High Level Research Articles

Pengaruh Perencanaan Program Kesiswaan Terhadap Pengembangan Karakter Siswa di Sekolah Menengah Pertama

The student program, which includes extracurricular activities, student organizations, and social activities, plays an important role in supporting the character development of students. This research aims to analyze the influence of student participation in extracurricular programs on character development at SMPN Sijunjung. This study employs a quantitative method with a survey approach and cross-sectional design. The research sample consists of 200 students randomly selected from several middle schools in Sijunjung. Data were collected using a Likert scale questionnaire to measure students' perceptions of their participation in student programs and character development. Data analysis was conducted using descriptive and inferential statistical tests, specifically Pearson correlation, using SPSS software. The research results indicate that students' participation in student programs is positively and significantly related to their character development, with a Pearson correlation value of r = 0.65. Sports extracurricular programs have the strongest influence on character development, followed by student organizations. More frequent participation in student activities is also associated with a higher level of character development. This research suggests the need for an improvement in the quality of student programs and stronger support from teachers, parents, and school authorities to maximize the positive impact on students' character

Psychological barriers in children: an exploratory study on Dengue transmission using an adapted DIPB scale

Dengue is an arboviral infection found in tropical and subtropical regions transmitted by hematophagous mosquitoes from the genus Aedes spp. and responsible for millions of cases every year. Public campaigns and educational curriculum are designed to educate people, including children. However, what has been reported is that many decide not to follow these guidelines, even though they allegedly know what has to be done. To understand this phenomenon, this study aims to identify psychological barriers behind the adoption of pro-environmental behaviors that seek to reduce Aedes aegypti’s population. For that, middle school students participated on two studies responsible for (1) adapting the Dragons of Inaction Psychological Barrier (DIPB) scale to the target group (n = 150) and then (2) testing it on a larger group (n = 449). In the exploratory factor analysis, Bartlett correlation (p < 0.001), Cronbach’s alpha (0.83), and KMO analysis (overall MSA = 0.84) showed that data was suited for factor analysis. Five factors were retained by Kaiser Criterion and scree test (i.e., Conflicting goals and unnecessary changes—α 0.76, Interpersonal relations—α 0.72, Conflicting goals and lacking knowledge—α 0.58, Tokenism—α 0.73, and Tokenism toward the government—α 0.66). After that, the scale was tested across 11 different schools, where students also answered a questionnaire about the mosquito. Results suggested that the factors Conflicting goals and lacking knowledge and Tokenism toward the government presented a higher level of agreement for all students (means: 2.6 and 2.12 out of five, respectively). Those who scored higher in the mosquito’s questionnaire had factors Conflicting goals and unnecessary change and Interpersonal relations inhibited when compared to others (p < 0.05). These results suggests that future educational campaigns should build different actions that focuses on addressing both internal and external factors, creating a mosaic of projects, with different goals, each aiming different environmental challenges.

Welfare assessment of dromedary camels kept under pastoralism in Pakistan

Standardized welfare assessment protocols are crucial to enhance animal welfare; up to date, there is no data on the level of welfare of camels kept under pastoralism. A tailored protocol for measuring welfare in dromedary camels kept under nomadic pastoralist conditions was recently developed, drawing from the currently available welfare protocol for dromedary camels kept in intensive systems. This study, therefore, aimed to apply the newly developed tailored protocol and assess the welfare of dromedary camels kept under pastoralism in the Southern Punjab Province of Pakistan. A total of 44 welfare indicators (animal-, resource, and management-based measures) aligning with animal welfare principles (“Good Feeding”, “Good Housing”, “Good Health”, and “Appropriate Behavior”) were gathered into two assessment levels: “Caretaker-Herd level” and “Animal level”. Data were collected in 2023 in the Cholistan desert in the southern Punjab province. Fifty-four herds were evaluated for a total population of 1,186 camels, of which 510 (495 females and 15 males; average age: 5–6 years old) were assessed at the animal level. The indicators were scored and aggregated to obtain Principle Aggregated Indexes (PAIs) and a total Welfare Index (TWI). Using the PAIs classification, 4 herds were categorized as excellent, 42 satisfactory, and 8 unsatisfactory. Total Welfare Index (TWI) varied from 55.7 to 82.2, and the thresholds for classification into tertiles were 65.4 and 70.6. Good feeding and Good housing were the most problematic PAIs, with Good feeding as the most influential variable for classification into welfare categories. As expected, camels kept under pastoralism had a higher level of welfare than those reported in the literature for intensive systems, especially concerning the Appropriate Behavior principle. Our findings are a first step in proposing welfare standards for dromedary in Pakistan and worldwide.

Contemporary prenatal diagnosis of congenital heart disease in a regional perinatal center lacking onsite pediatric cardiac surgery: obstetrical and neonatal outcomes.

Determine obstetrical and neonatal outcomes in neonates with major CHD delivered at a level IV neonatal intensive care units (NICU) center lacking onsite pediatric cardiac surgery. A 10- year retrospective review of all neonates admitted to our level IV NICU, with CHD between January 1st, 2011 and December 31st, 2021. Births and NICU charts were cross queried with those from our perinatal center which include pediatric cardiology records. Terminations and stillbirths were excluded. A total of 285 neonates with major CHD and 78 withminor defects were included. In the major CHD group, 82.8 % had an isolated cardiac anomaly and 17.2 % had an extracardiac anomaly. Type of extracardiac anomaly had noimpact on neonatal survival. Prenatal diagnosis of aneuploidy did not impact survival in major CHD. Truncus arteriosus had the highest NICU mortality at 34.0 % followed by hypoplastic left heart syndrome (HLHS) at 31.6 %. Double outlet right ventricle with transposition of the great vessels and interrupted aortic arch (both types) had a 25 % mortality. Neonates with truncus arteriosus and total anomalous pulmonary venous returns were likely to have 5-min Apgar score<7. Transfer rate of neonates with major CHD for cardiac surgery was 58.6 %. Of those 81.5 % were discharged home, 14.3 % expired before discharge, and 1 % were transferred elsewhere post-operatively for higher level of care. Neonates with major CHD can deliver safely at a level IV NICU lacking onsite pediatric cardiac surgery. Our neonatal mortality was high for HLHS and truncus arteriosus, however comparable to other centers with proximate pediatric cardiac surgery.

First detection of fungal diversity associated with Prunus salicina Lindl malformation syndrome

The Chinese deciduous fruit Prunus salicina Lindl is loved by people because of its distinctive flavor and significant industrial worth. This study presents the first report of abnormal leaf bud in Prunus salicina Lindl. Malformation of Prunus salicina Lindl leaf buds leads to abnormal development and growth, causing deformities and a decrease in fruit yield. Identifying the underlying causes and causative pathogens is essential for effective disease management. In this experiment, we observed the Malformation Syndrome in Prunus salicina Lindl and used the internal transcribed spacer (ITS) to compare fungal diversity between malformed and healthy leaf buds. These results show a higher level of fungal diversity in diseased leaf buds. Alternaria, Curvibasidium, Symmetrospora, Fonsecazyma, and other genera among the identified fungi are suspected to induce the malformations. Potential contributors to these malformations include Endophyte-plant_Pathogen and Plant_pathogen-Undefined_saprotroph. These findings provide valuable insights for further research on the etiology of plum bud diseases, identifying potential pathogens, and formulating control strategies.

Evaluation of renal function: choosing the right equation

The article presents examples of the difference in estimated GFR (eGFR) results obtained using different CKD-EPI creatinine equations (2009) and (2021). In these examples, the results were not reclassified to a higher level of renal function, but the eGFR obtained remained within the same CKD stage despite the different equations. However, it should be borne in mind that a significant reclassification to higher eGFR categories may have undesirable consequences, such as changes in the composition of the CKD population and for initiation of renoprotection measures, dosing and discontinuation of certain medications, timely referral to a nephrologist and RRT planning.The article presents validated eGFR estimating equations according to the KDIGO 2024 Guidelines for the Evaluation and Management of CKD (CKD-EPI creatinine equation (2009), CKD-EPI creatinine equation (2021), CKD-EPI creatinine-cystatin C equation (2021), EKFC equation et al.), as well as eGFR calculators available on the National Kidney Foundation (NKF) website.

Young people’s civic engagement in Italy: evidence on grade 8 students from the international civic and citizenship education study (ICCS) 2016

Civic engagement represents a key aspect of a democratic society and is itself a multidimensional construct. Research has shown that the promotion of civic engagement is an important component of civic and citizenship education intended in a broad sense, pertaining to formal, non-formal and informal learning situations. Within a national scenario characterised by increasing levels of general institutional disaffection and a lack of electoral and political involvement, the recent reform in the area of civic and citizenship education (Law 92/2019) has led to lively debates on the status of its implementation in Italian schools and recent research at the national level has highlighted the lack of activities to promote students’ engagement. This study further investigates the ICCS 2016 findings on civic engagement of Italian students with two objectives: to identify possible groups of Italian eighth-grade students on the basis of their level of civic engagement and to examine the associations among these groups and some key factors reflecting school contexts and students’ attitudes and behaviours. To reach these goals, the data analyses encompassed a latent profile analysis and a logistic regression model. The latent profile analysis allowed the identification of three groups of Italian students: disengaged, moderately engaged and engaged students. The results of the regression model showed that engaged students were characterised by a higher level of citizenship self-efficacy. These findings confirm those of previous research on the key role of internal self-efficacy in promoting students’ civic engagement.

Cu (ii) Immobilized on Mesoporous Poly (Guanidine–Triazine–Sulfonamide) (PGTSA/Cu): A New Catalyst for the Synthesis of Tetrazolo[1,5‐a]pyrimidines

ABSTRACTThe study focuses on the synthesis and characterization of a new mesoporous polysulfonamide stabilizer using condensation polymerization and the nanocasting technique. The resulting material, PGTSA, was modified with copper ions and used as a nanocatalyst in the reaction of benzaldehydes, 1H‐tetrazole‐5‐amine, and malononitrile. The performance of the mesoporous PGTSA/Cu (II) was compared with non‐porous PGTSA/Cu (II), highlighting the significance of support porosity in catalytic activity and loading of copper species. Based on the analysis of the ICP and catalytic performance, it was observed that mesoporous PGTSA/Cu (II) exhibited a higher level of catalytic activity compared to PGTSA/Fe3O4/Cu (II) and non‐porous PGTSA/Cu (II). Also, the catalytic activity of the aryl aldehyde was significantly influenced by its electrical characteristics. The recovery and reusability of the PGTSA/Cu (II) catalyst are noteworthy aspects, highlighting the practicality and sustainability of the catalytic system. The amount of copper in fresh catalyst and the recycled catalyst after six times recycling is 1.57% and 1.52%, respectively. Therefore, ICP‐OEIS analysis indicated that copper leaching of this catalyst is very low. The procedure offered high product yields, easy recovery of the nanocatalyst, remarkable reusability, short reaction times, and compatibility with various substrates.

Evaluation of durum and hard red spring wheat panels for sensitivity to necrotrophic effectors produced by Parastagonospora nodorum.

Septoria nodorum blotch is an important disease of both durum and hard red spring wheat (HRSW) worldwide. The disease is caused by the necrotrophic fungal pathogen Parastagonospora nodorum when compatible gene-for-gene interactions occur between pathogen-produced necrotrophic effectors (NEs) and corresponding host sensitivity genes. To date, nine sensitivity gene-NE interactions have been identified, but there is little information available regarding their overall frequency in durum and HRSW. Here, we infiltrated a global HRSW panel (HRSWP) and the Global Durum Panel (GDP) with P. nodorum NEs SnToxA, SnTox1, SnTox267, SnTox3, and SnTox5. Frequencies of sensitivity to SnTox1 and SnTox5 were higher in durum compared to HRSW and vice versa for SnTox267 and SnTox3. Strong associations for the known sensitivity loci Tsn1, Snn1, Snn2, Snn3, Snn5, and Snn7 along with potentially novel sensitivity loci on chromosome arms 7DS and 3BL associated with SnToxA and SnTox267, respectively, were identified in the HRSWP. In the GDP, Snn1, Snn3, and Snn5 were identified along with novel loci associated with sensitivity to SnTox267 on chromosome arms 2AS, 2AL, and 6AS and with SnTox5 sensitivity on 2BS and 7BL. These results reveal additional NE sensitivity loci beyond those previously described demonstrating a higher level of genetic complexity of the wheat-P. nodorum system than previously thought. Knowledge regarding the prevalence and genomic locations of SNB susceptibility genes in HRSW and durum will prove useful for developing efficient breeding strategies and improving varieties for SNB resistance.

Avatar Detection in Metaverse Recordings

The metaverse is gradually expanding. There is a growing number of photo and video recordings of metaverse virtual worlds being used in multiple domains, and the collection of these recordings is a rapidly growing field. An essential element of the metaverse and its recordings is the concept of avatars. In this paper, we present the novel task of avatar detection in metaverse recordings, supporting semantic retrieval in collections of metaverse recordings and other use cases. Our work addresses the characterizations and definitions of avatars and presents a new model that supports avatar detection. The latest object detection algorithms are trained and tested on a variety of avatar types in metaverse recordings. Our work achieves a significantly higher level of accuracy than existing models, which encourages further research in this field.

A multi-index comprehensive evaluation method for assessing the water use balance between economic society and ecology considering efficiency-development-health-harmony.

Quantitative assessment of the water use balance between economic society and ecology (EEWB) is the basis for coordinating the competitive relationship of water use between human activity and ecological requirements and. It is of great significance for optimizing the water resources carrying capacity and achieving a healthy regional water balance. Based on the concept of harmonious balance, this paper puts forward the definition and connotation of EEWB regarding the competition in water use between economic society and ecology. And, a novel framework for assessing the EEWB is proposed. It has four aspects relating to water resources, economic society, ecology, and human-water relationship. Linked to these aspects the Data Envelopment Analysis (DEA) technique, Water Ecological Footprint (WEF) model, InVEST model and indicators system of human-water relationship are used to establish a water resources efficiency index (IEEWB-W), economic society high-quality development index (IEEWB-ES), ecology health index (IEEWB-E), harmony index of human-water relationship (IEEWB-H). The four indices were then integrated into the water use balance between economic society and ecology index (IEEWB) with Euclidean distance, thus forming the EEWB quantification method system. Finally, the temporal and spatial characteristics of EEWB during 2010-2022 was diagnosed in Henan Province and cities of China. Results reveal that: (1) The water resources utilization efficiency exhibit a changing trend of initial decrease followed by subsequent increase; (2) Southern cities in Henan Province have a higher economic society development level compared to northern cities; (3) IEEWB-E in Henan Province is below 0.60, indicating that the regional ecology health remains consistently vulnerable; (4) IEEWB-H in Henan Province shows an increasing trend, indicating that a gradual improvement and overall upward development in the human-water relationship; (5) IEEWB multi-year average was within [0.53, 0.65] in Henan Province, indicating a state of Proximity imbalance. The low level of ecological health is the primary influencing factor. These findings will contribute to a better understanding of the water use balance between economic society and ecology and provide scientific reference for achieving a healthy regional water balance.

Relationship between smoking, excessive androgen and negative emotions in women with polycystic ovary syndrome (PCOS)

BackgroundLifestyle intervention is the first-line treatment for PCOS. Numerous studies have investigated the effect of various lifestyle factors, including dietary habit, smoking, and alcohol consumption on PCOS women. These studies have found that such factors may be associated with physiological parameters such as androgen, and emotional states like anxiety or depression. Smoking, a harmful lifestyle habit widely recognized to contribute to various diseases, has also been found to be related to PCOS. Current research has not adequately compared the effects of smoking with other lifestyle habits on PCOS, and there is little mention of its relationship with the emotional states of patients with PCOS. To further elucidate the association between smoking and other lifestyle factors with clinical symptoms in patients with PCOS, we conducted a cross-sectional evaluation using data from Peking University Third Hospital, with a special focus on analyzing smoking habits and comparing it with a variety of lifestyle factors.MethodsThis cross-sectional study included 601 PCOS women and 184 healthy controls who underwent physical examinations, hormone profiles and psychological measures. We assessed the association between smoking and the clinical symptoms in PCOS women.ResultsWe found a significant correlation between smoking and the degree of depression in PCOS women among the three emotional states: anxiety, depression, and stress. Smoking was also significantly associated with testosterone level in PCOS participants, suggesting that PCOS women who smoke exhibited more severe depressive symptoms and higher testosterone level. In addition, compared to the control group, PCOS women had notably higher testosterone (T) and luteinizing hormone (LH) levels. Smoke and alcohol were statistically significantly more common in women with PCOS than the Control.ConclusionWomen with PCOS who smoke were found to have elevated testosterone levels and more severe depression. These findings suggest that clinicians should monitor smoking women with PCOS for symptoms of depression and assess their hyperandrogenic status.

Enhancing Learning Engagement in the Flipped Classroom using a Video-Annotation Tool

In the realm of academia, there has been a burgeoning interest in examining student engagement within the context of the flipped classroom approach, particularly at the higher education level. Nevertheless, research pertaining to a pivotal facet of this pedagogical methodology—namely, student engagement during the individualized, at-home preparatory phase—remains limited. Within this void, the primary objective of this study is to delve into the prospective benefits offered by a video annotation tool in augmenting students’ level of engagement during this autonomous study phase. Throughout the course of this investigation, a bespoke questionnaire was crafted, grounded in a multifaceted framework for evaluating student engagement, with a specific emphasis on dissecting four distinct dimensions: behavioral, emotional, agentive, and cognitive. This questionnaire is geared towards gauging student engagement within the domain of the Flipped Classroom model that relies on video-based instructional content—a facet heretofore poorly explored within the scholarly literature. Both quantitative and qualitative data were collected by administering the aforementioned questionnaire to a cohort of 68 undergraduate engineering students at Politecnico di Milano (Italy), all within the authentic context of a case study. The outcomes stemming from this empirical inquiry showcase a noteworthy enhancement in student engagement, with particular prominence accorded to the realms of emotional and agentive engagement. Moreover, this study establishes that the interactivity and proactive involvement necessitated by the video annotation tool do not obstruct students’ behavioral and cognitive engagement levels. In summation, this research endeavors to illuminate the potentiality of bridging a pivotal juncture in the Flipped Classroom paradigm, specifically the phase characterized by independent at-home study. This bridge is facilitated by the utilization of a video annotation tool designed to heighten student engagement. This transformative approach effectively transmutes the traditionally passive at-home study phase of the Flipped Classroom into an active experience, thereby enhancing the overall efficacy of this pedagogical approach.

How do rest-pause and sarcoplasma stimulating training models affect metabolic and psychoaffective responses in bodybuilding athletes compared to traditional training?

IntroductionStrength training (ST) is a strategy to enhance quality of life through increased strength, muscle hypertrophy, and functional capacity. Training systems are associated with manipulation of volume and intensity, generating different stimuli, such as Rest-Pause (RP) and Sarcoplasmic Stimulating Training (SST). These systems induce greater mechanical and physiological stress, leading to increased strength and muscle hypertrophy. However, the metabolic and psycho-affective effects of advanced systems in experienced practitioners remain inconclusive. The purpose of the study is to analyze the acute effects of RP, SST, and Traditional (TMS) systems on metabolic and psycho-affective responses in adult men.MethodsThis experimental crossover study assessed 15 subjects (30.38 ± 2.06 years; 88.40 ± 6.50 kg; 1.74 ± 0.07 cm) experienced in ST, evaluated under TMS, RP, and SST during flat bench press and leg press 45° exercises. Body composition, muscular strength via 1-RM testing, lactate concentration (LAC), and psycho-affective measures (Rating of Perceived Exertion-RPE; Visual Analog Scale-VAS; Feeling Scale-FS) were determined. Statistical analysis was performed using the Minitab software, with p ≤ 0.05, IC-95%).ResultsThe finals results showed SST exhibited a 38.10% lower LAC concentration post-training session compared to TMS, while RP showed 37.20% lower LAC concentration than TMS post-session. Average RPE values for RP and SST were higher (8.50 ± 1.10 and 8.60 ± 0.90, respectively) than TMS (6.00 ± 1.10). VAS displayed higher average values for RP and SST (8.00 ± 2.00 and 8.00 ± 1.00, respectively) compared to TMS (5.00 ± 1.00), with affective ratings indicating positive values for TMS and values between 0 and −5 for RP (40%) and SST (60%) post-training sessions, suggesting that RP and SST induced less affective response than TMS.DiscussionThe results lead to the conclusion that manipulation of training volume and intensity led to higher RPE and pain (VAS). The data suggest that inappropriate prescription of these systems could lead to greater displeasure, leading us to hypothesize that a higher likelihood of discontinuation from strength training programs would occur, suggesting that greater repetition volumes (RP and SST) should be targeted at individuals with a higher training level.

Use of Complementary and Alternative Medicine by Greek Patients with Inflammatory Bowel Disease

Background and Objectives: Complementary and alternative medicine (CAM) is regularly used by several patients with inflammatory bowel disease (IBD) in many countries. Data concerning the use of CAM in Greek patients with IBD are lacking. This study aimed to determine the prevalence and indicators of CAM use in Greek IBD patients. Patients and Methods: Adult patients with IBD attending our specialized IBD department in “Metropolitan General” Hospital, Holargos, Greece, completed a special questionnaire regarding the use of CAM. Several clinical and epidemiological characteristics were recorded. The results were compared with a disease-control group (patients with irritable bowel syndrome or gastroesophageal reflux disease). The study outcome was the prevalence of CAM use in both groups. In this study, 270 patients, of whom 128 were female, with IBD (Crohn’s disease 134 and ulcerative colitis 136) and a median age of 42.3 ± 17.5 years (range 31–52), and 138 patients serving as the disease control group were analyzed. Results: The prevalence of previous and current CAM use in patients with IBD was 36.3% versus 27.5% in the control group (no significant differences). No significant differences were also noticed between the patients with either CD or UC. In the multivariable analysis, university education and treatment with steroids and TNF-α inhibitors were independent social indicators of CAM use. Conclusions: The percentage of CAM use by the Greek patients with IBD was quite high, similar to other European countries. Although numerically higher, this percentage was not significantly different compared with the disease control group. The use of CAM in IBD patients in Greece is associated with a higher educational level, and treatment with steroids and TNF-α inhibitors.

Impact of the digital trade on lowering carbon emissions in 46 countries

Digital trade, as one of the vanguards of the global technological revolution and industrial transformation, empowers low-carbon economic cooperation on a global scale. This study based on panel data from 2007 to 2021 of 46 countries with varied development levels, constructed a multi-dimensional indicator system from six aspects: trade potential, digital infrastructure, digital innovation, digital skills and security, scale of digital trade, and digital trade environment, aim to measure the development level of digital trade and explore its impact on carbon emissions, followed by a heterogeneity analysis. The research results indicate that there are significant differences in the development levels of digital trade among countries with different economic strengths. Countries with stronger economic power and larger trade scales have a higher level of digital trade development, while less developed regions lag in digital trade. As the level of digital trade development increases, the impact of digital trade on carbon emissions will also change. Overall, digital trade exhibits a pronounced low-carbon effect, while its impact varies among countries with different development levels.

The hybrid immunity defined by weaker immune imprinting of people living with HIV has a stronger neutralizing response against Omicron variants. A suggested explanation for fewer symptoms in people living with HIV after SARS-CoV-2 variants breakthrough infection

AimsHuman immunodeficiency virus(HIV) co-infection may cause different immune imprinting, which leads to different hybrid immunity and clinical manifestations of coronavirus disease 2019. This study aims to evaluate the immune imprinting from wild-type(WT) vaccination in people living with HIV(PLWH) and analyze its effect on hybrid immunity and clinical manifestations. Materials and methodsWe enrolled 118 PLWH to compared the differences of BA.5-specific immune response in different immune modes. 20 vaccinated healthy individuals(HC) and 30 vaccinated PLWH were matched to compare the differences of the status of Omicron infection, serum neutralizing antibody levels against WT and BA.5, and specific lymphocytes expression, separately. Key findingsHybrid immunity had a higher level of BA.5 IgG than either vaccine immunity only or natural immunity only in PLWH but didn't have a higher level of BA.5-specific lymphocytes responses. PLWH had fewer symptoms than HC after breakthrough infection. The neutralizing inhibition rate of PLWH was higher for BA.5 and lower for WT, while the neutralizing inhibition rate of HC was higher for WT and lower for BA.5. The difference value of specific B lymphocytes/memory B cells/follicular helper T cells of PLWH was greater than that of HC. SignificanceHybrid immunity of PLWH has a higher level of Omicron-specific IgG without a higher level of Omicron-specific lymphocytes due to immune imprinting. However, there is a stronger neutralizing ability against variants of PLWH due to the weaker immune imprinting of PLWH than that of healthy people, which may lead to fewer symptoms in PLWH after breakthrough infection.

Reduced vancomycin susceptibility in Staphylococcus aureus clinical isolates: a spectrum of less investigated uncertainties

BackgroundStaphylococcus aureus clinical isolates with vancomycin MICs of 2 µg/ml have been associated with vancomycin therapeutic failure and the heterogenous vancomycin-intermediate S. aureus (hVISA) phenotype. While carriage of van genes has usually been associated with higher level of MIC and frank vancomycin resistance, the unrecognized risk of hetero-resistance is frequently underestimated. Methods used for assessing vancomycin susceptibility have also shown different concordance and variable performance and accessibility in routine clinical diagnostics posing a challenge to inform treatment selection in hospital settings.MethodsA total of 195 clinical samples were obtained among which 100 S. aureus isolates were identified. Ninety-six MRSA isolates have been identified using cefoxitin disc and mecA gene detection. The vanA and vanB genes have been screened for in the studied isolates using conventional PCR amplification. Examination of reduced vancomycin susceptibility has been performed using vancomycin screen agar, Broth Micro Dilution method (BMD), and VITEK2. Blood isolates were screened for hVISA using PAP-AUC method.ResultsVancomycin screening agar applied to 96 MRSA isolates revealed 16 isolates with reduced vancomycin susceptibility. Further MIC testing revealed that 7 isolates were VISA and only 1 isolate was identified as VRSA using both BMD MIC method and VITEK2. Among 24 tested blood isolates, 4 isolates (16.7%) revealed the hVISA phenotype as identified using PAP-AUC method. Using PCR, vanA gene was identified in 5 S. aureus isolates (5%). Three of them were VSSA while the other two isolates were VISA.ConclusionIn this study, we report the very low prevalence of VRSA among the tested S. aureus clinical isolates (1%) and the existence of hVISA phenotype among studied S. aureus blood isolates at the rate of 16.7% in our setting. Fifty percent (8/16) of isolates that demonstrated reduced vancomycin susceptibility using vancomycin agar screen tested susceptible using both broth dilution method and VITEK2. These finding together with the concerning silent carriage of vanA gene among VSSA and VISA (5%) may underly hidden and uninvestigated factors contributing to vancomycin treatment failure that warrant cautious vancomycin prescription.

The Role of Indigenous Plants in Sustaining Food Sources in Lesten Village, Gayo Lues Regency, Indonesia

The Gayo tribe in Lesten Village has historically relied on plants to fulfill their nutritional needs. Expanding knowledge about diverse plant-based food sources offers a promising strategy for addressing future food insecurity. A dependence on conventional plant species has often resulted in inadequate food supplies, highlighting the need for alternative approaches that incorporate a broader range of plant resources to mitigate food scarcity. Located within the Leuser mountain buffer landscape, Lesten Village in Gayo Lues Regency, Aceh Province, represents a key agricultural area with significant potential to benefit the local community. This study aimed to document and analyze the plant species used as food sources by the Lesten Village community. Data collection combined qualitative and quantitative methods, including exploration, direct observation, and semi-structured interviews. The results revealed that female respondents had a higher level of knowledge about plant use as food sources. Notably, 52.9% and 55.7% of these respondents were aged 50 years or older. The community in Lesten utilized a total of 51 plant species from 26 families as food ingredients. Vegetables constituted the largest category (34%), followed by spices (30%), fruits (21%), and carbohydrates (15%). Fruits were the most frequently used plant part for food (61%). The species with the highest use value was Cacica papaya (1.07). Additionally, the traditional food with the highest fidelity level was serbet (62.82%). These findings emphasize the importance of integrating a diverse range of plant resources into food systems to enhance food security and stimulate economic development in the region.

Polycystic ovary syndrome: Fertility, prenatal care, pregnancy, and postpartum care.

Polycystic ovary syndrome (PCOS) is a complex, heterogeneous reproductive endocrinopathy affecting 8% to 13% of women in their reproductive years. PCOS has a vast array of clinical manifestations, including metabolic complications, biochemical and phenotypical hyperandrogenism, menstrual cycle dysfunction, and anovulation resulting in infertility. Understanding the relationship of the disorder's pathophysiologic and clinical manifestations is key to successfully managing patients with PCOS. Patients may have different prenatal, perinatal, and postnatal experiences than those who do not have PCOS, and may require a higher level of care or treatment plan adjustments.