High Quality Research Articles

Developing a Postpandemic Model for Hybrid Clinical Ethics Rotations in Postgraduate Medical Education.

Bioethics education in residency helps trainees achieve many of the Accreditation Council for Graduate Medical Education milestones and gives them resources to respond to bioethical dilemmas. For this purpose, The Providence Center for Health Care Ethics has offered a robust clinical ethics rotation since 2000. The importance of bioethics for residents was highlighted as the COVID-19 pandemic raised significant bioethical concerns and moral distress for residents. This, combined with significant COVID-19-related practical stressors on residents led us to develop a virtual ethics rotation. A virtual rotation allowed residents flexibility as they were called to help respond to the unprecedented demands of a pandemic without compromising high quality education. This virtual rotation prioritized flexibility to support resident wellbeing and ethical analysis of resident experiences. This article describes how this rotation was able to serve residents without overstraining limited bandwidth, and address the loci of resident pandemic distress. As pandemic pressures lessened, The Providence Center for Health Care Ethics transitioned to a hybrid rotation which continues to prioritize resident wellbeing and analysis of ongoing stressors while incorporating in-person elements where they can improve learning. This article provides a description of the rotation in its final form and resident feedback on its effectiveness.

Analyzing the adoption of nutrition-sensitive carp-SIS polyculture technology: evidence from a case study in Bangladesh

IntroductionSmall indigenous species (SIS) of fish are rich in micronutrients that are essential to combat the existing malnutrition in Bangladesh. However, their availability is constantly decreasing due to gradual environmental degradation making their availability irregular and hence expensive in the market. Integrating SIS with carps in homestead ponds is being promoted as a form of nutrition-sensitive aquaculture to enhance both production and consumption of these nutrient-rich species. Various improved pond management techniques (IPMTs) are suggested to boost the nutrition-sensitive carp-SIS polyculture.ObjectivesThis study examines the trends and factors influencing the adoption of IPMTs using the sustainable livelihood framework (SLF) approach. We address the following three key questions: (i) What are the trends in production and consumption of fish, in particular SIS from homestead ponds? (ii) Have farm households adopted or disadopted IPMTs over time? (iii) What are the determinants of adoption and disadoption of IPMTs?MethodsBased on primary data of 234 households from Barishal district from 2014 and 2022, we perform significance tests to compare project and non-project households in 2014 versus 2022 and apply fixed effects Poisson regression and fixed effects negative binomial regression models to identify household decisions to adopt the IPMTs.Results and conclusionQuantitative survey results indicate a significant increase in the production and consumption of SIS over time. In 2014, the project households exhibited adoption rates of 60% or more for various IPMTs such as stocking of fast-growing species, pre-stocking liming, pond dike construction, fertilizer application, stocking of high quality fish seeds, aquatic weed control, and turbidity management. However, by 2022, some of these IPMTs were disadopted by project households and only a few techniques, including providing sunlight exposure to ponds, pre-stocking liming, and supplementary feeding, were more widely used. Additionally, many non-project households also increased their adoption rates of IPMTs significantly. The fixed effects regression model shows that adoption is positively influenced by the number of household members participating in aquaculture, size of the pond, sole ownership of the pond and the number of years household has been involved in aquaculture. Follow-up activities such as monitoring and training of the project beneficiaries and government support are recommended to support long-term adoption of the IPMTs.

Effects of KNO3 Seed Priming and Fertilizer Management on Growth and Yield of Green Gram (Vigna radiata L.) in a Temperate Agro-climate

Green gram (Vigna radiate L) is one of the most important nutritive pulse crop. It is an excellent source of protein with high quality of lysine. Seed priming techniques are used to improve germination, to reduce the time between sowing and emergence and for uniform emergence in the main field, especially under adverse environment. Keeping in view the nutritive importance of green gram, an investigation was carried out to assess the effects of seed priming and nutrient management for higher yield in green gram at research farm of Division of Agronomy, Faculty of Agriculture Wadura SKUAST-K Sopore during kharief-2021&2022 and the experiment was laid out in randomized complete block design (RCBD) with twelve treatments viz T0-Control,T1-Priming with 1% KNO3,T2-RFD,T3-RFD+ Priming with 1% KNO3,T4-1/2RFD,T5-1/2RFD+ Priming with 1% KNO3, T6-1/4RFD,T7-1/4RFD+ Priming with 1% KNO3,T8-1/2RFD+VAM,T9- 1/2RFD+VAM+ Priming with 1% KNO3,T10-1/4RFD+VAM and T11-1/4RFD+VAM+ Priming with 1% KNO3. Among the treatments studied in both years, highest number of pod cluster per plant (9.66 and 9.33), number of pods per cluster (18.33 and 19.00), number of seeds per pod (13.00 and 13.33), 1000 -seed weight (43.66& 44.50 g) and yield per hectare (12.83 &13.30 q) respectively were noticed with full recommended dose of fertilizer along with seed priming by 1% KNO3.

HPB SO70 - Evaluating the Outcome of Laparoscopic Common Bile Duct Exploration Against Key Performance Indicator (KPI) of the British Benign Upper GI Surgical Society (BBUGSS)

Abstract Background Treatment of common bile duct (CBD) stone(s) can be challenging with a risk of significant complications. Laparoscopic common bile duct exploration (LCBDE) displays superior outcomes when compared to endoscopic retrograde cholangiopancreatography (ERCP). Acknowledging the impact of patient variables and surgical proficiency, the British Benign Upper GI Surgical Society (BBUGSS) developed Key Performance Indicators (KPIs) to optimize LCBDE outcomes. The present study comprises an audit of LCBDE outcomes with respect to the BBUGSS KPIs and aims to determine the feasibility and quality of LCBDE that can be achieved in a district general hospital (DGH) with a recently developed LCBDE service. Method This retrospective observational study examined all adult patients who underwent LCBDE between August 2022 and June 2024 by two specialized biliary surgeons at a single surgical unit within a DGH. This DGH also serves as a referral center for biliary cases from affiliated hospitals. The preference in our surgical unit is single stage management (laparoscopic cholecystectomy and simultaneous LCBDE) of CBD stones in surgically fit patients. The analysis included preoperative assessments, intraoperative observations, and postoperative outcomes, with respect to the published BBUGSS KPIs for LCBDE. Results 60 patients were eligible for inclusion; median age was 56 years (IQR 40-67) and 40 (66.7%) were female. 33 (55%) were emergency cases. 52 (86.7%) were transcystic exploration; of these 8 (15.4%) utilised basket-in-catheter and 44 (84.6%) utilised choledochoscopes. Median post-operative stay for transcystic exploration was 1 day (IQR 0-2) and for cholechodotomy 8 days (IQR 5-9). Key Performance IndicatorBBUGSS StandardOur outcomeConversion rates<10%0%Bile duct clearance rates>85%91.7%Bile Leak Rates<5%0%Returns to theatre<5%0%Readmission rates (within 30 days)<15%6.7%Overall Morbidity<15%3.3%Overall Mortality<1%0% Conclusion This study indicates that the BBUGSS KPIs for LCBDE are satisfactorily achieved in our centre. Adequate ductal clearance with minimal morbidity was achieved. Our outcomes are likely attributed to the recent commencement of a specialist biliary service and utilisation of predominantly transcystic approach, with the aid of electrohydraulic lithotripsy where needed, as opposed to choledochotomy. Furthermore, the present study suggests a high quality LCBDE service is feasible in a DGH setting if there is sufficient clinical and managerial motivation. We suggest that single stage management of bile duct stones model should be considered in other similar centres.

BS SO13 - Reversal of OAGB- Audit and steps of surgery

Abstract Background OAGB is a well-established procedure that gives good outcomes in terms of benefits from obesity related morbidity and weight loss. The nutritional complications of OAGB are not common. The most common complication for OAGB is bile reflux which can be controlled with medical or surgical management. The need to convert OAGB to normal anatomy or sleeve does not arise frequently. It is needed in a few patients. It is a technically challenging procedure and should be done in expert centers Method We would like to present a video on the steps of reversal surgery. We recorded our procedure and used imovies software to edit it demonstrating each step of surgery with a written commentary for ease of understanding We would also take this opportunity to present an audit of our series of patients. We gathered our operative sheets from December 2016- Jan 2024. There were 12 patients who needed conversion or reversal. 10 needed conversion to RYGB for bile reflux. 2 needed reversal to normal anatomy. Results High quality video presentation with narration talking about steps of surgery and results from our audit Conclusion Reversal surgery is a technically challenging procedure. It should be done in expert center. Also, since this surgery is not needed frequently, it needs expert surgeons.

HPB SO53 - Implementation of High Volume-Low Complexity 'GIRFT' lists for laparoscopic cholecystectomy

Abstract Background Waiting times for elective surgery have risen steadily since 2010, with particularly sharp increases after the Covid pandemic. There have been several initiatives to improve theatre productivity and increase operative numbers and these are broadly encompassed within GIRFT standards and the development of the concept of a High Volume-Low Complexity list. Current GIRFT standards recommend six laparoscopic cholecystectomies on an all-day operating list. This study aimed to describe the development and implementation of these lists within out district general hospital setting and outline the key barriers and solutions for other units to learn from. Method All patients on the waiting list for laparoscopic cholecystectomy were assessed and screened by a panel of consultant surgeons to assess suitability for a HVLC list. Theatre staff, anaesthetists and surgeons were widely consulted within local focus groups and a novel method of remuneration for additional work was developed: a 'cost-per-case (CPC)' remuneration structure was introduced (in contrast to standard remuneration by session time) to ensure productivity and high quality surgery. Operations were carried out on weekend lists in a dedicated accredited Elective Surgical Hub and staff were able to finish the day when all operations were completed. Results CPC lists took place from August 2023 to May 2024. All lists had six laparoscopic cholecystectomies or eight hernia repairs (or a combination) in line with GIRFT standards. Overall 124 cholecystectomies were performed and 119 were completed on a day case basis. The remaining 5 patients had a single night stay. There were no returns-to-theatre or major morbidity. All lists had started by 830AM and the latest finish time throughout the study period was 1525PM. The utilisation of CPC lists contributed to waiting times falling dramatically from over 52 weeks to 28 weeks by the end of the study period. Conclusion By utilising a novel form of remuneration, based on volume of work completed rather than time, we were able to maximise productivity without compromising safety whilst developing employment conditions that encouraged colleagues to perform additional work. Key facets to successful implementation include appropriate screening of cases, allowing staff to leave when the work is completed (rather than have to wait till the end of the day) and standardising equipment and kit to reduce wastage and turnaround time between cases. These lessons can be implemented in any surgical unit to improve productivity and increase volume of cases performed.

Hyoid Bone Position and Upper Airway Morphology of Children With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis.

The objective of this systematic review was to summarise the existing evidence regarding hyoid bone position and upper airway morphology of children with obstructive sleep apnea (OSA). Electronic searches were carried out in PubMed, Embase, Web of Science, CINAHL and WorldCat databases without any restrictions on language from inception to March 2024. The studies which compared the hyoid bone position and upper airway morphology using lateral cephalograms between children with and without OSA will be included. The methodological quality of the included studies was assessed using Newcastle-Ottawa Scale, and the meta-analysis was conducted utilising random-effects model. Twelve cross-sectional studies and one case-control study were included. One study was rated as low quality, three as medium quality, five as high quality, and four as very high quality. Meta-analysis showed that compared to healthy children, children with OSA tended to have increased distance between hyoid bone and mandibular plane (Hy-MP, MD: 3.33, 95% CI: 1.90 to 4.77, p < 0.00001, I2 = 72%), increased distance between hyoid bone and cervical vertebra (Hy-C3, MD: 1.54, 95% CI: 0.62 to 2.46, p = 0.001, I2 = 68%), and a smaller airway space behind the soft palate (U-MPW, MD: -3.07, 95% CI: -4.76 to -1.38, p = 0.0004, I2 = 68%). Whereas there was no significant difference in inferior posterior airway space between children with OSA and healthy controls (IPAS, MD: -1.51, 95% CI: -3.37 to 0.35, p = 0.11, I2 = 71%). In children with OSA, the hyoid bone may exhibit a more anterior and inferior position and the airway posterior to the soft palate demonstrated a narrower dimension. Registration: PROSPERO (CRD42024528171).

Large-Scale Parameter Estimation for Crystal Structure Prediction. Part 1: Dataset, Methodology, and Implementation.

Crystal structure prediction (CSP) seeks to identify all thermodynamically accessible solid forms of a given compound and, crucially, to establish the relative thermodynamic stability between different polymorphs. The conventional hierarchical CSP workflow suggests that no single energy model can fulfill the needs of all stages in the workflow, and energy models across a spectrum of fidelities and computational costs are required. Hybrid ab initio/empirical force-field (HAIEFF) models have demonstrated a good balance of these two factors, but the force-field component presents a major bottleneck for model accuracy. Existing parameter estimation tools for fitting this empirical component are inefficient and have severe limitations on the manageable problem size. This, combined with a lack of reliable reference data for parameter fitting, has resulted in development in the force-field component of HAIEFF models having mostly stagnated. In this work, we address these barriers to progress. First, we introduce a curated database of 755 organic crystal structures, obtained using high quality, solid-state DFT-D calculations, which provide a complete set of geometry and energy data. Comparisons to various theoretical and experimental data sources indicate that this database provides suitable diversity for parameter fitting. In tandem, we also put forward a new parameter estimation algorithm implemented as the CrystalEstimator program. Our tests demonstrate that CrystalEstimator is capable of efficiently handling large-scale parameter estimation problems, simultaneously fitting as many as 62 model parameters based on data from 445 structures. This problem size far exceeds any previously reported works related to CSP force-field parametrization. These developments form a strong foundation for all future work involving parameter estimation of transferable or tailor-made force-fields for HAIEFF models. This ultimately opens the way for significant improvements in the accuracy achieved by the HAIEFF models.

Marketing strategies to improve service quality at sports and fitness venues: a systematic review

The sports and fitness industry has seen accelerated growth with increasing public awareness about the relevance of health and well-being. Nowadays, facilities such as gyms, stadiums, swimming pools and fitness centers have become essential elements of lifestyle in society. Marketing strategies are important to attract and retain customers. The programs offered should be viewed as service products that have sales value. Therefore, implementing effective marketing strategies is necessary to compete, satisfy customer needs and increase customer loyalty. This research aims to conduct a systematic review of existing literature regarding marketing strategies for sports and fitness venues using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method. This study includes research published in the last 10 years from indexed journal sources and identifies important findings regarding the effectiveness of various marketing strategies in service and retaining customers. The research results shows that personalization of service, utilization of technology, deep understanding of customer needs, and high service quality are key strategies that can increase perceived value, satisfaction, and customer loyalty in the sports and fitness sector.

New winter common wheat variety ‘Saban’ for the middle Volga Region

Winter wheat in the Republic of Tatarstan is sown annually on an area of more than 300 K hectares. The purpose of the current work was to develop a new variety ‘Saban’ and characterize its ability to produce high yields and grain quality in the northern regions of the Middle Volga region. The study was conducted on the fields of the Tatarsky RIA, SSU of the FRC KazRC of RAS in 2020–2022. Seeds were laid in ‘black’ fallow at the optimal time. The variety ‘Saban’ was developed by the method of individual selection from a hybrid population obtained from crossing the varieties ‘Kazanskaya 285’ and ‘Bezenchukskaya 380’. On average, over three years of testing, winter resistance was 88 %, and the plant height was 74 cm, which is 9.7 cm lower than that of the standard variety ‘Kazanskaya 560’. Lodging resistance was 8.7 points with a coefficient of variation of 6.66 %. The variety ‘Saban’ is of the intensive type, responsive to the application of complex fertilizers. The variety was better than the standard variety ‘Kazanskaya 560’ in productivity by 0.64 t/ha. Under arid conditions of 2021 the variety yielded 4.20 t/ha, which was 0.65 t/ha more than the standard variety did. This result was due to the productive stem density and a large number of grains per ear. The variety produced heavy kernels, its nature weight was 770–802 g/l. Crude protein percentage in grain ranged from 13.2 % to 15.2 %, and gluten varied from 27.0 % to 29.7 %. The variety formed high indicators of rheological qualities, such as 301 u.a. of flour strength, and 59 % of valorimetric estimation. The general baking assessment for three years of study was 4.5 points. The variety can be recommended for cultivation in the Middle Volga region of the Russian Federation from 2024.

From the player to the sponsor: exploring the interplay of attitudes in MMA sports sponsorship

PurposeThis study aims to investigate the complex dynamics of sports sponsorship within the context of mixed martial arts (MMA). Specifically, it explores how audience attitudes toward MMA influence their perceptions of players and sponsors, and subsequently, how these attitudes affect brand perceptions and purchase intentions. Furthermore, this research examines the moderating effect of fans' attitudes toward MMA on the relationship between their attitudes toward sponsors and their purchase intentions. MMA was selected as the focus of this study due to its propensity to evoke more intense emotional responses than other sports, as evidenced by previous research.Design/methodology/approachStudy 1 was conducted to systematically assess the emotional responses elicited by MMA. This preliminary study involved 277 participants. Building on the findings from Study 1, Study 2 employed an online survey to investigate the relationships among various constructs related to MMA. This survey was facilitated through an external portal and included a sample of 459 participants residing in the United States. The constructs measured in this survey were attitudes toward the player (ATP), attitudes toward the sponsor (ATS), perception of brand quality (PBQ), purchase intention (ITP) and attitudes toward mixed martial arts (ATM).FindingsThe study reveals that respondents rated MMA the most negatively among the analyzed sports, with the highest standard deviation, indicating that MMA evokes extreme emotional responses. The findings confirm that attitudes toward the player positively influence attitudes toward the sponsor, aligning with sponsorship-linked marketing theory. Moreover, positive attitudes toward the player were found to enhance perceptions of the sponsor’s brand quality. The research further demonstrated that attitudes toward the sponsor and perceptions of brand quality mediate the relationship between attitudes toward the player and purchase intentions, underscoring the complex nature of consumer decision-making in MMA sponsorship.Originality/valueThis research provides novel insights into the critical role of audience engagement and personal connection with sports in formulating effective sponsorship strategies. It emphasizes the need for marketers to tailor their approaches to align with the sport’s personal significance to the audience, employing narratives that resonate with their identities and values. Enhancing player-sponsor associations through co-branded campaigns and endorsements is essential. Furthermore, consistently maintaining high product quality and fostering emotional connections with the sport are key strategies to drive increased purchase intentions.

Power Quality Analysis of a Microgrid-Based on Renewable Energy Sources: A Simulation-Based Approach

At present, microgrids (μGs) are a focal point in both academia and industry due to their capability to sustain operations that are stable, resilient, reliable, and of high power quality. Power converters (PCs), a vital component in μGs, enable the decentralization of power generation. However, this decentralization introduces challenges related to power quality. This paper introduces a μG model, based on the IEEE 14-bus distribution system, with the objective of investigating power quality when the μG is operating in conjunction with the conventional power grid. The μG model was developed using MATLAB-Simulink®, a tool specialized for electrical engineering simulations. The results obtained undergo thorough analysis and are compared with the compatibility levels set by the IEEE-519 standard. This method enables a precise evaluation of the μGs’ capacity to maintain acceptable power quality levels while interconnected with the conventional power grid. In conclusion, this study contributes significantly to the field of μGs by providing a detailed and quantitative assessment of power quality. This will assist in the design and optimization of μGs for effective implementation in real-world electric power systems.

Automated programming approaches to enhance computer-aided translation accuracy

With the continued development of information technology and increased global cultural exchanges, translation has gained significant attention. Traditional manual translation relies heavily on dictionaries or personal experience, translating word by word. While this method ensures high translation quality, it is often too slow to meet the demands of today’s fast-paced environment. Computer-assisted translation (CAT) addresses the issue of slow translation speed; however, the quality of CAT translations still requires rigorous evaluation. This study aims to answer the following questions: How do CAT systems that use automated programming fare compared to more conventional methods of human translation when translating English vocabulary? (2) How can CAT systems be improved to handle difficult English words, specialised terminology, and semantic subtleties? The working premise is that CAT systems that use automated programming techniques will outperform traditional methods in terms of translation accuracy. English vocabulary plays a crucial role in translation, as words can have different meanings depending on the context. CAT systems improve their translation accuracy by utilising specific automated programs and building a translation corpus through translation memory technology. This study compares the accuracy of English vocabulary translations produced by CAT based on automatic programming with those produced by traditional manual translation. Experimental results demonstrate that CAT based on automatic programming is 8% more accurate than traditional manual translation when dealing with complex English vocabulary sentences, professional jargon, English acronyms, and semantic nuances. Consequently, compared to conventional human translation, CAT can enhance the accuracy of English vocabulary translation, making it a valuable tool in the translation industry.

Pros and Cons of Different Irrigation Scheduling Approaches: A Review

Scheduling irrigation involves making a decision of how much water to apply and when. Three factors enter into the decision: water needs of the plants, water availability, and storing capacity of the soil around the roots. When to irrigate should be greatly influenced by water needs of the plants. Irrigation scheduling (IS) aims to give plants the right amount of water at the right times in order to promote plant growth and achieve high yield and/or quality. The four most popular ways of operating irrigation scheduling includes: evapotranspiration and water balance (ET-WB), soil moisture status, plant water status, and models based irrigation scheduling. When the four types of irrigation scheduling systems are thoroughly examined, it becomes clear that they are all centered on soil moisture, which serves as a link or bridge between crop water needed for growth and irrigation management). A few studies have been accomplished on pros and cons of different irrigation scheduling approaches. The purpose of this review was to provide some information on pros and cons of four selected irrigation scheduling methods, viz: evapotranspiration and water balance (ET-WB), soil moisture status, plant water status, and models based irrigation scheduling. When the four types of irrigation scheduling systems are thoroughly examined, it becomes clear that they are all centered on soil moisture, which serves as a link or bridge between crop water needed for growth and irrigation management. Plant-based techniques can need professional oversight since farmers may find it difficult to understand the tracked data, which reduces the dependability of irrigation. When built software or a procedure is based on a well-calibrated model, model-based methods are simpler for users. When compared to the soil moisture sample irrigation scheduling approach, the evapotranspiration losses irrigation scheduling method uses less irrigation water regardless of the minimal yield difference.

Can Friendship Quality Buffer the Impact of Parental Phubbing on Adolescents’ Gratitude? The Longitudinal Mediating Role of Basic Psychological Needs’ Satisfaction

This study aims to explore the longitudinal relationship between parental phubbing and adolescents’ gratitude, as well as the mediating role of basic psychological needs’ satisfaction and the moderating role of friendship quality. We conducted this longitudinal study in two waves with a 7-month, and surveyed 643 Chinese adolescents and constructed a moderated mediation model. The results indicated the following: First, there is a significant negative correlation between parental phubbing and adolescents’ gratitude. Second, adolescents’ basic psychological needs’ satisfaction mediates the relationship between parental phubbing and gratitude. Finally, friendship quality moderates the negative relationship between parental phubbing and adolescents’ basic psychological needs’ satisfaction and the mediating effect of basic psychological needs’ satisfaction. Specifically, compared to adolescents with lower friendship quality, the negative effect of parental phubbing on basic psychological needs’ satisfaction is stronger among adolescents with higher friendship quality, and the negative indirect effect of parental phubbing on gratitude through basic psychological needs’ satisfaction is also stronger in these adolescents. The findings suggest that parental phubbing is a significant risk factor for decreased adolescents’ gratitude, with high friendship quality adolescents being more susceptible to the impact of parental phubbing. The negative impact of parental phubbing outweighs the influence of friendship quality. This study provides insights into interventions promoting adolescents’ positive development.

Developing a construction waste management performance calculator for highway construction.

The generation of a substantial amount of construction waste (CW) poses significant challenges to the green transition of highway construction projects. However, the construction industry lacks integration of construction waste management (CWM) practices into the construction process. This paper aims to develop a calculation for assessing the performance of CWM to monitor its effectiveness in highway construction. Initially, this study utilizes the Site waste management plan (SWMP) as a foundation and develops a Construction Waste Management Performed Assessment Method (CWMPAM). The extension of CWM is incorporated into earned value management (EVM) to manage costs, schedules, and the performance of CWM within a unified framework. The functionality and sensitivity of CWMPAM and CWM-embedded EVM are validated through pilot testing and scenario analysis. The research results are computerized into a calculator to facilitate the practical application of CWM, and its validity is tested using random cases. CWMPAM and CWM-embedded EVM prove satisfactory in assessing and monitoring the execution and performance of CWM. The developed calculator simplifies the practical application of the outcomes. Essentially, the developed calculator represents a groundbreaking integration of CWM and construction management, enabling project managers to monitor and compare the CWM performance across different segments of highway construction. Not only does this contribute to the green transformation of highway projects, it also promotes high quality and sustainable development in the construction industry.

Studies on Effect of Planting Dates on Seed Quality of Onion (Allium cepa L.) in North Eastern Dry Zone of Karnataka, India

Aim: To study the effect of planting dates on seed quality of onion varieties. Study Design: Split plot design and FCRD. Place and Duration of Study: Agricultural Research Station, Hagari, University of Agricultural Sciences, Raichur (Karnataka) during Rabi 2023-24. Methodology: Two varieties as main plot with five planting dates as sub plots. Results: The results revealed that significantly highest seed germination (89.3 %), shoot length (8.97 cm), root length (7.02 cm) and seedling vigour index I and II (1428 and 1294, respectively) in D1 (1st fortnight of November). While, lowest seed germination (84.7 %), shoot length (7.65 cm), root length (6.04 cm), and seedling vigour index I and II (1250 and 1047, respectively) in D5 (1st fortnight of January). Among the varieties, Bhima super (V2) registered significantly highest seed germination (87.8 cm), shoot length (8.49 cm), root length (6.18 cm), and seedling vigour index I and II (1291 and 1116, respectively). Whereas, lowest seed germination (86.5 cm), shoot length (8.07 cm), root length (5.89 cm), and seedling vigour index I and II (1209 and 978, respectively) recorded in Bellary red (V1). Conclusion: The results of present investigation revealed that, bulbs planted during 1st fortnight of November and Bhima super were found to be superior for high quality seed production of onion.

Abstract 4131622: Opportunistic Screening of Chronic Liver Disease With Deep Learning Enhanced Echocardiography

Introduction: Chronic liver disease affects more than 1.5 billion adults worldwide, but the majority of cases are asymptomatic and undiagnosed. Echocardiography is broadly performed and visualizes the liver; however, this information is not diagnostically leveraged. Hypothesis and Aims: We hypothesized that a deep-learning algorithm can detect chronic liver diseases using subcostal echocardiography images that contains hepatic tissue. To develop and evaluate a deep learning algorithm on subcostal echocardiography videos to enable opportunistic screening for chronic liver disease. Methods: We identified adult patients who received echocardiography and abdominal imaging (either abdominal ultrasound or abdominal magnetic resonance imaging) with ≤30 days between tests. A convolutional neural network pipeline was developed to predict the presence of cirrhosis or steatotic liver disease (SLD) using echocardiogram images. The model performance was evaluated in a held-out test dataset, dataset in which diagnosis was made by magnetic resonance imaging, and external dataset. Results: A total of 2,083,932 echocardiography videos (51,608 studies) from Cedars-Sinai Medical Center (CSMC) were used to develop EchoNet-Liver, an automated pipeline that identifies high quality subcostal images from echocardiogram studies and detects presence of cirrhosis or SLD. In a total of 11,419 quality-controlled subcostal videos from 4,849 patients, a chronic liver disease detection model was able to detect the presence of cirrhosis with an AUC of 0.837 (0.789 - 0.880) and SLD with an AUC of 0.799 (0.758 - 0.837). In a separate test cohort with paired abdominal MRIs, cirrhosis was detected with an AUC of 0.726 (0.659-0.790) compared to MR elastography and SLD was detected with an AUC of 0.704 (0.689-0.718). In the external test cohort of 66 patients (n = 130 videos), the model detected cirrhosis with an AUC of 0.830 (0.738 - 0.909) and SLD with an AUC of 0.768 (0.652 – 0.875). Conclusions: Deep learning assessment of clinically indicated echocardiography enables opportunistic screening of SLD and cirrhosis. Application of this algorithm may identify patients who may benefit from further diagnostic testing and treatment for hepatic disease.

Pondering the problem of peri-implant pathology.

Randomised control trials were identified via searches of PubMed, Embase, Web of Science and The Cochrane Library. Only randomised control trials involving adults with at least a single dental implant which had experienced peri-implant mucositis or peri-implantitis were considered. Within studies, one cohort must have been treated with a combination of mechanical debridement (MD) and non-surgical strategies, and the other solely by mechanical debridement. Outcomes were measured using periodontal indices such as bleeding on probing, and each group needed to comprise minimum five patients. Extracted information included the name of the lead author, size of patient groups, length of follow-up and the main results from the studies. The results indicated that in peri-implantitis the most effective treatment in reducing periodontal pocketing depths (PPDs) was photo biomodulation therapy and MD, while systemic antibiotics and MD were the most effective in improving clinical attachment loss and marginal bone loss. With regards to peri-implant mucositis; probiotics and MD yielded the best improvement in PPDs and plaque index, whereas systemic antibiotics with MD improved bleeding on probing the most. This analysis gives potentially useful data regarding specific treatment combinations for peri-implant disease. In light of this, it may help in guiding clinical decisions, but should be used in conjunction with recognised guidelines, and further high quality primary research is still required in the field.

Perspective on patient-centered communication: a focus group study investigating the experiences and needs of nursing professionals.

Delivering high quality care tailored to patients' needs necessitate patient-centered communication. High physical and mental workload, as well as organizational barriers, contribute to challenges nurses face in patient-centered communication. Participation in a communication skills training can help nurses to improve their patient-centered communication skills. Thus, the aim of this study was to investigate the experiences of nursing professionals in patient-centered communication and delineate the requisite content for a communication skills training. We conducted focus group interviews with nursing professionals working at an academic medical center in Germany. The focus group interviews were audio-recorded and transcribed verbatim. Data analysis was performed using Kuckartz's qualitative content analysis. 31 nursing professionals from diverse medical disciplines (e.g., pediatrics, obstetrics, cardiology, neurology, oncology) participated in the study, unveiling a spectrum of communication experiences, including organizational and system-related challenges, constraints induced by the COVID-19 pandemic, management of personal emotions, and communication challenges with patients and relatives. They also identified aspects they experienced as beneficial for patient-centered communication (e.g., allocating sufficient time, being authentic, providing clear information). Furthermore, participants identified specific aspects, which should be included in a patient-centered communication skills training. The findings suggests that not only nurses from oncology and intensive care, but also from other medical disciplines, experience significant communication challenges with patients and relatives. Applying patient-centered aspects of communication was considered beneficial for effective communication. The needs identified through participants' experiences (e.g., core communication skills and strategies, handling escalating situations, and discussing serious illness, death and dying) informed the development of a patient-centered communication skills training specifically tailored for nursing professionals across diverse medical disinclines in Germany.