adults with moderate care needs compared with conventional care management. There was a notable discrepancy in the use of care services, with the advanced care management group having lower rates of use of home-help services and community-based day care services compared with the conventional care management group.

Optimizing hemostasis in HoLEP surgery: retrospective review of selective bipolar plasmakinetic technology guided by bladder irrigation fluid color

ObjectTo evaluate the effectiveness of selective bipolar plasmakinetic technology based on bladder irrigation fluid color on hemostasis in HoLEP surgweryMethodsA total of 209 patients who underwent HoLEP surgery from October 2021 to July 2023 were included and divided into Hemostasis Management Group and control group. the color of the irrigation fluid was categorized into 5 levels and the bipolar plasmakinetic technology was applied when the color came to level 4 or up. The following was analyzed: postoperative use of balloon compression, blood loss, irrigation time, length of hospital stay, and the number of a second operation.ResultsOnly 4 patients in Hemostasis Management Group required postoperative urinary catheter balloon compression, while there are 15 in the control group(p=0.03). The average irrigation time for patients in the HM Group with bipolar plasmakinetic hemostasis was 21.88±13.76 hours, compared to that in patients with catheter balloon compression(p=0.007).ConclusionBased on the bladder irrigation color chart, the selective application of bipolar plasmakinetic hemostasis led to a significant reduction in the number of patients requiring postoperative bladder catheter balloon compression. Secondly, the irrigation time of patients who underwent bipolar plasmakinetic hemostasis also decreased.

Effects of integrated management on surgical outcomes and mental health of patients following endoscopic submucosal dissection.

Endoscopic submucosal dissection (ESD) is a less invasive local treatment for diseases throughout the gastrointestinal tract. To develop an integrated management protocol and analyze its effects on surgical outcomes and mental health of patients after ESD. The study population consisted of patients undergoing ESD before implementation of integrated management and those undergoing ESD by the same pool of surgeons after implementation of integrated management. The management group exhibited shortened fasting time and length of hospital stay compared to the control group (P < 0.05). The management group exhibited a higher incidence rate of postoperative complications than the control group (3 cases vs 11 cases; P = 0.043). The management group exhibited a lower uncertainty score for disease knowledge compared to the control group 12 h after surgery (P < 0.05). The management group gave more scores on the domains of patient familiarity to the responsible nurses, professional skills of responsible nurses, and general evaluation compared to the control group. The management group had a higher total score of patient satisfaction towards the responsible nurses in term of health care than the control group (P < 0.01). The management group exhibited lower Self-Rating Anxiety Scale and Self-Rating Depression Scale scores compared to the control group 12 h after surgery (P < 0.01). The study demonstrates that integrated management could improve surgical outcomes and mental health of patients undergoing ESD.

Estimating the soil water retention curve by the HYPROP-WP4C system, HYPROP-based PCNN-PTF and inverse modeling using HYDRUS-1D

Due to the difficulty of direct field measurement, soil hydraulic properties are often obtained in laboratory settings using small undisturbed soil samples or estimated indirectly through pedotransfer functions (PTFs). The pseudo-continuous pedotransfer function (PCNN-PTF) is a neural network-based approach for estimating soil hydraulic properties. The main objective of this study was to use field soil moisture and tension data to assess soil water retention curves obtained from the HYPROP-WP4C system and the HYPROP-based PCNN-PTF. The in-situ soil water retention data were simultaneously acquired using Acclima TDT and MeterGroup MPS-6 sensors (every 30 min, May to September 2020) from 11 hybrid bermudagrass plots under different irrigation treatments in Riverside, California. We utilized extended evaporation and dewpoint methods using HYPROP-WP4C (Meter Group Inc., USA) devices to obtain lab-measured SWRCs. In addition, SWRCs were estimated from Rosetta (Schaap et al., 2001) and by inverse modeling in HYDRUS-1D utilizing in-situ moisture retention data. Although the hysteresis impacted field data, overall, there was a good agreement between the in-situ and lab water retention data for most samples, especially within the pF range of 2–3.5. The PCNN-PTF outperformed Rosetta in estimating laboratory (RMSE=0.034 cm3 cm−3 vs 0.063 cm3 cm−3) and in-situ soil moisture data (RMSE=0.048 cm3 cm−3 vs 0.082 cm3 cm−3). Inverse modeling of in-situ data also performed well in estimating the SWRC (RMSE=0.043 cm3 cm−3); however, further attention is required in dry and saturated soil conditions. We developed a simple, free, and easy-to-access tool called PC-PTF for estimating the SWRC using the PCNN-PTF model evaluated in this study. The PC-PTF can be accessed from the Verdi Water Management Group website: http://www.ucrwater.com/software-and-tools.html.

ESPRIT adventure: Assessing hybrid fuzzy-crisp rule-based AI method effectiveness in teaching key performance indicators

Key performance indicators (KPIs) are a fundamental tool for understanding the outcomes of business policies. Teaching these indicators is conventionally accomplished through verbal lecturing using mathematical equations, accompanied by presentation graphics and tabular information representing the company's operational, financial, and strategic achievements. The conventional teaching method enables the student to understand what a KPI means and how it is calculated, however, it does not enable the student to understand easily how to interpret it. Here, a hybrid fuzzy-crisp rule-based AI system is presented and its effectiveness when applied with a group of management and organization students at the University of Belgrade, Faculty of Organizational Sciences, during the 2022/2023 academic year is evaluated. The potential of this tool is reflected in its ability to simulate adaptive and realistic business economic situations, its high interactivity and user-friendly interface, and intuitive graphical and tabular results that are easy to interpret enhanced with natural-language-inference-explanations. Univariate analysis along with some complementary statistical tests was used to examine students' satisfaction with the system and to distinguish between students who used the system, and students who attended conventional classes, both in terms of acquiring knowledge and retaining knowledge. In general, the results showed high students' satisfaction with the system. The scores obtained by the former group on the objective knowledge assessment test were on average significantly higher compared to those of the latter, proving the positive effect of the hybrid fuzzy-crisp rule-based AI teaching approach.

Certified Community Behavioral Health Clinic Services for Clients With Co-occurring Disorders: A Latent Class Approach.

Certified community behavioral health clinics (CCBHCs) are designed to provide comprehensive care for individuals with co-occurring mental and substance use disorders. The authors classified outpatient mental health treatment facilities on the basis of provision of services for clients with co-occurring disorders and assessed whether CCBHCs differed from other outpatient mental health facilities in services provided. The authors used latent class analysis to identify distinct services for clients with co-occurring disorders in 5,692 outpatient mental health facilities in the 2021 National Substance Use and Mental Health Services Survey. Nine indicators were included: treatment for clients with substance or alcohol use disorder co-occurring with serious mental illness or serious emotional disturbance, specialized programs or groups for such clients, medication-assisted treatment (MAT) for alcohol use disorder, MAT for opioid use disorder, detoxification, individual counseling, group counseling, case management, and 12-step groups. A multinomial logistic regression was used to estimate whether CCBHCs were associated with any identified classes after analyses controlled for facility characteristics. A four-class solution provided a model with the best fit, comprising comprehensive services (23.4%), case management services (17.7%), counseling and self-help services (58.6%), and professional services (4.3%). Regressing class membership on facility type and covariates, the authors found that compared with community mental health clinics (CMHCs), CCBHCs were more likely to belong to the comprehensive services class than to the case management services, counseling and self-help services, and professional services classes. CCBHCs were more likely than other outpatient programs to offer comprehensive care, and CCBHC status of a CMHC facilitated enhanced service provisions.

Effect of Gender and Generation on the Adoption of Irrigation and Good Farming Practices in Bontanga and Golinga Irrigation Schemes in Northern Ghana

This study examined the challenges faced by men, women, and different age groups in irrigation water management and farming practices in the Bontanga and Golinga irrigation schemes. The results of the study revealed that there are significant differences in irrigation and farming practices between men and women as well as between older and younger farmers. For men, the main challenges were; limited access to financial resources for investing in modern irrigation technologies and equipment, inadequate knowledge and awareness of sustainable farming practices and water management insufficient government support, and lack of policies tailored to their specific needs. For women, these were gender inequalities and limited access to land, water, and productive resources, lack of control and decision-making power over irrigation water allocation, and limited access to training and extension services to enhance their farming skills. Youth recognized limited interest and involvement in agriculture due to the perception of low profitability and lack of modernization, inadequate access to education and training opportunities in agricultural practices and water management, and insufficient support and mentorship programs to encourage youth participation in farming.

Assessment of Antibody Titers after 6 Months of Vaccination against SARS-COV-2 in Patients with CKD Stage 4, 5 and CKD 5d

Background: Since the pandemic of COVID-19 started from December 2019, remarkable numbers of infections and deaths associated with COVID-19 have been recorded worldwide. Chronic kidney disease patients are particularly at high risk of infections due to impairments in the innate and adaptive immune systems. Adequate humoral (antibody) and cellular (T cell-driven) immunity are required to minimize pathogen entry and promote pathogen clearance to enable infection control. Vaccination can generate cellular and humoral immunity against this specific pathogen. COVID-19 prevention through successful vaccination is therefore paramount in chronic kidney disease population. But vaccination efficacy is diminished in these patients because premature ageing of the immune system and chronic systemic low- grade inflammation are the main causes of immune alteration in these patients. Therefore, it is urgently necessary to establish a different vaccination strategy for chronic kidney disease and dialysis patient in terms of the dose and administration time. Aims: This study aimed to assessment of antibody titers after vaccination against SARS-COV-2 in patients with chronic kidney disease stage 4, 5 on conservative management and maintenance haemodialysis. Methods: This prospective observational comparative was conducted in Nephrology department of Dhaka Medical College Hospital. Selectionof patients was done by purposive sampling according to inclusion and exclusion criteria. Total 135 patients distributed in three groups: 45 patients of chronic kidney disease (CKD) stage 4, 5 on conservative management, 45 patients on maintenance haemodialysis (MHD) and 45 healthy controls were approached for the study who were receiving SARS-COV-2 vaccination. Demographic, clinical and laboratory data were collected initially. At first a pre vaccination sample or 1st sample was taken for antibody measurement. Then participants from all groups were given 2 doses MODERNA vaccine containing 100 µg in 0.5 ml each in 28 days apart. Then after 14 days of 1st dose of vaccination the 2nd samples were taken, 3rd samples were taken 14 days after the 2nd dose vaccination. Study populations were subdivided into two groups according to pre vaccination SARS-COV-2 antibody titer; seropositive- positive response before vaccination and seronegative- negative response before vaccination. They were also divided into two groups according to quantitive antibody response; positive response- values ≥10 DU/mL were positive Negative response- values of &lt;10 DU/mL were negative. Result: Seroconversion rate was around 20% among study participants before vaccination. 14 days after the 1st dose of vaccination, 90.04% patients had positive immune response in CKD stage 4, 5 on conservative management group whereas in MHD group 84.82% responded to vaccination and immune response in control group was 100%. Immune response is 100% among all the groups after 14 days of 2nd dose of vaccination but the concentration of antibody differs significantly among the study groups. Responders were comparatively younger with normal BMI. Conclusion: Haemodialysis patients as well as patients with chronic kidney disease stage 4, 5 on conservative management showed a favorable but profoundly lower early antibody response, which decreased substantially during follow-up.

Genetic and genomic analysis of Belgian Blue’s susceptibility for psoroptic mange

BackgroundPsoroptic mange, caused by Psoroptes ovis mites, is affecting Belgian Blue cattle’s welfare and production potential. The Belgian Blue cattle—known for its high degree of muscling, low feed conversion ratio and high beef quality—is highly susceptible for this disease.ResultsIn this study, we phenotyped 1975 Belgian Blue cattle from more than 100 different groups on commercial beef farms for their psoroptic mange susceptibility. Substantial individual differences were observed within these management groups, with lesion extent differences up to ± 15%. Animal models showed that estimated heritabilities were low for lesion extent and severe lesion extent (0.07 and 0.09, respectively) and 0.12 for the number of mites. A genome wide association study for mange susceptibility revealed signals on BTA6, BTA11, BTA15 and BTA24. In these regions, candidate genes GBA3, RAG2, and TRAF6 were identified.ConclusionsDespite the challenges in phenotyping for psoroptic mange due to the timing of screening, the continuous evolution of lesions and different management conditions, we successfully conducted a study on the genetic susceptibility to psoroptic mange in Belgian Blue cattle. Our results clearly indicate that psoroptic mange is under polygenic control and the underlying candidate genes should be studied more thoroughly. This is the first study providing candidate genes for this complex disease. These results are already valuable for Belgian Blue breeding, however, further research is needed to unravel the architecture of this disease and to identify causal mutations.

Investigation of landscape risk factors for the recent spread of varroa mite (Varroa destructor) in European honeybee (Apis mellifera) colonies in New South Wales, Australia.

In June 2022, an exotic pest of the European honeybee (Apis mellifera), the varroa mite (Varroa destructor), was detected in surveillance hives at the Port of Newcastle, New South Wales (NSW). Previously, Australia remained the only continent free of the varroa mite. In September 2023, the National Management Group decided to shift the focus of the response from eradication to management. It is estimated that the establishment of varroa mite in Australia could lead to more than $70 million in losses each year due to greatly reduced pollination services. Currently, there are no reported studies on the epidemiology of varroa mite in NSW because it is such a recent outbreak, and there is little knowledge of the factors associated with the presence of V. destructor in the Australian context. We sourced publicly available varroa mite outbreak reports from June 22 to December 19, 2022, to determine if urbanization, land use, and distance from the incursion site are associated with the detection of varroa mite infestation in European honeybee colonies in NSW. The outcome investigated was epidemic day, relative to the first detected premises (June 22, 2022). The study population was comprised of 107 premises, which were declared varroa-infested. The median epidemic day was day 37 (July 29, 2022), and a bimodal distribution was observed from the epidemic curve, which was reflective of an intermittent source pattern of spread. We found that premises were detected to be infected with varroa mite earlier in urban areas [median epidemic day 25 (July 17, 2022)] compared to rural areas [median epidemic day 37.5 (July 29, 2022)]. Infected premises located in areas without cropping, forests, and irrigation were detected earlier in the outbreak [median epidemic days 23.5 (July 15, 2022), 30 (July 22, 2022), and 15 (July 7, 2022), respectively] compared to areas with cropping, forests, and irrigation [median epidemic days 50 (August 11, 2022), 43 (August 4, 2022), and 47 (August 8, 2022), respectively]. We also found that distance from the incursion site was not significantly correlated with epidemic day. Urbanization and land use are potential factors for the recent spread of varroa mite in European honeybee colonies in NSW. This knowledge is essential to managing the current varroa mite outbreak and preventing future mass varroa mite spread events.

Lung Ultrasound Evaluation of Pulmonary Abnormalities in Children with Congenital Heart Diseases

Abstract Background and Aims Congenital heart disease (CHD) can cause several abnormalities of the lungs, such as pulmonary overflow (PO), pulmonary hypertension and chest infection like pneumonia. We aimed to assess pulmonary abnormalities using lung ultrasound (LUS) in children with congenital heart diseases. Patients and Methods This is a cross-sectional study, which included (33) CHD patients aged between 0.5 to 3.5 years who were admitted to the Cardiology Unit,Ain Shams University, Children’s Hospital. The patients were subjected to detecting any consolidation and measuring B vertical lines in all lung zones. LUS score was recorded at baseline and after course of management. Results There was statistically reduction in the after management group compared to the before management group according to LUS score with p-value (p &amp;lt; 0.001). There was a difference between types of management according to LUS score and its severity in the before management group, with p-value (p &amp;lt; 0.001) whereas, surgical type of management had the highest mean value of the LUS score compared to other types of management among our studied patients before management with a highly statistically significant difference, with p-value (p &amp;lt; 0.001). Conclusion Lung ultrasound is an ideal tool for the diagnosis and follow-up of pulmonary complications such as lung congestion, pulmonary edema and pneumonia. Also, there was improvement in pulmonary congestion after management among CHD children.

A Study on The Relationship between Coaching Styles towards Work Engagement in Artificial Intelligence Industries

An organisation with a large workforce from a variety of backgrounds collaborates on various projects with different groups of individuals in order to achieve specific goals. Employers who develop coaching relationships with staff members may create high-quality results. According to this viewpoint, an employee who is receiving excellent training or coaching will be able to interact with the tasks assigned successfully in order to meet the organisational aim. The objective of this study is to examine how managerial coaching, executive coaching, and group coaching relate to work engagement in artificial intelligence during the COVID-19 season. It is obvious that the best coaching methods, including managerial coaching, executive coaching, and group coaching, will boost employee involvement, excitement, drive, and motivation while producing great results. 110 personnel of the artificial intelligence business are involved in this study. For data gathering in this study, a survey was used as a quantitative method. In order to analyse the data for this study, Pearson's correlation coefficient and the Statistical Package for the Social Science (SPPS) version 29.0 were both employed. The findings indicated that executive coaching has a high mean average of 3.96 and a significant link (r=0.856, p=0.01) between executive coaching and work engagement. Despite the study's shortcomings, the empirical findings contribute to our understanding of job engagement and purpose in public organisations. Consequently, training is essential in an organisation.