Inadequate Quality Research Articles

Coral reefs of Pakistan: a comprehensive review of anthropogenic threats, climate change, and conservation status

The coral reefs along Pakistan’s coastline are of ecological and economic significance. However, they are increasingly threatened by anthropogenic threats and climate change. These vulnerable ecosystems are declining due to various factors such as sedimentation, climate change, overfishing, destructive fishing practices, marine pollution, and tourism development. We found that 29%, 24%, 26%, 16% and 18% of the studies exceeding, marine pollution, overfishing/destructive fishing, coastal tourism, climate change and sedimentation, respectively; thus, indicating inadequate water quality status in part of Pakistan coastal water. These influences lead to several negative impacts, such as jeopardized coral health, decline in biodiversity, and the simplification of reef structures. In response to these threats, conservation efforts are imperative. This literature review provides an in-depth analysis of anthropogenic threats, climate change and the conservation of coral reefs in Pakistan. This review provides suggestions on how the country could better conserve its coral reef ecosystem. These include (1) initiatives such as establishing marine protected areas (MPAs), (2) encouraging sustainable fishing practices and reducing pollution, (3) developing the country as an ecotourism destination and implementing climate change adaptation measures, and (4) community engagement through awareness campaigns and fostering collaboration among, governmental organizations, non-governmental organizations (NGOs) and scientists. These comprehensive conservation policies address human-caused and other challenges, safeguarding their ecological, economic, and cultural relevance for future generations.

Diet and sleep quality in chilean university students.

To evaluate an association between eating patterns and sleep quality in Chilean university students. A cross-sectional analytical study was conducted. Participants included students from 4 Chilean universities. Each student was administered survey Questionnaire on the frequency of healthy and unhealthy eating habits and Pittsburgh Sleep Quality Index and their weight and height were taken to obtain the Body Mass Index (BMI). A total of 1,079 young university students, 80.26 % were women and the average age was 21.7 years. The 73.68 % have inadequate sleep quality. There is a significant differences in frequency between sleep quality and the intake of breakfast (p<0.001), fish (p<0.05) and dinner (p<0.05), that is, university students who reported optimal sleep consume breakfast and dinner on a daily basis and their fish intake is in line with nutritional recommendations. With respect to the association between sleep quality and healthy dietary patterns, it is observed a significant association (p<0.01) between optimal sleep and daily breakfast consumption in model 3 (Odds Ratio (OR): 0.61 (0.46-0.82)). Regarding unhealthy dietary patterns, a significant association (p<0.05) is observed in model 3 between sleep quality and alcohol consumption (OR: 1.42 (1.02-1.96)). Furthermore, a significant association between optimal sleep and salt consumption is observed in both model 2 (OR: 0.73 (0.54-0.99)) and model 3 (OR: 0.72 (0.53-0.97)). Finally, a significant relationship between not tobacco use and optimal sleep is observed (OR: 0.68 (0.48-0.96)). A positive relationship between healthy diet and sleep quality was observed in university students, which certain dietary patterns, such as the consumption of breakfast and low salt consumption and alcohol, are crucial to talk about a good sleep quality in this population group.

Assessing Implementation of Strengthening Mathematics and Science in Secondary Education (SMASSE): In the Case of Selected Secondary School of Kellem Wollega Zone, Oromia Regional State, Ethiopia

This study aimed to identify the methods teachers use to integrate science and mathematics. These factors affect the implementation of integrated science and mathematics education and students' attitudes toward this integration in secondary schools in the Kellem Wollega zone of Ethiopia. Both open-ended and closed-ended questionnaires, along with structured interviews, were designed for the selected sample population. This targeted population was chosen from five different sites within the zone, comprising a total of 506 samples, of which 392 were students and 114 were teachers and school principals. The study found that teachers integrate science and mathematics using the PDSI approach, the ASEI approach, a student-centered approach, and generally the SMASSE approach. They employ various strategies, including assigning projects, conducting practical work with students, providing assignments and worksheets, and fostering team spirit among students. Several factors hindering the implementation of SMASSE in the study area were identified, including the teacher-student ratio, the disproportion between class size and the number of students, students' attitudes toward science and mathematics, a lack of laboratory facilities and equipment, an absence of a planned schedule, insufficient access to computers, inadequate assessment practices, a lack of sufficient time to complete the curriculum, and an inadequate quality assurance system. On the other hand, students exhibited a negative attitude toward the integration of science and mathematics education, which was influenced by factors such as their perceptions of mathematics, student-teacher interactions, feedback from teachers, teaching methods, course content, teachers' competencies, school management, and limited student participation in the classroom.

A model for standardizing Nigerian SMEs: Enhancing competitiveness through quality control

Small and Medium Enterprises (SMEs) play a critical role in Nigeria's economic development, contributing significantly to employment, innovation, and gross domestic product (GDP). However, Nigerian SMEs face persistent challenges that hinder their growth and global competitiveness, particularly a lack of standardisation and inadequate quality control. This review proposes a comprehensive model for standardizing Nigerian SMEs, focusing on enhancing competitiveness through robust quality control mechanisms. The model is built on four key components: the development of a sector-specific quality control framework, government and institutional support, technology integration, and collaboration within SME clusters. By implementing industry-specific standards and providing training programs, SMEs can align their products and services with global benchmarks, increasing their potential for international market penetration. The model emphasizes the need for government incentives and regulatory bodies to foster adoption while encouraging the use of digital tools to monitor quality in real-time. Additionally, public-private partnerships are recommended to drive technology transfer, making quality control more affordable and accessible. The proposed model also promotes collaboration among SMEs through networking and knowledge sharing, enabling small businesses to adopt best practices collectively. Pilot programs in sectors such as agriculture and manufacturing are suggested to assess the feasibility and effectiveness of the model. This review argues that adopting this standardized quality control model will significantly enhance the competitiveness of Nigerian SMEs, reducing barriers to growth, and facilitating economic development. The success of this initiative relies on coordinated efforts from government, industry associations, and SMEs themselves. Keywords: Nigerian SMEs, Competitiveness, Quality control, Economic Development.

Probabilistic human health risk assessment of commercially supplied jar water in Gopalganj municipal area, Bangladesh

Every day, the amount of quality fresh water decreases notably due to contamination of drinking water. As a result, people use commercially supplied jar water in the southern part of Bangladesh as well as in the Gopalganj municipal area. This study aims to investigate the physicochemical parameters, trace elements, and microbial parameters for assessing human health risks from oral ingestion of these elements. This study gathered commercially supplied jar water samples from 15 companies in the Gopalganj municipal area during the post-monsoon season. Temperature, potential of hydrogen (pH), total dissolved solids (TDS), electrical conductivity (EC), and salinity showed significant variation among the samples, and the level was within the national and international standard limits. The concentrations of iron (Fe) and arsenic (As) were measured using a UV–VIS spectrophotometer and atomic absorption spectroscopy (AAS), respectively. The microbial analysis was conducted by the membrane filtration method. The study found that the water samples had an average concentration of 0.16 mg/L in terms of Fe and 0.016 mg/L in terms of As, with the mean value of As exceeding the standard limits. On the other hand, the mean Fe concentration value did not exceed the standards. Probable human health risk from heavy metal in the jar water was determined by hazard quotient (HQ), hazard index (HI), and carcinogenic risk (CR) assessments. A child (HI = 3.5914) is more vulnerable to non-carcinogenic human health risks than an adult (HI = 1.6931). Furthermore, pollution in water samples was found to pose a high carcinogenic risk, with children (CR = 1.6 × 10−3) being more vulnerable to carcinogenic risk than adults (CR = 7.5 × 10−4). In the microbial analysis, 100% of the samples exceeded the total coliform and fecal coliform standard limits, and 80% of the samples exceeded the Escherichia coli standard limits. Among the samples, 7% present high risk, around 47% present medium risk, 26% show low risk, and 20% show no risk based on the E. coli standard limits. This study did not find any samples that exceeded the extremely high limit for E. coli concentration. This study found that drinking jar water samples had inadequate quality, which may increase the risk of water-borne infections such diarrhea as well as heart disease, diabetes, and cancer. As a result, the manufacturer of drinking water in jars must carry out the essential quality control procedures, and the government should regularly monitor the procedures.

DEEP-C Consortium: Carbon sink or methane source – local to global scale assessment of lentic waters’ role in the climate system

Lentic waters are biogeochemical reactors, producing and receiving carbon (C) originally fixed by the terrestrial and aquatic biosphere, which is then buried in sediments or respired back to the atmosphere in the forms of carbon dioxide (CO2) and one of the more potent greenhouse gas (GHG) methane (CH4). Additionally, lakes serve as archives of terrestrial and aquatic carbon processes within their sediments, enabling the reconstruction of historical changes spanning thousands of years. These changes encompass alterations in land cover, indicated by pollen records, soil carbon erosion and shifts in lake productivity resulting from changes in land use and climate. Both the burial of C in lakes and the emissions of GHGs are recognised as important components of Earth's climate system, yet they remain poorly understood and constrained due to inadequate quantities and qualities of observations. In the case of GHG emissions from lakes, observations are often sporadic, failing to capture the significant spatial and temporal variations in emissions across diverse lentic systems. To address this challenge, process-based models that incorporate the interconnected biogeochemical processes occurring within lakes and their watersheds would arguably be the best tool to extrapolate from site-level observations to regional and finally global scales, to quantify the anthropogenic impact on these fluxes and to reconstruct long-term shifts in emissions and burial due to changes in land cover and climate. However, the development and evaluation of such models is hampered by the lack of observations in sufficient quality. In this project, we bring together a unique consortium of specialists in aquatic ecology, biogeochemistry, palynology, sedimentology and modelling of terrestrial and aquatic biogeochemistry. This project will put forth a national programme of systematic, long-term observations of lake GHG and C cycling processes of unmet detail, consistency and quality. First, at 40 pilot sites spanning typological and environmental gradients, there will be a comprehensive data acquisition endeavour to evaluate biological processes and mesological factors influencing the sequestration or recycling of organic carbon. This effort will be complemented with a synthesis of existing data (WP1). Second, based on well-dated sediment records, which include both newly-acquired and synthesised existing data, variability of lake C burial and their climate and land-use controls will be reconstructed over the past 150 years (WP2). For 15 of these pilot sites, reconstruction will go back until the mid-Holocene (5,000 years BP), allowing us to shed light on the anthropogenic perturbation of the C cycle in this earlier part of human history, which is commonly excluded from this type of research due to lack of information. The activities of these first two WPs will result in an open-source national database, guaranteeing valorisation of our research far beyond this project. In WP3, we will use the land surface model (LSM) ORCHIDEE C-lateral to assess C cycling in the terrestrial biosphere and the mobilisation of biospheric C into lakes, which is possible due to an explicit representation of soil C leaching and erosion processes and a downscaling scheme permitting us to assess C exports from watersheds at sub-grid scale. While LSMs are used to assess evolution of biospheric C budgets from the beginning of the Industrial Period, we will use it to hindcast the evolution since the mid-Holocene, using lake sediment records for model validation. Moreover, we will develop a new process-based lake C model supported by the database established in WPs 1 and 2, which we will couple to ORCHIDEE C-lateral to simulate lake C burial and GHG emissions in response to climate and processes in the lake watershed. This model set-up will first be used to better constrain contemporary large-scale lake GHG emissions and to disentangle the anthropogenic perturbation of these fluxes from the natural background flux. These estimates will be revolutionary, as they will allow attributing part of lake GHG emissions to anthropogenic emissions for national GHG budget reporting. Then, these models will be emulated to reconstruct evolution of lake GHG budgets and C budgets of the whole lake watershed since the mid-Holocene. While simulations will first be performed at the scales of France and Europe, the development of international partnerships to implement observations from other biomes (WP4) will finally support simulations at the global scale.

Ice-ice disease in cultivated eucheumatoid seaweeds: The perspectives of farmers

ABSTRACT Eucheumatoid seaweeds, encompassing the genera Kappaphycus and Eucheuma, are widely cultivated globally, particularly in tropical regions. However, ice-ice disease (IID) poses a significant challenge to their production, causing substantial economic losses. This study aimed to elucidate the factors contributing to IID in eucheumatoid seaweeds, focusing on the perspectives of seaweed farmers in Sibutu, Tawi-Tawi, Philippines. A mixed methods approach was employed, utilizing both one-to-one interviews (n = 96) and focus group discussions. The majority of the interviewed farmers were male, aged between 31 and 60 years, with extensive experience (11‒25 years) in seaweed cultivation. Notably, all participants possessed a familiarity with IID since childhood. Farmers described IID as a pathological condition affecting eucheumatoid seaweeds, characterized by the emergence of white and soft areas on the seaweed thalli. The initial stages of the disease manifest as a pale discolouration of the thalli and the presence of epiphytes or debris. Several environmental factors were identified by the farmers as contributing to IID incidence, including high or low water temperatures, low salinity (particularly after heavy rainfall), stagnant water currents, nutrient deficiencies, inadequate seedling quality, and poor farm management practices. Additionally, deepwater (nearshore) farms were reported to be more susceptible to IID. Farmers noted that easterly winds could exacerbate the disease by facilitating the infestation of epiphytes on the seaweed. Furthermore, the prevalence of IID was observed to be highest during the dry and hot season. Kappaphycus striatus was identified by the farmers as being more susceptible to IID compared with K. alvarezii and Eucheuma denticulatum. The negative impact of IID on farmers’ livelihoods was also highlighted. Some mitigation strategies employed by the farmers included the application of inorganic nutrient enrichments (e.g. ammonium phosphate (16–20-0, N-P-K) and complete (14–14-14, N-P-K) fertilizers), frequent relocation of infected seaweed to different farms, and the cultivation of more IID-resistant species.

Prisoner's Rights in Somalia Law and International Law: Comparative Analysis

The article, titled "Comparative Analysis of Prisoners' Rights in Somali Law and International Law," seeks to investigate the compatibility of Somalia's domestic legislation with prevailing global standards, treaties, and principles relating to the rights of prisoners. The research methodology utilized in this study is qualitative, with a specific focus on document analysis, the researcher considers this method is regarded more reliable than alternative methods due to its precise interpretation of legal content. Existing literature on Somalia's prison facilities reveals substandard living conditions that do not meet international benchmarks, encompassing issues such as inadequate food and water quality, poor sanitation, legal system uncertainties, and insufficient mechanisms for monitoring prison conditions; therefore, this study will address the gap in comparing prisoner rights at the national and international levels where such a comparison is currently lacking. Since the establishment of the United Nations in 1945, numerous conventions aimed at protecting human rights, including those of prisoners, have been established at the international level. These include the Universal Declaration of Human Rights in 1948, the International Covenant on Civil and Political Rights in 1966, the Convention against Torture in 1987, the Kampala Declaration in 1996, and the Nelson Mandela Rules in 2015. These conventions emphasize that prisoners possess inherent human dignity, deserve better living conditions, and have the right to education and employment. International mechanisms are in place to safeguard prisoners' rights, a commitment mirrored in Somalia's national laws. However, unlike international law, Somalia's national legislation does not strongly emphasize the prohibition of torture and the use of solitary confinement as a last resort for disciplinary measures.

Titanium patient-specific scaphoid replacement for unreconstructable nonunions: a case series study.

Although reconstruction is the preferred treatment option for symptomatic scaphoid nonunions, this may not be an option due to inadequate bone quality or degenerative changes. Existing salvage procedures tend to compromise function. This study introduces an alternative approach through the utilisation of a 3-D-printed titanium patient-specific scaphoid implant. In this retrospective case series, the outcomes of 12 patients treated for an unreconstructable scaphoid nonunion with a 3-D-printed prosthesis were evaluated. Patient-reported outcomes, range of motion, grip strength and plain radiographs were assessed pre- and postoperatively. The mean follow-up was 2 years and 8 months. Range of movement and patient-reported outcome scores improved postoperatively, although improvement in movement was not significant. Except for one, all implants showed satisfactory alignment on radiographs without any further degenerative changes. 3-D-printed titanium scaphoid replacement may be an alternative to salvage procedures for unreconstructable scaphoid nonunion.Level of evidence: IV.

Clinical Validation of the Nursing Diagnosis 'Inadequate Health Self-Efficacy' in People With Hypertension.

To test the clinical validity of clinical indicators and causal relationships of aetiological factors of the new nursing diagnosis of inadequate health self-efficacy in people with hypertension. The diagnosis of inadequate health self-efficacy has both theoretical and content validity. However, a clinical validation study is needed to establish an appropriate framework for distinguishing individuals who manifest this unique human response. The study adopts a cross-sectional clinical validation approach, adhering strictly to the STROBE guidelines throughout its design and implementation. Naturalistic sampling was used to identify 302 adults diagnosed with hypertension. Their data were subjected to latent class analysis, which facilitated the identification of a comprehensive set of clinical indicators that demonstrated better diagnostic accuracy and established posterior probabilities to guide the inference of inadequate health self-efficacy. In addition, logistic regression analysis was used to assess the magnitude of the impact of aetiological factors. The prevalence of inadequate health self-efficacy was 76.61%. Among the 13 indicators examined, seven demonstrated notable sensitivity: 'risk-prone health behaviour', 'failure to take action that prevents health problems', 'inadequate self-control', 'avoidance behaviours', 'negative health self-perception', 'inadequate health-related quality of life' and 'difficulty feeling good about adopting a healthy lifestyle'. Additionally, two indicators showed high specificity: 'difficulty feeling good about adopting a healthy lifestyle' and 'inadequate adherence to treatment regimen'. Notably, 15 aetiological factors were identified as significantly associated with an increased risk of inadequate health self-efficacy. A clinical framework consisting of eight clinical indicators and 15 aetiological factors was developed to characterise inadequate health self-efficacy in individuals with hypertension. Clinical validation provides insight into the precision of clinical indicators and the magnitude of the effect of putative causal elements, thereby facilitating identification and tailored intervention for individuals with hypertension and inadequate health self-efficacy.

Recruitment feasibility and dietary and behavioral patterns in toddlers with ASD: Preliminary results from the Autism Eats program

BackgroundProblematic mealtime behaviors and inadequate diet quality are pressing concerns for children with autism spectrum disorder (ASD). This study aimed to evaluate recruitment feasibility and baseline outcomes of the Autism Eats program for children under 3 years with ASD. MethodsRecruitment feasibility was assessed through reach and participation rates. The Healthy Eating Index (HEI-2015) scores were calculated from 3-day food records. Problematic mealtime behaviors were assessed with the Brief Autism Mealtime Behavior Inventory. Parental feeding practices were assessed using the Child Feeding Questionnaire. Anthropometric measurements of children and parents were taken. Weight-for-length percentiles were calculated based on the CDC growth charts. Descriptive statistics, one-sample t-tests, and Spearman's rho correlations were used for data analysis. ResultsOf the contacted dyads, 74 % agreed to participate. All 51 enrolled dyads completed baseline survey (100 %), and 98 % completed 3-day food records and anthropometric measurements. Significantly higher problematic mealtime behaviors were observed, compared to the reference (e.g., Total score 55.7 vs. 32.5; p < .001). Children with ASD exhibited lower HEI-2015 scores than national data (e.g., Total score 59 vs. 62). A large proportion of the children (29 %) had a weight-for-length ≥ 95th percentile. Several significant associations were found among mealtime behaviors, diet quality, parental feeding practices, and weight status. ConclusionRecruitment was highly feasible, and the findings suggest that early nutrition intervention may hold promise in addressing problematic mealtime behaviors and promoting healthier dietary habits in young children with ASD.Clinical Trial Registration: This trial has been registered at www.ClinicalTrials.gov (NCT05194345).

Selective FFRCT testing in suspected stable angina in clinical practice - initial experiences

Coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) is recommended for physiological assessment in intermediate coronary stenosis for guiding referral to invasive coronary angiography (ICA). In this study, we report real-world data on the feasibility of implementing a CTA/FFRCT test algorithm as a gatekeeper to ICA at referral hospitals. Retrospective all-comer study of patients with new onset stable symptoms and suspected coronary stenosis (30–89%) by CTA. Evaluation of CTA datasets, interpretation of FFRCT analysis, and decisions on downstream testing were performed by skilled CT-cardiologists. CTA was performed in 3974 patients, of whom 381 (10%) were referred directly to ICA, whereas 463 (12%) to non-invasive functional testing: FFRCT 375 (81%) and perfusion imaging 88 (19%). FFRCT analysis was rejected in 8 (2%) due to inadequate CTA image quality. Number of patients deferred from ICA after FFRCT was 267 (71%), while 100 (27%) were referred to ICA. Obstructive coronary artery disease (CAD) was confirmed in 62 (62%) patients and revascularization performed in 53 (53%). Revascularization rates, n (%), were higher in patients undergoing FFRCT-guided versus CTA-guided referral to ICA: 30–69% stenosis, 28 (44%) versus 8 (21%); 70–89% stenosis, 39 (69%) versus 25 (46%), respectively, both p < 0.05. Implementation of FFRCT at referral hospitals was feasible, reduced the number of invasive procedures, and increased the revascularization rate.

Antidiabetic Agents and Bone Quality: A Focus on Glycation End Products and Incretin Pathway Modulations.

Diabetes mellitus is associated with inadequate bone health and quality and heightened susceptibility to fractures, even in patients with normal or elevated bone mineral density. Elevated advanced glycation end-products (AGEs) and a suppressed incretin pathway are among the mechanisms through which diabetes affects the bone. Accordingly, the present review aimed to investigate the effects of antidiabetic medications on bone quality, primarily through AGEs and the incretin pathway. Google Scholar, Cochrane Library, and PubMed were used to examine related studies until February 2024. Antidiabetic medications influence AGEs and the incretin pathway directly or indirectly. Certain antidiabetic drugs including metformin, glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl-peptidase-4 (DDP-4) inhibitors, α-glucosidase inhibitors (AGIs), sodium-glucose co-transporter-2 inhibitors, and thiazolidinediones (TZDs), directly affect AGEs through multiple mechanisms. These mechanisms include decreasing the formation of AGEs and the expression of AGEs receptor (RAGE) in tissue and increasing serum soluble RAGE levels, resulting in the reduced action of AGEs. Similarly, metformin, GLP-1RA, DDP-4 inhibitors, AGIs, and TZDs may enhance incretin hormones directly by increasing their production or suppressing their metabolism. Additionally, these medications could influence AGEs and the incretin pathway indirectly by enhancing glycemic control. In contrast, sulfonylureas have not demonstrated any obvious effects on AGEs or the incretin pathway. Considering their favorable effects on AGEs and the incretin pathway, a suitable selection of antidiabetic drugs may facilitate more protective effects on the bone in diabetic patients.

Prospective Life Cycle Assessment of Hydrogen: A Systematic Review of Methodological Choices

This systematic review examines methodological choices in assessing hydrogen production and utilisation technologies using prospective life cycle assessments (LCA) between 2010 and 2022, following PRISMA guidelines. The review analysed 32 peer-reviewed articles identified through Scopus, Web of Science, and BASE. The study reveals a significant gap in the consistent application of prospective LCA methodologies for emerging hydrogen technologies. Most studies employed attributional approaches, often lacking prospective elements in life cycle inventory (LCI) modelling. Although some initiatives to integrate forward-looking components were noted, there was often lack of clarity in defining LCA objectives, technology readiness level (TRL), and upscaling methods. Of the 22 studies that focused on emerging hydrogen technologies, few detailed upscaling methods. Additionally, the review identified common issues, such as the limited use of prospective life cycle impact assessment (LCIA) methods, inadequate data quality evaluation, and insufficient sensitivity and uncertainty analysis. These findings highlight the substantial gaps in modelling low-TRL hydrogen technologies and the need for more robust, comprehensive approaches to assess uncertainties. The review also identified common practices and areas for improvement to enhance the reliability and relevance of hydrogen technology environmental assessments.

A conceptual framework of service quality on patient’s behavioral assessment: Insight from Pakistan

The healthcare sector is progressively modest and patients expect higher service quality; therefore, healthcare practitioners’ and academic researchers’ attention upsurges in exploring service quality, intensifying satisfaction and generating behavioral intention. Despite the significance of the healthcare sector and the importance of quality-related matters, there is a paucity of research and publications dealing with healthcare service quality. This conceptual review evaluates the service quality in Pakistani healthcare sector rendering patients’ perspective. The proposed model emphasizes patients’ switching intention caused by poor or inadequate service quality through intervening constructs of satisfaction and alternative attractiveness. Additionally, current review explored the alternative attractiveness as mediator which was neglected in healthcare context. The model also attempts to propose the association between alternative attractiveness and outcome variable by switching costs regarding patients’ perspectives. The conceptual framework enables hospital managers to comprehend how patients assess healthcare quality provided in the presence of alternatives. The perception of patients would assist them in allocating healthcare resources and hospital management attain performance feedback through service quality parameters. Present review developed an inclusive framework as a novel injector in healthcare sector for patients’ perceived service quality.

Echocardiographic image quality deteriorates with the severity of cardiogenic shock

BackgroundTransthoracic echocardiography (TTE) is the primary tool for assessing left ventricular (LV) function in cardiogenic shock (CS). However, inadequate image quality often hinders it. In this retrospective study, we investigated factors associated with LV image quality in patients admitted to the intensive care unit (ICU) with ischemic CS.ResultsTwo critical care physicians accredited in echocardiography independently reviewed the TTEs of 100 patients admitted to our tertiary cardiac ICU with ST-elevation myocardial infarction complicated by CS between October 2016 and September 2019. Endocardial border definition (EBD) was graded for each myocardial segment of the apical 4-chamber and 2-chamber views using a conventional scoring system (1 = good, 2 = suboptimal, 3 = poor, and 4 = not possible). The biplane EBD index (EBDi) was calculated by averaging all segments from both views. An average EBDi of both observers was correlated with clinical and echocardiographic parameters. The median age was 62 years [54, 73], and 78% were males. LV ejection fraction and cardiac index (CI) medians were 29% [20, 35] and 1.93 l/min/m2 [1.40, 2.51], respectively. The median biplane EBDi was nearly suboptimal (1.833 [1.542, 2.083]). There was no correlation between EBDi and age, sex, or body mass index. However, biplane EBDi demonstrated statistically significant correlations with PaO2 (r2 = 0.066, p = 0.01), mean arterial pressure (MAP, r2 = 0.055, p = 0.03), CI (r2 = 0.105, p < 0.01), tricuspid annulus systolic velocity (RV S’, r2 = 0.092, p = 0.01), and tricuspid regurge maximum velocity (TR Vmax, r2 = 0.067, p = 0.01). In a multivariate model, only CI correlated independently with EBDi (r2 = 0.105, p < 0.01). The biplane EBDi predicted CI (area under the curve (AUC) 0.70, p = 0.001) with good sensitivity (71%) and reasonable specificity (61%).ConclusionsThe study suggests that in patients admitted to the ICU with ischemic CS, LV image quality by TTE deteriorates with the severity of shock, as indicated by CI.

Cost Control and Analysis in University Financial Management

In modern university financial management, cost control and analysis are critical means for enhancing economic efficiency and resource utilization. However, universities currently face numerous challenges in cost control, including imperfect management systems, insufficient levels of informatization, and inadequate personnel quality. This paper aims to explore methods of cost control and analysis in university financial management, proposing optimization strategies through the comparison of traditional and modern cost analysis tools to help university administrators improve financial management. The research provides not only theoretical guidance for universities but also practical and feasible solutions for implementation.

A novel UV-curable composite coating with superior anti-corrosion and mechanical properties

The UV curing method is free from volatile organic compounds (VOC) and exhibits high curing efficiency. However, pore flaws and inadequate mechanical qualities after cure greatly hinder their utilization in metal anti-corrosion. Herein, layered double hydroxides (LDH) supported by molybdic acid and cerium ions were synthesized in situ on the sericite (SC) surface, enhancing the shielding, corrosion inhibition, resin compatibility, and cross-linking density of the coating. Compared with carbon steel immersed in a 3.5 wt% NaCl solution, the incorporation of SC/KH560@LDH reduced the corrosion current density (Icorr) from 2.001 × 10−5 A/cm2 to 7.883 × 10−6 A/cm2. Moreover, the low-frequency impedance of the UV-SC/KH560@LDH coating remained high at 1.939 × 1010 Ω·cm2 after 70 days of immersion in a 3.5 wt% NaCl solution. The excellent corrosion resistance of UV-SC/KH560@LDH can be attributed to the barrier properties of the filler, the chloride ion trapping, and the passivation effect. Furthermore, the UV-curable alkyd resin used in this work formed a chemical bond with the metal substrate, enhancing the mechanical properties of the coating. The adhesion strength of the UV-SC/KH560@LDH was measured at 11.50 MPa. The thickness loss (21.3 μm) of the UV-SC/KH560@LDH were minimal after 5000 cycles of wear. A new research concept for preparing the UV-SC/KH560@LDH with superior anti-corrosion and mechanical properties for carbon steel plate surfaces has been proposed to meet the demands of practical applications.

Perceived effects of residential design on mental well-being: A quasi-experimental study of the University of Michigan's Munger graduate residences

IntroductionResearch documents effects of residential settings on mental well-being (MWB), yet studies on graduate student housing and MWB are scarce. The University of Michigan's (UM) Munger Graduate Residences (“Munger”) building, located in Ann Arbor, Michigan, USA, offers students a central campus housing location, generous common areas, and residential units containing shared living spaces for six or seven residents who each receive their own private bedroom and bathroom. Of the building's 631 bedrooms, 87% do not have windows. MethodsThis quasi-experimental, multi-method study compared Munger (n = 124) and non-Munger (n = 132) graduate student residents’ self-reported MWB, identified design elements residents perceived to affect MWB, and explored how these design elements influenced MWB according to residents. A questionnaire was distributed virtually to 2295 UM graduate students (618 Munger residents, 1677 living elsewhere, locally) that consisted of an existing MWB scale (three subscales: Attentional Function Index, Positive and Negative Affect Scale, and Social Connectedness Scale) and open-ended questions about design elements and MWB. MWB scale and subscale scores were compared for the 256 completed (of 447) responses using multiple linear regression, accounting for demographic, academic, and residential characteristics. Quantitative content analysis of 236 complete open-ended responses was used to identify and compare frequencies of design elements associated with MWB. Design elements most frequently associated with MWB were further analyzed using qualitative content analysis to understand how residents perceived design to affect MWB. ResultsWhen compared to non-Munger residents, Munger residents reported significantly lower MWB (p < .001), attentional function (p = .004), positive and negative affect (p = .001), and social connectedness (p = .002). Content analyses revealed 13 design element categories residents perceived to influence MWB. Positive MWB effects were reported for Munger's amenities and non-Munger units' amount of space for privacy and interaction. Munger residents reported more negative and fewer positive MWB effects of design than non-Munger residents. Although design elements reported to negatively affect MWB across groups primarily related to poor indoor environmental quality and control (e.g., lighting, temperature, ventilation) and social control over privacy and interaction, 75.9% of Munger (vs. 0%, non-Munger) residents reported that windowless bedrooms negatively affected MWB. ConclusionsAccording to residents, Munger's generous shared amenities and naturally lit common areas did not compensate for perceived negative MWB effects of windowless private bedrooms, inadequate indoor environmental quality, inability to control lighting, temperature, and ventilation, and high-density living with randomly-assigned roommates. Study findings have implications for designers, planners, developers, and policy makers working with future graduate student and multi-unit housing, as well as recommendations for existing housing management to support MWB.

“They made me feel like I mattered”: a qualitative study of how mobile crisis teams can support people experiencing homelessness

BackgroundMobile crisis teams (MCTs) can be important alternatives to emergency medical services or law enforcement for low-acuity 911 calls. MCTs address crises by de-escalating non-violent situations related to mental health or substance use disorders and concurrent social needs, which are common among people experiencing homelessness (PEH). We sought to explore how an MCT in one city served the needs and supported the long- and short-term goals of PEH who had recently received MCT services.MethodsWe conducted 20 semi-structured interviews with service recipients of the Street Crisis Response Team, a new 911-dispatched MCT implemented in San Francisco in November 2020. In the weeks after their encounter, we interviewed respondents about their overall MCT experience and comparisons to similar services, including perceived facilitators and barriers to the respondent’s self-defined life goals. We analyzed interview transcripts with thematic analysis to capture salient themes emerging from the text and organized within a social-ecological model.ResultsNearly all respondents preferred the MCT model over traditional first responders, highlighting the team’s person-centered approach. Respondents described the MCT model as effectively addressing their most immediate needs (e.g., food), short-term relief from the demands of homelessness, acute mental health or substance use symptoms, and immediate emotional support. However, systemwide resource constraints limited the ability of the team to effectively address longer-term factors that drive crises, such as solutions to inadequate quality and capacity of current housing and healthcare systems and social services navigation.ConclusionsIn this study, respondents perceived this MCT model as a desirable alternative to law enforcement and other first responders while satisfying immediate survival needs. To improve MCT’s effectiveness for PEH, these teams could collaborate with follow-up providers capable of linking clients to resources and services that can meet their long-term needs. However, these teams may not be able to meaningfully impact the longstanding and complex issues that precipitate crises among PEH in the absence of structural changes to upstream drivers of homelessness and fragmentation of care systems.