Medium Size Research Articles

Effectiveness of a chatbot in improving the mental wellbeing of health workers in Malawi during the COVID-19 pandemic: A randomized, controlled trial.

We conducted a randomized, controlled trial (RCT) to investigate our hypothesis that the interactive chatbot, Vitalk, is more effective in improving mental wellbeing and resilience outcomes of health workers in Malawi than the passive use of Internet resources. For our 2-arm, 8-week, parallel RCT (ISRCTN Registry: trial ID ISRCTN16378480), we recruited participants from 8 professional cadres from public and private healthcare facilities. The treatment arm used Vitalk; the control arm received links to Internet resources. The research team was blinded to the assignment. Of 1,584 participants randomly assigned to the treatment and control arms, 215 participants in the treatment and 296 in the control group completed baseline and endline anxiety assessments. Six assessments provided outcome measures for: anxiety (GAD-7); depression (PHQ-9); burnout (OLBI); loneliness (ULCA); resilience (RS-14); and resilience-building activities. We analyzed effectiveness using mixed-effects linear models, effect size estimates, and reliable change in risk levels. Results support our hypothesis. Difference-in-differences estimators showed that Vitalk reduced: depression (-0.68 [95% CI -1.15 to -0.21]); anxiety (-0.44 [95% CI -0.88 to 0.01]); and burnout (-0.58 [95% CI -1.32 to 0.15]). Changes in resilience (1.47 [95% CI 0.05 to 2.88]) and resilience-building activities (1.22 [95% CI 0.56 to 1.87]) were significantly greater in the treatment group. Our RCT produced a medium effect size for the treatment and a small effect size for the control group. This is the first RCT of a mental health app for healthcare workers during the COVID-19 pandemic in Southern Africa combining multiple mental wellbeing outcomes and measuring resilience and resilience-building activities. A substantial number of participants could have benefited from mental health support (1 in 8 reported anxiety and depression; 3 in 4 suffered burnout; and 1 in 4 had low resilience). Such help is not readily available in Malawi. Vitalk has the potential to fill this gap.

First theropod footprint identified in the middle Kimmeridgian of Buarcos (West Central Portugal): scientific and educational implications

ABSTRACT A dinosaur track was recently discovered at Buarcos (Figueira da Foz, Portugal). The stratigraphic level is in the upper part of the Boa Viagem Sandstone Formation, and the specimen is the first evidence for the presence of middle Kimmeridgian dinosaurs in the Cabo Mondego area. This track reveals a medium size theropod estimated with one meter height to the hip. Moderate dinoturbation indicate the presence of more than one dinosaur at that time. This finding suggests that Buarcos area may have a relevant ichnological fossil record, highlighting the importance of further works in this formation. It's also a good indicator for the presence of dinosaur remains which are poorly known in this time interval. Based on the currently known stratigraphic distribution of the theropod fossil record in the Upper Jurassic of the Lusitanian Basin, the trackmaker could have been either Ceratosaurus, Lourinhanosaurus or Allosaurus. The paleoenvironment is interpreted as a deltaic alluvial plain, with small to medium size migrating channels and flooding areas. The footprint has also didactic and aesthetic features which, on display in a museum, contribute to enhance cultural and educational activities. The context of the discovery of this specimen allows to address issues on the geological heritage.

Occupational therapy's role in promoting the “Learn the Signs. Act Early.” developmental monitoring program to public health employees

AbstractBackgroundOccupational therapists can play a key role in early identification of delay at the population health level by providing education to public health employees on how to implement developmental monitoring with caregivers of children birth to age 5.MethodsA pretest posttest design was utilized to assess the online education and training that was provided to Department of Public Health employees (N = 339), including Head Start, Special Supplemental Nutrition Program for Women, Infants and Children, Home Visiting, and Early Intervention.ResultsAnalysis of pretest–posttest survey data showed significant results for all 12 key learning outcomes. Six out of 12 outcomes were found to have a large effect size (d > 0.8), 4 outcomes indicated a medium effect size (d > 0.5), and 2 outcomes had a small effect size (d > 0.2). Participants gained knowledge of the “Learn the Signs. Act Early.” (LTSAE) developmental monitoring program, the difference between developmental monitoring and screening, the state's referral system and age‐appropriate parental engagement activities through knowledge of child development.ConclusionsOccupational therapists are child development specialists who can provide education on developmental monitoring and activities for parental engagement. The online course proved to be an effective platform to promote LTSAE within state agencies.

EVALUATION OF POSTOPERATIVE COMPLICATIONS AND REOPERATIONS IN PATIENTS UNDERGOING OPEN UMBILICAL HERNIA REPAIR

Abstract Background Umbilical hernia repair is a common surgical procedure. Open repair is recommended for small to medium size hernias, and use of mesh reduces recurrence. The primary aim was to evaluate the risk of postoperative complications and reoperations after emergency and elective open umbilical hernia repair, and secondly to evaluate whether complications and reoperations were associated to type of repair. Methods A single center retrospective cohort study of patients undergoing open umbilical hernia repair from October 2022 to September 2023. Data was extracted from the patient charts. Results A total of 151 had an umbilical hernia repair, 103 (68%) elective surgeries and 48 (32%) emergency surgeries. For the elective repairs, 37 (36%) got a suture- and 66 (64%) a mesh repair. There was no difference in complications, 5.4% versus 7.6%, p = 0.675. A higher percentage of emergency surgeries had the mesh placed in the onlay position 45.8% (22/48) compared to elective surgeries 30.1% (31/103), which more often received a preperitoneal mesh 34% (35/103). The overall complication rate tended to be higher for emergency repair compared with elective surgery, 6.8% and 14.6%, p = 0.124, with a tendency towards more complications with the use of mesh 12.1% (12/99) compared with suture repair 3.8% (2/52), p = 0.096. The most frequent complications were wound related (seroma, hematoma, wound infection). There were three (3%) reoperations in the elective group due to infection, and correspondingly two (4%) in the emergency group. Conclusion There is no difference in postoperative complication regarding suture or mesh repair of umbilical hernias.

FUZZY APPLICATION (MAMDANI METHOD) IN DECISION-MAKING ON LED TV SELECTION

Science is now developing very quickly. Information technology has been used in various places. Using computers in business, government, and personal activities shows how important science and technology are in helping human activities. One method used to solve various problems is fuzzy logic. Several types of Fuzzy are classified as Fuzzy Inference Systems (FIS), namely Tsukamoto, Mamdani, and Sugeno. The application of vague logic in making decisions about choosing an LED TV is to make it easier to select electronic media. This research aims to help people who need clarification on the many LED TV choices currently available. So, we need a decision-making method to help people choose an LED TV that suits their needs and budget. One of the methods used in this research is the Mamdani method. There were 50 LED TV brands in this research, and the criteria used in selecting LED TVs were based on size, resolution, and price. An LED TV that meets the medium size, high resolution, and normal price criteria will be purchased. The LED TV data that meets the medium size, high resolution, and normal price criteria is the Samsung UA43AU7000KXXD brand LED TV. However, the actual decision remains based on the buyer's decision.

Analysis of the Combined Effect of Major Influencing Parameters for Designing High-Performance Single (sBHE) and Double (dBHE) U-Tube Borehole Heat Exchangers

In this paper, a comprehensive analysis of the combined effect of major influencing parameters on heat transfer in a single U-tube BHE (sBHE) and a double U-tube BHE (dBHE) with two independent circuits was performed by using a validated numerical heat transfer model. Geometrical parameters, such as shank spacing (with maximum, average, and minimum values), borehole diameter (large, medium, and small borehole sizes), and borehole depth (shallow, average, and deep borehole depths) as well as the thermal conductivity of soil and grout, which ranges from minimum to high values, were considered. The combined impact of these parameters was included under the following four major cases: (1) the combined effect of borehole depth, borehole size, and shank spacing; (2) the combined effect of borehole depth and soil and grout thermal conductivity; (3) the combined effect of soil and grout thermal conductivity and borehole size; and (4) the combined effect of soil thermal conductivity, borehole size, and shank spacing. Each of these major cases has nine different design options for both sBHEs and dBHEs. A series of results of heat transfer per unit borehole depth were generated for all the considered various cases. With the given parameters, the BHE case that provides the highest heat transfer among the various cases of sBHEs and dBHEs were obtained.

Clinical Profile and Natural History of Children with Ventricular Septal Defects in Tripoli, Libya from 1996 through 2009

Introduction and Objectives: Ventricular septal defect (VSD) is the most common congenital heart diseases, it accounts 40%. This study carried out to describe the epidemiological characters and clinical presentation of patients with VSD in Western and Southern Libya, and to evaluate spontaneous versus surgical closure in different types.  Patients and Methods It is hospital case series study conducted by reviewing the medical records of 1092 patients followed at cardiology outpatient department (OPD) of Tripoli Children Hospital from 1996 through 2009, the data abstracted from medical records and filed in a worked sheet, Excel and SPSS software used to analyze the data.  Results We identified 1092 patients. The results revealed that 30.9% diagnosed during the first month, and 49.7% from1 to 12 months. From 1092 patients; 50.8% have peri- membranous VSD, 18.8% muscular, and 13% having an apical type. 97.2% of males have peri-membranous VSD where muscular and apical seen more in female, p value = 0.001. Cardiac murmur is the common presenting sign 61.3%, 9.3% have feature of Down syndrome. Positive Family history of CHD in 9.9% with significant relationship between family history and type of VSD (peri- membranous type), P value = 0.001. Small VSDs accounts 66.9%, large VSDs 16.1%, followed by medium size VSD 11.8% of cases. Patients with large VSDs more prone for hospital admission as 101 (57.4%) from 176 patients were admitted to hospital, followed by moderate size (45%), P value = 0.001. 70.3% of patients with large VSD need either medical or surgical treatment, P value = 0.001. Spontaneous closure seen in 17%, 0.6% died, while 41.9% still on follow up. Muscular VSD shows the highest tendency for spontaneous closer as 72% closed by the age of 2 years.  Conclusion We conclude that peri- membranous VSD is the most common type. Two thirds of patients had been diagnosed in the first year of life. Big defects and some of moderate VSDs need either medical or surgical treatment. Spontaneous closer is usually seen in the first 2 years of life.  Recommendations We highly recommend for further multi-center study all over the country to get reliable data on the prevalence of congenital heart diseases and the incidence of ventricular septal defect in our population.

Assessing the response of marine fish communities to climate change and fishing.

Globally, marine fish communities are being altered by climate change and human disturbances. We examined data on global marine fish communities to assess changes in community-weighted mean temperature affinity (i.e., mean temperatures within geographic ranges), maximum length, and trophic levels, which, respectively, represent the physiological, morphological, and trophic characteristics of marine fish communities. Then, we explored the influence of climate change and fishing on these characteristics because of their long-term role in shaping fish communities, especially their interactive effects. We employed spatial linear mixed models to investigate their impacts on community-weighted mean trait values and on abundance of different fish lengths and trophic groups. Globally, we observed an initial increasing trend in the temperature affinity of marine fish communities, whereas the weighted mean length and trophic levels of fish communities showed a declining trend. However, these shift trends were not significant, likely due to the large variation in midlatitude communities. Fishing pressure increased fish communities' temperature affinity in regions experiencing climate warming. Furthermore, climate warming was associated with an increase in weighted mean length and trophic levels of fish communities. Low climate baseline temperature appeared to mitigate the effect of climate warming on temperature affinity and trophic levels. The effect of climate warming on the relative abundance of different trophic classes and size classes both exhibited a nonlinear pattern. The small and relatively large fish species may benefit from climate warming, whereas the medium and largest size groups may be disadvantaged. Our results highlight the urgency of establishing stepping-stone marine protected areas to facilitate the migration of fishes to habitats in a warming ocean. Moreover, reducing human disturbance is crucial to mitigate rapid tropicalization, particularly in vulnerable temperate regions.

The association between dynamic balance andexecutive function: Which dynamic balance test hasthe strongest association with executive function? Asystematic review and meta-analysis.

The aging global population poses increasing challenges related to falls and dementia. Early identification of cognitive decline, particularly before noticeable symptoms manifest, is crucial for effective intervention. This review aims to determine the dynamic balance test most closely associated with executive function, potentially serving as a biomarker for cognitive decline. Based on recent reviews, inhibitory control, a component of executive function, holds significance in influencing balance performance. Studies suggest that the strength of the correlation between cognition and balance tends to be domain-specific and task-specific. Despite these findings, inconclusive evidence remains regarding the connection between executive function and various dynamic balance assessments. Our review identifies a significant association between all dynamic balance tests and executive function, albeit with varying strengths. Notably, a medium effect size is observed for the Timed Up and Go and Functional Reach Test, a small effect size for balance scales, and a strong effect size for postural sway. This review underscores a clear relationship between dynamic balance task performance and executive function. Dynamic posturography holds potential as a clinical biomarker for early detection of cognitive decline, with a note of caution due to observed heterogeneity and limited studies.

A combined observational and Mendelian randomization investigation reveals NMR-measured analytes to be risk factors of major cardiovascular diseases

Dyslipidaemias is the leading risk factor of several major cardiovascular diseases (CVDs), but there is still a lack of sufficient evidence supporting a causal role of lipoprotein subspecies in CVDs. In this study, we comprehensively investigated several lipoproteins and their subspecies, as well as other metabolites, in relation to coronary heart disease (CHD), heart failure (HF) and ischemic stroke (IS) longitudinally and by Mendelian randomization (MR) leveraging NMR-measured metabolomic data from 118,012 UK Biobank participants. We found that 123, 110 and 36 analytes were longitudinally associated with myocardial infarction, HF and IS (FDR < 0.05), respectively, and 25 of those were associated with all three outcomes. MR analysis suggested that genetically predicted levels of 70, 58 and 7 analytes were associated with CHD, HF and IS (FDR < 0.05), respectively. Two analytes, ApoB/ApoA1 and M-HDL-C were associated with all three CVD outcomes in the MR analyses, and the results for M-HDL-C were concordant in both observational and MR analyses. Our results implied that the apoB/apoA1 ratio and cholesterol in medium size HDL were particularly of importance to understand the shared pathophysiology of CHD, HF and IS and thus should be further investigated for the prevention of all three CVDs.

A Meta-Analysis of Anomia Treatment in Bilingual Aphasia: Within- and Cross-Language Generalization and Predictors of the Treatment Outcomes.

The present meta-analysis investigated the efficacy of anomia treatment in bilingual and multilingual persons with aphasia (BPWAs) by assessing the magnitudes of six anomia treatment outcomes. Three of the treatment outcomes pertained to the "trained language": improvement of trained words (treatment effect [TE]), within-language generalization of semantically related untrained words (WLG-Related), and within-language generalization of unrelated words (WLG-Unrelated). Three treatment outcomes were for the "untrained language": improvement of translations of the trained words (cross-language generalization of trained words [CLG-Tx]), cross-language generalization of semantically related untrained words (CLG-Related), and cross-language generalization of unrelated untrained words (CLG-Unrelated). This study also examined participant- and treatment-related predictors of these treatment outcomes. This study is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42023418147. Nine electronic databases were searched to identify word retrieval treatment studies of poststroke BPWAs of at least 6 months postonset. Pre- and posttreatment single-word naming scores were extracted for each eligible participant and used to calculate effect sizes (within-case Cohen's d) of the six treatment outcomes. Random-effects meta-analyses were conducted to assess weighted mean effect sizes of the treatment outcomes across studies. Multiple linear regression analyses were used to examine the effects of participant-related variables (pretreatment single-word naming and comprehension representing poststroke lexical processing abilities) and treatment-related variables (type, language, and duration). The methodological quality of eligible studies and the risk of bias in this meta-analysis were assessed. A total of 17 published studies with 39 BPWAs were included in the meta-analysis. The methodological quality of the included studies ranged from fair (n = 4) to good (n = 13). Anomia treatment produced a medium effect size for TE (M = 8.36) and marginally small effect sizes for WLG-Related (M = 1.63), WLG-Unrelated (M = 0.68), and CLG-Tx (M = 1.56). Effect sizes were nonsignificant for CLG-Related and CLG-Unrelated. TE was significantly larger than the other five types of treatment outcomes. TE and WLG-Related effect sizes were larger for BPWAs with milder comprehension or naming impairments and for treatments of longer duration. WLG-Unrelated was larger when BPWAs received phonological treatment than semantic and mixed treatments. The overall risk of bias in the meta-analysis was low with a potential risk of bias present in the study identification process. Current anomia treatment practices for bilingual speakers are efficacious in improving trained items but produce marginally small within-language generalization and cross-language generalization to translations of the trained items. These results highlight the need to provide treatment in each language of BPWAs and/or investigate other approaches to promote cross-language generalization. Furthermore, anomia treatment outcomes are influenced by BPWAs' poststroke single-word naming and comprehension abilities as well as treatment duration and the provision of phonological treatment. https://doi.org/10.23641/asha.25595712.

Microstructural evolution and carbides precipitation behavior and their effects on mechanical property of Nb–Ti microalloyed FB590 steel

Ferrite-bainite dual phase steels have been widely used in automobile manufacturing industry due to their high strength and excellent hole expansion performance. In this study, the effects of coiling temperature on mechanical properties and hole expansion performance of low carbon Nb–Ti micro-alloyed FB590 ferrite-bainite steel have been studied. Additionally, the microstructure evolution and carbide precipitation behavior during hot rolling and coiling processes have been investigated. The influence mechanism of microstructures and carbides on both mechanical properties and hole expansion performance has also been discussed. The results suggest that the fraction of the retained austenite and the martensite decreases gradually with increasing coiling temperatures from 450 °C to 500 °C. The main reason for the formation of martensite and retained austenite in steel CT450 coiled at 450 °C is that the coiling temperature is near the martensitic transformation temperature Ms. Increasing the coiling temperature to 500 °C which is above the Ms leads to ferritic and bainitic structure. The carbides precipitation behavior has been studied by TEM, thermodynamic and kinetics calculation. The results show that the size of the carbides increases with increasing coiling temperatures from 450 °C to 500 °C. Most of the large size carbides above 100 nm with high percent of Ti are the undissolved particles in austenite during slab heating. The medium size particles between 50 nm and 100 nm and enriched in Ti precipitate during rough rolling at higher temperature, while the particles smaller than 50 nm enriched in Nb precipitate during finish rolling and coiling processes. The strength of the steel is effectively increased by the fine carbides and martensite formed at low coiling temperature of 450 °C. With increasing coiling temperature from 450 °C to 500 °C, the steel's strength decreases from 630 MPa to 591 MPa, while the HER are improved from 76.8 % to 119.9 % due to the reduction of martensite and retained austenite. Although the strength is a little reduced due to the coarsening of carbides and reducing of the martensite, the plasticity and hole expansion performance is improved significantly with the coiling temperature of 500 °C.

225 Genomic diversity of Katahdin sheep and impacts on genomic prediction

Abstract In the late 1950s, Katahdin hair sheep were developed as a composite breed of medium size and moderate prolificacy, with potential to express resistance to gastrointestinal nematodes. With its increasing popularity and the recent adoption of genomic prediction in the Katahdin breeding program, evaluating the genetic diversity in this breed is necessary. Prediction accuracies rely on the strength of genetic relationships. That strength often increases with selection using genomically-enhanced estimated breeding values; however, it carries the risk of decreasing diversity. We aim to characterize the genetic diversity present in the breed and the subsequent impact on the accuracies of genomic predictions. Genotypes on Katahdin sheep from member flocks in the National Sheep Improvement Program were used. Data from two medium density 50k bead chips and one high density 600k bead chip were merged and limited to shared autosomal single nucleotide polymorphisms (SNP). After quality control, there were 9,705 animals and 31,984 SNP remaining. Only for analyses of inbreeding and heterozygosity, linkage disequilibrium (LD) pruning was performed; variants with an LD score exceeding 0.8 were removed with 29,904 SNP remaining. To determine the extent of population structure, principal component (PC) analysis was conducted with PC one and PC two explaining 4.9% and 3.8% of the variation in the population, respectively. When examining subpopulations, a single ancestral population explained 99.9% of the genetic variation among animals. When clustered by identity-by-state, all animals were placed in a single cluster. Inbreeding coefficients were estimated with four methods: method of moments, variance-standardized relationship minus one, excess homozygosity, and correlation between uniting gametes. Across methods, average inbreeding coefficients ranged from 1.14% to 1.20% with Pearson and Spearman correlations ranging from -0.51 to 0.91 (Table 1). Historical effective population sizes (Ne) were estimated for earlier generations, and a linear regression fit to predict more recent Ne. At the founding of the breed, historical Ne was estimated to be 310, and the current Ne was estimated to be 150. Effects of Ne on the accuracy of genomic predictions were examined for reference population sizes ranging from 1k to 25k for traits of low (0.1), moderate (0.3), and high (0.5) heritabilities. The corresponding number of effective chromosomal segments were 2NeL, where L was the length of the genome in morgans (26M). Accuracies of genomic predictions increased as the reference population size grew, with only marginal gains once the population exceeded 15k. Overall, there were no detectable genetic subpopulations in the Katahdin breed. Current levels of inbreeding were low. With a small Ne the breed can achieve high accuracy for genomic predictions by aiming for a reference population of 15k animals. Negative impacts on genetic diversity due to genomic selection are not of immediate concern.

Multi-scale surface folding in metal cutting

In this work, commercially pure small-grained copper is used to investigate the nature of plastic flow through in situ image analysis supported by extensive electron backscatter diffraction characterization of the chip. Non-laminar sinuous flow, manifested with surface perturbations (bumps) and folds, produces a highly heterogeneous strain field during cutting. A series of mushroom-shaped morphology, termed as large bumps, separated by large folds on the free surface of the chip are captured in high-resolution field emission scanning electron microscopy. Large bumps or folds, captured in the high-speed camera, consist of many medium and small-size bumps. While the size of the small bump is comparable with the grain size of the base metal, a cluster of grains takes part in forming medium-size bumps. The pinning points for the small size bumps are either grain boundary or hard grains. The hard grains also act as pinning points for the medium size bump. The bump boundaries (folds) are characterized by higher strain and greater refinement of grains, whereas, less strain and larger elongated grains are the characteristics of the central region of the bumps. The evolution of different length scale features on the free surface is discussed in terms of the orientation of grain, position of the grains on the surface, and induced strain in the chip. This study suggested that the development of folding at different length scales is capable of providing deeper insight into the formation of a wide variety of chip morphology observed during the cutting of metals.

The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review.

To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing. Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible. We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed. Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.

Difference in badminton-specific endurance evaluated by a newly developed on-court test between competitive levels: A pilot study of female players.

We developed a test to evaluate badminton-specific endurance. The study included 10 female badminton players. Five participants were ranked in Japan's top 100 national rankings (ranked), whereas the others were unranked (unranked). Participants reacted quickly with badminton-specific steps from the base center to the four sensors at each corner of a singles badminton court. On each set, they reacted eight times to randomized instructions at stage-specific intervals (1.2, 1.0, and 0.8 s for stages 1, 2, and 3, respectively), which were performed six times with a rest of 20 s in each stage (8 movements × 6 sets × 3 stages). On a different day, participants ran on a treadmill as a comparative test. Blood lactate concentration (BLa) was measured on each test. In the badminton-specific test, ranked participants had lower BLa (4.2 ± 1.7 mM vs. 6.3 ± 3.1 mM), with medium or large effect sizes. The average reach time to sensors was shorter in ranked participants (1.56 ± 0.03 s vs. 1.62 ± 0.07 s), with medium or large effect sizes. BLa was similar between groups, with trivial or small effect sizes in the running test. These results suggest that the newly developed test can evaluate badminton-specific endurance.

Nursing Students who Identify as Men; Efficacy and Persistence

AimTo evaluate the efficacy of nursing students who identify as men and its correlation with intent to complete their nursing program. BackgroundMen are an underrepresented population in nursing, despite mandates to improve the diversity of the nursing profession. There also exists a nursing shortage, that is worsening as nurses retire or change professions. Improving the recruitment and retention of men in nursing could have a positive impact on both of these problems. DesignQuantitative correlational research MethodsThe Belongingness Scale-Clinical Placement Experience instrument was used to measure efficacy and one item from the Undergraduate Nursing Intention Survey was used to measure the student’s intent to complete their nursing program. A SurveyMonkey link was sent by the National Student Nursing Association to those students who identified in their database as men and were enrolled in a Bachelor of Science in Nursing program. The inclusion criteria required that the participants identified as a man, were a student in a Bachelor of Science in Nursing program and they had one or more years of clinical experience in their nursing program. Students who have completed one or more years of clinical experience, have completed all nursing pre-requisites and a portion of their nursing courses. At this point in a nursing program, the students’ age would be 18 years of age or older. Inclusion criteria or 18 years of age or older would also make the consent process easier, as the study would not include a vulnerable population. ResultsThere were 290 responses, 252 of which met inclusion criteria and completed the survey in its entirety. The dependent variable, student intent to complete their nursing program, was not normally distributed. For this reason, Spearman’s correlation and eta squared were used for statistical evaluation. Spearman’s correlation was significant at 0.05 and eta squared demonstrated effect size at 0.01, 0.06 and 0.14 for small, medium and large effect sizes, respectively. Spearman’s rho, p=0.147, demonstrated a correlation between efficacy and student intent to complete their nursing program. The eta squared effect size was 0.96 which represented a large effect. ConclusionsNursing students who identify as men could demonstrate improved persistence in their nursing programs if effective interventions targeting efficacy were undertaken.

Potential toxic elements distribution and phytoextraction status of Avicennia marina in eastern coast of Sri Lanka

This research sought to evaluate the phytoextraction capability of Avicennia marina plants for potentially toxic elements (Cr, Ni, Co, Cu, As, Cd and Pb) in Batticaloa and Uppar lagoons along the east coast of Sri Lanka, thereby investigating its potential application in ecological restoration and coastal management. An experiment was conducted to identify the elemental concentration in roots above and below water level, stem and leaves of well grown Aicennia marina plants and sediment samples obtained along a transect from the plant to the deeper levels of the lagoon in six selected locations. The grain size distribution of sediments and organic geochemical proxies of sediments and plants were correlated with elemental distributions to identify their effect on the mobility. The average clay and silt contents of these lagoons are <1.03% with high contents of fine to medium size sands (about 66%). The pollution load indices (PLI) for both lagoons are low to moderate, however, Ni concentration exceeds Effect Range-median limit for some locations. The ecological risk indices and toxicity response of the sediments are in low risk levels may be due to the low development state of the region and sedimentary distributions. The elemental concentration in roots are high for Cr, Ni, Co, Cu and As compared to the stem and leaves of Avicennia marina whereas, Cd and Pb shows high values in stem parts regardless of the C/S and C/N ratios. The average bio concentration factor for Cr, As, Co, Ni, Cu, Pb and Cd are 31.77, 19.98, 17.33, 15.38, 4.57, 3.53 and 2.77 respectively indicating significant values compared to the most other studies which might be controlled by the climate.

Morphometric Evaluation of the Foramen Magnum in the West African Population: Implications for Neurosurgical Interventions

Background and objectivesWhile various pathologies affecting the foramen magnum region can have severe consequences, little research has been conducted on the unique morphological patterns in the West African subregion. The study aimed to assess these patterns and their implications for surgeries, comparing them with global standards. MethodsA descriptive study was conducted on 315 patients over a two-year period, excluding those with specific abnormalities. Measurements obtained from cranial 1.5T MRI scans included anteroposterior and transverse diameters of the foramen magnum. From these, the foramen magnum area and index were calculated. The data was analyzed by inferential, comparative and descriptive statistics, and a p value < 0.05 was regarded as statistically significant. ResultsOn average, the transverse and anteroposterior diameters were 28.51 mm and 33.02 mm for males and 28.39 mm and 33.47 mm for females, with a slightly smaller foramen magnum area in males (7.42 cm²) compared to females (7.47 cm²). Despite these differences, the variations were not statistically significant. However, the foramen magnum indices indicated medium size configuration for females and large size configuration for males, aligning with global trends. ConclusionThe study concluded that West Africans exhibited lower foramen magnum carea and indices compared to other regions, with minor differences between sexes. Females tended to have a medium size configuration, while males tended to have a larger size configuration. These findings provide valuable insights for clinicians, highlighting the importance of considering ethno-regional variations in surgical approaches and interventions related to the craniocervical junction.

Assessing sleep quality in elite and junior cyclists.

In the pursuit of optimal recovery, the significance of sleep cannot be overstated for elite cyclists, including high-level cyclists within the junior category. This study aims to assess the sleep quality of elite athletes of different categories and disciplines, including junior. The sleep quality of 112 high-level cyclists (males n = 80; females n = 32) participating in endurance and sprint disciplines was evaluated using the Pittsburgh Sleep Quality Index (PSQI). A noteworthy 41% of both elite and junior cyclists displayed poor sleep quality. No significant differences were observed between elite and junior cyclists in terms of sleep quality, but there was a medium effect size, indicating greater sleep efficiency in junior cyclists [0.36 (0.16, 0.53)]. Gender differences were found, with females exhibiting worse PSQI scores (males = 4.00 [2.25]; females 5.00 [3.00]; p = 0.035). Endurance cyclists spent more time in bed compared to cyclists from sprinting disciplines (8:30 [1.00] and 8:00 [1:03], respectively; p = 0.019). These findings reveal poor sleep habits, even among individuals classified as good sleepers by the PSQI, emphasizing the importance of preventing sleep disorders in cyclists. This study provides valuable insights into athlete sleep quality, encompassing various categories, genders, and cycling disciplines. In conclusion, elite cyclists demonstrate suboptimal sleep quality, suggesting the potential for interventions utilizing the PSQI. These findings advocate for the incorporation of sleep quality assessments into routine evaluations for athletes.