Longer Use Research Articles

INNV-09. DISTANT PARENCHYMAL RECURRENCE DURING LONG-TERM USE OF TTFIELDS TREATMENT FOR GLIOBLASTOMA

Abstract BACKGROUND Tumor treating fields (TTFields) treatment has been an important option for the treatment of glioblastoma. The introduction of novel treatment options may lead to distinct recurrence patterns compared to those observed with conventional therapies; however, the specific recurrence pattern during TTFields treatment has not been elucidated. METHODS AND RESULTS Here, we analyzed 39 cases of glioblastoma treated with TTFields. Although a usage rate of more than 75% is recommended, among 39 cases, 18 discontinued TTFields treatment owing to requests by patients with lower usage rates. In these discontinued cases, patients exhibiting sensory aphasia were more frequently included compared to those who continued TTFields (44.4%, p<0.001). Among 21 cases involving patients who continued TTFields, tumor recurrence was observed in 15 of those cases. Five out of 15 cases (33.3%) exhibited recurrence in distant parenchyma from the primary lesion. A higher usage rate and relatively longer use of TTFields were observed in these five cases, along with more favorable progression-free survival than those in the other 10 cases (p=0.019, p=0.040, and p=0.024, respectively). In one case, recurrent tumors with lower-grade glioma histology but molecular markers characteristic for glioblastoma, IDH-wildtype were identified. This tumor arose in an area that received a lower local minimum power density of TTFields compared to the primary lesion, following long-term TTFields therapy CONCLUSIONS Long-term use of TTFields might be correlated with a high frequency of distant parenchymal recurrence in cases with favorable response.

The ‘Stemming from the Heart’ Series of Cultural and Creative Designs

With the development of the Internet in recent years, ‘terriers’ have become ubiquitous around us and have been integrated into our lives. Just like the national trend, the ‘terrier’ trend has been unstoppable. This is the beginning of design, which is both design and life. The characteristic of ‘terrier’ itself is that it varies from person to person and from time to time. Its diversity makes its own meaning is very rich, through the design of the ‘terrier’ meaning presented in front of everyone, to achieve graphic visualisation, the overall design through the vector cartoon shape for fun design, so that everyone can easily understand and love. In this information age, we often even love to use emoticons, which can enrich and fully express our inner language, in a word, everything is in the words. The emoticons we design are also ‘terriers’ that the general public can use everyday, and they are more practical. When we chat, we no longer use crepe words, but cute and animated pictures, which may be able to bring our friends and family closer together. For today's emergence of a large number of hot ‘terrier’, new ‘terrier’ and ‘terrier’ meaning, can be searched in the APP, so that the ‘terrier The app allows you to search for the meaning of ‘terrier’ in the app, so that ‘terrier’ can be used more aptly and better integrated into our lives. At the same time, there will also be related emoticons pushed, so that the design is more closely linked. The final display uses neon lights, a ‘tide’ of influenza, making the design more contemporary. In the display, the cultural and creative products will look more trendy and energetic in this atmosphere. Therefore, design is an expression of trend and a display of life.

Reducing plastic waste in intensive care from longer use of intravenous administration and invasive monitoring sets: A before-and-after study

IntroductionIntensive care unit (ICU) treatment carries a large environmental burden. Extending routine replacement of plastic line sets that belong to intravenous administration or invasive monitoring might lower waste from single-use plastics in ICUs. We extended the routine replacement interval of line sets from 4 to 7 days and assessed plastic waste reduction. MethodsIn this single center retrospective study the extension of the time interval from 4 to 7 days for routine replacement of line sets and its effect on plastic waste was assessed. The intervention was done at the start of 2022. Secondary outcomes were catheter-related bloodstream infections (CRBSI), nursing workload, costs and material durability. ResultsIn total 1221 patients were admitted to ICU; 636 in the pre-intervention period and 585 in the post-intervention period. There was a reduction of 881 replacement sets, 182 kg of waste and 96 nursing hours in 2022. There was no difference in CRBSI incidence. ConclusionThis study demonstrates the benefits of 7-day replacement intervals for intravenous administration and invasive monitoring sets. We established this in terms of waste reduction, patient safety and costs.

Impact of age at the second implantation, experience of amplification use, and long-term binaural experience on sound localization of children with bilateral cochlear implants

ObjectivesTo assess the influence of three factors using retrospective chart review: age at which 2nd cochlear implant (CI) is implanted, prior hearing aid (HA) experience in the 2nd CI ear, and long-term experience with bilateral cochlear implants (BICIs) on sound localization in children with sequential BICIs. MethodsMean absolute error (MAE) in localizing speech noise of 60 children with sequential BICIs was compared across four age groups of the 2nd CI (1–5.0; 5.1–10.0; 10.1–14.0; & 14.1–19.0 years) and two extents of prior HA experience (more than and less than one year). MAE was also longitudinally analyzed after 4–6 years of experience with BICI involving 18 participants out of 60. ResultsChildren who received 2nd CI before five years of age demonstrated significantly better localization than those who received it after ten years of age. More than one year of prior HA experience in the 2nd CI ear and extensive experience with sequential BICIs significantly enhanced localization performance. Inter-implant intervals and age at the 2nd CI showed a significant positive correlation with the MAE (poorer localization). ConclusionThe results indicate that age at 2nd CI is important in developing sound localization skills. Based on the results, obtaining 2nd CI within the first five years of life and no later than ten years old is recommended. The results also suggest that longer use of amplification before 2nd CI and prolonged BICI experience significantly fosters localization development.

Self-Reported Sobriety Labels: Perspectives from Alumni of Inpatient Addiction Treatment.

There is a lack of consensus in the addiction field as to how to refer to alumni of residential treatment who no longer use substances or who reduce their use. In the literature, this label and broader identity are typically discussed in technical (amount and frequency of use) or social terms (environment and social network changes). The current paper seeks to simplify the discussion by focusing on personal labels without complex technical or social considerations. Alumni of an inpatient addiction treatment facility were asked how they refer to themselves regarding their sobriety status post-discharge. Forty-nine patients were contacted 3 months post-discharge from a residential inpatient addiction treatment (men = 67%; Mage = 47.75 years). The patients completed a post-discharge assessment that was conducted by a trained research assistant over a 20-minute video call. The current study focused on a "sobriety label" measure in which patients indicated what they want to be called. Patients also explained why they chose their answer in an open-ended question. Most patients identified as in recovery (n = 29; 59.18%) followed by a sober person (n = 7; 14.29%) and four other responses. No alum selected the in remission option, which is notably a common way to refer to patients who no longer use substances. The current study adds a critical patient/alumni perspective to the existing body of literature and serves as a call to action for researchers to add a similar "sobriety label" measure to future assessments, studies, and batteries in effort to bring consistency to the labels, definitions, and identities that are published. This methodology of understanding how this population identifies will create uniformity in future literature and decrease the stigma surrounding addiction.

Opposition Resistance of the Nature Concerned Community Movement in Wadas Village (Equake Dewa) in Resisting Andesite Quarry Mining in Wadas Village, Purworejo Regency, Central Java

Gerakan Masyarakat Peduli Alam Desa Wadas (Gempa Dewa) is here to reject andesite mining in their village. The reason for the rejection of Gempa Dewa was the loss of living space and residences that had been abandoned for a long time. On the other hand, there are also several accompanying reasons, namely environmental problems and the collective memory that the community has about the natural disaster that hit Wadas decades ago. The aim of this research is to analyze the opposition resistance carried out by Gempa Dewa in rejecting the andesite mining assistance in Wadas Village. This research uses qualitative research methods with data collection techniques, literature studies and documentation studies. Researchers used [1] data analysis techniques to obtain valid and comprehensive data. The results of this research were that it was found that several forms of oppositional resistance were carried out by Gempa Dewa in rejecting mining, including resistance through art, resistance with Mujahadah, and resistance by women's groups using symbols in their resistance. The hope is that with opposition resistance, the government will no longer use Wadas Village as an andesite mining location.

Current status of advance care planning, palliative care consultation, and end-of-life care in patients with glioblastoma in South Korea.

Given the typical trajectory of glioblastoma, many patients lose decision-making capacity over time, which can lead to inadequate advance care planning (ACP) and end-of-life (EOL) care. We aimed to evaluate patients' current ACP and EOL care status. We conducted a cohort study on 205 patients referred to oncologists at a Korean tertiary hospital between 2017 and 2022. We collected information on sociodemographic factors, cancer treatment, palliative care consultation, ACP, legal documents on life-sustaining treatment (LST) decisions, and aggressiveness of EOL care. With a median follow-up time of 18.3 months: 159 patients died; median overall survival: 20.3 months. Of the 159 patients, 11 (6.9%) and 63 (39.6%) had advance directive (AD) and LST plans, respectively, whereas 85 (53.5%) had neither. Among the 63 with LST plans, 10 (15.9%) and 53 (84.1%) completed their forms through self-determination and family determination, respectively. Of the 159 patients who died, 102 (64.2%) received palliative care consultation (median time: 44 days from the first consultation to death) and 78 (49.1%) received aggressive EOL care. Those receiving palliative care consultations were less likely to receive aggressive EOL care (83.3% vs 32.4%, P < .001), and more likely to use more than 3 days of hospice care at EOL (19.6% vs 68.0%, P < .001). The right to self-determination remains poorly protected among patients with glioblastoma, with nearly 90% not self-completing AD or LST plan. As palliative care consultation is associated with less aggressive EOL care and longer use of hospice care, physicians should promptly introduce patients to ACP conversations and palliative care consultations.

Bahasa Tolaki di Kalangan Anak Remaja dalam Kehidupan sehari-hari di Desa Totombe Jaya

This study aims to determine the influence and causes of the Fading of the Use of Tolaki Language Among Adolescent Children in Sampara District in Konawe Regency. The selection of informants in this study used purposive techniques. This research uses Bronislaw Malinowski's Cultural Diffusion theory (1944) The data collection technique used in this research is a field work technique using observation and in-depth interviews. This research is qualitative research with ethnographic research methods. The results of this study show that: First, several things make teenagers there cannot speak Tolaki, namely because of several external and internal factors. The internal factor is the family. While external factors are school and friends. Second, due to habits from childhood, they are not taught from childhood, making it difficult for them to know their local language. This makes the teenagers there no longer use Tolaki regional language anymore but to the general language of Indonesian.

No improvement in mortality among critically ill patients with carbapenems as initial empirical therapy and more detection of multi-drug resistant pathogens associated with longer use: a post hoc analysis of a prospective cohort study.

Whether empirical therapy with carbapenems positively affects the outcomes of critically ill patients with bacterial infections remains unclear. This study aimed to investigate whether the use of carbapenems as the initial antimicrobial administration reduces mortality and whether the duration of carbapenem use affects the detection of multidrug-resistant (MDR) pathogens. This was a post hoc analysis of data acquired from Japanese participating sites from a multicenter, prospective observational study [Determinants of Antimicrobial Use and De-escalation in Critical Care (DIANA study)]. A total of 268 adult patients with clinically suspected or confirmed bacterial infections from 31 Japanese intensive care units (ICUs) were analyzed. The patients were divided into two groups: patients who were administered carbapenems as initial antimicrobials (initial carbapenem group, n = 99) and those who were not administered carbapenems (initial non-carbapenem group, n = 169). The primary outcomes were mortality at day 28 and detection of MDR pathogens. Multivariate logistic regression analysis revealed that mortality at day 28 did not differ between the two groups [18 (18%) vs 27 (16%), respectively; odds ratio: 1.25 (95% confidence interval (CI): 0.59-2.65), P = 0.564]. The subdistribution hazard ratio for detecting MDR pathogens on day 28 per additional day of carbapenem use is 1.08 (95% CI: 1.05-1.13, P < 0.001 using the Fine-Gray model with death regarded as a competing event). In conclusion, in-hospital mortality was similar between the groups, and a longer duration of carbapenem use as the initial antimicrobial therapy resulted in a higher risk of detection of new MDR pathogens.IMPORTANCEWe found no statistical difference in mortality with the empirical use of carbapenems as initial antimicrobial therapy among critically ill patients with bacterial infections. Our study revealed a lower proportion of inappropriate initial antimicrobial administrations than those reported in previous studies. This result suggests the importance of appropriate risk assessment for the involvement of multidrug-resistant (MDR) pathogens and the selection of suitable antibiotics based on risk. To the best of our knowledge, this study is the first to demonstrate that a longer duration of carbapenem use as initial therapy is associated with a higher risk of subsequent detection of MDR pathogens. This finding underscores the importance of efforts to minimize the duration of carbapenem use as initial antimicrobial therapy when it is necessary.

The effect of formal de‐policing on police traffic stop behavior and crime: Early evidence from LAPD's policy to restrict discretionary traffic stops

AbstractResearch SummaryOn March 1, 2022, correspondence from the Los Angeles Police Department (LAPD) headquarters stated that officers can no longer use minor infractions (e.g., equipment violations) as a pretextual reason to further investigate drivers for criminal behavior. If LAPD officers are to execute a discretionary stop, they must activate their body‐worn cameras and reasonably articulate to the civilian why they are being investigated. The intent is to reduce racial/ethnic disparities in stops and build trust of the police within the community. Critics of the policy argue that elevated crime rates will result due to the crime suppression effect of such stops. This study examines racial differences in stops before and after the policy change, as well as whether Part 1 violent and property crimes increased. Descriptive findings show that while the counts of stops, arrests, and contraband seizures during stops decreased, the percentage of non‐White civilians stopped decreased only minimally following the intervention. Results from using Bayesian synthetic control methods indicate an increase in both violent and property crimes post‐intervention compared with the synthetic counterfactual. The increase in violent crimes has a low probability of being different from the counterfactual, whereas the increase in property crimes has a high probability, suggesting that the intervention led to a real change in property crimes compared with what would have been expected under the counterfactual.Policy ImplicationsThis study provides preliminary evidence that emerging policies intended to restrict discretionary stops may not have the intended effect on racial disparities in police traffic stops. Instead, agencies passing similar policies may expect to see the potential unintended consequence of a spike in jurisdictional property crimes. We argue that such types of stops across a jurisdiction may have a general deterrent effect on more common and calculative crimes such as property crimes. To combat violent crimes, agencies should consider focusing discretionary stops in known hot spots. Further, our findings offer implications for research on the effects of de‐policing on crime. Police agencies should monitor potential unintended impacts of these policies if enacted and be prepared to deal with such consequences.

The Effects of Longer Use of Teriparatide on Clinical and Radiographic Outcomes after Spinal Fusion in Geriatric Patients.

Background: Teriparatide is an anabolic agent for osteoporosis and is believed to improve the bone healing process. Previous studies showed that teriparatide could enhance not only fracture healing but also spine fusion. It has been reported that use of teriparatide could promote the spine fusion process and decrease mechanical complications. However, there was no consensus regarding optimal treatment duration. The purpose of this study was to compare surgical outcomes between short-duration and long-duration teriparatide treatment after lumbar fusion surgery in elderly patients. Materials and Methods: All consecutive patients older than 60 years who underwent 1-level lumbar fusion surgery for degenerative diseases between January 2015 and December 2019 were retrospectively reviewed. Based on the duration of teriparatide treatment (daily subcutaneous injection of 20 µg teriparatide), patients were subdivided into two groups: a short-duration (SD) group (<6 months) and a long-duration (LD) group (≥6 months). Mechanical complications, such as screw loosening, cage subsidence, and adjacent vertebral fractures, were investigated. Postoperative 1-year union rate was also evaluated on computed tomography. Clinical outcomes were recorded using visual analog scale (VAS) and Oswestry Disability Index (ODI). Between-group differences for these radiographic and clinical outcomes were analyzed. Results: Ninety-one patients were reviewed in this study, including sixty patients in the SD group and thirty-one patients in the LD group. Their mean age was 72.3 ± 6.2 years, and 79 patients were female. Mean T-score was -3.3 ± 0.8. Cage subsidence (6.7% vs. 3.2%), screw loosening (28.3% vs. 35.5%), and adjacent vertebral fracture (6.7% vs. 9.7%) were not significantly different between the SD and LD groups. Union rate at 1-year postoperative was 65.0% in the SD group and 87.1% in the LD group (p = 0.028). Both groups showed improvement in VAS and ODI after surgery. However, the differences of VAS from preoperative to 6 months and 1 year postoperative were significantly higher in the LD group. Conclusions: Longer teriparatide treatment after lumbar fusion surgery resulted in a higher union rate at 1-year postoperative than the shorter treatment. Also, it could be more beneficial for clinical outcomes.

Biomarkers of inflammation and coagulation after minimally invasive mitral valve surgery: a prospective comparison to conventional surgery

STRUCTURED ABSTRACT Objectives Minimally invasive cardiac surgery techniques are increasingly used but have longer cardiopulmonary bypass time, which may increase inflammatory response and negatively affect coagulation. Our aim was to compare biomarkers of inflammation and coagulation as well as transfusion rates after minimally invasive mitral valve repair and mitral valve surgery using conventional sternotomy. Design A prospective non-randomized study was performed enrolling 71 patients undergoing mitral valve surgery (35 right mini-thoracotomy and 36 conventional sternotomy procedures). Blood samples were collected pre- and postoperatively to assess inflammatory response. Thromboelastometry (ROTEM) was performed to assess coagulation, and transfusion rates were monitored. Results The minimally invasive group had longer cardiopulmonary bypass times compared to the sternotomy group: 127 min ([115–146] vs 79 min [65–112], p < 0.001) and were cooled to a lower temperature during cardiopulmonary bypass, 34 °C vs 36 °C (p = 0.04). IL-6 was lower in the minimally invasive group compared to the conventional sternotomy group when measured at the end of the surgical procedure, (38 [23–69] vs 61[41–139], p = 0.008), but no differences were found at postoperative day 1 or postoperative day 3. The transfusion rate was lower in the minimally invasive group (14%) compared to full sternotomy (35%, p = 0.04) and the chest tube output was reduced, (395 ml [190-705] vs 570 ml [400–1040], p = 0.04). Conclusions Our data showed that despite the longer use of extra corporal circulation during surgery, minimally invasive mitral valve repair is associated with reduced inflammatory response, lower rates of transfusion, and reduced chest tube output.

Effect of first-line bevacizumab on prognosis of second or later-line immunotherapy in patients with advanced non-squamous non-small cell lung cancer: A retrospective analysis.

e20570 Background: Previous studies have demonstrated that anti-angiogenic agents have the capacity to regulate tumor microenvironment and may affect the clinical effect of immune checkpoint inhibitors (ICIs). However, the impact of previous anti-angiogenic agents on clinical outcomes of non-squamous non-small cell lung cancer (nsqNSCLC) patients treated with ICIs remains unclear. Methods: In the present study, we incorporated POPLAR, OAK, and BIRCH trials with a total of 912 non-squamous NSCLC patients. Using Vivli data-sharing platform, we have obtained specific clinical information about individual patients. The progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier analysis with a log-rank test, and the corresponding hazard ratio (HR) and 95% confidence interval (CI) were estimated using the Cox proportional regression model. Chi-squared test was used to compare proportions between different groups. All statistical analysis and plotting were done in R version 4.1.1 and SPSS R26.0.0.2. P less than 0.05 was considered statistically significant. Results: In the overall cohort, PFS (2.77 months vs. 2.83 months; hazard ratio [HR],1.1; 95% confidence interval [CI], 0.9 to 1.3; p = 0.43) and OS (15.1 months vs. 14.3 months; HR,1.0; 95% CI, 0.8 to 1.3; p = 0.86) in patients treated with bevacizumab before atezolizumab (pre-bevacizumab group) and patients treated without bevacizumab before atezolizumab (no pre-bevacizumab group) were not statistically different. Merely in patients with KRAS mutation, no pre-bevacizumab group had an improved PFS (4.04 months vs. 1.64 months; HR,1.7; 95% CI, 1.0 to 2.7; p = 0.04) as compared to the pre-bevacizumab group. Longer use of bevacizumab (≥1.43 months) before atezolizumab suggested a longer PFS compared with shorter use of bevacizumab ( &lt; 1.43 months) (20.07 months vs. 2.75 months; HR,0.40; 95% CI, 0.17 to 0.95; p = 0.03). Conclusions: In conclusion, our study demonstrated that whether or not first-line bevacizumab is given has no effect on PFS or OS of second-line or later-line immunotherapies. Patients with longer duration of first-line bevacizumab use have a longer PFS on later immunotherapy. The more appropriate timing and sequence of administration of anti-angiogenic agents and ICIs will help us achieve a better therapeutic effect in the clinical practice of patients with advanced NSCLC.

Early discontinuation of long-acting reversible contraceptives methods and its associated factors in Hosanna town, central Ethiopia: a cross-sectional study

Long-acting reversible contraceptive (LARC) method use is an ideal strategy for longer protection against unintended pregnancies, unsafe abortions, maternal morbidities, and mortalities related to pregnancies and childbirth. Despite low utilization of LARC methods in Ethiopia, early discontinuation remains a problem. This study aimed to assess prevalence of early discontinuation of LARC methods and associated factors in Hossana town. A community-based cross-sectional study was conducted among 433 adult women of reproductive age who had a history of LARC use. Logistic regression model was considered for the analysis. Proportion of LARC methods discontinuation within one year was 24.5%, 95% CI (20.6, 26.8%). Women whose age ≥ 30 years (AOR = 3.16, 95% CI: 1.27, 7.89), who had < 3 live children (AOR = 5.17, 95% CI 2.30, 11.61), who had a desire for pregnancy (AOR = 2.35, 95% CI 1.14, 4.85), who did not get pre-insertion counseling on the benefits of LARC methods (AOR = 1.79, 95% CI 1.01, 3.21) and who experienced side effects (AOR = 3.63, 95% CI 2.07, 6.38) were more likely to discontinue LARC methods early than their counterparts. Nearly one-fourth of clients discontinued using the LARC methods within the first year of insertion, highlighting the need to promote longer use for improved protection and success of family planning programs.

Keep Calm: Does parental preoperative anxiety affect post-tonsillectomy pain scores in children?

PurposeTo understand if high parental anxiety leads to increased post-tonsillectomy pain in children.MethodsProspective study including parents of children aged 3–10 years old submitted to tonsillectomy with or without adenoidectomy. To evaluate anxiety, parents were asked to fill the State-Trait Anxiety Inventory form-Y, with postoperative pain being evaluated with the Wong-Baker FACES pain scale at postoperative days 1, 3 and 7. Parents were also asked to register the number of days during which children took analgesic and the number of analgesic intakes needed.Results41 parents were enrolled, of which 95.1% (n = 39) were female with a mean age of 35.64 years (SD 5.751), with 41 children also being enrolled, of which 85.4% of children (n = 35) underwent tonsillectomy and adenoidectomy. 43.9% (n = 18) of parents presented State anxiety scores above the cut-off level and 53.7% (n = 22) above the Trait anxiety scores above the cut-off. Children of parents with high State anxiety presented statistically higher pain scores in both the third (p = 0.035) and the seventh postoperative days (p = 0.006), with significantly longer use of analgesic medication (p = 0.043) being found, as well as a statistically higher number of analgesic intakes (p = 0.045) (Table 4).ConclusionThe present study establishes an association between preoperative parental anxiety, postoperative pain scores and the need for longer analgesic use in children undergoing tonsillectomy. This reinforces the importance of reducing parental anxiety and opens the door for further strategies to better post-tonsillectomy outcomes.

The potential impact of the new ‘Right to Repair’ rules on electrical and electronic equipment waste: A case study of the UK

Every year an estimated two million tonnes of waste electrical and electronic equipment (WEEE) are discarded by householders and companies in the United Kingdom (UK). While the UK has left the European Union (EU), its waste-related policies still mirror those of the EU, including the WEEE-related policies. Motivated by the recent introduction the so-called ‘Right to Repair’ policy for electrical and electronic equipment (EEE) across the EU and UK, this paper aims to demonstrate that, depending on the commitment and behavioural changes by the consumers and the government, the future of the WEEE management of the UK will vary. To this end, focusing on landfilled WEEE reduction we develop a generic system dynamics model and apply it to eleven WEEE categories. They depict the flow of EEE and WEEE representing the interaction among the stakeholders (e.g., consumers and producers of EEE) and relevant government regulations of the UK. Our four scenario analyses find that longer use of EEE and better WEEE collection seem to be effective in reducing landfilled WEEE, while more reuse and more recycling and recovery have negligible impacts, despite excluding the additional generation of landfilled WEEE as a result of recycling and recovery. Comparing with the business-as-usual scenario, one year longer EEE use and 10% more of WEEE collection could at maximum reduce landfilled WEEE by 14.05% of monitoring and control instruments and 93.93% of display equipment respectively. Backcasting scenario analyses reveal that significant efforts are required to reduce the targeted amounts.

Examining Burnout and Perspective on Videoconferencing in the Mental Health Workforce.

Objective: To examine burnout and perspectives on videoconferencing over time for the mental health workforce. Methods: Members of an academic psychiatry department completed two anonymous surveys about virtual work and burnout 18 months apart (T1n = 274, response rate = 66.8%; T2n = 227, response rate = 36.7%). A subset completed the burnout subscale of the Stanford Professional Fulfillment Index (T1n = 145; T2n = 127). Results: Respondents were well satisfied with videoconferencing at both time points and satisfaction was higher at T2. Videoconferencing was not perceived to contribute to feelings of fatigue at either time point and burnout levels decreased from T1 to T2. Conclusions: Videoconferencing is well received by the mental health workforce and is not widely perceived to contribute to feelings of fatigue. Longer use of videoconferencing coincided with decreased levels of burnout. There are likely benefits to virtual work for the mental health workforce and virtual work may be protective from burnout.

HIV-HBV coinfection and liver fibrosis in long time monitored patients from the former Romanian pediatric HIV cohort – a small study single center experience

The aim of this study was to determine the degree of liver fibrosis with the help of a non-invasive method - transient elastography - in a long term monitored HIV-HBV coinfected group of patients (from the former Romanian pediatric cohort) and to assess the implication of various factors as potential risk factors for the development of liver fibrosis. We have reviewed a total of 636 patients (Px) that were in the evidence of the HIV Department of the “Victor Babes” Hospital of Infectious Diseases of Craiova, from which we randomly selected a group of 37 patients that are monthly attending the HIV department. Mean age of the patients was 34.03±2 years old and they were monitored for a long period of time, mean duration of monitorization was 26.11±4.31 years. Patients have been split into group A (13 Px) with various degrees of liver fibrosis and group B (24 Px) without liver fibrosis; the mean value of liver stiffness was higher in group A vs group B 11.27±5.72 vs.4.93±0.98 kPa, p &lt;0.0001. Mean value of nadir CD4 was lower in group A. No significant differences were found between the 2 groups related to the number of associated risk factors, duration of treatment with Zidovudine, Didanosine, Zalcitabine, Stavudine, non-nucleoside reverse transcriptase inhibitor or Ritonavir. Longer duration with Lamivudine alone was associated with group A, while dual therapy (Tenofovir based) was characteristic with group B. In conclusion in a prolonged monitoring of HIV-HBV coinfected patients (from the former Romanian pediatric HIV cohort) liver fibrosis is associated with longer use of Lamivudine and shorter use or Tenofovir.

Current Status of Herbicide Resistance of Wild Oats (Avena spp) in Wheat Fields in Mardin and Şanlıufa Provinces of Türkiye

Wheat is a strategic crop with its role in human nutrition. In Türkiye, it has importance in agriculture and economy as well as being a staple crop. Mardin and Şanlıurfa provinces of Türkiye approximately produces 1.6 million tons of wheat on 600 thousand ha fields. One of the important factors limiting wheat production is weeds. Weeds compete with the wheat plant and cause significant yield and quality loss. Wild oat (Avena spp.) species are an important problem in wheat fields in both provinces. Herbicide applications are widely used to control wild oats due to their ease of use, short duration of action and low cost. Wheat fields were surveyed to supply data for strategies to be followed via determining the current situation of herbicide resistance in these provinces where herbicide resistant wild oats had been reported. Out of 95 fields visited, 65 fields had significant wild oat populations of which 61 A. sterilis and four A. fatua. Then these populations were tested to find out herbicide resistance levels against clodinafop-propargyl (ACCase inhibitor) and formulated mix of mesosulfuron-methyl and iodosulfuron-methyl sodium (ALS inhibitors). Only two populations, one low level and the other medium level were found to be resistant to the formulated mix of mesosulfuron and iodosulfuron while 11 populations were resistant to clodinafop, one high level, three medium level and the remaining low level. It was assumed that longer use history and wider use of clodinafop as well as herbicides used in winter rotational crops might cause more clodinafop resistant populations. It was concluded that a strategy to prevent or delay herbicide resistance in these provinces should be prepared because herbicide resistance has continued evolving.

APLIKASI SISTEM PELAPORAN TANDA BUKTI TRANSAKSI PADA PT. POS INDONESIA CABANG MRANGGEN

At PT. Pos Indonesia Mranggen Branch in making transaction receipt reports so far still uses Microsoft Excel where there are many columns in it, so that in its operation it still confuses users in this case are employees who work at the branch office. The purpose of this research is to assist employees in completing the work of making reports related to transaction reporting.&#x0D; In the process of collecting data with the aim of solving problems, the authors use descriptive data collection methods, namely by observation and interviews. And to design the software application, the writer uses Access Database 2007 and Visual Basic 6.0 Application, while the report system uses Crystal Report 8.5 Application.&#x0D; The final result of this research is a Transaction reporting system application that can provide convenience for employees in entering (input) transaction reporting data where there are several forms that are very easy to operate that no longer use many columns in it.&#x0D;