Moderate Levels Research Articles

Influence of Drying Conditions on Physicochemical, Phytochemical, and Antioxidant Properties of Medicinal Plant Stem Xáo Tam Phân (Paramignya trimera) Grown in Vietnam

Introduction: This study aimed to assess the physicochemical, phytochemical, and antioxidant properties of medicinal plant stem Xáo tam phân (Paramignya trimera) as influenced by 11 drying conditions. Xáo tam phân (Paramignya trimera (Oliv.) Guillaum) has been used in fold medicine for cancer prevention and treatment. The preparation of the dried sample is crucial and necessary for further investigation and application. To evaluate the effects of some popular drying methods, namely, sun drying, hot-air drying, microwave drying, infrared drying, and freeze drying on the physicochemical properties, the retention of phytochemical compounds (total saponins, phenolics, and flavonoids), and antioxidant properties (DRSC, CUPRAP, and FRAP) of dried P. trimera stem. Methods: The plant stem Xáo tam phân (Paramignya trimera) was dried by 11 drying conditions: sun drying at 36.6°C; hot-air drying at 60°C, 80°C, and 100°C; microwave drying at 270 W, 450 W, and 720 W; infrared drying at 40°C, 45°C, and 50°C; and freeze drying at -40°C. Results: The results show that among the 11 drying conditions used, hot-air drying at 80°C achieved the highest phytochemical contents of the P. trimera stem in terms of total saponins (28.82 mg EE/g DS), total phenolics (3.71 mg GAE/g DS), and total flavonoids (10.82 mg CE/g DS), and infrared drying at 50°C possessed the greatest antioxidant activity of the P. trimera stem (3.59 and 9.56 mg TE/g DS for DRSC and CUPRAC, respectively); however, both these drying methods had the longest drying time (1.5 to 7.0 h.) and consumed the highest energy (2.10 to 11.77 kWh). In contrast, microwave drying took the shortest drying time (0.1 to 0.4 h.) and consumed the least energy (0.07 to 0.14 kWh), but it still retained moderate levels of phytochemical compounds and antioxidant activity of the P. trimera stem. Conclusion: The findings achieved from this study recommend using hot-air drying at 80°C for the preparation of the dried sample from the P. trimera plant stem.

Food Safety Knowledge, Attitudes, and Practices Among Food Handlers in Jeddah, Saudi Arabia

Background: Several outbreaks of foodborne illness have recently occurred in Saudi Arabia, posing a public health concern, especially considering the increasing trend of food consumption at restaurants. Objectives: This study evaluates the food safety knowledge, attitudes, and self-reported practices among food handlers in Jeddah, Saudi Arabia, and their association with the food handlers’ sociodemographic characteristics. Methods: A cross-sectional study was performed for a convenience sample of 80 food handlers (15–65 years old), followed by face-to-face interviews. A validated questionnaire with 65 questions across four sections (sociodemographic characteristics, knowledge, attitudes, and practice related to food safety) was utilized for data collection. Data entry and analysis were conducted using the SPSS version 26 software. Results: Most of the participants exhibited moderate levels of food safety knowledge and practices and a high level of food safety attitudes. Food safety knowledge was significantly greater among the oldest participants (>45 years old), those holding valid health cards, and those who had attended training courses (p<0.05). However, no significant differences in food safety attitudes and practices were found based on the sociodemographic characteristics of the participants (p>0.05). Food safety knowledge was found to be significantly correlated with the food safety attitudes of the participants (r= 0.379, p= 0.001), and food safety attitudes were significantly correlated with practices (r= 0.264, p= 0.018). Conclusion: This study revealed that continuous implementation of food safety educational and training programs is necessary to improve the knowledge of food handlers and transform it into appropriate attitudes and practices.

Does each Component of Reactive Oxygen Species have a Dual Role in the Tumor Microenvironment?

Reactive oxygen species (ROS) are a class of highly reactive oxidizing molecules, including superoxide anion (O2 •-) and hydrogen peroxide (H2O2), among others. Moderate levels of ROS play a crucial role in regulating cellular signaling and maintaining cellular functions. However, abnormal ROS levels or persistent oxidative stress can lead to changes in the tumor microenvironment (TME) that favor cancer development. This review provides an overview of ROS generation, structure, and properties, as well as their effects on various components of the TME. Contrary to previous studies, our findings reveal a dual effect of ROS on different components of the TME, whereby ROS can either enhance or inhibit certain factors, ultimately leading to the promotion or suppression of the TME. For example, H2O2 has dual effects on immune cells and non-- cellular components within the TME, while O2 •- has dual effects on T cells and fibroblasts. Furthermore, each component demonstrates distinct mechanisms of action and ranges of influence. In the final section of the article, we summarize the current clinical applications of ROS in cancer treatment and identify certain limitations associated with existing therapeutic approaches. Therefore, this review aims to provide a comprehensive understanding of ROS, highlighting their dual effects on different components of the TME, and exploring the potential clinical applications that may pave the way for future treatment and prevention strategies.

Professional quality of life, psychological well-being, and work engagement of healthcare professionals in two Greek hospitals during COVID-19: A cross-sectional study.

During the COVID-19 pandemic, the mental health of healthcare professionals has emerged as an issue of great concern. To investigate the levels of professional quality of life, psychological well-being, and work engagement among healthcare professionals in two Greek hospitals during the COVID-19 pandemic. A cross-sectional study was conducted in December 2021 in two public hospitals in Greece. To assess the levels of professional quality of life, psychological well-being, and work engagement, respondents completed the Professional Quality of Life Scale Version 5 (ProQOL-V), the Psychological Well-being (PWB) scale, and the Utrecht Work Engagement Scale (UWES-17). A total of 150 questionnaires were distributed, and 102 were returned (response rate: 68%). It was found that as burnout levels increased, the levels of work engagement decreased (rho = -0.36, p-value < 0.01). Higher levels of compassion satisfaction were associated with higher work engagement (rho = 0.48, p-value < 0.01). Multivariable analysis revealed that healthcare personnel's contact with patients or service users exposed to or who have experienced traumatic events was associated with less positive relationships with others (and, consequently, lower levels of psychological well-being) (p-value = 0.035). Healthcare professionals in the two public hospitals in Greece, experienced moderate levels of compassion satisfaction, burnout, and secondary traumatic stress during the COVID-19 pandemic. Their psychological well-being was also found to be moderate, and their levels of work engagement were moderate to high. Supporting the physical and psychological well-being of healthcare professionals is essential for their ability to provide high-quality care in times of crisis, such as during the COVID-19 pandemic.

Do Social Exclusion and Parental Attitudes Predict Online Gaming Addiction in Adolescents?

Objective: This study aims to examine whether social exclusion and parental attitudes predict online gaming addiction in adolescents. &#x0D; Method: The sample consisted of 393 individuals, of which 4.6% (n=18) were females and 95.4% (n=375) were males, which was determined by the purposive sampling method. Socio-demographic Information Form, Online Gaming Addiction Scale (OGAS), Ostracism Experience Scale for Adolescents (OES-A) and Parental Attitudes Scale (PAS) were used to obtain the personal information of the participants in this study.&#x0D; Results: The findings showed that there was a positive and statistically significant correlation between the disruption sub-dimension of the OGAS and the OES disregard, exclusion and overall total at a moderate level and the acceptance/affection and psychological autonomy sub-dimensions of the PAS. There was a moderate statistically significant positive relationship between the achievement sub-dimension of the OGAS and the OES neglect, exclusion and overall total and there was a negative and statistically significant relationship with the acceptance/affection and psychological autonomy sub-dimensions of the PAS. There was a moderate statistically significant negative relationship between the economic gain sub-dimension of the OGAS and the psychological autonomy sub-dimension of the PAS. It was found that social exclusion and the autonomic parental attitude scale were significant predictors of online gaming addiction in adolescents.&#x0D; Conclusion: Social exclusion and autonomous parenting attitudes are effective on online game addiction in adolescents.

Stress parental e perceção dos cuidados de enfermagem parentais em neonatologia

Introduction: the psychoemotional state of parents is affected when their newborn is hospitalized when facing a new environment, dealing with strangers and delegating their first protective care. Objective: to determine the level of parental stress and theperception of parental nursing care in the neonatology service of a national hospital in Peru. Methodology: quantitative, descriptive-correlational, cross-sectional study. With a sample of 75 parents of babies hospitalized in neonatology. Questionnaires were applied: Parental Stress Scale - PPS:NIICU with α=0.7 and Nursing Parent Support Tool - NPST (α = 0.96). Results: 68.7% of the participants presented moderate level of parental stress, the main sources of stress were: alteration of parental role, impact of appearance, treatment and behavior of the baby. They considered parental nursing care to be low, with deficienciesin emotional, communicational and informational support; however, they recognized good nursing care. Finally, no significant relationship was found between both variables (Tau-b: -0.07; with p &lt; 0.05). Conclusions: there is an urgent need to implement initiatives thatinvolve parents in different processes during the hospitalization of their babies, in addition to the training of nurses to identify and attend to psychoemotional needs.

Comparative assessment of psychometric performance on the adjusting amounts versus the 21-item Monetary Choice Delay Discounting tasks among young adult substance users.

Delay discounting (DD) assessments offer a wide variety of procedures to suit specific clinical and research needs. This study compared the reliability and validity of two DD tasks: (a) an adjusting amounts task presented on a computer (AAC) and (b) the 21-item Monetary Choice Task, which was administered online (MCT). Participants were 1,573 Spanish young-adults reporting past-month substance use. Measures included quantity and severity of drug use (i.e., cigarette smoking, cannabis, alcohol) and two DD assessments (i.e., AAC, MCT). Reliability was assessed using both the classical test and item response theory. Correlations and linear regressions examined the validity of both DD tasks in relation to substance use. The MCT showed higher internal consistency than the AAC (α = .941 vs. α = .748). AAC precision was adequate for moderate levels of discounting (θ values between -2 and +2), but the MCT showed superior reliability at low, moderate, and high levels of discounting (θ values between -1 and +1.5). Both DD tasks showed more significant correlations for alcohol-related measures (|rs| ranged between .053 and .093) compared to cigarettes and cannabis. The incremental validity of DD tasks in relation to nicotine dependence (AUClogd: β = -.664, 95% CI [-1.256, -.071]) and alcohol problems (AUClogd: β = -3.098, 95% CI [-5.209, -.988]) was only supported for the AAC. The MCT was more reliable than the AAC for measuring impulsive choice in young adult substance users. Nevertheless, the AAC may serve as a valid marker of nicotine dependence and alcohol problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An Investigation into the Effects of Chemical, Pharmaceutical, and Herbal Compounds on Neuroglobin: A Literature Review.

Neuroglobin (Ngb) is an oxygen-binding globin protein that is mainly expressed in the neurons of the central and peripheral nervous system. However, moderate levels of Ngb have also been detected in non-neural tissues. Ngb and Ngb modulating factors have been increasingly studied over the last decade due to their neuroprotective role in neurological disorders and hypoxia. Studies have shown that a number of chemicals, pharmaceuticals, and herbal compounds can modulate the expression of Ngb at different dose levels, indicating a protective role against neurodegenerative diseases. Iron chelators, hormones, antidiabetic drugs, anticoagulants, antidepressants, plant derivatives and short-chain fatty acids are among these compounds. Therefore, this study aimed to review the literature focused on the possible effects and mechanisms of chemical, pharmaceutical, and herbal compounds on Ngbs.

Stigma and its influencing factors for seeking professional psychological help among pregnant women: A cross-sectional study

Although the stigma associated with seeking professional psychological help has received significant attention, few studies have focused on the status and factors influencing this stigma among pregnant women, especially those with a Chinese cultural background. This study aimed to assess the status of stigma associated with seeking professional psychological help and its influencing factors. A total of 1325 pregnant women were recruited from Hunan Province, China. The Stigma for Seeking Professional Psychological Help questionnaire, Patient Health Questionnaire-9, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and questionnaires on sociodemographic characteristics and pregnancy-related information were used. Descriptive, univariate, correlation, and multivariate linear regression analyses were used to investigate the status of stigma and identify its influencing factors. Pregnant Chinese women experienced a mild to moderate level of stigma associated with seeking professional psychological help, and self-stigma was more common than social stigma associated with seeking psychological help. The results of the multivariate analysis suggested that perceived social support, positive coping styles, negative coping styles, and depressive symptoms were the factors influencing self-stigma and social stigma associated with seeking professional psychological help. Advanced age and a low educational level were the only predictors associated with self-stigma, while a history of multiple pregnancies had an effect only on social stigma associated with seeking professional psychological help. Chinese pregnant women experienced a mild to moderate level of stigma associated with seeking professional psychological help. Destigmatizing interventions focusing on self-stigma and social stigma should be designed according to maternal characteristics, social support, coping style, and depressive symptoms.

Contribution of Hurdles Technology to Preserve the Qualities of Broccoli and Extend Their Shelf-Life

Due to its high concentration of bioactive components, broccoli heads have a lot of potential as a functional food. Broccoli is perceived as a tasty, wholesome and healthful food product. This product nevertheless has a limited shelf life and quality retention issues, especially in tropical temperature zones. The hurdles techniques are starting to become more acceptable in the sector of food preservation since they affect moderate levels. This study evaluates the impact of hurdles techniques and various storage conditions (ambient at 25 °C, cold at 4 °C, and frozen at -18 °C) on broccolis cut characteristics. For the hurdles experiment, broccoli cuts were soaked in four solutions (the 1st: boiling water, the 2nd: metabisulphite solution (150 ppm), the 3rd: sodium chloride (4%), citric acid (1%), sodium benzoate (200 ppm) and the 4th: 1% chitosan) followed by packaging using two approaches (aerobic and vacuum). Sensory attributes, browning index, ascorbic acid, total phenolic, total flavonoids and antioxidant activity % (by DPPH, ABTS and FRAP) of hurdled and un-hurdled broccoli cuts during storage were investigated. Results demonstrated that using hurdle technology (different soaking solutions, packaging methods and storage conditions) had significant impact on the quality properties of the broccoli cuts. Additionally, vacuum packaging demonstrated the highest protection against decreasing the values of ascorbic acid, total phenolic, total flavonoid, and antioxidant components.

Joint trajectories of bullying victimization and sexual harassment victimization as predictors of adolescent alcohol use.

The present study examined the independent and joint effects of bullying victimization and sexual harassment victimization on adolescent alcohol use over time within a community sample of adolescents. Adolescents aged 13-15 years old at baseline (N = 800, Mage = 14.42, SD = 0.83; 57.5% female) recruited from Western New York State made five online survey reports of peer victimization and alcohol use over a 2-year period. Latent class growth analysis was used to identify trajectory classes of victimization from bullying and sexual harassment over time, and regression modeling was used to examine the associations with later alcohol use. Three developmental courses were identified for bullying victimization (moderate/decreasing, high/decreasing, never or low) and for sexual harassment victimization (moderate/decreasing, moderate/increasing, never or low). Adolescents in the moderate/decreasing group of bullying victimization subsequently consumed more alcoholic drinks when they drank. Belonging to the moderate/increasing group of sexual harassment was associated with increased later alcohol intoxication and number of drinks. Bullying victimization and sexual harassment victimization were concurrently correlated over time. Adolescents who followed the joint trajectory group of moderately decreasing bullying and increasing sexual harassment were more likely to report increased later alcohol intoxication and number of drinks. Moderate levels of bullying victimization along with increasing sexual harassment victimization are associated prospectively with greater alcohol use in adolescence. Findings highlight the importance of considering the cumulative, joint effects of multiple types of peer victimization on adolescent health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Organizational Climate and Job Satisfaction Among Workers in a Peruvian Company

Organizational climate is a crucial factor that influences job satisfaction among workers in any organization. This research aims to describe the perceived levels of organizational climate and job satisfaction among workers in a Peruvian company and determine the relationship between both variables. This is a basic, non-experimental, and correlational quantitative study. The sample consists of 40 workers employed in a civil construction company in Lima, Peru, and is a census sample. Organizational climate and job satisfaction questionnaires were used to collect data, with 28 and 25 items, respectively. The results report that organizational climate and job satisfaction reached moderate levels, with 62.50% and 60.00%, respectively. Based on the obtained Spearman’s rho value of 0.755 and a p-value of 0.000 &lt; 0.05, it was determined that there exists a significant and high direct relationship between the variables under study.

Facilitators and Barriers of Employing Electronic Exams as Perceived by Nursing Students and the Relation to their Satisfaction

Context: Nowadays, during the COVID-19 pandemic, electronic exams are perceived as a fast-evolving assessment tool because of their accuracy and reliability. It provides relatively more accurate results and immediate feedback for students and instructors. Aim: To assess facilitators and barriers of employing electronic exams as perceived by nursing students and the relation to their satisfaction. Methods: A descriptive correlational research design was used to achieve the aim of this study. The study was conducted at the Faculty of Nursing at Benha University on 970 nursing students from the four academic years (2020/2021). They were selected using a stratified random sampling technique. Data was collected using three tools. The student perception of electronic-exams facilitators questionnaire, the student perception of electronic-exams barriers questionnaire, and the nursing students’ satisfaction assessment scale. Results: More than half of nursing students (59.9%) had a high perception level about facilitators of electronic exams, whereas nearly two-thirds of nursing students (60.9%) had a moderate perception level about barriers to electronic exams, and 75.5% had a high satisfaction level regarding electronic exams. Conclusion: This study concluded that more than three-quarters of students had high satisfaction. There was a positive, statistically significant correlation between total students' satisfaction with facilitators of the electronic exam and a statistically significant negative correlation with barriers to the electronic exam. The study recommends that students must receive regular, periodic in-service computer skills courses and study the factors that influence university students to embrace and use electronic exams with an online test system.

Barriers and Facilitators of Parent Presence in the Neonatal Intensive Care Unit.

The purpose of this study was to describe system-level and personal factors influencing parent presence in the neonatal intensive care unit (NICU) and identify differences in factors by sociodemographic characteristics. In a cross-sectional national survey study using social media recruitment, participants rated the frequency of 13 potential barriers and 12 potential facilitators using a 5-point Likert scale. Experiences of discrimination and parent-staff engagement were also measured. Valid responses were analyzed from 152 participants. Uncomfortable facilities and home responsibilities were the most highly reported system-level and personal barriers, respectively. Encouragement to participate in caregiving and social support were the most highly reported system-level and personal facilitators, respectively. Participants reported low to moderate levels of discrimination and moderate levels of parent-staff engagement. Latent class analysis revealed three sociodemographic clusters. Differences in barriers, facilitators, discrimination, and engagement were found among clusters. NICU facilities are uncomfortable and may discourage parent presence. Allowing support persons to accompany parents, providing comfortable facilities, and engaging parents in caregiving may promote greater parent presence and improved parent and child outcomes. Studies of potential bias toward parents with lower education and income and effects on parent presence and infant outcomes are needed.

Embedding higher order thinking skills in Islamic history (Sirah) education in Malaysia

&lt;span lang="EN-US"&gt;The promotion of integrating higher order thinking skills (HOTS) in the Malaysian education system is pivotal to producing analytical thinkers to keep up with the rapid globalization of this era. Thus, the implementation of HOTS in learning and facilitation (PdPc) has been emphasized. However, little is known about the integration of HOTS in Islamic history and civilization (&lt;/span&gt;&lt;em&gt;&lt;span lang="EN-US"&gt;Sirah&lt;/span&gt;&lt;/em&gt;&lt;span lang="EN-US"&gt;) lessons. Furthermore, teachers continue to use traditional methods and disregard incorporating HOTS in PdPc. Therefore, the current study conducted an in-depth investigation into the components of &lt;/span&gt;&lt;em&gt;&lt;span lang="EN-US"&gt;Sirah&lt;/span&gt;&lt;/em&gt;&lt;span lang="EN-US"&gt; lessons to support the implementation of the Malaysian education development plan (PPPM) 2013-2015 by strengthening teaching techniques through the use of HOTS for a better understanding of &lt;/span&gt;&lt;em&gt;&lt;span lang="EN-US"&gt;Sirah&lt;/span&gt;&lt;/em&gt;&lt;span lang="EN-US"&gt; lessons. Using an explanatory sequential mixed method design, the findings reveal that the teaching components of &lt;/span&gt;&lt;em&gt;&lt;span lang="EN-US"&gt;Sirah&lt;/span&gt;&lt;/em&gt;&lt;span lang="EN-US"&gt; lessons with the integration of HOTS are at a moderate level in the conclusion stage of a lesson. Therefore, the current study proposes a model that integrates HOTS, i.e., the element of attitude, preparation and planning, teaching aids with relevant aspects of PAK21, knowledge of HOTS, mastery of the subject content, teaching techniques and approach, assessment, and evaluation.&lt;/span&gt;

Growth and evolution of low-mass planets in pressure bumps

Observations of protoplanetary disks have revealed dust rings that are likely due to the presence of pressure bumps in the disk. Because these structures tend to trap drifting pebbles, it has been proposed that pressure bumps may play an important role in the planet formation process. In this paper, we investigate the orbital evolution of a 0.1 M⊕ protoplanet embedded in a pressure bump using 2D hydrodynamical simulations of protoplanetary disks consisting of gas and pebbles. We examine the role of thermal forces generated by the pebble accretion-induced heat release, taking into account the feedback between the luminosity and the eccentricity. We also study the effect of the pebble-scattered flow on the planet’s orbital evolution. Due to the accumulation of pebbles at the pressure bump, the planet’s accretion luminosity is high enough to induce significant eccentricity growth through thermal forces. Accretion luminosity is also responsible for vortex formation at the planet’s position through baroclinic effects, which cause the planet to escape from the dust ring if dust feedback on the gas is neglected. Including the effect of the dust feedback leads to weaker vortices, which enable the planet to remain close to the pressure maximum on an eccentric orbit. Simulations in which the planet mass is allowed to increase as a consequence of pebble accretion result in the formation of giant planet cores with masses in the range of 5–20 M⊕ over ~2 × 104 yr. This occurs for moderate values of the Stokes number, St ≈ 0.01, such that the pebble drift velocity is not too high and the dust ring mass not too small. Our results suggest that pressure bumps mays be preferred locations for the formation of giant planets, but this requires a moderate level of grain growth within the disk.

Do you feel prepared? EFL learners’ readiness for online learning and self-directed learning ability

In recent years, the widespread use of online learning environments and tools, especially with the outbreak of the COVID-19 pandemic, has brought students’ readiness for online learning and their ability to manage their own learning processes to the fore. This study aims to investigate the online learning readiness (OLR) and self-directed learning skills of English language learners at a state university in Turkey. For this purpose, a cross-sectional, descriptive study methodology was employed. The study group consisted of 202 randomly selected first-year volunteer students. An information form and two scales were used to collect data. Additionally, the effects of some demographic factors on EFL students’ OLR and self-directed learning skills were also investigated. The results of the study revealed that university students have a moderate level of self-directed learning and readiness to learn in the online environment. As another result of the study, it was determined that various independent variables had an impact on the participants’ OLR levels. In parallel with the findings of the study, some pedagogical strategies were discussed and suggested.

Disentangling the Diagnoses of Psychotic Depression, Catatonia, Neurocognitive Disorders, and Delirium: A Multidisciplinary Approach

An ambiguous clinical presentation can create diagnostic uncertainty, leading to delays in effective interventions and increasing the likelihood of adverse clinical outcomes. Unfortunately, many psychiatric conditions share overlapping clinical symptoms. Psychotic depression, catatonia, neurocognitive disorders, and delirium are all examples of distinct clinical conditions with overlapping symptomatology, and all require decidedly different therapeutic interventions. While much literature is devoted to the diagnostic criteria and management of these clinical conditions, little is dedicated to the challenge of disentangling these diagnoses when faced with a complex clinical presentation.We present here a complicated psychiatric inpatient hospitalization of a 77-year-old male who exemplified this diagnostic challenge. He primarily presented with severely depressed mood and decreased functionality, remaining in bed for much of the day with little attention to basic hygiene and oral intake. While records from a recent outside hospitalization carried a historical diagnosis of catatonia, his moderate level of engagement with providers and somatic delusion of disseminated prostate cancer suggested an alternate diagnosis of psychotic depression. However, before a diagnostic conclusion could be reached, other clinical characteristics surfaced. Following a singular administration of olanzapine shortly after his initial assessment, he developed Lilliputian hallucinations, prominent parkinsonism, and significantly altered mentation.Neuroleptic sensitivity raised clinical suspicion for an underlying neurocognitive disorder such as dementia with Lewy bodies, and a consult was placed to the neuropsychology service. While dementia could not be fully ruled out, they did recommend additional workup to rule out herpes simplex encephalitis, autoimmune limbic encephalitis, and paraneoplastic syndromes. After his MRI imaging revealed moderate microvascular ischemic changes, a true multidisciplinary approach to care was taken, as neurology was consulted to also help narrow the differential. An EEG was unremarkable and a serum encephalitis panel was also unremarkable. Olanzapine was discontinued with significant improvement in parkinsonism and cognition; however, severe neurovegetative symptoms and somatic and nihilistic delusions persisted. While antipsychotics remained clinically indicated for a suspected depression with psychotic features, caution was taken due to established neuroleptic sensitivity, subtle catatonic features, and the related risks of neuroleptic malignant syndrome. Ultimately, low-dose quetiapine was initiated with some benefit; however, he continued to remain acutely depressed and withdrawn with prominent negativism. Trials with benzodiazepines for these catatonic features were also approached with caution to avoid potential risks of delirium.Over time, a multidisciplinary approach to psychopharmacologic interventions and medication trials led the team to a principal diagnosis of major depressive disorder with psychotic features and subtle catatonia. The abrupt changes observed early in the hospital course were determined to be related to olanzapine-induced anticholinergic delirium. With greater diagnostic certainty, the team was able to counsel the patient and family about the importance of pursuing electroconvulsive therapy (ECT). The patient's cardiovascular risk factors and known microvascular changes were considered in the determination of the appropriateness for ECT. After starting ECT, he was immediately noted to have objective improvement, and following his fifth treatment, he was deemed appropriate for discharge after exhibiting significant improvement in depression and functionality and reporting near-resolution of somatic delusions. He was able to complete ECT on an outpatient basis and follow-up visits note durable improvements in mood, functionality, and quality of life, continuing to enjoy an active lifestyle of socializing with family and playing tennis. We use this case to further explore the clinical challenges that stem from the symptomatic similarity between psychotic depression, catatonia, neurocognitive disorders, and delirium and discuss optimal therapeutic approaches when the presentation appears complex and equivocal.

Examination of the Relationship Between Physical Activity, Perceived Stress and Sleep Quality of Nursıng Students: A Cross-Sectional and Correlational Study

Nursing students often experience challenges related to sleep quality, which can have implications for their overall well-being and academic performance. The aim of this study is to examine the relationships between physical activity, perceived stress, and sleep quality among senior nursing students. This study employed a cross-sectional and correlational design. The study was conducted between September and Ocober 2021, involving senior nursing students who were undergoing practical training in a state hospital. Data were collected through face-to-face interviews using the "Introductory Information Form," "International Physical Activity Questionnaire (Short)/IPAQ" "Perceived Stress Scale/PSS" and "Pittsburgh Sleep Quality Index/PSQI". Out of 42 students, 40 students participated in the study. Data analysis involved descriptive statistics such as frequency, percentage, minimum and maximum scores, mean scores, standard deviation, and Pearson correlation test. The mean score for physical activity assessed using the IPAQ was 1051.38±890.17 MET (metabolic equivalent), the average score on the PSS was 27.88±8.72, and the average score on the PSQI was 14.10±2.38. The correlation analysis revealed a significant positive correlation between sleep quality and physical activity levels (p≤0.05). Furthermore, a positive and moderate relationship was observed between sleep quality and perceived stress levels (p≤0.05). The findings indicate that nursing students have moderate levels of physical activity and perceived stress, and their sleep quality is considerably low.

Posterior thigh muscles activity during the active H-test: An electromyographic and kinematic analysis

The Askling's H-test is considered a useful return to play criterion after a hamstring muscle injury (HMI). However, it assesses only the active and passive flexibility of posterior thigh muscles. This may lead the practitioner to underestimate a compensation or abnormal movement pattern. The aim of this study was to analyze these kinematic aspects and their reliability, and evaluate the hamstring (HM) and gluteus maximus (GM) muscles' activities. Twelve healthy male volunteers were tested during two session of three trials for passive and active tests. Dynamic flexibility (97.2 ± 6.0°) was significantly greater than the passive one (70.5 ± 14.7°) (p < 0.001), and good intra-individual reproductibility for most kinematic characteristics was observed. Biceps Femoris long head, semitendinosus and GM mean activities (20.1 ± 11.2%; 14.3 ± 7.3% and 25.2 ± 22.1%, respectively) were found to be low to moderate, indicating that only a moderate level of activity occurred during the active H-test, in comparison to other movements such as sprinting itself. In addition, the activity of the posterior thigh muscles during the active H-test appeared to be variable among the volunteers. These findings suggest that the H-test should be interpreted on an individual basis rather than relying on general characteristics, and be considered as an intermediate tool before more strenuous activities such as returning to sprint. With this comprehensive approach, clinicians can gain a more accurate understanding of their patients' progress and make more informed decisions about their readiness to return to play.