Pre Period Research Articles

Demonetization and its effects on Indian economy

Indian government has taken a bold decision on note ban on 08/11/2016. Central government was a judicious, well-thought out and well-implemented step, and whether it would really eradicate all the existing black money. Here I have utilized the opinions of great expert on economics, financial economist and intellectual politicians. This study will help us to know about the positive and negative impact of note ban decision taken by Indian government. This study is purely based on secondary data, which is collected from news papers, magazines, websites from internet, some useful books related to topic etc. This paper entails the problems related to pre and post demonetization period and thereby to find out solutions and to provide suggestions in order to overcome the problem. Demonetization is the process of withdrawal of a particular form of currency from circulation. The purpose of the study is to compare and analyse the impact of demonetization on Indian economy during pre and post period. The older denominations must be replaced with the new ones. The findings of the study reveal that India will achieve a significant growth by adopting the demonetization strategy and will create a huge positive impact on the entire economy in a long run. This paper also shows that it was quick step taken by the government of India without any measures which people had to face a lot of consequences in standing in the long queues to exchange their older denominations.

MENINGIOMA OEDEMA AND SEIZURES – A META-ANALYSIS

Abstract AIMS Meningiomas are primary intracranial neoplasms. Oedema and seizures can occur in the pre and postoperative period and oedema is commonly cited as a risk factor for seizures. A meta-analysis of eight studies published in 2016 identified preoperative oedema as a risk factor for preoperative seizures. Our aim is to perform an updated review. The literature base has grown and there are studies presenting data on postoperative seizures. METHOD The meta-analysis protocol is uploaded to INPLASY (DOI: 10.37766/inplasy2023.7.0101). Existing literature from seven databases was collected and Cochrane guidance was followed. Data was analysed using packages within R programming software. Part of this work was presented in draft form at ILAE 2023 and here we present updated work. RESULTS Our search identified 44 unique studies for meta-analysis. Many studies were biased by subjective oedema measurement or lack of seizure definition. Preoperative oedema increased the odds of preoperative seizures; odds ratio (OR) 3.41, 95% confidence interval (CI) 3.00 to 3.87, p <.001, studies (k) 24, participants (n) 6,917, low heterogeneity (I2) 0%. There were no subgroup differences by oedema measurement or use of seizure definition. Preoperative oedema was associated with increased odds of early postoperative seizure (within one week of surgery) but the difference was not significant; OR 1.39, CI 0.97-1.99, p =.063, k = 6, n = 2,445, I2 = 0% (low). Preoperative oedema increased the odds of late postoperative seizures; OR 1.95, CI 1.55-2.45, p <.001, k = 7, n = 1,722, I2 = 0% (low). Oedema was associated with seizures following stereotactic radiosurgery in two studies. CONCLUSION Preoperative oedema is associated with seizures prior to and following treatment. While there is a positive association between preoperative oedema and early postoperative seizure it is not statistically significant.

Effect of streamlining prior authorization processes for systemic cancer treatments on efficiency and financial losses.

412 Background: Prior authorizations (PAs) for systemic cancer treatments are a barrier to timely quality cancer care delivery. The high administrative burden to complete peer to peer’s (P2P) and appeals leads to care delays and revenue losses. At our tertiary academic cancer center, in partnership with our cancer registry and Epic teams, we shifted the clerical work required for PAs from clinicians to certified tumor registrars (CTRs) to increase authorization efficiency and decrease financial losses from denials. Methods: Clinicians place the treatment plan order which goes to the CTR work queue. We leveraged the Epic staging smart form to consolidate and auto-populate common elements needed for PA. The CTRs then complete and validate the form prior to the authorization specialists obtaining the PA. We compared the pre (1/2022-9/2022) and post-implementation (11/2022-4/2024) periods on our primary outcomes: average monthly number of PAs pending review (including P2P, appeals and authorizations requiring clarifying clinical documentation), average monthly denial rate and average time spent on PAs by the authorization specialists. We compared the financial losses from denied PAs from calendar year 2022 to 2023. Analyses were conducted using descriptive statistics. Results: There was a 1.4% reduction in the average monthly number of PA’s pending review (350 vs 345). The average monthly authorized rate was steady from the beginning of the intervention (94%) to present time (95%). The average monthly denial rate was 2.9% at the beginning of the intervention and 0.9% at present time. There was a consistent decrease in the average time a PA was spent in pending review status: 118 hours in 2022, 102 hours in 2023 and 79 hours in quarter 1 of 2024. Despite the overall increase in volume of authorizations submitted, there was an overall cost savings of $27,392,894 from 2022 ($49,964,703) to 2023 ($22,571,809) from the decrease in denials. In 2022, 6.2% of total approved charges were denied and this decreased to 2.7% in 2023. Conclusions: By leveraging the EHR and optimizing existing non-clinical staff workflows, we maintained sustained average authorized and denial rates despite overall volume going up due to improved authorization efficiency and reduced financial losses due to denials. Additionally, there were overall cost savings for the institution due to the decreased percent of denials of total approved charges. Future work will include further refinement of treatment and disease specific optimizations.

Temporal Variations in and Predictive Values of ABG results prior to In-Hospital Cardiac Arrest

In-hospital cardiac arrest (IHCA) has been understudied relative to out-of-hospital cardiac arrest. Further, studies of IHCA have mainly focused on a limited number of pre-arrest patient characteristics (e.g., demographics, number and types of comorbidities). Arterial blood gas (ABG) analysis, one of the most common diagnostic tests for assessing and managing critically or acutely ill hospitalized patients, reflects pathophysiological changes associated with adverse events or complications, including IHCA. Yet the predictive and prognostic values of patterns of pre-arrest ABG parameters for IHCA have not been fully studied. The purpose of this retrospective pilot cohort study was to investigate temporal variations in and predictive values of pre-IHCA ABG values among patients with a history of cardiopulmonary disease. Eligible patients had a history of structural heart disease, heart failure, or pulmonary disease. Patients were excluded if their IHCA was due to trauma, drug overdose, hypothermia, drowning, chronic terminal illness such as cancer or human immunodeficiency virus, or bleeding not caused by hemorrhage in the brain or heart. Also collected were dates, times, and causes of mechanical intubation prior to IHCA and cause of mortality. Co-primary outcomes were initial rhythms of IHCA and return of spontaneous circulation (ROSC). We conducted a pilot study and the ABG results (pH, partial pressure of carbon dioxide [PCO2], partial pressure of oxygen [PaO2], bicarbonate [HCO−3], and lactate) from each of the 3 days prior to IHCA were extracted from the electronic health records of patients (N = 44) who had experienced IHCA at a single medical center. To characterize differences in ABG parameters among study days, coefficients of variation (CVs) were compared using the modified likelihood ratio test (MLRT) using the worst ABG values. Linear regression models were run for the continuous ABG parameters and logistic regression models for the dichotomous ABG variables. Overall model effect and least squares means, SDs, mean differences within and between days (with 95% confidence intervals), p-values and effect sizes are reported for continuous variables. For categorical variables, estimates and standard errors, 95% confidence intervals, Wald X2 variables and p-values are presented. The CVs for pH, PaCO2, and HCO3− differed significant between study days (p <.05). The least squares means with 95% confidence intervals for pH and lactate differed significantly in days (p <.01). Moderate to large effect sizes were obtained for all ABG parameters. Arterial lactate predicted initial rhythm (shockable versus non-shockable) and ROSC, while pH and HCO−3 predicted ROSC. Results demonstrate, for the first time, the presence of significant variability in ABG parameters across 72hr prior to IHCA and the predictive potential of these parameters for initial rhythms of IHCA and ROSC. While validation in a larger sample is necessary, this study confirms the feasibility and potential value of exploring temporal patterns of pre-arrest ABG values from the EHR. Findings of future larger studies on pre-arrest patterns of ABG parameters and other laboratory values may be used to design models that better predict risk for IHCA and guide patient care in the pre and intra-arrest periods.

Investigating Pre-Service EFL Teachers’ Self-efficacy in Their Classroom Management Skills using the EPOSTL as a Self-assessment Tool

Self-efficacy in classroom management is one of the important dimensions of the concept of teacher self-efficacy. Higher levels of classroom management self-efficacy (CMSE) have been positively correlated with an increase in teacher resilience and students’ learning outcomes. Therefore, it is crucial for teachers to develop CMSE beliefs to promote the quality of their teaching. Although the issue of classroom management has been comprehensively explored in the field of education, there are not many studies focusing on pre-service EFL teachers’ development of CMSE beliefs. Moreover, the relationship among several variables such as teachers’ affective states and students’ attitudes towards teachers or courses has been explored in the context of foreign language education (FLE). However, whether there is a relationship between self-assessment and development of CMSE beliefs in FLE settings has not been studied extensively. In this vein, the purpose of this study is to investigate pre-service EFL teachers’ CMSE beliefs depending on their use of the European Portfolio for Student Teachers of Languages (EPOSTL) as a self-assessment tool in their undergraduate education. This study follows an interventionist experimental design based on mix-method data collection. The participants of the study are 31 senior pre-service EFL teachers studying at a state university in Türkiye. Quantitative data of this study were collected through Teachers’ Sense of Efficacy Scale (TSES) by Tschannen-Moran and Woolfolk Hoy (2001) in the form of pre-test and post-test to the participants. Between pre and posttest period, the participants assessed themselves through the EPOSTL for three times. Qualitative data were collected through the participants’ reflective reports and semi-structured interviews and subjected to thematic analysis. The findings of the study have shown that the use of EPOSTL leads to an increase in participants’ level of CMSE beliefs. It may be stated that the wide-spread use of the EPOSTL can be fostered by designing language teacher education programs as more reflection-oriented. By this way, pre-service EFL teachers’ autonomy, CMSE beliefs, perseverance, and continuous professional development can be sustained.

A Retrospective Assessment of Guideline Adherence and Treatment Outcomes From Clostridioides difficile Infection Following the IDSA 2021 Clinical Guideline Update: Clostridioides difficile Infection

Abstract Background The 2021 update to the Infectious Diseases Society of America Clostridioides difficile infection (CDI) guidelines recommended fidaxomicin as the preferred treatment over vancomycin for patients with initial and recurrent CDI. Few studies have examined how treatment patterns and clinical outcomes of hospitalized CDI patients changed after the postguideline update or contemporary real-world outcomes of fidaxomicin vs vancomycin. Methods This retrospective, observational study used the PINC AI Healthcare Database on adult patients who received CDI treatment between 1/2020 and 6/2021 (pre period) and between 10/2021 and 9/2022 (post period). We examined treatment patterns of fidaxomicin, vancomycin, and metronidazole, as well as clinical and health care resource use outcomes of patients treated exclusively with fidaxomicin vs vancomycin, using nearest-neighbor propensity matching and hierarchical regression methods. As a sensitivity analysis, we repeated the fidaxomicin vs vancomycin comparisons among patients with recurrent and nonrecurrent index infections. Results A total of 45 049 patients with CDI from 779 US hospitals met initial inclusion criteria. Comparing the pre vs post periods, the proportion of patients treated with fidaxomicin increased from 5.9% to 13.7% (P &amp;lt; .001), vancomycin use decreased from 87.9% to 82.9% (P &amp;lt; .001), and metronidazole use decreased from 21.6% to 17.2% (P &amp;lt; .001). When comparing fidaxomicin vs vancomycin in the post period, fidaxomicin was associated with lower CDI recurrence (6.1% vs 10.2%; P &amp;lt; .001) and higher sustained clinical response (91.7% vs 87.8%; P &amp;lt; .001). Ninety-day postdischarge costs were not significantly different between groups. A sensitivity analyses showed similar findings. Conclusions Since the 2021 guideline update, fidaxomicin use has increased significantly but could be further utilized given its association with better clinical outcomes and no increase in postdischarge costs.

Sport and sexual recovery after total hip arthroplasty in young adults: a retrospective cohort study

Abstract Introduction : Total Hip Arthroplasty (THA) is the main treatment for end-stage degenerative hip arthrosis in the elderly, while became increasingly performed as treatment of secondary arthrosis in younger patients, a population at high functional requests in terms of resumption of physical activity and resumption of sexual activity. This study evaluates the physical, sports recovery and the sexual quality of life in young patients undergoing primary THA. Materials and methods Patients undergoing primary THA aged between 18 and 45, operated in a 10 year timeframe, were selected. Demographic, clinical, and radiological data were collected. The Harris Hip Score (HHS) was assessed before and after the surgery. The UCLA Activity Score was collected, sport participation in pre and post-operative period was acquired. The quality of sexual activity (SQoL) before and after surgery was analysed through a qualitative questionnaire. Collected data were also compared on the surgical approach, namely Direct Anterior (DAA), Postero-Lateral (PL) and Direct lateral (DL). Results The population consisted of 242 THA implanted in 232 patients, including 143 males and 89 females, with an average age of 37.4. The mean follow-up period was 51.0 months, with a minimum of 2.9 months and a maximum of 122.6 months. Postoperatively, the average HHS was 90.29 ± 0.9 points, compared to 62.43 ± 1.34 points preoperatively (p &lt; 0.001). The UCLA Activity Score in the postoperative period was 7.17 ± 0.17 matching to intermediate impact sport activity. The 64% of patients reported an improvement in SQoL after-surgery, 73% of which being females that show a significant improvement in SQoL compared to males (p = 0.046). By surgical approach comparison, DAA patients demonstrated better UCLA Activity Score (p = 0.037) and Return to sport (p = 0.027) compared to PL and DL. Conclusion Primary THA surgery in young adults can improve the level of physical activity and promote the involvement of subjects in moderate impact sports. Patients showed a better quality of sexual life compared to the preoperative period, an effect more evident in female patients.

387 Impacts of rumen protected omega-6 fatty acid supplementation on cow reproduction and calf growth

Abstract Maternal nutrition during pregnancy is crucial for proper fetal development. Rumen protected omega-6 (ω-6) fatty acids (FA) may improve health and reproductive success in beef cattle. Previous research studied the effects of supplementing ω-6 on cow production either during late gestation or post-breeding but not during both stages. Our objective was to determine the effects of ω-6 supplementation during late gestation and post-breeding on cow reproduction and calf pre-weaning growth. Eighty cows were assigned to either a saturated FA control (C) or rumen protected ω-6 supplements for 40 d before parturition (PRE) and/or 35 d after artificial insemination (AI, POST) using a 2 × 2 factorial: PRE C-POST C(n = 19); PRE C-POST ω-6(n = 19); PRE ω-6-POST ω-6(n = 17); PRE ω-6-POST C(n = 18). Cows were fed ad libitum hay and water when on/off supplementation periods. Supplements were provided in low moisture tubs. Individual animal intake of supplement was measured by a GrowSafe system. Cow body weights and plasma FA concentrations were measured prior to and after supplementation during each period. Calves were weighed at birth, branding, 150 d old and weaning. Reproductive measurements included postpartum estrus activity, estrus response at fixed-time AI (FTAI), and pregnancy rates. Blood plasma for progesterone analysis was collected on d 7 post-AI on all cows. Corpus luteum (CL) area was measured on d 7 via transrectal ultrasonography on a subset of cows during the POST period (PRE ω-6-POST ω-6 n = 8; PRE C-POST C n = 8; PRE C-POST ω-6 n = 8; PRE ω-6-POST C n = 8). The relationship between supplement intake and plasma FA concentration was analyzed via linear regression, and all other variables were analyzed via ANOVA. Supplement intakes within treatments and between the PRE and POST supplemental periods were highly variable. Body weights remained similar for cows (P = 0.52), but POST ω-6 calves had larger weaning weights than POST C calves (P = 0.02). There was a positive linear relationship (r2 = 0.14, P &amp;lt; 0.03) between supplement intake and plasma FA for PRE ω-6 and POST ω-6. Positive linear relationships between intake and plasma ω-6 FA concentration were observed for PRE C (r2 = 0.11, P &amp;lt; 0.05), PRE ω-6 (r2 = 0.2, P &amp;lt; 0.007) and POST ω-6 (r2 = 0.31, P = 0.0005). Post-partum estrus activity was similar (P = 0.81) between PRE C and PRE ω-6 cows, and estrus response at FTAI was similar (P = 0.13) between POST C and POST ω-6 cows. POST ω-6 cows had larger CL areas than POST C cows (P = 0.03); however, blood progesterone concentrations at d 7 did not differ between treatments (P = 0.65). There was no difference in conception to FTAI between POST C and POST ω-6 (P = 0.08). These results indicate that free choice ω-6 FA supplementation during late gestation and post-AI result in large variation in intake between cows that influence plasma concentrations, but did not markedly alter reproductive measures in mature beef cows.

Analyzing the market and financial impacts of the State Bank of India’s Merger: A comprehensive Event Study

This article presents detailed information about the event study that analyzed the market and financial impacts of the State Bank of India’s (SBI) merger. The merger of the SBI with its associate banks plays a significant role in the banking sector. The main aim of this study is to estimate the abnormal return and cumulative abnormal return test the significance of the shares of the SBI and also examine the impact of the merger of the SBI using Event study methodology. The market model is to be used in this study. The researcher has used the Wilcoxon Signed Ranked test for the event study to test the significance. The study reveals no significant difference in abnormal return of the SBI-merger during the pre and post-window periods. By applying the market model, a linear relationship between a stock return and market return be assumed. The findings of the study indicate that there is no significant relation between the pre and post-event windows in the abnormal returns. This suggests the market has already anticipated the effects of the merger. Moreover, the research will analyse the broader implications of the merger such as profitability, asset quality, and operational efficiency. The study contributes to the ongoing disclosure of the effectiveness of mergers in the banking sector and provides valuable insights for policymakers and investors.

EP588 - Review of the need for Immediate Nasogastric Tube Insertion in patients with Small Bowel Obstruction: Single Centre Quality Improvement Project

Abstract Aim This QIP was conducted in a busy UK hospital. It aims to review, improve, and stress the importance of early insertion of an NG tube in patients who have clinically suspected or radiologically confirmed small bowel obstruction. Method Retrospective data collection involving 72 patients, in a period from Jan to April 2023 (50 patients) and from May to July 2023 (22 patients)Inclusion criteria: adult patients with SBO (clinically suspected or radiologically confirmed) and NGT insertion advised by the surgical teamExclusion criteria: paediatric patients, LBO, and patients not advised NGT in ED Results In the first cycle, we found that NG insertion is delayed 84% &amp;gt; 7 hrs. With associated morbidity of pneumonia, including aspiration in 20% of patients, ileus and sepsis in 8%, and re-admission and mortality in 6%, respectively. The following interventions were carried out. Broad communication with the ED team to highlight the importance of NG insertion for suspected patients. Provide NGT training for ED nursing staff The surgical team and admission nurses should inquire about NGT insertion before accepting patients' admission to surgical emergency wards. Circulating the QIPS recommendation Trust-wide as sharing learning point Post-intervention, we noticed a 50% delay in NGT insertion, which is a huge improvement compared to the 84% delay Conclusion Early insertion of NG for decompression in both pre and post-op periods is known to decrease associated complications, including bowel oedema, perforation, aspiration pneumonia, and post-ileus, leading to better outcomes and a significant decrease in hospital stay length.

Functional performance of patients submitted to cardiac surgery with different levels of sleep quality: an observational study

ObjectiveTo describe pulmonary function, muscle strength and functional performance in the different qualities of sleep and the impact of this on the number of physiotherapeutic assistances. MethodsThis is an observational study. In the pre and post operative period, sleep behavior was evaluated using the Pittsburgh questionnaire. Patients were divided into three groups: Good Sleep Quality (GSQ), Poor Sleep Quality (PSQ) and Sleep Disordered (SDB). At this time, other tests were also performed, such as: 6-Minute Walk Test (6MWT), Sit and Stand Test (SST), gait speed test and Timed Up to Go (TUG), Medical Research Council (MRC), maximal inspiratory pressure and maximal expiratory, vital capacity and peak expiratory flow. The functional performance and lung function of each group were compared. ResultsA total of 105 people, undergoing cardiac surgery and admitted to hospital were evaluated, 33 with GSQ, 41 with PSQ and 31 with SD. Patients who were in the SDB group had a lower functional performance than the other groups. 6MWT (meters) in the GSQ was 499 ± 87, versus 487 ± 91 in the PSQ and 430 ± 78 in the SD (p = 0.02). In the SST (seconds) it was 10.4 ± 1.1 in the GQS, 11.1 ± 2.3 in the PSQ and 15.4 ± 2.1 in the SD (p = 0.04). Lung function and muscle strength did not differ between groups. Regarding the refusal to perform physical therapy, the SD group was more incident, the main reason being drowsiness. ConclusionBased on the results, we found that sleep quality interferes with functional performance and physical therapy assistance during the hospital stay in patients undergoing cardiac surgery.

A Comparative Study On Financial Performance Of Sbi In The Pre And Post Merger Periods Using Camels Rating Model

The core objective of the study aims to compare the performance of State Bank of India through CAMELS model during the pre and post merger periods with five of its associates. The study period covers 2012 to 2022. Data from secondary sources were used in this study. The comparison is made on the basis of the parameters like capital adequacy, asset quality, management quality, earning quality, liquidity and sensitivity to market risk. Data is analysed by using Paired sample t-test and also CAMELS ratings in the present study. The outcomes of the study reveals that SBI’s financial competency is improving post merger periods. But attention is required in liquidity quality in terms of total loans to total deposits (L1). Liquidity quality in terms of circulating assets to total assets (L2) and sensitivity to market are excellent in CAMELS ranking. Out of six parameters in CAMELS, management quality and liquidity quality in terms of total loans to total deposits (L1) are found to be significant in the post merger period. The study concluded that post-merger SBI's earnings quality is improved but liquidity did not. So management should be meticulous with managing liquid assets.

&amp;lt;i&amp;gt;Pāňcālī &amp;lt;/i&amp;gt;— A Local Administrative Unit of Ancient Nepal (4&amp;lt;sup&amp;gt;th&amp;lt;/sup&amp;gt; to 8&amp;lt;sup&amp;gt;th&amp;lt;/sup&amp;gt; Century A.D.): An Inscriptional Overview

Licchavi kingdom was an ancient kingdom in Nepal, which existed in the Kathmandu Valley from approximately from ca. A.D. 300 to ca. 879. Centuries earlier at the start of the Buddhist era, a powerful republic known as Licchavi existed in what is today Bihar. It is to be mentioned here, some legendary sources from the Kathmandu Valley also describe the Kirātas as early rulers there, taken over from earlier Gopāls or Ᾱbhiras, both of whom may have been cow herding tribes. In the pre Lichhavi period a village administration existed in the valley of Nepal. In that village administration there were some local chief officials named &amp;lt;i&amp;gt;Brahmum, Shulham&amp;lt;/i&amp;gt;, &amp;lt;i&amp;gt;Tepulam&amp;lt;/i&amp;gt; who maintained law and orders of the villages. In the Ᾱdī- Nārāyaṇa temple Inscription of Nepal there are 18 functionaries in which &amp;lt;i&amp;gt;Brahmum, Shulham&amp;lt;/i&amp;gt;, &amp;lt;i&amp;gt;Tepulam &amp;lt;/i&amp;gt;are mentioned. These non sanskritic terms disappeared after sometime and replaced by sanskritic terms such as &amp;lt;i&amp;gt;svatalasvāmī&amp;lt;/i&amp;gt; and later &amp;lt;i&amp;gt;dauvārika&amp;lt;/i&amp;gt;, a post which endured permanently in Nepal village administration. In the period of Aṁśuvarmā we see a significant change occurred in the use of land and its administration by the ushering in of the &amp;lt;i&amp;gt;pāňcālīs. Pāňcālī&amp;lt;/i&amp;gt; has been used in the sense of modern &amp;lt;i&amp;gt;Pāňcāyet.&amp;lt;/i&amp;gt; In ancient Nepal &amp;lt;i&amp;gt;Pāňcālī&amp;lt;/i&amp;gt; was a village administration and &amp;lt;i&amp;gt;Pāňcālīkā&amp;lt;/i&amp;gt; is the member of the administrative body &amp;lt;i&amp;gt;Pāňcālī. &amp;lt;/i&amp;gt;In this paper an attempt has been made to discuss about the meaning of the term &amp;lt;i&amp;gt;pāňcālī,&amp;lt;/i&amp;gt; its characteristics, responsibilities and roles in Nepal administration.

Donor and newborn profiles and their influence on donation volume and duration: a cross-sectional study in a Spanish human milk bank

BackgroundHuman milk banks are essential facilities to provide donated human milk (DHM) to preterm and term infants with health complications. Little is known regarding milk bank donors and how their characteristics may influence the particularities of the donation process. The present study aims to assess characteristics of donors and their newborns to identify associations with the amount of DHM and initiation and donation time, during the first and second year of the milk bank operation in Córdoba, Spain.MethodsThis cross-sectional study was conducted in three periods: pre-opening of the milk bank (PRE) including all women who gave birth to a newborn between January – May 2017 and were hospital users; donors in the first year after the opening (Period 1 (P1): April 2019 – March 2020); and in the second year (P2: April 2020 – March 2021). For P1 and P2, DHM data were recorded. The relationships between donor and newborn characteristics and the donation process were examined using univariable and regression models.ResultsFrom 391 women interviewed in the PRE period, 55 (14%) showed intention to donate. In P1 and P2, there were 51 and 25 human milk (HM) donors, respectively. Age, gestational age (GA) and parity were similar between periods. In P2, a higher proportion of donors had higher education (P1: 46%; P2: 70.8%, p = 0.045). Around 40% of donors in both periods were on maternity leave. In P1, donors who had low birth weight infants (< 2500 g) donated more HM than those with infants weighing ≥ 2500 g (p = 0.020). In P2, women whose GA was < 37 weeks donated a higher volume vs. those with ≥ 37 weeks (p = 0.002). Maternity leave was linked to a shorter initiation time for donations in both periods (P1: p = 0.002; P2: p < 0.001).ConclusionsData obtained from a Spanish human milk bank indicate that prematurity and low birth weight appear to influence the amounts of DHM. Employment status might be a decisive factor in initiating HM donation. Additional efforts are required to identify shared donor characteristics that influence the initiation and volume of donation.

Sentiment Analysis of Bali Calendar Application Reviews using K-Nearest Neighbor

The Bali Calendar application received various responses from its users, comprising both positive accolades and negative critiques. This study employs the K-Nearest Neighbor (KNN) method to categorize sentiments into positive and negative, gauging public satisfaction with the Bali Calendar app. Additionally, the Tomek Links method is implemented to enhance the KNN classification code's performance in scrutinizing app reviews. The research distinguishes data timelines into pre and post-Covid periods due to an elevated number of negative reviews post-update during the pandemic.Pre-Covid results reveal KNN accuracy peaked at 93.7% and 94.3% without or with Tomek Links with parameter K=5 and K=3. Post-Covid, KNN accuracy reached 86.0% and 87.2% without or with Tomek Links with parameter K=9. Notably, Tomek Links yield a higher accuracy boost in post-Covid data (1.2%) compared to pre-Covid (0.6%). This underscores Tomek Links' impact on KNN accuracy amid unbalanced datasets.

Pandemic rollercoaster: University students’ trajectories of emotional exhaustion, satisfaction, enthusiasm, and dropout intentions pre-, during, and post-COVID-19

The COVID-19 pandemic might have lasting effects on university students' well-being and motivation. However, existing studies examining students’ well-being and motivation have not covered the entire pre, during and post-pandemic period. This study investigated German university students' well-being (emotional exhaustion, study satisfaction) and motivation (dropout intentions, enthusiasm) from 2020 to 2023. Latent Change Score Models from 1967 students indicated increased emotional exhaustion and dropout intentions in 2021–2023 compared to 2020. Study satisfaction initially rose during the 2021 lockdown but declined subsequently, while enthusiasm remained stable. These findings emphasize the need for ongoing university support to mitigate pandemic-related student distress.

Perioperative use of erythrocyte-containing blood components in children during the first months of life

BACKGROUND: Anemia can be diagnosed before surgery, occur during surgical treatment, and develop and worsen in the postoperative period in children with surgical diseases. Anemia is associated with increased morbidity, severe complications, and even death after surgical treatment. AIM: This study aimed to determine the frequency and indications for transfusion of red blood cell-containing components in the perioperative period in children in the first months of life. MATERIALS AND METHODS: This cohort study included 187 children from the G.N. Speransky Children’s Hospital No. 9. The hemoglobin, hematocrit, and red blood cell levels were studied as well as the volume of intraoperative blood loss, hemodynamic parameters, the presence of hemorrhagic syndrome, and the use of adrenomimetics in the perioperative period. The stage of the perioperative (pre, intra, or post) period at which the transfusion of erythrocyte-containing components was conducted was recorded. Statistical data analysis was performed using the statistical computing environment R 4.3.0. RESULTS: The average age of the children at the time of surgery was 41 (16.5–63) days [5.9 (2.4–9) weeks]. Sixty-four (34.2%) children were in their first month of life, 72 (38.5%) in their second month, and 51 (27.3%) in their third month, and 76 (40.6%) children were premature. The surgeries were emergent and urgent in 102 (54.5%) children and planned in 85 (45.5). The hemoglobin, hematocrit, and erythrocyte levels at which erythrocyte-containing components were transfused were 82 (77–90) g/l, 25% (22%–28%), and 2.8 (2.3–3.0) × 1012/l, respectively. The volume of erythrocyte-containing components was 54.0 (32.9–74.4) ml (10–30 ml/kg/child’s body weight). The need for and duration of artificial pulmonary ventilation in the postoperative period were 31 (72.1%) cases and 48.5 (22.5–190) hours, respectively, in contrast to children who did not receive transfusions of red blood cell-containing components—57 (39.6%) cases and 40 (22–96) hours. The indication for transfusion was anemia of varying degrees; however, 74.4% of children received adrenergic agonists simultaneously with transfusion to stabilize hemodynamics: dopamine monotherapy in 23 (74.2%) and combinations of dopamine and norepinephrine in 8 (25.8%) at 10 (8–12) mcg/kg/min and 0.2 (0.15–0.4) mcg/kg/min, respectively. CONCLUSION: The frequency of use of red blood cell-containing components was 23%. Threshold values for transfusion of erythrocyte-containing components Hb, Ht, and erythrocytes were 82 (77–90) g/l, 25% (22%–28%), and 2.8 (2.3–3.0) × 1012/l, respectively.

Effectiveness of Culinary Nutrition Workshops on the Mood and Nutritional Interest of Inpatients With Mental Disorder.

Background Promoting healthy eating habits through nutrition education programs is crucial to improving the overall healthof people with mental disorders. This study aims to assess the effectiveness of culinary nutrition workshops on the mood and nutritional interest of hospitalized adults with mental disorders (MD)from the acute psychiatric unit of two general hospitals in Catalonia, Spain. Methods A pilot randomized control trial (RCT) was conducted with MD inpatient. Participants were randomly assigned to two groups: the intervention group receivedweekly culinary nutrition workshops with flexible participation andthe control group continued routinary care. The interest in nutrition was analysed with an ad hoc item pre and post-intervention period. Mood changes were studied with a visual analog scale and analysed pre- and post-intervention periods as well as before and after every session.An ad hoc questionnaire was also used to assess the satisfaction of participants with the intervention. The obtained data were analysed at both descriptive and inferential levels. Results We included 81 participants, with a mean age of 45.3 (SD: 17.0); 66.7% were women, with 41 assigned to the intervention group and 40 to the control group. At the end of every culinary nutrition workshop, a statistically significant improvement in mood was observed in the intervention group (5.9 vs. 7.4 points, p<0.001).However, there were no significant differences in mood changes between the control and intervention groups after the intervention period (control group: 1.0 vs. intervention group: 1.5, p=0.473), while the nutritional interest was significantly improved after the intervention period intergroups (control group: 4.1 vs. intervention group: 37.2, p<0.001). The intervention was excellently valued by the participants regarding content, space, and health professionals, and generated interest and motivation, with scores above 9 on all these items. Conclusion The improvement of interest in nutrition and the satisfaction of hospitalised people with MD with the nutrition culinary workshops emphasizethe need to design more comprehensive RCTs in hospitals and rehabilitation centers.

Building Resilience for Transformational Recovery: An Analysis of Monetary Policy and Economic Growth in West Africa before and Following the COVID-19 Periods

This study investigates the effectiveness of monetary policy in the pre and post COVID-19 periods in West Africa. The panel fully modified ordinary least squares (FMOLS) was used. Before the estimation, the correlation analysis and summary statistics were done. Unit root test was carried out to ascertain whether the data series are stationary or not and the panel cointegration test was used to determine the existence of long run relationship among the variables. The findings indicate that monetary policy has 12.3% negative and significant effects on economic growth in the periods before COVID-19, while it has insignificant effect after the pandemic. Furthermore, monetary policy has 21.01% negative and significance effects on inflation in the pre COVID-19 era, while it has 52.5% negative and significant effect on inflation after the pandemic. This indicates that the effectiveness of the central bank’s efforts to affect and control inflation has declined after COVID-19. Causes for this could include the pandemic’s effect on supply chains, demand, and the weaker economic environment. On this basis, the monetary authority should create an economic environment that will play a crucial role in determining the effectiveness of monetary policy in the post-COVID-19 periods to foster economic recovery.

Practice Patterns of Glucagon-Like Peptide-1 Agonist Use Among Pediatric Bariatric Surgeons: A National Survey

IntroductionGlucagon-like peptide-1 receptor agonist (GLP-1A) medications are gaining widespread popularity for the treatment of obesity. The optimal use of these drugs in pediatric bariatric populations, and especially in those considering metabolic and bariatric surgery (MBS), is yet to be established. We sought to characterize current practice patterns of GLP-1A use at major pediatric bariatric centers across the United States. Materials and MethodsWe administered an online survey to a purposive sample of 46 surgeons who perform MBS on children and adolescents. Survey questions explored practices prescribing GLP-1As in patients considering MBS, holding them prior to elective operations, and restarting them postoperatively following MBS. Responses were summarized with descriptive statistics and inductive content analysis. ResultsThere were 22 responses (48% response rate) representing 19 institutions. Most (86%) respondents do sometimes prescribe GLP-1As for patients considering MBS, but the specific indications vary. Practices for holding GLP-1As preoperatively also vary, from not at all to holding for 2 wk. Over half (55%) of respondents sometimes restart GLP-1As after MBS. Free-response themes included still-evolving preoperative utilization patterns, difficulty with access and insurance coverage, and a lack of data informing GLP-1A use in the pre and postoperative periods. ConclusionsGiven the increasing use of these medications for weight loss purposes, this substantial variation in practice highlights a need for further research to examine the safest and most effective use of GLP-1As in the pre and postoperative periods and for practice guidelines to standardize care pathways in pediatric bariatric contexts.