Individual Strains Research Articles

ПІДГОТОВКА МАЙБУТНІХ ОФІЦЕРІВ РОЗВІДНИКІВ ДО ПРОФЕСІЙНОЇ ДІЯЛЬНОСТІ В УМОВАХ ЗМІШАНОГО НАВЧАННЯ ЗАСОБАМИ ІНФОРМАЦІЙНО-ОСВІТНЬОГО СЕРЕДОВИЩА

The article analyzes scientific works, the regulatory and legal framework and the content of educational and methodological documentation regarding the organization of professional training of future intelligence officers. Modern approaches related to distance learning and digitalization of professional training of future specialists of the national security and defense sector of Ukraine, as well as the European Union, have been identified. The results of previous studies have been summarized. It has been established that the professional training of future intelligence officers in the conditions of pandemics and full-scale war can be carried out in the format of blended learning using the means of a specially created informational and educational environment. It is substantiated that blended learning of future military intelligence officers consists of the educational activity in two forms: in form of training sessions in specialized classrooms under the direct supervision of the scientific and pedagogical workers and in form of independent work with electronic resources of a specially created information and educational environment. Varieties of blended learning models in the conditions of pandemic and full-scale war are distinguished, namely "rotational model", "flexible model", "person-oriented model" and "enriched virtual environment model". Pedagogical components of information and educational environment tools for blended learning of future intelligence officers have been developed, which include: independent study of new educational material, independent study of material using elements of creativity, independent improvement of theoretical knowledge and practical skills in conditions of quasi-professional activity, and independent in-depth study of material. The introduction of innovative forms, methods and means of obtaining intelligence information into the professional training of future intelligence officers in the format of blended learning by means of the information and educational environment is proposed. The experience of conducting military intelligence acquired by the intelligence units of the armies of NATO member countries and the Armed Forces of Ukraine during the de-occupation of the territories of sovereign Ukraine captured by Russian-terrorist forces is considered as part of the blended learning. Standards of individual and collective training of future intelligence officers of the Armed Forces of Ukraine and NATO are applied. Key words: future intelligence officers, blended learning, blended learning models, information and educational environment tools, pedagogical components of information and educational environment tools.

The inductive effect of musical mode types on emotions and physiological responses: Chinese pentatonic scales versus Western major/minor modes.

The value of music lies in its ability to evoke emotions. People can gain emotional experiences in music and can also regulate their own emotions through music. Music has its own structural rules, and exploring the relationship between musical structure and emotions is an important approach to understanding the mechanism of music-induced emotions. Musical mode refers to the arrangement of intervals around the tonic, presenting different musical modes based on the central tone and the arrangement of intervals, including Chinese pentatonic modes and Western major and minor modes. Musical morphology indicates significant differences in the construction intensity of traditional Chinese pentatonic modes and major and minor modes, affecting their mode forms and thus determining their adaptability to external influences. Exploring the modalities of music and the effects of individual music training experiences on emotion induction; validating whether musical modes exhibit cross-cultural universality in the process of emotion induction. This study recruited 65 university students as participants (34 with music training experience, 31 without music training experience). Through a passive listening paradigm using the GEMS and combined with a biofeedback equipment, it explored the differences in behavioral and physiological indicators (skin conductance, temperature, heart rate) of emotional experiences (basic and aesthetic emotions) influenced by the modal forms of Chinese traditional pentatonic modes and Western major and minor modes. Firstly, the arousal level of music emotion is a primary factor influencing individuals' aesthetic emotional experiences in music, which is related to the intensity of modal construction in music; Secondly, the emotional pleasure and skin temperature change induced by pentatonic music are greater than those induced by major and minor modes; Thirdly, the arousal level, electrodermal change, and heart rate variability of major and minor modes are greater than those of pentatonic music; Finally, music training experience enhances college students' familiarity and preference for pentatonic music, thereby strengthening the electrodermal physiological indicators of emotional experiences. The different modal forms of music express different levels of emotional arousal, leading to differences in individuals' emotional dimensions and physiological indicators in music. Additionally, individuals' music training experiences and cultural backgrounds also influence their experience of music emotions.

Inadequate intensive care physician supply in France: a point-prevalence prospective study

BackgroundThe COVID-19 pandemic has highlighted the importance of intensive care units (ICUs) and their organization in healthcare systems. However, ICU capacity and availability are ongoing concerns beyond the pandemic, particularly due to an aging population and increasing complexity of care. This study aimed to assess the current and future shortage of ICU physicians in France, ten years after a previous evaluation. A national e-survey was conducted among French ICUs in January 2022 to collect data on ICU characteristics, medical staffing, individual physician characteristics, and education and training capacities.ResultsAmong 290 ICUs contacted, 242 responded (response rate: 83%), representing 4943 ICU beds. The survey revealed an overall of 300 full time equivalent (FTE) ICU physician vacancies in the country. Nearly two-thirds of the participating ICUs reported at least one physician vacancy and 35% relied on traveling physicians to cover shifts. The ICUs most affected by physician vacancies were the ICUs of non-university affiliated public hospitals. The retirements expected in the next five years represented around 10% of the workforce. The median number of physicians per ICU was 7.0, corresponding to a ratio of 0.36 physician (FTE) per ICU bed. In addition, 27% of ICUs were at risk of critical dysfunction or closure due to vacancies and impending retirements.ConclusionThe findings highlight the urgent need to address the shortage of ICU physicians in France. Compared to a similar study conducted in 2012, the inadequacy between ICU physician supply and demand has increased, resulting in a higher number of vacancies. Our study suggests that, among others, increasing the number of ICM residents trained each year could be a crucial step in addressing this issue. Failure to take appropriate measures may lead to further closures of ICUs and increased risks to patients in this healthcare system.

Addressing Mental Health Challenges in Nepal: A Review of Policies, Status, and Strategies for Improvement

Mental health is a crucial aspect of overall well-being, encompassing an individual's emotional, psychological, and social well-being. In Nepal, mental health issues are a significant concern, with challenges related to governance, policy implementation, and service delivery. This review examines the mental health status in Nepal, analyzes existing policies, and proposes strategies for improvement. Databases, including ScienceDirect, Springer, NepJol, PubMed, and Google Scholar, were searched to gather relevant literature. The review identified key challenges in Nepal's mental health system, including the lack of a revised and fully implemented mental health policy, discriminatory provisions in the legislation, inadequate planning and funding at the district level, and limited workforce and resources. Despite positive developments, such as including mental health in general health policies and NGO involvement, significant barriers remain. To improve mental health in Nepal, it is essential to implement public policies favoring mental health, train individuals in personal skills, promote healthy lifestyles, and intervene through community actions. These strategies aim to create supportive environments and increase awareness of mental health issues, ultimately improving the population's overall well-being.

Acute effects of muscle fatigue on the knee joint-position sense of trained and non-trained individuals

Acute effects of muscle fatigue on the knee joint-position sense of trained and non-trained individuals

Differences in Aerobic Capacity and Running Speed Across Various Somatotype Structures and Body Fat Compositions among Professional Football Athletes in Indonesia

Highlights:1. This study emphasizes the significance of understanding professional football players' various somatotype structures and body fat compositions as an important contribution to the area of sports science.This study lays the groundwork for future research to better understand the intricate interactions between somatotype structures, body composition, and athletic performance.2. Since a one-size-fits-all approach may not be successful, this study advocates for tailored evaluations of training regimens to cater to athletes' unique requirements and skills, which may lead to higher overall performance. Abstract This study investigated the effects of somatotype structures and body fat composition on professional football athletes' aerobic capacities and running speed. This study used an analytical observational design with a cross-sectional approach. The subjects comprised 27 professional football athletes from Bhayangkara Football Club, located in Bekasi, Indonesia. This study measured several variables, i.e., players' age, playing position, somatotype structures assessed using the Somatotype Rating Form and Heath-Carter Somatochart, body fat composition measured using Brozek and Siri formulas, aerobic capacities determined by the maximum rate of oxygen (VO2 max) through the Yo-Yo Intermittent Recovery Test Level 2, and running speed over a 30 m distance. The data were presented as mean ± standard deviation (SD), frequency (n), and percentage. The Shapiro-Wilk was used to determine the normality of the data distribution. The statistical analyses were conducted using one-way analysis of variance (ANOVA) followed by the post-hoc least significant difference (LSD) test, the Kruskal-Wallis test followed by the post-hoc Mann-Whitney test, as well as the independent t-test, the Mann-Whitney test, and Pearson's or Spearman's correlation tests. A value of p<0.05 was considered statistically significant. The athletes exhibited a predominant somatotype structure of mesomorph-endomorph (88.9%). Notable associations were found between mesomorphy rating and running speed (r=-0.548; p=0.003), body fat composition and aerobic capacity (r=-0.448; p=0.019), as well as age and aerobic capacity (r=-0.515; p=0.006). Notably, differences in aerobic capacity were observed among various age groups (p=0.031). There were also differences in body fat composition (p=0.003) and running speed (p=0.036) between two distinct somatotype structures. These findings underscore the importance of considering individualized training and conditioning programs that account for athletes' unique body compositions and ages.

Experimental study of the antibacterial effect of anodic dissolution of a copper electrode used in endodontic treatment of teeth

BACKGROUND: One of the possible ways to improve the quality of dental treatment with obliterated root canals is the use of transcanal direct current exposure. AIM: The aim of the study was to investigate the comparative antibacterial activity of anodic dissolution of copper and silver-copper electrodes used in the endodontic treatment of teeth in the experiment. MATERIALS AND METHODS: An experimental study was performed by implementing a technique for the automatic cultivation of microorganisms in liquid culture media. We used for the study clinical isolates of individual strains of bacteria and yeasts, namely: S. constellatus, P. intermedia, C. albicans, as well as mixed cultures: 1) S. constellatus + F. nucleatum; 2) Streptococcus sanguis + Enterococcus faecium obtained from the root canals of the teeth during treatment of chronic pulpitis. RESULTS: The results of the study showed that anodic dissolution of both silver-copper and copper electrodes had a significant and, in general, unidirectional antibacterial effect. At the same time, it was found that, if for clinical isolate of P. intermedia the use of a silver-copper electrode was more effective, then for S. constellatus and C. Albicans strains, as well as for mixed cultures of pathogenic microorganisms S. constellatus + F. nucleatum and Streptococcus sanguis + Enterococcus faecium anodic dissolution of a copper electrode showed a more pronounced antibacterial effect. CONCLUSION: In endodontic treatment of teeth with partially obliterated root canals, along with anodic dissolution of silver-copper electrodes, it is possible to use anodic dissolution of copper electrodes as a means capable of having a pronounced antibacterial effect.

Eyes on CVI: Eye movements unveil distinct visual search patterns in Cerebral Visual Impairment compared to ADHD, dyslexia, and neurotypical children

Visual search problems are often reported in children with Cerebral Visual Impairment (CVI). To tackle the clinical challenge of objectively differentiating CVI from other neurodevelopmental disorders, we developed a novel test battery. Visual search tasks were coupled with verbal and gaze-based measurements. Two search tasks were performed by children with CVI (n: 22; mean age (SD): 9.63 (.46) years) ADHD (n: 32; mean age (SD): 10.51 (.25) years), dyslexia (n: 28; mean age (SD): 10.29 (.20) years) and neurotypical development (n: 44; mean age (SD): 9.30 (.30) years). Children with CVI had more impaired search performance compared to all other groups, especially in crowded and unstructured displays and even when they had normal visual acuity. In-depth gaze-based analyses revealed that this group searched in overall larger areas and needed more time to recognize a target, particularly after their initial fixation on the target. Our gaze-based approach to visual search offers new insights into the distinct search patterns and behaviours of children with CVI. Their tendency to overlook targets whilst fixating on it, point towards higher-order visual function (HOVF) deficits. The novel method is feasible, valid, and promising for clinical differential-diagnostic evaluation between CVI, ADHD and dyslexia, and for informing individualized training.

Parent stress and social support in a randomized controlled trial of individual versus group parent training for children with HKD/ADHD

AbstractObjectivesAssess (a) the relative benefit of individual versus group parent training compared to treatment as usual (TAU) with an emphasis on parent outcomes. Investigate (b) if group parent training increases social support more than other modes of treatment and explore (c) how social support interacts with different modes of treatment.MethodCompared individual with group parent training and treatment as usual (TAU) in a randomized controlled trial for N = 237 children with Hyperkinetic Disorder/Attention Deficit Hyperactivity Disorder (HKD/ADHD). Employed two formats of the same cognitive‐behavioural parent training in the same settings to maximize comparability. Controlled for medication status and assessed changes from pre‐ to post‐treatment and 6‐month follow‐up.ResultsParents reported more positive changes in the parent training groups than in TAU in relation to child behaviour problems and moodiness as well as more positive changes in parent stress and sense of competence. However, gains on parent stress were limited after group training as were gains on satisfaction. Social support improved similarly in all treatment groups. While results indicated clear main effects of social support on all child and parent measures, interactions of social support and treatment outcomes were found for child moodiness and parent stress.ConclusionsCognitive‐behavioural parent training is beneficial beyond TAU, especially when it can be provided individually. Surprisingly, group training did not reduce parent stress more than TAU or individual training. Social support related to all measures and interacted with treatment on some outcomes. The findings have numerous implications for research and practice.

Feasibility and acceptability of an online group dialectical behavioural therapy skills training in a Transdiagnostic group with Anxiety and Depression

Transdiagnostic approaches offers a paradigm shift in managing psychiatric disorders. Emotion regulation difficulties are a transdiagnostic prevalent across various mood and personality disorders. Dialectical Behavioural Therapy Skills Training (DBT-ST), initially designed as part of treatment for borderline personality disorder, targets emotion regulation and has shown promise in diverse psychiatric conditions. In lower middle-income countries with resource-constrained settings, online delivery of evidence-based interventions holds potential to bridge treatment gaps. This study assesses the feasibility and acceptability of online group DBT skills training for individuals with depression or anxiety disorders in India. Mental health professionals practising in India referred twenty-four eligible participants currently not engaged in psychotherapy. Of these, 18 initiated the 8-week virtual group DBT-ST program, with 12 completing it (66 % female, 18-35 years of age, 5 on concurrent medication). They provided feedback on therapy content's usefulness. Baseline, post-intervention, and one-month follow-up assessments measured changes in emotion regulation difficulties, depression, and anxiety symptoms. Treatment retained 66.7 % of participants, all participants found the intervention beneficial. Repeated measures ANOVA indicates significant reductions in self-reported difficulties in emotion regulation, depression, and anxiety symptoms post-intervention. These findings highlight the promise of transdiagnostic interventions like DBT-ST that merit further evaluations using RCTs with larger sample sizes.

The role of inspiratory muscle fatigue and its impact on strength and respiratory function

Inspiratory muscles are essential for breathing and during exercise. However, excessive effort on the respiratory system can cause the inspiratory muscles, such as the external intercostals and the diaphragm, to become fatigued, therefore impairing performance (Wuthrich et al., 2013, Exp Physiol, 12, 1705–1717). Inspiratory muscle fatigue is when there is a loss in the capacity to produce force and/or velocity in a muscle, meaning they become tired and weak due to increased work demands (Tsukamoto et al., 2019, J Phys Ther Sci, 31, 318–325). Inspiratory muscle fatigue impacts performance because the force produced by the inspiratory muscles starts to decline which therefore causes them to fatigue as they cannot work to the maximum capacity no longer. This is vital in aerobic exercises such as rowing, cycling and running as the demand for oxygen is higher to perform the tasks. The diaphragm is the most dominant respiratory muscle involved in inspiration, alongside the external intercostal muscles. During inspiration, the diaphragm contracts and flattens, and the external intercostal muscles contract, pulling the ribcage up and outwards. The main function of these muscles is to allow a maximum amount of oxygen into the lungs by increasing the surface area in the thoracic cavity (Siafakas et al., 1999, Thorax, 54, 458–465). Several studies have explored delaying muscle fatigue by using inspiratory muscle training in healthy individuals. This is because it improves the strength of the respiratory muscles by increasing the endurance and capacity of the diaphragm. Results highlighted that maximum inspiratory pressure increased between 16 and 18% (Segizbaeva et al., 2014, Hum Physiol, 40, 683-689), a 7% increase in inspiratory muscle strength (Smith et al., 2021, Am J Physiol, 312, 1013-1018), a delay in muscle fatigue, and an improvement in performance. There is limited research on cycling, rowing, and running; therefore, this study aims to determine whether any of these exercises delay or increase muscle fatigue and to determine if maximal inspiratory pressure and maximal expiratory pressure improve respiratory function. This study aims to recruit 9–12 participants, which will involve four visits to the laboratory. Exercises include a 10-kilometre cycling session, a 3-kilometre treadmill running session, and a 2-kilometre rowing session, and these will be done in a randomised order. Visit 1 includes familiarisation; visit 2 involves baseline measures being recorded and test 1 being conducted; visit 3 includes test 2 being administered; and visit 4 involves test 3 being conducted. The measurements that will be collected at each kilometre are heart rate, rate of perceived exertion, and dyspnea. Blood lactate, maximal inspiratory pressure, and maximum expiratory pressure, however, will be collected before and after each test. At this present time, results are pending. My hypothesis for this study would be that all the cardio-based exercises will see an improvement in respiratory function and strength, with treadmill running having the biggest improvement as, throughout the 4 weeks, adaptation would have occurred.

Inter-species interaction of bradyrhizobia affects their colonization and plant growth promotion in Arachis hypogaea.

Bradyrhizobia are the principal symbiotic partner of the leguminous plant and take active part in biological nitrogen-fixation. The present investigation explores the underlying competition among different strains during colonization in host roots. Six distinct GFP and RFP-tagged Bradyrhizobium strains were engineered to track them inside the peanut roots either independently or in combination. The Bradyrhizobium strains require different time-spans ranging from 4 to 21days post-infection (dpi) for successful colonization which further varies in presence of another strain. While most of the individual strains enhanced the shoot and root dry weight, number of nodules, and nitrogen fixation capabilities of the host plants, no significant enhancement of plant growth and nodulation efficiency was observed when they were allowed to colonize in combinations. However, if among the combinations one strains is SEMIA 6144, the co-infection results in higher growth and nodulation efficiency of the hosts. From the competition experiments it has been found that Bradyrhizobium japonicum SEMIA 6144 was found to be the most dominant strain for effective nodulation in peanut. The extent of biofilm and exopolysaccharide (EPS) production by these isolates, individually or in combinations, were envisaged to correlate whether these parameters have any impact on the symbiotic association. But the extent of colonization, growth-promotion and nitrogen-fixation ability drastically lowered when a strain present together with other Bradyrhizobium strain. Therefore, it is imperative to understand the interaction between two co-inoculating Bradyrhizobium species for nodulation followed by plant growth promotion to develop suitable consortia for enhancing BNF in peanut and possibly for other legumes.

Railway Track Faults Detection Using Ensemble Deep Transfer Learning Models

Railway track fault detection is an essential task for ensuring the safety and reliability of railway systems, particularly in the summer and rainy seasons when train wheels may slide due to fractures in the track or corrosion may cause track fractures. In this study, we propose a novel approach for the automated detection of railway track faults using deep transfer learning models. The proposed method combines image processing techniques and the training of three pretrained models: InceptionV3, ResNet50V2, and VGG16, on a dataset of railway track images. We evaluated the performance of our proposed method by measuring its accuracy on a test set of railway track images. The individual training accuracies for InceptionV3, ResNet50V2, and VGG16 were 94.30%, 96.79%, and 94.64%, respectively. We then combined these models using an ensemble approach, which achieved an impressive accuracy of 98.57% on the test set. Our results demonstrate the effectiveness of using deep ensemble transfer learning for railway track fault detection. Moreover, our proposed method can be used as a valuable tool for railway track maintenance and monitoring, which can ultimately lead to the improvement of the safety and reliability of railway systems. our proposed approach for railway track fault detection using ensemble deep transfer learning models shows promising results, indicating that it has great potential for detecting track faults accurately and efficiently. The proposed method can be used in various railway systems worldwide, ultimately leading to improved safety and reliability for passengers and cargo transportation.

Simultaneous bioremediation of diesel-contaminated soil and water ecosystems using mixed culture of Acinetobacter baumannii IITG19 and Providencia vermicola IITG20

ABSTRACT Diesel degradation and bacterial growth were investigated in soil, marine water, and freshwater ecosystems using Acinetobacter baumannii IITG19, Providencia vermicola IITG20, and their mixed culture. Both bacteria were found to be effective in all three ecosystems, with the best degradation occurring in freshwater. Acinetobacter baumannii IITG19 showed higher degradation (59%, 62%, and 76%) than Providencia vermicola IITG20 (31%, 57%, and 67%) in soil, marine water, and freshwater, respectively. Alkanes showed higher degradation than naphthenes and aromatics for both strains. The mixed culture showed higher diesel degradation efficiency than individual strains in all ecosystems. The overall degradation was similar in soil and marine water (66%), while freshwater showed the highest degradation of 81%. In the presence of the mixed culture, the degradation of alkanes was more than 90%. Bacterial growth was highest in freshwater and lowest in soil for both bacteria and the mixed culture. Metabolite analysis confirmed alcoholic degradation for alkanes and cyclo-alcoholic degradation for naphthenes. The degradation rate for mixed culture was higher than that of both the individual strains. The mixed culture had highest degradation rate constant in freshwater at 0.11 day−1 followed by that in marine ecosystem at 0.078 day−1. The rate constant was lowest for soil ecosystem at 0.066 day−1. Thus the mixed culture showed effectiveness in all three ecosystems, with its highest effectiveness observed in the freshwater ecosystem.

Beyond the double helix: the multifaceted landscape of extracellular DNA in Staphylococcus aureus biofilms.

Staphylococcus aureus forms biofilms consisting of cells embedded in a matrix made of proteins, polysaccharides, lipids, and extracellular DNA (eDNA). Biofilm-associated infections are difficult to treat and can promote antibiotic resistance, resulting in negative healthcare outcomes. eDNA within the matrix contributes to the stability, growth, and immune-evasive properties of S. aureus biofilms. eDNA is released by autolysis, which is mediated by murein hydrolases that access the cell wall via membrane pores formed by holin-like proteins. The eDNA content of S. aureus biofilms varies among individual strains and is influenced by environmental conditions, including the presence of antibiotics. eDNA plays an important role in biofilm development and structure by acting as an electrostatic net that facilitates protein-cell and cell-cell interactions. Because of eDNA's structural importance in biofilms and its ubiquitous presence among S. aureus isolates, it is a potential target for therapeutics. Treatment of biofilms with DNase can eradicate or drastically reduce them in size. Additionally, antibodies that target DNABII proteins, which bind to and stabilize eDNA, can also disperse biofilms. This review discusses the recent literature on the release, structure, and function of eDNA in S. aureus biofilms, in addition to a discussion of potential avenues for targeting eDNA for biofilm eradication.

The Utility of Heartrate and Heartrate Variability Biofeedback for the Improvement of Interoception across Behavioural, Physiological and Neural Outcome Measures: A Systematic Review.

Interoceptive dysfunctions are increasingly implicated in a number of physical and mental health conditions. Accordingly, there is a pertinent need for therapeutic interventions which target interoceptive deficits. Heartrate and heartrate variability biofeedback therapy (HR(V)-BF), interventions which train individuals to regulate their cardiovascular signals and constrain these within optimal parameters through breathing, could enhance the functioning of interoceptive pathways via stimulation of the vagus nerve. Consequently, this narrative systematic review sought to synthesise the current state of the literature with regard to the potential of HR(V)-BF as an interoceptive intervention across behavioural, physiological and neural outcome measures related to interoception. In total, 77 papers were included in this review, with the majority using physiological outcome measures. Overall, findings were mixed with respect to improvements in the outcome measures after HR(V)-BF. However, trends suggested that effects on measures related to interoception were stronger when resonance frequency breathing and an intense treatment protocol were employed. Based on these findings, we propose a three-stage model by which HR(V)-BF may improve interoception which draws upon principles of interoceptive inference and predictive coding. Furthermore, we provide specific directions for future research, which will serve to advance the current knowledge state.

How Healthcare Providers Decide on a Referral Location in Telephone Triage: A Cross-sectional Study.

Approximately 25% of patients that present to the emergency department (ED) do so after contact with a healthcare professional. Many of these patients could be effectively managed in non-ED ambulatory settings. Aligning patients with safe and appropriate outpatient care has the potential to improve ED overcrowding, patient experience, outcomes, and costs. Little is understood about how healthcare providers approach triage decision-making and what factors influence their choices. To evaluate how providers think about patient triage, and what factors influence their decision-making when triaging patient calls. Cross-sectional survey-based study in which participants make triage decisions for hypothetical clinical scenarios. Healthcare providers in the specialties of internal medicine, family medicine, or emergency medicine within a large integrated healthcare system in the Southeast. Differences in individual training and practice characteristics were used to compare observed differences in triage outcomes. Free-response data were evaluated to identify themes and factors affecting triage decisions. Out of 72 total participants, substantial variability in triage decision-making was observed among all patient cases. Attending physicians triaged 1.4 fewer cases to ED care compared with resident physicians (p < 0.001, 95% CI 0.62-2.1). Academic attendings demonstrated a trend toward fewer cases to ED care compared with community attendings (0.61, p = 0.188, 95% CI - 0.31-1.5). Qualitative data highlighted the complex considerations in provider triage and led to the development of a novel conceptual model to describe the cognitive triage process and the main influencing factors. Triage decision-making for healthcare providers is influenced by many factors related to clinical resources, care coordination, patient factors, and clinician factors. The complex considerations involved yield variability in triage decisions that is largely unexplained by descriptive physician factors.

Metabolic effects of training with blood flow restriction

Relevance. Training with limited blood flow, which is performed with partial vascular occlusion using inflatable cuffs, can cause an increase in skeletal muscle mass and strength, similar to those observed with classical high-intensity training with weights, although with a noticeably lower mechanical load. Performing a load with a restriction of blood flow leads to the accumulation of metabolites, recruitment of motor neurons with a higher excitation threshold, edema of muscle cells, an increase in the concentration of reactive oxygen species, which, in turn, contributes to hypertrophy of muscle fibers, increased muscle strength, mitochondrial biogenesis, angiogenesis, increased activity of glucose transporters. Based on this, training with limited blood flow should have a positive effect on metabolic health.The aim of the study is a theoretical analysis of the metabolic effects of blood flow restriction training in healthy individuals and in clinical populations.Methods and organization of the study - this review examines the metabolic effects of TOK in both healthy and clinical populations.Conclusions. BFR can be considered as a potential method for improving muscle function and metabolism of glucose, triglycerides and fatty acids.

Synergistic biocementation: harnessing Comamonas and Bacillus ureolytic bacteria for enhanced sand stabilization

Biocementation, driven by ureolytic bacteria and their biochemical activities, has evolved as a powerful technology for soil stabilization, crack repair, and bioremediation. Ureolytic bacteria play a crucial role in calcium carbonate precipitation through their enzymatic activity, hydrolyzing urea to produce carbonate ions and elevate pH, thus creating favorable conditions for the precipitation of calcium carbonate. While extensive research has explored the ability of ureolytic bacteria isolated from natural environments or culture conditions, bacterial synergy is often unexplored or under-reported. In this study, we isolated bacterial strains from the local eutrophic river canal and evaluated their suitability for precipitating calcium carbonate polymorphs. We identified two distinct bacterial isolates with superior urea degradation ability (conductivity method) using partial 16 S rRNA gene sequencing. Molecular identification revealed that they belong to the Comamonas and Bacillus genera. Urea degradation analysis was performed under diverse pH (6,7 and 8) and temperature (15 °C,20 °C,25 °C and 30 °C) ranges, indicating that their ideal pH is 7 and temperature is 30 °C since 95% of the urea was degraded within 96 h. In addition, we investigated these strains individually and in combination, assessing their microbially induced carbonate precipitation (MICP) in silicate fine sand under low (14 ± 0.6 °C) and ideal temperature 30 °C conditions, aiming to optimize bio-mediated soil enhancement. Results indicated that 30 °C was the ideal temperature, and combining bacteria resulted in significant (p ≤ 0.001) superior carbonate precipitation (14–16%) and permeability (> 10− 6 m/s) in comparison to the average range of individual strains. These findings provide valuable insights into the potential of combining ureolytic bacteria for future MICP research on field applications including soil erosion mitigation, soil stabilization, ground improvement, and heavy metal remediation.

Robot-Assisted Gait Training in Individuals With Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Spinal cord injury (SCI) rehabilitation emphasizes locomotion. Robotic-assisted gait training (RAGT) is widely used in clinical settings because of its benefits; however, its efficacy remains controversial. We conducted a systematic review and meta-analysis to investigate the efficacy of RAGT in patients with SCI. We searched international and domestic databases for articles published until April 18, 2024. The meta-analysis employed a random effects model to determine the effect size as either mean difference (MD) or standardized MD (SMD). Evidence quality was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Twenty-three studies with a total of 690 participants were included in the final analysis. The overall pooled effect size for improvement in activities of daily living was 0.24, with SMD (95% confidence interval [95% CI], 0.04-0.43; GRADE: high) favoring RAGT over conventional rehabilitation. Muscular strength (MD, 0.23; 95% CI, 0.02-0.44; GRADE: high), walking index for SCI (MD, 0.31; 95% CI, 0.07-0.55; GRADE: moderate) and 6 min walk test distance (MD, 0.38; 95% CI, 0.14-0.63; GRADE: moderate) showed significant improvement in the robot group. Subgroup analysis revealed that subacute patients and intervention periods >2 months were more effective. This meta-analysis revealed that RAGT significantly improved activities of daily living, muscular strength, and walking abilities. Additional studies are needed to identify the optimal treatment protocol and specific patient groups for which the protocol is most effective.