SPSS Software Research Articles

Oral health improvement and satisfaction among recipients of home-visiting oral health education

Objectives: In connection with government projects, the Gwangju medical welfare social cooperative launched the “Visit Oral Health Education Activities” as part of the Gwangju+ Gwangsan Integrated Care Service Project in 2023. This study aims to analyze the improvement in oral health and the level of satisfaction following home-visiting oral health education. Methods: A total of 51 participants who had undergone home-visiting oral health education more than seven times and agreed to participate were eligible for interviews. The data were analyzed using SPSS software. Results: As a result of oral environment improvement and satisfaction with home-visiting oral health education, the average satisfaction scores were 4.67 for educator attitude, 4.46 for educational activities, 3.82 for oral health improvement, and 3.55 for self-management attitude improvement. Satisfaction with oral health improvement showed a positive correlation with educators’ work attitude, satisfaction with educational activities, and improvement in self-management attitude. Conclusions: To improve satisfaction with home-visiting oral health education, the development of various educational programs and standardization of educator work manuals are necessary.

Prolonged ventricular activation time as a novel biomarker identifying burn-out phase of hypertrophic cardiomyopathy

Abstract Background Patients with hypertrophic cardiomyopathy (HCM) classically have preserved systolic function and decreased left ventricular end-diastolic volume. However, in a small sub-population, patients paradoxically develop systolic dysfunction, left ventricular dilatation, and ventricular wall thinning, which is known as end-stage hypertrophic cardiomyopathy or "burned-out cardiomyopathy’. Although an electrocardiogram (ECG) is a pivotal tool in HCM, its role in the detection of burned-out HCM has not been investigated. Purpose We assessed the ventricular activation time (VAT), an ECG marker of the duration of ventricular depolarization, as a predictive tool in the detection of the HCM burn-out phase. Methods We prospectively studied consecutive patients diagnosed with HCM via echocardiography at our medical center between 2017 and 2022. The ECG, along with echocardiography, was performed on the same day as the diagnosis. VAT was measured in milliseconds between the onset of the QRS complex to the peak or R wave on the V5 and V6 precordial ECG lead. HCM burn-out phase was supported when the left ventricular ejection fraction (LVEF) was below 50%, measured with echocardiography. Statistical analysis was performed using the SPSS software. Results Forty-five patients with HCM were studied, and their mean age was 51, while 78% (35/45) were male. Echocardiography data upon diagnosis revealed a mean maximum wall thickness of 19 (±3mm) and a mean left ventricular ejection fraction of 65% (±5%). Left ventricular outflow obstruction was present in 31% (14/45). During the study, 24% (11/45) presented atrial fibrillation, 44% (20/45) had an ICD implantation, and 22% (10/45) progressed to the burn-out phase of HCM. HCM patients who presented atrial fibrillation (63±31 vs. 46±14msec, p=0.018) or burn-out phase (65±32 vs. 46±13msec, p=0,009) had a significantly higher VAT than those subsets without. Notably, there was a significant positive relationship between VAT a burn-out phenotype (r=0,385, p=0.009). HCM patients with greater VAT also had a significantly higher risk of presenting a larger left atrial diameter (r=0,295, p=0.048), an increased left ventricular end-diastolic diameter (r=0.306, p=0.041), and a trend of presenting a lower LVEF (r=-0,262, p=0.082). Finally, we revealed a positive relationship between VAT and atrial fibrillation incidence (r=0,352, p=0.018). Conclusion Prolongation of VAT predicts the incidence of burn-out stage in patients with HCM and atrial fibrillation. Therefore, it seems to be a promising, inexpensive ECG marker for HCM progression and severity. Our findings emphasize the pivotal role of the ECG as a useful and inexpensive tool in the diagnostic follow-up of HCM.

Analysis on the Impact of English Teachers' Continuing Professional Development (CPD) on Teaching Ability: A Case Study of Applied Undergraduate Colleges in Henan Province

Background and purpose: With the rapid development of higher education in China and the rise of applied undergraduate colleges, the continuing professional development (CPD) of English teachers is becoming increasingly important. This study aims to explore in depth the impact of CPD on the teaching ability of English teachers in applied undergraduate colleges in Henan Province, analyse teachers' attitudes towards and participation in CPD and its effectiveness, and examine the role of demographic characteristics and teacher creativity in this process. Method: A mixed research method was used, combining quantitative and qualitative analysis. A questionnaire survey was conducted among 294 English teachers (with a 85.5% response rate) from 10 applied undergraduate colleges in Henan Province. The questionnaire included aspects such as teachers' background information, frequency of CPD participation, attitudes towards CPD, and perceived teaching ability. In addition, 20 semi-structured interviews and four focus group discussions (24 participants in total) were conducted to obtain more in-depth qualitative data. Descriptive statistics, correlation analysis and multiple regression analysis were performed using SPSS software, and Hayes' PROCESS macro was used to analyse moderated effects. Main results: Teachers had a generally positive attitude towards CPD (mean score 4.587/5), but institutional support was lower (mean score 3.326/5). There were significant differences in the frequency of participation in CPD activities: professional reading had the highest participation rate (65.9% participated frequently or very frequently), while industry-university cooperation had the lowest (only 22.8%). CPD had a positive impact on all aspects of teaching ability, especially technology integration (72.5% reported a significant or transformative impact). Multiple regression analysis showed that the frequency of CPD participation was the strongest predictor of perceived teaching ability (β = 0.458, p < 0.001), followed by attitude towards CPD (β = 0.265, p < 0.001). Teacher creativity significantly moderated the relationship between CPD participation and teaching competence (B = 0.087, p = 0.026), indicating that teachers with higher creativity are better able to translate their CPD experiences into teaching practice. Heavy workload (65.6%) and insufficient time (59.5%) were the main barriers to CPD participation. Technical training (64.9%) and reflective practice groups (59.2%) were the most popular types of CPD activities. Conclusions and recommendations: The findings of this study highlight the important role of CPD in improving the teaching capacity of English teachers in applied undergraduate institutions, while also revealing the challenges in the current implementation of CPD. Recommendations for educational institutions are as follows: Increase institutional support for CPD to create more time and resources for teachers to participate in CPD. Design a diversified CPD programme with a balanced mix of activities, with a particular focus on industry-university collaboration and action research. Focus on technical training and reflective practice to improve teachers' digital literacy and innovation capabilities. Develop personalised CPD pathways that take into account teachers' career stages, educational backgrounds and career aspirations. Explore more flexible CPD formats, such as microlearning modules or blended learning approaches, to overcome time and workload barriers. This study provides an empirical basis and practical guidance for the CPD of English teachers in applied undergraduate colleges in Henan Province and even in China, which is of great significance for improving teaching quality and student learning outcomes.

Histological Change of Placenta in Diabetic Pregnant Women in Comparison to Normal Pregnant Women

Background: The placenta is a foeto-maternal organ and its alterations is directly related to the disease’s length and severity. The human placenta experiences a number of functional and structural pathologic alterations when complicated by metabolic disorder such as diabetes mellitus. Methods: This cross-sectional comparative study was conducted over a period of threeyears from January 2019 to December 2021 at the Department of Anatomy, Rajshahi Medical College, Rajshahi, in collaboration with the Department of Obstetrics and Gynaecology, Rajshahi Medical College Hospital and Diabetic Hospital Rajshahi, Bangladesh. The study was carried out on 70 pregnant women, among them 35 diabetics and 35 non-diabetics. The fibrinoid necrosis, syncytial knot and immature villi of the placenta were studied in diabetic and non-diabetic pregnant women. SPSS software, version-24 was used for data analysis, with a p-value < 0.05 indicating statistically significance for all tests. Results: The diabetic and non-diabetic pregnant women groups were almost identical in terms of attachment of umbilical cord to placenta with marginal attachment being more often found in either group (p = 0.829). Histological examination of placenta showed that fibrinoid necrosis was common in placenta of diabetic mothers than that of the normal mothers (p < 0.001). Syncytial knot and immature villi were higher in the former group than those in the latter group, here p values were also less than .001. Conclusion: Histological findings (fibrinoid necrosis, syncytial knot and immature villi) were more in placenta of diabetic mother and they were highly significant different between the groups. EWMCJ Vol. 12, No. 1&2, January-July 2024: 27-33

One year incidence of events after definite coronary stent thrombosis: a retrospective vs prospective comparison and a conglomerate determination of prognostic factors of mortality

Abstract Background Although many studies analysed the predictive factors of coronary stent thrombosis (ST), there are few data on prognostic factors of clinical outcomes after definite ST. The purpose of the current study was to analyse clinical presentation and outcomes at one year after definite coronary ST in two distinct cohorts: a retrospective cohort and a prospective cohort and to determine the prognostic factors. Methods Among 22’039 consecutive patients treated between January 2008 and December 2021, 275 patients presented a definite ST and were included in this study (retrospective cohort n=83 and prospective cohort n=192). Baseline characteristics, clinical ST presentation and 1-year outcomes were analysed between the two cohorts using SPSS Software. According to the obtained results data of both cohorts were pooled and prognostic factors of clinical outcomes determined using multivariate analysis. Results There was no statistical difference between the two cohorts concerning baseline characteristics and clinical ST presentation. All-cause mortality and MACE rate up to 1 year follow-up did not differ either among cohorts (16.9% vs 14.6%, p=0.764 for mortality (Figure 1) and 26.5% vs 24% p=0.766 for MACE). Multivariate analysis of the aggregated data of both prospective and retrospective cohorts revealed age (OR: 1.05 95% CI [1.02;1.09]; p=0.0016), early stent thrombosis (OR: 3.3 95% CI [1.52;7.15] p=0.002), severe renal failure (OR: 3.37 95% CI [1.35;8.42] p=0.009), clinical presentation (cardiogenic shock [OR: 2.92 95% CI {1.17;7.28} p=0.02] and cardiac arrest [OR: 15.3 95% CI {6.62;35.39} p<0.0001]) as strongly associated with a higher risk of death at 1 year whereas higher LVEF was a protective factor (OR: 0.922 95% CI [0.891; 0.955] p<0.0001). Conclusion Comparing retrospectively collected data versus prospectively collected data for definite ST showed very similar data concerning qualitative variables (e.g. baseline characteristics and clinical presentation of ST) suggesting feasibility of data pooling to determine prognostic factors of clinical outcome at one year. Prognostic factors influencing one-year all-cause mortality were age, early ST thrombosis, renal failure, residual LVEF and clinical presentation.Figure 1

Use of ChatGPT and Generative AI in Higher Education: Opportunities, Obstacles and Impact on Student Performance

A generative form of Artificial Intelligence now pervades all domains. Artificial intelligence technologies, especially ChatGPT, are increasingly prevalent in a multiplicity of fields, especially in education. This study investigated the impact of generative AI usage on student outcomes, analyzed usage patterns of ChatGPT and highlighted the challenges and advantages of integrating ChatGPT in higher education. Employing the descriptive survey method, the study's sample comprised graduate and post graduate students from Govt. Sadiq College Women University Bahawalpur, totaling (354) participants. Data collected through self-structured, closed-ended questionnaire was analyzed using SPSS software. Descriptive statistics along with correlation analyses and one-way ANOVA were used to analyze the data. The findings indicated ChatGPT is used by 51% students regularly and perceived as an effective way to rapidly complete academic tasks, provide personalized tutoring and provide 24/7 accessibility and alternative strategies, by most participant but they believe that over reliance on ChatGPT, limits student’s exploration capabilities, critical thinking and academic honesty.

Workshops: Enhancing communication for nursing students with patients with hearing disabilities

Abstract Background Nursing students need guidance on effective communication strategies for interacting with patients with hearing disabilities, emphasizing the importance of addressing this gap in their education as future healthcare professionals. Methods A cross-sectional survey was conducted among nursing students at seven institutions before and after workshops led by guides with hearing disabilities from a non-profit organization Ma’agalei Shema and funded by the National Insurance Institute. Data was collected from 2023 to March 2024 and analyzed using SPSS software. Results 279 participants completed the survey before the workshops. and 136 responding afterward. Almost 80% were female. Before the workshops, 68.46% of students expected to gain communication tools for patients with hearing disabilities. About one-third believed the healthcare system offers accessible treatment to these patients, while only 22.22% foresaw no barriers. One-third reported no clinical contact with such patients. Among those who did, lip-reading (25.53%), writing (17.73%), assistance from family members (15.6%), and sign language (9.22%) were commonly used. Only 2.84% used professional sign language interpreters, and 20.57% reported never meeting a patient with hearing disabilities (8% reported “other”). Post-workshop surveys showed that around 82.48% of participants felt the workshops would significantly enhance their communication skills with such patients, with only 5.11% reporting a lack of practical tools received. Conclusions Practical workshops can significantly enhance communication skills and improve patient care. This study underscores the potential impact of minor adjustments in communication strategies on patient care, such as increasing the use of professional interpreters. Main messages: Providing training to nursing students in effective communication with these patients can streamline interactions, diminish reliance on family intermediaries, and enhance medical care. Key messages • Nursing students need guidance on communicating with patients with hearing disabilities to improve future healthcare interactions. • Practical workshops enhance communication skills, stressing the importance of minor adjustments for better patient care.

Effects of a multidisciplinary program with physical exercise in pediatric obesity

Abstract Background Childhood obesity is a growing public health concern worldwide, with prevalence rates increasing in recent decades. This epidemic not only predisposes children to immediate health risks such as cardiovascular disease and musculoskeletal problems but also significantly increases their risk of obesity-related comorbidities in adulthood. Recognizing the multifactorial nature of pediatric obesity, interventions targeting lifestyle modifications are crucial to its control. Among these interventions, physical exercise emerges as a cornerstone in combating pediatric obesity. Purpose Our study examines the effectiveness of a twelve-week online physical exercise program on body composition and functional capacity in children and adolescents with obesity. Methods The sample consists of 30 participants (9 girls and 21 boys, aged 11-17 y) from the Pediatrics Department of Senhora da Oliveira Hospital in Guimarães (HSOG). Using standardized protocols, anthropometric measures (body weight and waist circumference) were measured. Functional capacity was assessed through squats, push-ups, and elbow plank tests (maximum repetitions in 60 seconds). All analyses were done using SPSS software, and the alpha level was 5%. Results Significant impacts of the exercise program were observed in body weight and waist circumference variables. Multivariate tests indicated a statistically significant interaction between the Moment*Groups factors (weight p = 0.040; waist circumference p = 0.007). Moreover, functional capacity was also influenced by the exercise program (squat p = 0.034; push-ups p = 0.013; and elbow plank p = 0.025). Conclusions Our results underscore the significant public health impact of integrating physical exercise into a multidisciplinary program for pediatric obesity. Innovative use of online interventions facilitated broader reach and accessibility, resulting in measurable improvements in body weight, waist circumference, and functional capacity among participants. Key messages • Integrating exercise into multidisciplinary programs improves pediatric obesity outcomes. • Online interventions broaden accessibility and effectiveness in preventing childhood obesity.

Association of polymorphism of apolipoprotein e gene with acute myocardial infarction and its short term clinical outcome

Abstract Background/Introduction Myocardial infarction (MI) is a multifactorial disease influenced by environmental and genetic factors. Apolipoprotein E (ApoE) is a protein incorporated into serum lipoproteins directing their catabolism via binding to receptors. It is a structural component of both chylomicrons and very low density lipoprotein (VLDL) remnants. ApoE is thought to play a central role in atherosclerosis by participating in overall plasma cholesterol homeostasis. In addition to other classical risk factors, positive family history of cardiovascular disease (CVD) has been found to be significantly and independently associated with MI in epidemiological studies (1). Besides traditional cardiovascular risk factors it is likely that additional genetic factors like ApoE gene polymorphism may interact with environmental factors to determine overall cardiovascular risk of an individual to develop MI. Purpose The purpose of our study was to determine the risk of association of variants of ApoE gene with Acute Myocardial Infarction. Moreover, we also wanted to study the impact of ApoE gene polymorphism in short term major adverse cardiac events (MACE) in patients with MI not willing for coronary intervention. Methods In this case control study a total of 200 consecutively admitted AMI patients admitted to the coronary care unit of our hospital were enrolled to the study along with 200 age and gender matched controls admitted during the same time period . ApoE gene polymorphism was detected by DNA extraction, DNA amplification by PCR in a DNA thermal cycler followed by restriction enzyme digestion(2). Chi square test was used to investigate the difference in genotype and allele frequencies in casend controls and also between observed and expected frequencies in the realm of Hardy-Weinberg equilibrium. Odds Ratio (OR) with 95 % confidence interval and p values were calculated while analysing the association of different genotypes of ApoE genetic polymorphism with the disease and MACE. Logistic regression analysis was carried out amongst the groups under consideration to find the unadjusted OR and adjusted OR of the genotypes in relation to the disease.p<0.05 was considered as significant Analysis was done in SPSS software. Results Besides the traditional risk factors Apo E4 allele (OR 2.298, CI 1.305-4.044 ) and Apo E3/E4 genotype (OR 2.116, CI 1.008-4.443, p=0.048) showed strong of association with the disease. There was a higher population of Apo E3/E4 genotypes and Apo E2/E3 genotypes with MACE events (25.6% and 28.6%), while the common ApoE3/E3 genotypes had a MACE event of 10.5 %. However, the difference was not significant (p=0.071, Χ 2 =8.63 df =4). Similarly, ApoE4 allele showed a non significantly higher MACE events (p=0.22, Χ 2 =3.01 df =4) Conclusion ApoE4 allele and ApoE3/E4 genotype are strongly and independently associated with AMI.RISK FACTORS AND RISK OF MIGenotype and MACE

The Impact of Smoking and Lifestyle Factors on Hair Transplant Outcomes in Patients with Androgenic Alopecia

Background: Hair transplantation is a popular treatment for androgenic alopecia, a common form of hair loss that significantly affects self-esteem and quality of life. However, it is important to note that smoking can potentially have a detrimental impact on the efficacy of this procedure. Objectives: The objective of this study is to examine the influence of smoking, alcohol consumption, and water pipe usage on hair density and growth rate in individuals with alopecia who have undergone hair transplantation at the Jordan Clinic in Tehran, Iran. Methods: A retrospective analysis was conducted on 23 smoker and 97 non-smoker patients who underwent hair transplantation at the Jordan Clinic between 2011 and 2013. A convenience sampling method was employed in the study. Data on smoking status, hair growth, and complications were collected and analyzed. The study included 94.2% male and 5.8% female patients. Data analysis was performed using SPSS software, version 13. The repeated measures ANOVA test was used for statistical analysis, with a significance level of five percent. Results: The results showed that smokers experienced spontaneous bleeding at the implant site after surgery, resulting in hairless areas following crust formation, a complication not observed in non-smokers (P > 0.05). Smokers also had significantly lower hair density and growth compared to non-smokers (P > 0.05). Additionally, alcohol users demonstrated significantly less hair growth than non-drinkers. Conclusions: Smoking—including cigarettes, hookah, and combined smoking—and alcohol consumption negatively impacted hair transplant outcomes in patients with androgenic alopecia treated at the Jordan Clinic. These findings underscore the importance of addressing lifestyle factors, such as smoking and alcohol consumption, in the management of androgenic alopecia and hair transplantation.

Hospital and one-year outcomes following a hypertensive urgency or emergency: a major challenge

Abstract Introduction Hypertension is an important issue, and recommendations are constantly evolving based on the latest research findings and directions. Hypertensive emergencies are defined as a severe elevation of blood pressure associated with organ damage. End organ damage was defined as the presence of one of the following findings: encephalopathy, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, acute heart failure, acute coronary syndrome, or aortic dissection. Furthermore, malignant hypertension is a HE characterized by small artery fibrinoid necrosis in the kidney, retina and brain. All these definitions are confusing, but what about their evolution? Objective:The present study aims to analyze the mortality in the short and long term (12months), the survival of the hypertensive patients, the frequency of malignant hypertension and hypertensive retinopathy. Methods For this purpose, we conducted a prospective study including all patients who followed or were diagnosed with hypertension and admitted to the emergency department for hypertensive urgency/emergency, from January to March 2023; after that, we studied the evolution of these patients for one year until January 2024. Demographic data, disease history, blood pressure, clinical presentation on admission, target organ involvement, ophthalmological examination and evolution during hospitalization were studied. Statistical analysis was performed using SPSS software. Preeclampsia and chronic renal failure were excluded.Result: Our work brought together 300 patients, mainly female, with an average age of 63.4. One hundred fifteen were admitted for HE and 185 for HU. The most common presenting symptoms at admission were headache, focal neurologic deficit and dyspnea. Malignant hypertension was identified in 9 patients based on optical coherence tomography angiography by identifying subclinical microvascular damage, and investigation is still in progress searching for hypertensive retinopathy grade III-IV Keith-Wagner in the second group. Patients were mainly hospitalized for hypertensive emergencies. Regarding their therapeutic management, except for the acute lowering of blood pressure in stroke, there was no consensus initially; ideally was to determine which organs are affected to assess the need for specific intervention other than lowering blood pressure. Overall, 49 had died from HE n=44/115(vs n=5/185 for HU). Of these, 33 have died at the Hospital (mortality was higher for HE and attributable to neurovascular emergencies rather than cardiovascular emergencies) and ten at 12 months. Conclusion Properly managing patients who come to the Emergency Department for BP elevation faces many difficulties. Can we still talk about hypertensive emergencies/urgency, discuss retinal lesions, and the importance of hypertension monitoring? However, all those definitions can be potentially life-threatening; these results justify better follow-up and treatment for these patients.

Knowledge, Attitude and Practice Regarding Use of ORS in Diarrhoea by Mothers in an Island of Bangladesh

Introduction: The second leading cause of death in under-five children is diarrhea. ORS is a simple and highly effective therapy for managing diarrhea. However inappropriate knowledge of preparation and lack of use of ORS leads to health hazards including increased rate of mortality and morbidity. So aim of this study to assess the knowledge, attitude, and Practice of mothers towards the use of oral rehydration solution in the treatment of acute diarrhea in children. Methods: A cross-sectional study was carried out over eight months (1st May to 30th December 2023) among 510 mothers who had children of six months to five years and had recent episodes of diarrhea. Data were collected by using a semi-structured questionnaire in face-to-face interview. Data were analyzed by using SPSS software program.Results: Among 510 mothers, 47.05% were 20-30 years old, 29.80% were below 20 years and 23.13% were over 30 years. One fourth of them had no institutional education and 36.27% had primary, 20.78% and 18.23% had secondary and tertiary level of education respectively. 40.39% were from lower socioeconomic condition, 31.97% were from middle and 27.64% from upper socioeconomic condition. 100% of family used sanitary latrine though 73.72% use safe drinking water as a preventive part of diarrhea.89.98% of mother was aware about ORS but only 75.88% used ORS in recent episode of diarrhea, among them 63.03% prepared ORS correctly and 60.98% used adequate amount. Age of mothers was not corresponds with the correct preparation and practice of ORS but socioeconomic condition and level of education carried statistically significant value. Conclusion: Knowledge and practice of ORS preparation and used of ORS in recent episode of diarrhea among the mother was unsatisfactory. Improve the Maternal education and socioeconomic status will improve ORS correct preparation and use. Mothers should be taught the importance of optimal use and correct preparation of ORS in diarrhea. EWMCJ Vol. 12, No. 1&2, January-July 2024: 43-49

Investigating the Relationship between Emotion Regulation Strategies and Anxiety Caused by COVID-19 in Employees of Rehabilitation Centers

Background and Objectives: In the current situation, it is essential to determine the level of anxiety in medical and non-medical employees due to the pandemic. Therefore, this research aims to assess the relationship between corona anxiety, emotion regulation strategies, and stress tolerance among the staff of rehabilitation centers in Tehran Province, Iran. Methods: This study was descriptive, cross-sectional, and correlational. The statistical population of the present study included the entire staff of rehabilitation centers served by the Welfare Organization of Tehran Province in 2022. Using simple random sampling, 10 rehabilitation centers were selected as study centers. Subsequently, 200 employees of these centers were selected and tested using Morgan’s sampling table (the male age of the participants was 31.5 years). The data collection instruments included the corona disease anxiety scale, the emotional distress tolerance questionnaire (2005), and the March emotional self-regulation strategies scale (2007). Data were analyzed by SPSS software, version 26. Results: The results showed that the mean of corona anxiety was 18.94 out of a maximum of 54 and the proportion of psychological symptoms of corona anxiety was higher than physical symptoms. The highest score from the participant’s point of view from dimensions of distress tolerance was assigned to the subjective assessment of distress. The mean score for distress tolerance was 52.68 out of a maximum of 75 points and the mean score for employees’ emotion regulation strategies was 134.37 points, which shows that the use of emotional self-regulation strategies is strong. The results of the current research showed that corona anxiety decreases significantly by increasing distress tolerance, absorption of negative emotions, regulation of efforts to relieve distress and distress tolerance, and corona anxiety also decreases significantly. Also, with the increase in the level of emotion regulation strategies, the anxiety of corona decreases significantly. Distress tolerance showed a negative correlation with corona anxiety, and with the improvement of distress tolerance, corona anxiety decreased (P=0.014). Conclusion: Based on the results, increasing and improving distress tolerance and emotional regulation strategies significantly reduced corona anxiety. Also, the experiences and work of experts with more work experience alongside the younger and less experienced forces and their cooperation prepared the ground to reduce the effects of corona anxiety, as well as to improve the level of stress tolerance and emotion regulation strategies of employees.

Comparative analysis of muscle sympathetic nerve activity in patients afflicted with orthostatic hypertension versus conventional hypertension

Abstract Introduction Standing places a significant hemodynamic burden on the cardiovascular system. In healthy individuals, neurohumoral reflex mechanisms, particularly the arterial baroreflex, maintain blood pressure during standing. However, in some cases, the counterregulatory response can be excessive, resulting in a condition known as orthostatic hypertension (OrthoHT), which appears to be linked to an increased cardiovascular risk. Epidemiologically, orthostatic hypertension has been reported in 5-30% of hypertensive patients. Furthermore, in recent years, it has garnered attention as a responder group in renal denervation therapy. Purpose In hypertensive patients, sympathetic hyperactivity is expected to exacerbate cardiovascular risk. However, the relationship between OrthoHT and sympathetic nerve activity remains poorly understood. This study aims to assess the differences in sympathetic nerve activity between OrthoHT and conventional hypertensive patients using muscle sympathetic nerve activity (MSNA) measurements. Methods We conducted an examination of hypertensive patients undergoing drug treatment at our clinic between April 1, 2023, and June 30, 2023, to identify cases of OrthoHT. Only patients with essential HT were included in the HT group; patients diagnosed with secondary HT were excluded. HT patients with other active CV diseases (i.e., symptomatic cerebral/coronary artery diseases or heart failure) and/or severe renal dysfunction (estimated glomerular filtration rate <30 mL/min/1.73 m2) were also excluded. OrthoHT was defined as a sustained increase in systolic blood pressure ≥20 mmHg and/or diastolic blood pressure ≥10 mmHg within 3 minutes of standing. MSNA was recorded from the left peroneal nerve using a tungsten microelectrode at supine position. We measured MSNA in the cases for which consent was obtained. Statistical analyses were performed using SPSS software. Results Among the 183 cases, 31 were diagnosed with OrthoHT, and 7 of them consented to MSNA measurement. Of the 11 cases of hypertensive patients who consented, two groups were well age-matched. We assessed body mass index, resting systolic blood pressure, diastolic blood pressure, heart rate, blood glucose level, creatinine, cholesterol, brain natriuretic hormone, and ejection fraction measured by echocardiography, but found no significant differences between the two groups. OrthoHT patients exhibited elevated MSNA burst frequency (28.3 +/- 5.7 vs. 38.4 +/- 12.2 bursts/min, P < 0.05) and burst incidence (44.6 +/- 11.1 vs. 61.1 +/- 21.3 bursts/100 heartbeats, P < 0.05) at rest. Conclusions OrthoHT is associated with sympathetic hyperactivity compared to normal hypertensive patients, contributing to an increased cardiovascular risk.

The contribution of iron metabolism to heart failure: a haematological and biochemical perspective

Abstract Introduction Heart failure (HF) can be influenced by diverse modulators, such as genes involved in iron metabolism - HFE, SLC40A1 and TMPRSS6, and haematological and biochemical parameters - serum iron, ferritin, transferrin saturation, mean corpuscular volume (MCV) and Red Cell Distribution Width (RDW). Objectives To investigate the association of genetic variants in the HFE gene [C282Y (rs1800562) and H63D (rs1799945)], SLC40A1 (rs1439816 and rs2304704) and TMPRSS6 (rs855791) with haematological parameters and biochemical biomarkers of iron metabolism in HF and in its various forms of presentation [preserved Ejection Fraction-HFpEF and non-preserved Ejection Fraction-HFnpEF (middly reduced + reduced)], in each sex. Methods 301 individuals with HF were studied (141 men and 160 women), with a median age of 80 years (min=31 and max=99) and a median body mass index (BMI) of 25.90 kg/m2 (min=16.50 and max=47.30). Multiplex PCR-ARMS technique was used to analyze the HFE gene variants (C282Y and H63D) and Endpoint Genotyping was used for the remaining variants. Statistical analysis was carried out using SPSS software, version 28.0, with a statistical significance level of p<0.05. Results The presence of indicators of iron deficiency anaemia was verified in the haematological and biochemical parameters in our population of HF. Significant differences were found in serum iron values in the presence of the mutant allele for the three genes studied: 1)in the H63D (p=0.006) for females, and more particularly in females with HFnpEF (p=0.020); 2) in the rs1439816 for males (p=0.035) and more particularly in males with HFpEF (p=0.036); and 3) in the rs855791 for males (p=0.018). As for ferritin, significant differences were found in the presence of the mutant allele for the rs2304704 (p=0.001) in females. For transferrin saturation, significant differences were found in the presence of the mutant allele for the three genes studied: 1) in the H63D (p=0.013) for females, more specifically in females with HFpEF (p=0.043); 2) in the rs1439816 in males (p=0.037); and 3) in the rs855791 in females (p=0.034), particularly in females with HFpEF (p=0.023), and in males (p=0.032), particularly in males with HFpEF (p=0.037). Analyzing the MCV, there were statistically significant differences in the presence of the mutant allele for the rs2304704 (p=0.012) in females, particularly in those with HFpEF (p<0.001). Regarding RDW, significant differences were found in the presence of the mutant allele of the C282Y polymorphism in females with HFpEF (p=0.048). Conclusion Ferropenic anaemia highly prevalent in this population with HF. All the genes analyzed contribute to the modulation of the analyzed parameters/biomarkers, however, the SLC40A1 gene showed greater modulating capacity. Genetic modulation was more relevant in HFpEF women, suggesting that this sex is the most susceptible to genetic modulation.

Does digitalization drive sustainable transformation in finance and accounting?

PurposeThis paper investigates the interplay among Finance-Accounting Digitalization (FAD), Advanced Finance-Accounting System (AFAS) and Accounting 2.0 and FinTech (AFT). It aims to elucidate how FAD impacts the adoption of AFAS, the evolution of AFT, and the ensuing sustainable evolution of finance and accounting practices.Design/methodology/approachA comprehensive survey was conducted from 2021 to 2023, involving 500 companies in Kosovo, spanning various sectors and sizes. The data were meticulously analyzed using SPSS and AMOS software, using structural equation modeling (SEM) to assess hypotheses, model fit and direct and indirect effects.FindingsSignificant relationships emerged between FAD, AFAS and AFT, highlighting the importance of computerized financial and accounting systems, the role of AFAS in achieving financial goals and the accessibility and adaptability of accounting data. In particular, the SEM analysis underscored a robust positive correlation between FAD and AFT, highlighting the transformative potential of digitalization. In addition, AFAS as a technological solution facilitates sustainability and operational efficiency. These findings provide crucial insights for future research and advocate for the use of digitalization to improve the efficiency of financial management.Research limitations/implicationsThe research is constrained by its focus on Kosovo’s companies, potentially limiting generalizability. Additionally, the study’s reliance on survey data might introduce response bias.Originality/valueThis research contributes to the literature by delineating the intricate relationships between FAD, AFAS and AFT, shedding light on their implications for financial and accounting practices. It underscores the transformative value of digitalization in these domains, offering novel perspectives for academic and managerial discourse.

The association between low serum vitamin D level & periodontal diseases in Bangladeshi population- An observational study

Aims: Bangladeshi population (20-45 age) presents early loss of tooth without any history of systemic disease. Low serum vitamin D level is one of the factors of early tooth loss. The aim of the study is to assess the significance of low or insufficient serum vitamin D level as a factor of early tooth loss in Bangladesh perspective. Materials and Methods: An observational study was performed in dental unit of TMSS Medical College from January 2021 to December 2022 after ethical clearance of IRB of this institute. Total number of patients was 70 selected by non-random sampling (judgment sampling) who fulfilled the inclusion and exclusion criteria. We assessed the variable like gingivitis, periodontal pocket & tooth mobility clinically. The depth of the periodontal pocket & gingivitis was assessed by the periodontal probe & the mobility by using a blunt instrument & feel with the fingers before & after Vit D supplementation. Data were processed and analyzed using computer software SPSS version 26.0. Results: Deficiency of low serum vit D level has significant effect on periodontal bone resorption and after correction of serum vit D level resulted clinical improvement on periodontal health. Conclusion: Vitamin D deficiency may place subject at risk of developing chronic periodontitis. J Bangladesh Coll Phys Surg 2024; 42: 363-367

Predictive factors for recurrent tricuspid regurgitation after tricuspid annuloplasty: 3D echocardiography study

Abstract Introduction There is growing concern about the recurrence of tricuspid regurgitation (TR) after tricuspid annuloplasty (TA) in individuals with functional tricuspid regurgitation (FTR). While TA is effective in treating FTR, a comprehensive understanding of the echocardiographic factors influencing TR recurrence is crucial. Aim This study aims to employ multivariate regression analysis to investigate the prognostic significance of tricuspid valve (TV) geometry and echocardiographic parameters associated with both RV geometry and function. The focus is on comprehending these relationships in the context of recurrent TR subsequent to TA. Methods This prospective observational cohort study aimed to explore factors contributing to recurrent tricuspid regurgitation (TR) after tricuspid annuloplasty (TA). The focus was on patients with moderate or severe functional TR due to left heart valvular disease, particularly severe mitral regurgitation, excluding those with ischemic heart disease. The cohort included 66 individuals undergoing preoperative assessments with 2D and 3D echocardiography, quantifying RV and right atrial (RA) geometry, functional, and tricuspid valve (TV) parameters. TR severity followed ESC guidelines. Patients were categorized into effective TA (50 patients) and recurrent TR (16 patients) groups, defined by mild-moderate TR and significant moderate-severe TR one year post-surgery, respectively. SPSS software facilitated statistical analysis, with adjusted logistic regression considering parameters such as age and gender. Results Among the patients (54% male, mean age 68±9 years), no significant differences were found in gender, left ventricular and atrial parameters, or preoperative TV orifice area between groups (recurrent TR vs. effective TA: 38 [33] mm2 vs. 29 [15] mm2, p=0.117). Univariate logistic regression analysis identified Septal-Lateral Systolic TA Diameter (OR 1.62), Septal-Lateral Diastolic TA Diameter (OR 1.99), and Major Axis Diastolic TA Diameter (OR 1.59) as key predictors. For diagnostic efficacy, ROC analysis revealed Major Axis Diastolic TA Diameter (AUC 0.848; cut-off 52.5 mm), TV Leaflet Tenting Volume (AUC 0.778; cut-off 5.1 ml), and RV Basal Diameter (AUC 0.763; cut-off 47.5 mm) as the most predictive parameters. The combined use of predefined RV basal diameter and Major Axis Diastolic TA Diameter showed the highest odds ratio for recurrent TR. Conclusion Key predictors, including Septal-Lateral Systolic and Diastolic TA Diameters, and Major Axis Diastolic TA Diameter, were identified, emphasizing their significance in understanding TR recurrence after tricuspid annuloplasty. The combination of predefined RV basal diameter and Major Axis Diastolic TA Diameter showed the highest odds ratio for recurrent TR, offering valuable insights for clinical assessment and preventive strategies.

Cross-sectional study of bystander roles in school bullying incidents in the United Arab Emirates

Abstract Background School bullying is a widespread public health issue with far-reaching consequences on the psychological well-being and academic performance of students. This study focuses on the perspective of bystanders to better understand their role in the dynamics of bullying in school environments in the United Arab Emirates. Methods We employed a multi-stage random sampling approach to collect data from students in grades 6 to 9 at the sample of public and private schools in Al Ain, using a validated self-report questionnaire. IBM SPSS software version 28.0 was used for the analysis using appropriate statistical tests. Results Out of 728 surveyed students, 290 (40%) were from private and 438 (60%) from public schools. A total of 425 (58%) of students were bystanders observing bullying incidents across all schools, with 65% of males versus 45% of females witnessing such events. Physical bullying was the most frequent type of bullying observed by 67% of students. The classroom was most often location, 75% in private schools and 61% in public schools. Verbal abuses such as making fun and name-calling were commonly reported. Bullying targeting physical appearance was particularly noted, with 31% of bystanders stating that bullying was due to perceptions of a student’s face being ‘funny’ and 21% due to beliefs about weight. 59% felt sad, and 29% didn’t go to school as a result of the bullying. Reporting to teachers was limited (25%). Conclusions The high prevalence of bystanders in school bullying incidents in Al Ain was observed, especially among male students. The results emphasize the critical need for comprehensive anti-bullying programs that include bystander intervention strategies to promote a supportive and inclusive educational environment. Key messages • Many of students are witnessing bullying, highlighting the need for effective intervention programs. • Empowering bystanders is crucial in preventing bullying and enhancing the safety at schools.

Prognostic preoperative factors for recurrence of tricuspid regurgitation following annuloplasty: examining the influence of 3d echocardiography

Abstract Introduction The increasing worry revolves around the reappearance of tricuspid regurgitation (TR) following tricuspid annuloplasty (TA) among individuals dealing with functional tricuspid regurgitation (FTR). Despite TA's efficacy as a treatment, a complete understanding of the echocardiographic elements influencing the recurrence of TR is pivotal. This knowledge holds the potential to guide the development of more robust preventive strategies, aiming to ease the incidence of recurrent TR after TA. Aim The aim of this study was to examine the prognostic value of tricuspid valve (TV) and echocardiographic parameters related to both right ventricular (RV) geometry and function. Specifically, our focus is on understanding these relationships in the context of recurrent TR following TA. Methods This prospective observational cohort study aimed to investigate determinants of recurrent TR post-surgical TV repair. The focus was on patients with moderate or severe functional TR related to left heart valvular disease, primarily severe mitral regurgitation, excluding those with ischemic heart disease. The study involved 66 participants, assessed preoperatively with 2D and 3D echocardiography, examining RV and right atrial (RA) geometry, functional, and TV parameters. TR severity followed ESC guidelines. Two groups were formed: effective TA group (50 patients) and recurrent TR group (16 patients), defined by mild to moderate TR and significant moderate-severe TR one year post-surgery, respectively. Statistical analysis employed SPSS software, with adjusted univariate logistic regression considering age and gender. Results Of the patients, 54% were male, with a mean age of 68±9 years. Echocardiography parameters in Table 1 showed no significant differences in gender, left ventricular, atrial geometrical, functional parameters, or preoperative effective regurgitant TV orifice area between groups (recurrent TR vs. effective TA: 38 [33] mm2 vs. 29 [15] mm2, p=0.117). Univariate logistic regression analysis highlighted RV and RA geometry, along with TV diameter, as predictors for recurrent TR. Notably, 3D TV geometrical parameters had prognostic significance, as confirmed by univariate adjusted logistic regression analysis. Functional RV parameters did not exhibit statistical significance in this analysis. Conclusion In conclusion, the recurrence of moderate-severe functional tricuspid regurgitation following tricuspid annuloplasty is linked to the tricuspid annulus size, as well as the geometry of the right atrium and right ventricle before surgery. Notably, no correlation was identified between the recurrence of TR and alterations in RV function.