Relative Values Research Articles

Why Not This Case? Differences Between Resident and Attending Operative Cases at Teaching Hospitals

IntroductionPrevious studies have focused on outcomes pertaining to resident operative autonomy, but there has been little academic work examining the types of patients and cases where autonomy is afforded. We sought to describe the differences between surgical patient populations in teaching cases where residents are and are not afforded autonomy. MethodsWe examined all general and vascular operations at Veterans Affairs teaching hospitals from 2004 to 2019 using Veterans Affairs Surgical Quality Improvement Program. Level of resident supervision is prospectively recorded by the operating room nurse at the time of surgery: attending primary (AP): the attending performs the case with or without a resident; attending resident (AR): the resident performs the case with the attending scrubbed; resident primary (RP): resident operating with supervising attending not scrubbed. Resident (R) cases refer to AR + RP. Patient demographics, comorbidities, level of supervision, and top cases within each group were evaluated. ResultsA total of 618,578 cases were analyzed; 154,217 (24.9%) were AP, 425,933 (68.9%) AR, and 38,428 (6.2%) RP. Using work relative value unit as a surrogate for complexity, RP was the least complex compared to AP and AR (10.4/14.4/14.8, P < 0.001). RP also had a lower proportion of American Society of Anesthesiologists 3 and 4 + 5 patients (P < 0.001), were younger (P < 0.001), and generally had lower comorbidities. The most common RP cases made up a higher proportion of all RP cases than they did for AP/AR and demonstrated several core competencies (hernia, cholecystectomy, appendectomy, amputation). R cases, however, were generally sicker than AP cases. ConclusionsIn the small proportion of cases where residents were afforded autonomy, we found they were more focused on the core general surgery cases on lower risk patients. This selection bias likely demonstrates appropriate attending judgment in affording autonomy. However, this cohort consisted of many “sicker” patients and those factors alone should not disqualify resident involvement.

SYNTHESIS, CHARACTERIZATION AND XRD ANALYSIS OF COPPER (II) AND IRON (II) COMPLEXES OF BENZOIC ACID HYDRAZIDE.

Schiff bases are an important class of organic compounds, which play an important role in medicinal and pharmaceutical applications. Metal complexes formed by the reactions of keto forms of Benzoic acid hydrazide (BAH) with Cu(II) and Fe(II) sulphate ions were prepared and characterized by X-ray Diffraction analysis (XRD), Fourier Transform Infrared (FTIR) and electronic absorption spectra studies. The results showed that the hydrazides reacted with the metal salts in 1:2 molar ratio in all the complexes and acts as neutral bidentate ligands. The X-ray diffraction (XRD) pattern of the metal complexes provides a detailed comparative account of the behavior of the metal complexes of hydrazide ligand metal complexes. The pattern of BAH complexes shows the main characteristics peak and broad shoulder. In view of the relative half value width (FWHM), it may be concluded that the BAH-Cu is partially crystalline and while the BAH-Fe shows an amorphous nature. The broad characteristic peak indicates the amorphous nature of the polymers. The solubility test on the ligands and its metal (II) complexes revealed their solubility in ethanol and dimethylsulphoxide (DMSO). The infrared spectra of the hydrazide showed that ?(C=O), the carbonyl stretching mode, the coupling between the in-plane bending ?(N-H) and ?(C-N) and the stretching frequency for the amino group ?(NH2) all experienced shifts to lower wave numbers in the complexes suggesting the coordination of the moieties to the metal ions. The electronic absorption spectra of Cu(II) complexes showed absorption band located at 36,496 cm-1 showing a tetrahedral geometry while Fe(II) BAH and BAH ligand show absorption band at a shoulder around 16051 cm-1 with 4A2 ? 4T1 (P) respectively consistent with a four coordinate tetrahedral geometry.

Studies on the nonlinear dielectric response in ferroelectric–dielectric composite system

The nonlinear dielectric response (NDR) of Bi3.25La0.75Ti3O12–Al2O3 systems has been studied. To reveal the effects of the dielectric layer (DL) systematically, a method based on the equivalent circuit analysis and parametric study is proposed. The consistency between the calculated results and the experimental results manifests the validity of the method. In addition to the Rayleigh coefficients varying monotonically with the capacitance of DL, it is revealed that the slope between the real and the imaginary parts of the complex capacitance under different ac voltages is related to the relative loss values of DL and the ferroelectric layer. The frequency dependence of the NDR parameters is also discussed. The method established in this work is useful for research on the devices based on the ferroelectric–dielectric system and the ultra-thin ferroelectric films.

Fabrication of SERS substrates by laser restructuring of interconnected Au nanostructures for urea detection

We discuss a facile, fast, simple, and reproducible fabrication method to modulate the structural morphology of the SERS substrate to improve its performance. The interconnected Au network structure named as nanoporous Au (NP–Au) is prepared by the dealloying method and further exposed with varied laser power in order to check the effect of power variation on the morphology as well as on the SERS performance. The effectiveness of the substrate has been tested by detecting Rhodamine 6G as a probe molecule. The Raman results show a good linear relationship with the laser power increment up to 3.2 mW and after that, the signal becomes saturated for a further increment in the power. The substrate is able to enhance the signal up to 102-fold as well able to show all the characteristic peaks without any damage to the probe molecule. Morphological identification reveals that different sizes and shapes of the pores (open, diffused, and interlinked) are responsible for the SERS signal enhancement. Subsequently, the sensitivity of SERS substrate has been examined and the result suggested that the optimal concentration of Rhodamine is 10−9 M. Furthermore, the substrate possesses good uniformity by representing a relative standard deviation value of less than 15 %. The substrate potential for real-world application has been examined by identifying urea (pesticide) molecules. The prepared nanoporous substrate is able to show a well-intensified signal with ∼16-fold enhancement compared to planar Silicon substrate.

Untapped Genetic Resources for Breeding Acidic Soil-Adapted Chickpea (Cicer arietinum L.) Cultivars

Globally, more than half of potentially arable land is acidic, and aluminum (Al) is the primary factor limiting plant growth and crop productivity on acidic soils worldwide. The development and utilization of Al-tolerant crops is a sustainable approach to enhancing crop production on acidic soils. For this purpose, screening available genetic resources under Al-stressed conditions is a crucial initial step. Hence, the present study aimed to evaluate the Al tolerance of 264 Ethiopian chickpea landraces under hydroponic conditions without Al (control) and with 120 µM Al (Al treatment). Significant (p &lt; 0.001) variations were detected among the genotypes for all studied traits under control (0 µM Al) and 120 µM Al concentration. The relative growth values for the 120 µM Al/0 µM Al ratio was also significant, indicating the presence of a considerable amount of genetic variation in Ethiopian chickpea landraces in terms of Al tolerance. Based on relative root growth (RRG) as an Al-tolerance parameter, the genotypes were grouped into five distinct (p &lt; 0.001) classes. The highest RRG value (1.59) was obtained for genotype ETC_209008, followed by ETC_41184 and ETC_212589, while ETC_208995 had the lowest RRG value of 0.27. Of the total landraces screened, 35% had higher RRG values than the tolerant genotype ETC_WL_1_2016 used as a reference, indicating the presence of adequate genotypes capable of outperforming the reference genotype on acidic soils. The genotypes identified in the present study may serve as sources of novel alleles in genes regulating Al tolerance in chickpea that can be utilized in breeding programs to improve the crop’s adaptation to acidic soils, thus contributing to smallholder farmers’ increased nutritional and food security.

Diversity, Vegetation Structure, Estimated Biomass and Carbon Stock in The Site of Limboto Lake of Gorontalo Regency

The development of Limboto Lake Site as the pilot area of Gorontalo Geopark is one step in rescuing the lake. This research aims to analyzed the vegetation structure, estimate biomass, and assess the carbon stock value of the vegetatio at the Limboto Lake site. This study employed a purposive sampling method. Important Value Index, a measure used to evaluate plant vegetation structure, was calculated based on Realtive Density, Relative Dominance, and Relative Frequency values. Biomass estimation and carbon stock assessment were conducted using allometric equations. The study’s finding showed that the vegetation surrounding Soekarno's landing area exhibited the highest IVI (sawlogs) scores for Swietenia mahagoni tree at 82.86%, Leucaena leucocephala saplings at 79.56%, and Manihot esculenta seedlings at 46.33%. Leucaena leucocephala consistently achieved the highest IVI score within the Limboto Lake area with a score as high as 76.90%, followed by Leucaena leucocephala on the sapling level with a score as high as 70.03%, and Nauclea orientalis on the seedling level with a score as high as 53.06%. Swietenia mahagoni, Samanea saman, and Leucaena leucocephala are three species with stems that predominate at the sawlog level and sapling, and these stems have high carbon absorption values.

Cultural Adaptation and Validation of the Attitudes Towards Alcohol Scale for Health Professionals in Portugal

AbstractWe aimed to conduct an adaptation and validation of the Attitudes towards Alcohol, Alcoholism and Individuals with Alcohol Use Disorders Scale (EAFAA) which set to address the main groups of attitudes. It is composed in its original version by 50 items, divided into 4 factors: (1) work and interpersonal relationships with patients with alcohol consumption disorders; (2) the person with alcohol consumption disorders; (3) alcoholism (aetiology) and (4) alcoholic beverages and their use. The cultural adaptation from Brazilian to European Portuguese changes 22 items and the designation of one factor. The content validity index scale was 0.96. The psychometric properties were analysed through a cross-sectional study, with a convenience sample of 500 health professionals and students. The confirmatory factor analysis model with the same four (4) original factors, led to the elimination of 9 items. The scale revealed Cronbach’s alpha of 0.801. Empirical adjustment indices were satisfactory with Minimum Discrepancy Function by Degrees of Freedom divided (CMIN) (X2/gl) = 3.91; p &lt; 0001, RMSEA = 0.076 and the goodness of fit index (GFI) with 0.8. Relative indices values were normal fit index (NFI) = 0.6, comparative fit index (CFI) = 0.7 and Tucker-Lewis index (TLI) = 0.7, with best parsimony indices PCFI = 0.595, PNFI = 0.530 and PGFI = 0.702.

Relevant edge probability‐based adaptively weighted active contour for medical image segmentation

AbstractThe level‐set based active contours have been found popular for medical image segmentation tasks, because of their inherent support for the topological changes—splitting and merging. Meanwhile, contour's leakage through the weak edges and premature convergence due to intensity inhomogeneity diminish its accuracy. Adjusting energy weights according to image features, local to the contour can be helpful. However, weight adjusted as deterministic function of the features is not adequate, limiting the segmentation accuracy. To address the problem, a new relevant edge probability based adaptively weighted level‐set evolution (REP‐WLSE) method for medical image segmentation is investigated. The weights used in this proposal are adaptive to an image relative value, obtained statistically from the feature‐explorations during the contour's evolution. The value is basically an estimate of contour's probability of finding relevant boundary edges on the image plane. Spatial intensity‐range filtering provides the feature space. An adaptive time‐step management scheme is also implemented, which controls the speed variation of the contour evolution. Time‐step is adjusted as a function of contour's alignment with the edges. The merits of the suggested methodology are—(i) reduced leakage through the weak edges, (ii) ability to handle the inhomogeneity, and (iii) increased chances of convergence around the foreground/region of interest (ROI). Experimental results using brain MR, abdominal ultrasound, and breast ultrasound images are presented. State‐of‐the‐art methods are compared using different metrics. The suggested methodology achieved better results.

Forecasting The Impact of the 2023 Current Procedural Terminology Coding Changes On Ventral Hernia Work Relative Value Units. A Cross-Sectional Study

BackgroundIn January 2023, significant changes were implemented to ventral hernia repair Current Procedural Terminology codes, with new codes replacing previous codes. The new codes were assigned a 0-day global period. The impact of these changes on clinical productivity remains unclear. Our objective was to forecast the impact of Current Procedural Terminology changes on ventral hernia-related work relative value units using historical data. MethodsVentral hernia repairs performed between March 2021 and December 2022 on adults by a single surgeon with available 90-day follow-up were retrospectively retrieved from the Abdominal Core Health Quality Collaborative. Demographic, hernia, and operative and postoperative data were collected. The ventral hernia repairs were coded twice using the previous and new Current Procedural Terminology codes, and work relative value units were calculated using both systems. The median work relative value units per case were compared using the Wilcoxon signed-rank test. ResultsA total of 143 ventral hernia repairs were included. The median age was 59 years, and 50% of patients were male. Median hernia width and length were 3.5 and 5.0 cm, respectively. The most common ventral hernia types were incisional 57% and umbilical 33%. Twenty percent of hernias were recurrent, and 99% were elective repairs. 49% of the procedures were open, 30% robotic, and 21% laparoscopic. Component separation was performed in 16%. The median length of stay was 0.0, and the median number of 90-day outpatient postoperative visits was 1.0. The new Current Procedural Terminology coding system was associated with a higher median 90-day work relative value units per case (14.1) than the previous system (13.8) (P = .002). Subset analysis identified statistically higher median 90-day work relative value units per case using the new versus previous Current Procedural Terminology codes for hernias with the largest defect dimension >10 cm (23.3 vs 18.8), umbilical/epigastric/Spigelian hernias (9.2 vs 7.1), recurrent hernias (20.1 vs 17.3) and open ventral hernia repairs (9.8 vs 7.1), all P < .05. Median 90-day work relative value units per case were statistically lower using the new versus previous codes for non-recurrent (11.6 vs 13.8) and incarcerated/strangulated (14.8 vs 14.9) hernias, all P < .05. In the new coding system, postoperative care within 90-days contributed to a median of 1.3 work relative value units per case (9% of total 90-day work relative value units). ConclusionWe forecast that in our practice, the 2023 ventral hernia repair Current Procedural Terminology changes will result in a modest impact on clinical productivity. The impact of these changes on a particular practice depends on surgical practice patterns and ventral hernia case mix.

Figure-4 Patient Positioning Increases Medial Meniscus Extrusion on Ultrasound in Patients With Posterior Medial Meniscus Root Tears of the Knee

To compare the degree of medial meniscal extrusion (MME) between knees with medial meniscus posterior root tear (MMPRT) and degenerative tears of the medial meniscus using ultrasonography (US) in different limb positions and to identify the findings characteristic of MMPRT. The study group comprised 25 subjects with MMPRT (group RT), 25 subjects with degenerative medial meniscal tears (group D), and 25 knees with no abnormalities of the medial meniscus (MM) on magnetic resonance imaging (MRI) (group C) whose age was ≥40 years. MME was evaluated using US in the supine, figure-4, feet-dangling, and standing positions. The MME was evaluated by the actual measurement values and the relative values to the MME in the supine position. The differences in the MME among the 3 groups in each limb position were analyzed using one-way analysis of variance. P < .05 was considered significant. The actual MME values were largest in group RT in all 4 limb positions. When changing the limb position from the supine to the figure-4, the actual MME increased from 3.8 ± 0.8 mm to 5.5 ± 1.3 mm in group RT, whereas it decreased from 3.4 ± 1.1 mm to 1.8 ± 1.2 mm in group D, showing the most significant difference in MME of the figure-4 position between the 2 groups (P < .001). In group RT, 88% of knees had the maximum MME in the figure-4 position. In group D, 60% of knees had the maximum MME in the standing position and only 2 knees (8%) had the maximum MME in the figure-4 position. The increase in MME from the supine to the figure-4 position was a characteristic finding of MMPRT but not degenerative tears. Level III, case-control study.

Postsystolic shortening by speckle tracking echocardiography predicts cardiovascular events and death in the general population

Abstract Background Postsystolic shortening (PSS) have demonstrated to be a valuable predictor of contractile dysfunction in the myocardium. Our objective was to investigate the prognostic value of PSS, assessed by two-dimensional speckle tracking echocardiography (2DSTE), in relation to cardiovascular morbidity and mortality in a large general population study. Methods This prospective longitudinal study consisted of 4466 participants of the general population. The postsystolic index (PSI) was defined as follows: [(maximum strain in cardiac cycle–peak systolic strain)/(maximum strain in cardiac cycle)]×100. The endpoints were heart failure, major adverse cardiovascular events (MACEs), and all-cause mortality. Results During a median follow-up of 3,5 years, 148 participants (3.8 %) experienced MACE, 85 participants (2.2 %) were diagnosed with heart failure, and 192 (4.9 %) died. In unadjusted models, PSS was significantly associated with both MACE, heart failure and all-cause mortality. Following multivariable adjustments, PSS remained significantly associated with MACE (HR: 1.54; [95% CI, 1.04 – 2.3]; P=0.033) and heart failure (HR: 1.28; [95% CI, 1.11 – 1.49]; P &amp;lt; 0.001). PSI provided incremental prognostic value in relation to MACE (SCORE risk chart with the addition of PSI: 0.86 (0.83-0.89), P &amp;lt; 0.001) and heart failure (SCORE risk chart with the addition of PSI: 0.86 (0.83-0.89), P = 0.014. Conclusions In the general population, PSS as assessed by two-dimensional speckle tracking echocardiography independently predict the occurrence of both MACE and heart failure.Postsystolic index cubic spline curves

Correlation of the novel biomarker cellular communication network factor 1 (CCN1) with miR-155 in serum of patients with dilated cardiomyopathy

Abstract Background We recently reported an independent prognostic ability of serum CCN1 to predict all-cause mortality in DCM, irrespective of its aetiology (inflammatory DCM (DCMi) or conventional DCM). Interestingly, CCN1 levels were lower in patients with DCMi than in patients with conventional DCM. In a murine model, miR-155, which has key functions in inflammation, repressed the expression of CCN1 and impeded its function in angiogenesis. In a recent study, patients with DCMi had higher miR-155 plasma levels than those with conventional DCM. Purpose The present study evaluated whether circulating levels of CCN1 and miR-155 are associated in order to provide insight into the underlying pathophysiology. Methods Patients with a primary diagnosis of DCM, defined as LVEF &amp;lt;45% and an increased LVEDD (according to HENRY &amp;gt;117%), were included in this single-centre study. Exclusion criteria comprised primary valvular diseases (≥ second degree), acute myocarditis, active infectious diseases, pulmonary diseases, cancer, chronic alcoholism, and heart failure of other origins. CCN1 levels were determined in serum at study inclusion using an enzyme-linked immunosorbent assay. miR-155-5p was measured in serum using quantitative real-time PCR and normalized to a spike-in of miR-39-3p from C. elegans for analysis. The primary endpoint was all-cause mortality during follow-up. An adjusted multivariable Cox regression model (comprising age, sex, time of symptoms, LVEF, eGFR, CRP, and NT-proBNP) was used to assess the association between CCN1 or miR-155 with all-cause mortality. Results Among 283 patients in the DCM cohort with CCN1 data, miR-155 measurements were available for analysis in 270 patients. Among those, 77.4% were males at a median age of 55.3 [IQR 47.8, 64.7] years with 3.84 [IQR 1.1, 19.3] months since onset of disease who had severely reduced LVEF (31 [IQR 26, 37] %), elevated LVEDD (67 [IQR 62, 72] mm), and normal eGFR (CKD-EPI) (91.5 [IQR 74.01, 103.3] ml/min). During a median follow-up of 12.4 [IQR 10.5, 13.9] years, a total of 101 (37.4%) patients died. There was no significant difference in miR-155 levels between DCMi and conventional DCM (ΔCt: 14.84 vs 14.94, P = 0.60; and ΔΔCt values 1.68 vs 1.49, P = 0.42). A positive correlation was found for miR-155 (relative expression ΔΔCt values) with CCN1 in serum from patients with conventional DCM (rS = 0.251, p = 0.002) but not with DCMi (rS = 0.007, p = 0.94) (Figure 1). Unlike CCN1 (HR 1.11; 95% CI 1.04, 1.19; p = 0.002), miR-155 was not associated with all-cause mortality (HR 0.95; 95% CI 0.82, 1.11; P = 0.54) in adjusted multivariable Cox regression models. Conclusion A differential correlation of miR-155 with CCN1 levels was found in patients with conventional DCM vs. those with DCMi, suggesting a potential role of these biomarkers only in conventional DCM. Further investigation of the pathophysiology of CCN1 in DCM is warranted, including -omics analyses.

APLIKASI SISTEM LAYANAN PEMESANAN JASA DESAIN DAN APLIKASI BERBASIS ABDROID PADA PT. PUTRA WISANGGENI SATU MENGGUNAKAN METODE WATERFALL

&lt;p align="justify"&gt;&lt;span style="font-size: 11.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;" lang="EN-US"&gt;PT. Putra Wisanggeni Satu is a company that is active in the field of digital platforms, business and trade consultants in the company. Almost all service ordering activities use WhatsApp messenger. revisions are in demand and vulnerable to conversation data being lost or accidentally deleted. The aim of this research is to design and build an Android-based application for ordering design services and applications to improve service quality and make it easier to order services more efficiently. This research involves several steps, including problem analysis, data collection, application design and development and application testing. At the data collection stage, it was carried out using interview and observation methods and for the system development method using the waterfall method. At the application testing stage, the blackbox testing method shows that almost all features are implemented successfully and function properly as well as the results of usability testing, on the Effectiveness aspect of 94.2%, Efficiency aspect of 0.163 goals / Sec with an overall relative efficiency value of 83.3%. And for the satisfaction aspect of 78.5 . The results of this study indicate that the application can view service price lists, place service orders, service revisions and pay by bank transfer method.&lt;/span&gt;&lt;/p&gt;

Evaluation and application of treadmill Cardiopulmonary Exercise Testing and field measurement results of female national team water polo players

Abstract Introduction Due to intensive sport adaptation, examinations of elite athletes are a special entity of cardiology. Cardiovascular follow-up of elite athletes is a significant method of supporting safe and successful sport. In many sports like water polo, training work takes place in different environments and with different forms of movement, then the tests applied in laboratory circumstances. Although treadmill cardiopulmonary exercise testing (CPET) is widely used in cardiology screening, we have little information of its usefulness in physical fitness follow-up in non-running sports. Purpose We aimed to analyze and to compare the data of elite youth team (YT) and adult water polo players collected from maximal intensity cardio-pulmonary exercise testing (CPET) and field examinations in definition of current fitness status of the different age groups. Methods During the age- and sport specific field measurements (swimming tests) and CPET examinations, we collected resting and exercise heart rate data and lactate levels at defined time points. During CPET, continuous 12-lead ECG, gas analysis and repeated blood pressure measurements were also carried out. Results 46 female water polo players were examined (age: 18.5±5.9y, adults: 19, training: 18.0±7.9h/w). Comparing CPET and field measurements, no differences were found between resting heart rate (75.7±13.4vs73.1±13.0 BPM, p=0.22) and resting lactate levels (1.5±0.4vs1.6±0.6 mM, p=0.29). Achieved maximal heart rates were higher during CPET examinations, than during field tests (196.3±9.7 vs 191.0±12.5 BPM, p=0.001) On the contrary, maximal lactate levels were lower during CPET in comparison to field measurements (8.4±2.4 vs 9.6±2.7 mM, p=0.01). Lactate levels stayed high after routine cool-down swimming ordered by the trainers, but decreased after suggested further training (6.6±2.7 vs 3.7±1.6 mM, p=10-16). When comparing the age groups, CPET examinations showed similar relative maximal aerobic capacity (44.4±4.8vs44.9±5.5 ml/kg/min, p=0.72) and peak lactate values (8.2±2.7vs8.7±1.9 mM, p=0.48), while maximal heart rates were higher in YT groups (200.7±7.2 vs 190.1±9.6 BPM, p&amp;lt;0.001) as compared to adults. Similarly, maximal lactate levels showed no differences (9.1±2.6 vs 10.4±2,7 mM, p=0.13), while maximal heart rates were higher in YT groups (197.7±10.0 vs 181.4±8.9 BPM, p&amp;lt;0.001) as compared to adults during field examinations. Conclusions Although field measurements and laboratory CPET results differ from several points of view, differences between age groups and the kinetics of the data are similar. Maximal heart rates are easier to achieve during CPET, while more intensive lactate increase could be observed during field measurements. Combining the above examinations helps defining maximal physiological values, fitness status, differences between different age groups, and optimizing training plans, as well as differentiating between physiological and pathological sport adaptation.

AGE AND GENDER DIFFERENCES IN BODY COMPOSITION IN YOUNG ADOLESCENTS

At the age of 11-15 (the period of younger adolescents), there are significant changes in body composition due to pre-pubertal and pubertal development. In our paper, the differences in indicators of body composition of elementary school students in the context of age and gender were evaluated. Boys and girls from primary schools aged 10-11 years (n=32 and n=38), 12-13 years (n=36 and n=57) and 14-15 years (n= 38 and n=33) were examined. In addition to age, body height (BH), body weight (BW), Quetelet's index (BMI), body fat mass (BFM), body fat mass index (BFMI), skeletal muscle mass (SMM), percentage of body fat (PBF), waist-hip ratio (WHR) and visceral fat (VFA) were monitored. The data were obtained using the InBody 230 device using the multi-frequency bioimpedance method of measuring body composition. The measured data were processed using IBM SPSS Statistics, version 20.0. Since data were not normally distributed (Shapiro-Wilk test), they were processed using non-parametric methods through Kruskal-Wallis Anova (age differences) and multiple comparisons with the Mann-Whitney U test with the application of the Bonferonni adjustment. The most significant differences were only found in the intersex comparison of 14-15-year-old pupils, when in the relative values of fat representation (BFMI and PBF), girls achieved higher mean values, on the contrary, higher values of in the group of boys are visible in the indicators describing active body mass (FFM, FFMI and SMM).

A study on different types of moral courage and coping styles of clinical nurses: based on potential profile analysis

BackgroundIn professional ethics-related events, there are various unpleasant and complex ethical issues that require strong moral courage. Our aim is to identify and describe the potential categories of moral courage among nurses and to clarify the coping styles of nurses under different categories.MethodA cross-sectional study was conducted using three data collection tools: a self-designed general information questionnaire, a Chinese version of the Moral Courage Scale, and a Trait Coping Style Questionnaire. Three hundred fourteen nurses from a tertiary hospital in Heilongjiang Province, China, were analysed using potential profile analysis, descriptive analysis, and Mann-Whitney U test data.ResultThe latent profile analysis (LPA) results indicate that the two-profile model is the most suitable and supports the existence of two different moral courage profiles: the low moral courage group (60.51%) and the high moral courage group (39.49%), with a high relative entropy value (0.922). The results point to a good profile solution, and there are significant differences between the two profiles. The Mann-Whitney U-test results showed that the positive coping scores of the high moral courage group were significantly higher than those of the low moral courage group, and the negative coping scores of the high moral courage group were significantly lower than those of the low moral courage group.ConclusionOur results reveal the heterogeneity of moral courage in the nurse sample and indicate that nurses in the high moral courage group tend to choose positive coping styles, while nurses in the low moral courage group are more likely to develop negative coping emotions. This provides important significance and reference value for nursing managers, who can propose customised management plans based on the types of moral courage of the nursing community and the coping styles under different categories.

Enhancing Salt Stress Tolerance and Yield Parameters of Proso Millet Through Exogenous Proline and Glycine Betaine Supplementation

Proline (Pro) and glycine betaine (GB) act as significant osmoprotectants, potentially mitigating the detrimental effects of various abiotic stresses in plants. Given the growth-enhancing capabilities and other regulatory roles of Pro and GB, the current study was conducted to assess their function in imparting salt stress resilience in proso millet (Panicum miliaceum L). Proso millet plants were subjected to two levels of salt stress (S1 = 150 mM; S2 = 300 mM). Foliar applications of Pro (0.5 mM) and GB (0.5 mM) were provided under control and salt-stressed conditions at 10-day intervals twice. Compared to control conditions, plant growth, fresh and dry weight, leaf relative water content (RWC), SPAD value, and yield-contributing attributes noticeably decreased under salt stress. In contrast, plants supplemented with Pro and GB exhibited enhanced characteristics. Moreover, growth and yield parameters improved in salt-treated proso millet plants when supplemented with Pro and GB. These results suggest that the foliar application of Pro and GB can alleviate salt-induced oxidative stress in proso millet plants by modulating the antioxidative defense.&#x0D; Bangladesh Agron. J. 2023, 26(1): 75-83

Development of a Low-Cost Automated Hydrological Information System for Remote Areas in Morelia, Mexico

Measurement of meteorological variables is essential to assess and analyze extreme events, such as droughts and floods, and even more so when the purpose is to generate early warnings of such natural phenomena. Nowadays, several mechanisms can estimate climatic variables like precipitation and temperature. However, no device measures precipitation values in real-time and at a low-cost, much less are these installed in remote areas of difficult access. Therefore, an Automated Hydrological Information System was developed based on low-cost meteorological stations with two communication protocols, Wi-Fi and GSM. The devices are equipped with a self-sustainable power supply, including a solar panel and energy storage that can last for up to three cloudy days. The precipitation, temperature, and relative humidity values are sent to a database, where they are then processed and displayed on a web page, accessible for download. Users can easily access the data from an official application that redirects them to the website without the need for a computer or a mobile browser. Warning systems are feasible due to the use of IoT services such as ThingSpeak and Ubidots. Ultimately, they allow the analysis of information and immediately send alerts if it exceeds the tolerance ranges.

Surgical Team Structure: How Familiarity and Team Size Influence Communication Effectiveness in Military Surgical Teams.

Preventable patient harm has persisted in health care despite recent advances to reduce errors. There is increasing recognition that non-technical skills, including communication and relationships, greatly impact interprofessional team performance and health care quality. Team familiarity and size are critical structural components that potentially influence information flow, communication, and efficiency. In this exploratory, prospective, cross-sectional study, we investigated the key structural components of surgical teams and identified how surgical team structure shapes communication effectiveness. Using total population sampling, we recruited surgical clinicians who provide direct patient care at a 138-bed military medical center. We used statistical modeling to characterize the relationship between communication effectiveness and five predictors: team familiarity, team size, surgical complexity, and the presence of surgical residents and student anesthesia professionals. We surveyed 137 surgical teams composed of 149 multidisciplinary clinicians for an 82% response rate. The mean communication effectiveness score was 4.61 (SD = 0.30), the average team size was 4.53 (SD = 0.69) persons, and the average surgical complexity was 10.85 relative value units (SD = 6.86). The surgical teams exhibited high variability in familiarity, with teams co-performing 26% (SD = 0.16) of each other's surgeries. We found for every unit increase in team familiarity, communication effectiveness increased by 0.36 (P ≤ .05), whereas adding one additional member to the surgical team decreased communication effectiveness by 0.1 (P ≤ .05). Surgical complexity and the influence of residents and students were not associated with communication effectiveness. For military surgical teams, greater familiarity and smaller team sizes were associated with small improvements in communication effectiveness. Military leaders can likely enhance team communication by engaging in a thoughtful and concerted program to foster cohesion by building familiarity and optimizing team size to meet task and cognitive demands. We suggest leaders develop bundled approaches to improve communication by integrating team familiarity and team size optimization into current evidence-based initiatives to enhance performance.

Morphological differentiation in giant salamanders, Andrias japonicus, A. davidianus, and their hybrids (Urodela, Cryptobranchidae), and its taxonomic implications.

For a long time, it has been debated whether the two giant salamanders, Andrias japonicus from Japan and A. davidianus from China, are conspecific or heterospecific. Morphological information about their diagnostic characteristics has been limited, without considering sexual dimorphism and/or body size variation. Recently, A. davidianus, which was introduced into Japan sometime in the past, has been found to hybridize with A. japonicus in situ. Taxonomic identification of individuals involved in this unusual breeding is made based on mitochondrial and nuclear DNA analyses. This identification method is time-consuming and costly. Thus, developing easier methods of identification, such as utilizing external morphological characteristics, is urgently needed. In this study, we verify previous descriptions showing that A. davidianus has a longer relative tail length than A. japonicus, and the tubercles on the lower jaw and throat were present in both sexes of A. davidianus. In addition, many head characteristics were found to be relatively larger in A. davidianus than in A. japonicus, which were new distinguishing characters. These morphological differences help support the idea that these are heterospecific lineages. In hybrids, relative values of head width and tail length were larger than those of A. japonicus, and the tubercles on their lower jaw and throat were present as in A. davidianus, suggesting that the hybrids and A. davidianus are distinguishable from A. japonicus.