Inappropriate Use Research Articles

Artificial intelligence-enabled antibiotic prescribing and clinical support in Nigerian health-care settings: Budgetary constraints, challenges, and prospect

Today, resistance developed by bacteria to common antibiotics that were otherwise regarded as effective is posing a serious challenge. It is believed that without any different efforts, this perennial problem will undermine all the ongoing efforts in antibiotic discovery and therapy development. In Nigeria, antibiotics are frequently prescribed in hospitals. However, issues like multidrug resistance (MDR) and inappropriate use and misuse of antibiotics, including incorrect dosages and use of broad-spectrum antibiotics for targeted infections, have precipitated the rise of MDR bacteria. Consequently, this leads to higher healthcare costs, mainly due to prolonged hospital stays and additional medications as well as increased patient mortality. The prospects of artificial intelligence (AI)-enabled antibiotic prescribing hold significant promise in transforming the current health-care practices. AI has the potential to enhance the precision and efficiency of antibiotic treatment through advanced algorithms and data analytics. This technology can contribute to improved diagnostic accuracy, providing real-time clinical support, optimizing dosage recommendations, personalized treatment plans, and streamlined antimicrobial stewardship, ultimately aiding the global fight against antibiotic resistance and optimizing patient outcomes. The integration of AI in antibiotic prescribing reflects a cutting-edge approach with the potential to revolutionize how antibiotics are prescribed to address challenges in antimicrobial stewardship, clinical decision-making, and combating antibiotic resistance. One of the key impediments to integrating AI into Nigeria’s health-care system is budgetary constraints. Addressing these constraints through strategic investments, improved budgetary allocation to research and development, and leveraging the opportunities presented by AI technologies can significantly enhance antibiotic prescribing and health-care practices, leading to improved public health outcomes.

Matrix effects in ultra-high performance supercritical fluid chromatography-mass spectrometry analysis of vitamin E in plasma: The effect of sample preparation and data processing

The approaches to matrix effects determination and reduction in ultra-high performance supercritical fluid chromatography with mass spectrometry detection have been evaluated in this study using different sample preparation methods and investigation of different calibration models. Five sample preparation methods, including protein precipitation, liquid-liquid extraction, supported liquid extraction, and solid phase extraction based on both “bind and elute” and “interferent removal” modes, were optimized with an emphasis on the matrix effects and recovery of 8 forms of vitamin E, including α-, β-, γ-, and δ-tocopherols and tocotrienols, from plasma. The matrix effect evaluation included the use and comparison of external and internal calibration using three models, i.e., least square with no transformation and no weighting (1/x0), with 1/x2 weighting, and with logarithmic transformation. The calibration model with logarithmic transformation provided the lowest %-errors and the best fits. Moreover, the type of the calibration model significantly affected not only the fit of the data but also the matrix effects when evaluating them based on the comparison of calibration curve slopes. Indeed, based on the used calibration model, the matrix effects calculated from calibration slopes ranged from +92% to – 72% for α-tocopherol and from −77% to +19% in the case of δ-tocotrienol. Thus, it was crucial to calculate the matrix effect by Matuszewski's post-extraction approach at six concentration levels. Indeed, a strong concentration dependence was observed for all optimized sample preparation methods, even if the stable isotopically labelled internal standards (SIL-IS) were used for compensation. The significant differences between individual concentration levels and compounds were observed, even when the tested calibration range covered only one order of magnitude. In methods with wider calibration ranges, the inappropriate use of calibration slope comparison instead of the post-extraction addition approach could result in false negative results of matrix effects. In the selected example of vitamin E, solid-phase extraction was the least affected by matrix effects when used in interferent removal mode, but supported liquid extraction resulted in the highest recoveries. We showed that the calibration model, the use of a SIL-IS, and the analyte concentration level played a crucial role in the matrix effects. Moreover, the matrix effects can significantly differ for compounds with similar physicochemical properties and close retention times. Thus, in all bioanalytical applications, where different analytes are typically determined in one analytical run, it is necessary to carefully select the data processing in addition to the method for the sample preparation, SIL-IS, and chromatography.

Antimicrobial Resistance in Aquaculture: Risk Mitigation within the One Health Context.

The application of antimicrobials in aquaculture primarily aims to prevent and treat bacterial infections in fish, but their inappropriate use may result in the emergence of zoonotic antibiotic-resistant bacteria and the subsequent transmission of resistant strains to humans via food consumption. The aquatic environment serves as a potential reservoir for resistant bacteria, providing an ideal breeding ground for development of antimicrobial resistance (AMR). The mutual inter-connection of intensive fish-farming systems with terrestrial environments, the food processing industry and human population creates pathways for the transmission of resistant bacteria, exacerbating the problem further. The aim of this study was to provide an overview of the most effective and available risk mitigation strategies to tackle AMR in aquaculture, based on the One Health (OH) concept. The stringent antimicrobial use guidelines, promoting disease control methods like enhanced farm biosecurity measures and vaccinations, alternatives to antibiotics (ABs) (prebiotics, probiotics, immunostimulants, essential oils (EOs), peptides and phage therapy), feeding practices, genetics, monitoring water quality, and improving wastewater treatment, rather than applying excessive use of antimicrobials, can effectively prevent the development of AMR and release of resistant bacteria into the environment and food. The contribution of the environment to AMR development traditionally receives less attention, and, therefore, environmental aspects should be included more prominently in OH efforts to predict, detect and prevent the risks to health. This is of particular importance for low and middle-income countries with a lack of integration of the national AMR action plans (NAPs) with the aquaculture-producing environment. Integrated control of AMR in fisheries based on the OH approach can contribute to substantial decrease in resistance, and such is the case in Asia, where in aquaculture, the percentage of antimicrobial compounds with resistance exceeding 50% (P50) decreased from 52% to 22% within the period of the previous two decades.

Critical risks with the permeability dimension to describe the hydrogen crossover phenomenon

Hydrogen crossover in water electrolyzer systems equipped with ion exchange membranes (IEM) poses significant safety risks and reduces overall process efficiency. This communication identifies and addresses two critical errors in current hydrogen crossover literature: inaccurate measurement methods and the inappropriate use of permeability (e.g., barrer) to quantify hydrogen crossover. Accurate evaluation of hydrogen crossover through an IEM can be challenging because it is a two-phase material fully hydrated in liquid water. We propose a standardized protocol for accurately measuring hydrogen crossover in fully hydrated IEMs and emphasize the necessity of using flux (e.g., mole∙m−2∙s−1) instead of permeability (e.g., barrer) dimension. The obtained data reveal that normalizing hydrogen crossover by transmembrane pressure and membrane thickness can result in significant errors, with relative errors reaching up to 25%. When applied to the actual electrolysis operation, using the permeability data to predict hydrogen crossover at a current density of 0.4 A cm−2 results in 47% error, with the actual system reaching the lower explosion limit (LEL) while the predicted value does not. Additionally, hydrogen crossover data provides insights into the internal ion channel morphology of IEMs. This communication article intends to convey the current existing safety hazards to the hydrogen research community with a detailed transport models and validation.

Pengembangan Media Pembelajaran Komik Digital pada Pembelajaran IPS Materi Kegiatan Ekonomi Kelas IV SD Negeri 43 Pangkalpinang

This research is motivated by students’ lack of understanding of economic activities due to the inappropriate use of learning media to describe economic activity material and its relationship with various fields of work around where they live. This research aims to produce digital comic learning media for social studies learning material for class IV economic activities at SD Negeri 43 Pangkalpinang that is feasible and practical. The type of research used is research and development (R&D) using the ADDIE (Analyse, Design, Develop, Implement, and Evaluate) development model. The data collection techniques used were interviews, questionnaires, and tests. The data analysis technique is quantitative descriptive using a Likert scale, the Kolmogrov-Smirnov test, and a paired t-test. The subjects in this research were fourth-grade students at SD Negeri 43 Pangkalpinang. This research produces digital comic learning media that is “feasible and practical." This can be seen from the material expert validation percentage results of 88.88% and the media expert validation results of 94.66%. Furthermore, the results of the practicality of learning media from the results of student questionnaire responses in small classes were 97.33%, and the results in large classes were 97.65%. Based on the pretest and posttest results, the average pretest score was 51.66, and the average posttest value was 81.00. Based on the paired t-test results, it was obtained that t_count>t_le was 15.832>1.699, meaning that Ha was accepted.

Epidemiologic changes in thyroid disease.

To analyze the evolving epidemiologic trends in thyroid disease, focusing on risk factors, underlying drivers of these changes, and their implications on clinical practice and research priorities. Thyroid disease remains one of the most prevalent groups of disorders globally, and the shift in its frequency and distribution is multifactorial. The prevalence of hypothyroidism increases with age, although normal thyrotropin ranges appear to be age-dependent, raising concern for potentially inappropriate levothyroxine use. Hyperthyroidism and Graves' disease continue to be predominant in reproductive-age women but exhibit a milder phenotype at diagnosis. Thyroid nodules are increasingly found in asymptomatic patients, likely from more widespread use of neck and chest imaging. Thyroid cancer incidence has risen exponentially over the years, mostly driven by overdiagnosis of low-risk tumors; however, a small rise in incidence of higher risk tumors has been noted. Obesity appears to be a risk factor for thyroid cancer occurrence and more aggressive forms of the disease. Understanding epidemiologic trends in thyroid disease is crucial for guiding clinical practice and research efforts, aiming to optimize patient outcomes while preventing unnecessary and potentially harmful interventions.

Genomic diversity and nutritional analysis of multi-drug resistant extended spectrum β-lactamase Producing-Klebsiella pneumoniae genes isolated from mastitic cattle milk in district peshawar, Pakistan

The increasing incidence of resistance extended spectrum-beta lactamase (ESBL) producing Klebsiella pneumonia become worldwide issue. The current study aimed to determine the genomic diversity of ESBL-producing K. pneumoniae in milk samples collected from cows with mastitis as well as their antibiotic sensitivity profiles and genetic identification in Peshawar, Pakistan. The california mastitis test (CMT) was initially used to verify the presence for mastitis in 700 collected milk samples. The molecular identification of the 16SrRNA gene confirmed 120/700 (17.14 %) propagation of K. pneumonia. Out of these isolates MDR ESBL-producing isolates were 60/120 (50 %). The lactose were found (M = 3.96 ± 0.28, SD = 2.19), followed by fats (M = 3.12 ± 0.11, SD = 0.90), protein (M = 5.97 ± 0.24, SD = 1.84), sodium (M = 55.74 ± 2.07, SD = 15.81), potassium (M = 138.5 ± 1.53, SD = 11.71), chloride (M = 0.74 ± 0.03, SD = 0.24), calcium (M = 10.27 ± 0.31, SD = 2.42), and chlorine (M = 2.80 ± 0.22, SD = 1.70), respectively. Amikacin (80 %), ceftazidime (71 %), and tetracycline (71 %) were shown to be the most effective antimicrobials against all of the isolates. The occurrence of the blaSHV gene was observed at 56.00 % whereas the blaTEM gene and blaCTX-M gene were 36.00 %, and 30.00 %. The distribution of blaCTX-M subgroup genes was followed by blaCTX-M-1 (38.00 %), blaCTX-M-9 (22.20 %), and blaCTX-M-15 (61.10 %). Co-occurrence of blaCTX-M+ blaSHV was (15.00 %), blaCTX-M+ blaTEM were (6.60 %), and blaSHV + blaTEM were (10.00 %), respectively. The inappropriate, prolonged and common use of antibiotics may apply selective pressure for propagation and the occurrence of resistant isolates.

Evaluating the Expression of Efflux Pumps in Pseudomonas aeruginosa in Exposure to Sodium Dodecyl Sulfate, Didecyldimethylammonium Chloride, and Octenidine Dihydrochloride.

Emerging resistance of Gram-negative bacteria, including Pseudomonas aeruginosa, to commonly used detergents and disinfectant is encountering us with hazard. Inappropriate use of disinfectants has forced bacteria to gain resistance. The ability of bacteria to extrude substrates from the cellular interior to the external environment has enabled them to persist in exposure to toxic compounds, which is due to existence of transport proteins. Efflux pumps, in Gram-negative bacteria, are proteins responsible for exporting molecules outside of the cell, by crossing the two membranes. In this study, 40 P. aeruginosa strains from hospitals, clinics, and burn center laundries and 40 P. aeruginosa strains from urban laundries were collected. This study evaluated the minimum inhibitory concentration (MIC) level of sodium dodecyl sulfate (SDS), didecyldimethylammonium chloride (DDAC), and octenidine dihydrochloride (Od) in P. aeruginosa strains. The real-time PCR was carried out to evaluate the expression of MexAB-OprM, MexCD-OprJ, and MexXY-OprM efflux system. The obtained results indicated a higher MIC level for SDS, DDAC, and Od in medical laundries. The sub-MIC level of DDAC and Od increased the expression level of MexAB-OprM, MexCD-OprJ, and MexXY-OprM in P. aeruginosa strains, suggesting that efflux pumps contribute to disinfectant resistance in P. aeruginosa.

Use of multiple pharmacies by people living with HIV

Using multiple pharmacies has been linked to negative outcomes including increased inappropriate drug use, toxicity, and mortality, yet up to half of all patients in the US use multiple pharmacies. A pilot survey was administered to measure pharmacy use in people living with HIV (PWH) and examine the associated attitudes and outcomes. In a midwestern HIV clinic, a convenience sample was surveyed based on using single (SPU) versus multiple pharmacies (MPU). One hundred forty-two subjects participated (69 SPU; 73 MPU): 75% male, 59% white, and > 70% being ≥ 40 years old. There was a trend towards increased recall of self-reported CD4 and viral load status for SPUs vs MPUs [OR 2.26 (95%, 0.91–5.64)]. SPU participants indicated acquiring all meds in one place [Likert Scale weighted average (LS WA) = 4.45], proximity (LS WA = 3.64), the identification of adverse effects (LS WA = 4.17), and concerns about missing potential drug-drug interactions (LS WA = 4.06) as reasons for preferring a single pharmacy. The desire to keep HIV status private (LS WA = 3.65) was noted as a significant reason for using a separate pharmacy specifically for acquiring antiretrovirals in MPU participants. Results indicate patients often have justifiable reasons for using single versus multiple pharmacies.

Exposure variables in veterinary epidemiology: are they telling us what we think they are?

This manuscript summarizes a presentation delivered by the first author at the 2024 symposium for the Calvin Schwabe Award for Lifetime Achievement in Veterinary Epidemiology and Preventive Medicine, which was awarded to Dr. Jan Sargeant. Epidemiologic research plays a crucial role in understanding the complex relationships between exposures and health outcomes. However, the accuracy of the conclusions drawn from these investigations relies upon the meticulous selection and measurement of exposure variables. Appropriate exposure variable selection is crucial for understanding disease etiologies, but it is often the case that we are not able to directly measure the exposure variable of interest and use proxy measures to assess exposures instead. Inappropriate use of proxy measures can lead to erroneous conclusions being made about the true exposure of interest. These errors may lead to biased estimates of associations between exposures and outcomes. The consequences of such biases extend beyond research concerns as health decisions can be made based on flawed evidence. Recognizing and mitigating these biases are essential for producing reliable evidence that informs health policies and interventions, ultimately contributing to improved population health outcomes. To address these challenges, researchers must adopt rigorous methodologies for exposure variable selection and validation studies to minimize measurement errors.

Evaluation of Antibiotic Prescribing Practices in Surgical Departments at the University Hospital Center-Yalgado Ouedraogo, Burkina Faso

Introduction: Inappropriate use of antibiotics is one of the main causes of the emergence of antibiotic resistance in sub-Saharan Africa. To contribute to better antibiotic prescribing, the aim of this work was to evaluate prescribing in the surgery and surgical specialties department at the University Hospital Center Yalgado Ouedraogo (CHU-YO). Methods: This was a prospective cross-sectional study from December 15 to 21, 2021. Patients hospitalized in the surgical department were included. Compliance guidelines were the recommendations of the SFAR and the guide to good antibiotic prescribing in Burkina Faso. Results: A total of 162 patients were hospitalized during the study period, of whom 97 were included. The prevalence of antibiotic prescriptions was 59.9%. Curative antibiotic therapy accounted for 66% of prescriptions, while all surgical patients received antibiotic prophylaxis. The β-lactam family was prescribed in 88.5% of cases for prophylaxis and 91.3% for curative treatment. Ceftriaxone was prescribed in 71.3% of cases for prophylaxis and 44.9% for curative antibiotic therapy. Overall compliance was 22.3% for antibiotic prophylaxis and 49.3% for antibiotic therapy. Non-compliance with antibiotic prophylaxis was linked to an inappropriate choice of antibiotic for prophylaxis, and to unjustified prescribing for antibiotic therapy. Conclusion: Capacity-building for prescribers and the development of guidelines could help improve the appropriateness of antibiotic use at CHU-YO.

Analisis Proses Pascapanen Kopi di Pusat Pelatihan Pertanian dan Pedesaan Swadaya (P4S) Kopi Gunung Ikamaja Kecamatan Sumberjaya Kabupaten Lampung Barat

The post-harvest coffee process is vital in determining the quality and quantity of coffee production. Problems that often occur in the post-harvest coffee process are incomplete or overcooked fermentation, improper drying process, high water content, improper roasting process, and inappropriate use of resources. For this reason, it is important to carry out proper processing in the post-harvest coffee process so that the quality of the coffee can be optimal. This research aims to analyze the post-harvest process of robusta coffee and identify post-harvest coffee facilities and infrastructure at P4S Kopi Gunung Ikamaja. The types of data used are primary data and secondary data. The data collection methods used in this research are expert interviews and active participation observation. The results of the study show that there are post-harvest coffee processes that do not comply with the provisions for post-harvest processing according to Minister of Agriculture Regulation Number 52/Permentan/OT.140/9/2012. In natural processing processes, those that are appropriate are the sorting, drying, horn stripping, roasting, and fine grinding stages, while those that are not appropriate are the packaging process. Honey process processing is in accordance with Minister of Agriculture Regulation Number 52/Permentan/OT.140/9/2012. The full wash process is not by Agriculture Ministerial Decree Number 52/Permentan/OT.140/9/2012 at the fermentation stage. Facilities and infrastructure based on building location are not yet appropriate; however, based on tools and machines and based on containers and packaging, they are by the provisions of Minister of Agriculture Number 52/Permentan/OT.140/9/2012.

Ethanolic Extracts of Cupressaceae Species Conifers Provide Rapid Protection against Barium Chloride-Induced Cardiac Arrhythmia.

Sudden cardiac death (SCD) is responsible for a high percentage of cardiovascular fatalities, with ventricular arrhythmias being the most common cause. Despite numerous clinically available antiarrhythmic drugs (AADs), AADs retain some undesirable arrhythmic effects, and their inappropriate use can lead to severe adverse reactions. The exploration of new therapeutic options against arrhythmias with fewer unreceptive effects is of utmost importance. The ethanolic extracts of seven Cupressaceae species, namely, Chamaecyparis obtusa, Juniperus chinensis (L.) Ant., Sabina chinensis (L.) Ant. cv. Kaizuca, Platycladus orientalis (L.) Franco, Juniperus sabina L., Fokienia hodginsii, and Juniperus chinensis 'Pyramidalis' were investigated for their pharmacological effects on barium chloride (BaCl2)-induced arrhythmia using normal II lead electrocardiogram (ECG) measurements in a mouse model. According to the ECG profiles, pretreatment with C. obtusa, P. orientalis, and J. sabina extracts provoked dose-dependent protection against BaCl2-induced arrhythmia, while pretreatment with the other four species and amiodarone did not exert cardioprotective effects. The treatment effects were confirmed using a rat model. The therapeutic effects of C. obtusa, P. orientalis, and J. sabina extracts on the M2 and M3 receptors but not the M1 receptor were mediated by the inhibition of the M2 receptor blocker (methoctramine tetrahydrochloride), M3 antagonist (4-DAMP), or M1 receptor blocker (pirenzepine dihydrochloride). This first-line evidence illustrates that certain Cupressaceae species possess active antiarrhythmic components. The first line of key findings revealed that active components of certain Cupressaceae species have cardioprotective effects, suggesting that these innovative phytochemicals have promising potential for preventing the occurrence of cardiac arrhythmia and reducing sudden cardiac death.

Inappropriate Use of Cardiac Telemetry Within an Emergency Department Setting

Inappropriate Use of Cardiac Telemetry Within an Emergency Department Setting

Allopurinol is Associated with an Increased Risk of Cerebral Infarction: A Two-Sample Mendelian Randomization Study.

Previous studies have reported that the inappropriate use of allopurinol may increase the risk of cerebrovascular accidents, but some studies have also confirmed that allopurinol is a protective factor against stroke. To clarify whether there is a relevant causal relationship between allopurinol and cerebral infarction, we conducted a two-sample Mendelian randomization (MR) study. Data on single nucleotide polymorphisms (SNPs) associated with allopurinol and genome-wide association studies of cerebral infarction were obtained from the genome-wide association study (GWAS) web site. Five basic MR analyses were performed using MR-Egger regression, weighted median (WM1), inverse variance weighting (IVW), weighted mode (WM2), and simple mode. Sensitivity analysis was subsequently performed to detect horizontal pleiotropy, heterogeneity, and potential outliers. The final analysis results were mainly based on the IVW estimates. A total of 10 SNPs were used as instrumental variables (IVs). MR analysis [(IVW: odds ratio (OR) = 1.053, 95% confidence interval (CI): 1.019-1.088, P = 0.002), (WM1: OR = 1.053, 95% CI: 1.009-1.098, P = 0.017), (WM2: OR = 1.050, 95% CI: 1.008-1.095, P = 0.044), (MR Egger: Q = 4.285, P = 0.830)] showed a positive causal association between allopurinol and the risk of cerebral infarction. Sensitivity analysis such as horizontal pleiotropy and heterogeneity increased the reliability of this result. The results of this study provide direct evidence that there is a causal relationship between allopurinol and cerebral infarction and that allopurinol may increase the risk of cerebral infarction.

Gaining Recovery in Addiction for Community Elders (GRACE) Project: The Impact of Age-Specific Care on Clinical Outcomes and Health Care Resource Utilization in Older Adults With Substance Use Disorder in an Interprofessional Addiction Clinic.

The prevalence of substance use disorders (SUDs) in older adults has been increasing, necessitating tailored and effective addiction care for this aging demographic. The purpose of this study was to assess the impact of age-specific, interprofessional addiction care on clinical outcomes and health care resource utilization in older adults with SUD. This quasi-experimental study directly compares patients enrolled in the Gaining Recovery in Addiction for Community Elders (GRACE) Project, an interprofessional age-specific addictions treatment program, with age-matched older adults who received conventional "treatment as usual" (TAU). Through retrospective comparative analysis, substance use outcomes, mental and physical health improvements, and inappropriate use of emergency services were examined among 78 older adults with SUD. Clinical outcomes and health care resource utilization were superior for older adults who received age-specific addictions care through the GRACE Project, as compared to mixed-age conventional "TAU." GRACE patients had improved treatment adherence, fewer relapses, and longer treatment engagement. While both groups exhibited significant reductions in depression and anxiety scores, GRACE patients showed greater improvements. This group demonstrated superior control of both hypertension and diabetes. Importantly, they had fewer inappropriate emergency department visits and avoidable hospitalizations than conventional "TAU." Addiction treatment delivered by an interprofessional team to meet the unique strengths and needs of older adults has the potential to improve treatment adherence and more favorable long-term outcomes in substance use, mental health, and chronic medical conditions. Nurses are poised to lead interprofessional teams to meet the growing demand for specialized addiction treatment and integrated care for older adults.

Black Phosphorus Nanosheets-Based Hydrogel for Efficient Bacterial Inhibition and Accelerating Wound Healing.

With the swift evolution of multidrug-resistant bacteria resulting from the intense and inappropriate use of antibiotics, there is a pressing need for innovative solutions. In this study, a thermosensitive hydrogel was developed for efficient bacterial inhibition and promotion of wound healing. The antibacterial chitosan (CS) thermosensitive hydrogel, cross-linked with two-dimensional photothermal nanomaterial black phosphorus (BP) nanosheets through electrostatic interactions, effectively encapsulates and sustains the release of angiogenic drug deferoxamine mesylate (DFO). This facilitates the acceleration of re-epithelialization and neovascularization by enhancing cell migration and proliferation. Following near-infrared (NIR) treatment, this hydrogel demonstrates rapid eradication of the most common multidrug-resistant bacteria encountered in clinical settings, achieved through physical disruption of bacterial membranes and photothermal therapies. Noteworthy is the significant upregulation of IL-19 expression via STAT3 signaling pathways by the BP/CS-DFO hydrogel in a full-thickness wound model. This results in the polarization of the anti-inflammatory M2 macrophage phenotype, altering the microenvironment to a pro-healing state and enhancing extracellular matrix deposition and blood vessel formation. In conclusion, the BP/CS-DFO hydrogel shows immense promise as a potential clinical candidate for wound healing and antimicrobial therapy. Its innovative design and multifunctional capabilities position it as a valuable asset in combating antibiotic resistance and enhancing efficiency in wound healing.

Evaluating and Incorporating Generative AI in Nursing Informatics and Data Science Graduate Courses.

The disruptive effect and lasting implications of generative artificial intelligence ("Gen AI") tools for higher education are yet unknown. ChatGPT 3.5 was released in November 2022 and soon had over 100 million users. This public software release triggered a global Gen AI race among technology industry giants. Educators in higher education were unprepared for this seismic shift. For the Fall 2023 term, we revised two graduate courses in nursing informatics and data science using generative AI to anticipate broad student awareness of these tools. The aim of this report is to present two different examples of course component evaluation using publicly available Gen AI tools to inform course component revisions. This effort was undertaken to "proof" assignments against inappropriate use of Gen AI, revise assignments to incorporate use of Gen AI tools, and inform course policies about appropriate use of Gen AI for course work.

Fat-Free Mass Index in Sport: Normative Profiles and Applications for Collegiate Athletes.

Jagim, AR, Harty, PS, Jones, MT, Fields, JB, Magee, M, Smith-Ryan, AE, Luedke, J, and Kerksick, CM. Fat-free mass index in sport: normative profiles and applications for collegiate athletes. J Strength Cond Res 38(9): 1687-1693, 2024-Recent concerns have been raised regarding the ethical considerations of conducting body composition assessments in sports. Specific apprehensions pertain to the inappropriate use of percent body fat and the limited application of the results to performance and recovery. Fat-free mass index (FFMI), a height-adjusted assessment of FFM, can serve as an alternative body composition metric to focus on in sports. Fat-free mass index provides valuable context regarding an optimal amount of FFM, accounting for skeletal frame and height while helping to qualify an athlete's FFM as low, moderate, or high. This review posits that shifting the focus of body composition measures to FFM can support more ideal targets across athletic seasons, careers, and the return to play after injury. In addition, a FFM focus may help change the perception of body composition assessment and how athletes perceive their current body because of the increased focus on the FFM compartment and the goal of maximizing tissue accrual, rather than focusing on fat loss. Fat-free mass index is calculated by dividing FFM (kg) by height (m 2 ) and can serve to normalize FFM, relative to height, and enable comparisons across athletes, sport types, and sex. Previous research has identified differences in FFMI across sex and among sport categories. Still, there is a need for more published data to develop optimal ranges for FFMI across sex, sports, and positions. As more data become available, FFMI has the potential to provide normative guidelines for optimal FFM development, performance, and injury risk reduction. The purpose of the current review was to summarize FFMI values across collegiate sport categories and competitive status to provide normative profiles, according to sex and sport type.

Causes of occupational stress and burnout amongst administrative staff in public universities: case of Pakistan

PurposeThe primary aim of this study is to delve into the causes of occupational stress and burnout amongst administrative staff members in Pakistani universities. It does so by employing a qualitative research strategy, offering a comprehensive understanding of the issue.Design/methodology/approachThis study uses a qualitative research strategy to examine the causes of occupational stress and burnout amongst administrative staff members in Pakistani universities. Around 20 semi-structured interviews were conducted via Teams with administrative employees in renowned universities in Rawalpindi, Islamabad and the Lahore region of Pakistan. Saldana's (2014) structured inductive data analysis method was used to analyse the collected data.FindingsThe study sheds light on the harsh realities faced by university administrative staff in Pakistani universities. These include top management ineffectiveness, role ambiguity, role conflict, favouritism, inequality, a communication gap with higher authorities, disparity of rewards and recognition, no career paths and opportunities, feeble leadership, corruption, inappropriate use of power, mishandling of qualified staff and non-acceptance of shifting roles from administration to academia. These are not just academic concepts but real-life challenges that demand immediate attention.Originality/valueThe study's findings have significant implications for Pakistan's Ministry of Education. Based on these findings, the recommendations proposed can serve as a roadmap for enhancing interpersonal development, implementing career development programmes, succession planning and supporting university administrative staff. These initiatives can lay the groundwork for achieving the UN Sustainable Development Goal-4 targets, making this research a valuable resource for policymakers.