Usage Rate Research Articles

Closing the gap: addressing telehealth disparities across specialties in the sustained pandemic era

Missed appointments, or no-shows, disrupt healthcare delivery, exacerbating chronic disease management and leading to worse health outcomes. Telehealth has surged as a viable solution to reduce no-shows and improve healthcare accessibility, especially during the COVID-19 pandemic. However, telehealth disparities and its long-term efficacy across various medical specialties remain understudied. To address this, we performed a retrospective analysis of electronic health records from a heterogenous network of hospitals in Illinois, examining telehealth use and no-shows across among 444,752 adult patients with 1,973,098 outpatient encounters across nine specialties during the sustained pandemic phase (i.e., January 1, 2021 to July 1, 2022). Among them, 84,290 (4.27%) were no-shows, and telehealth constituted 202,933 (10.3%) of the total encounters. Telehealth use during the sustained phase varied significantly by specialty type. Overall, telehealth encounters were associated with reduced no-show odds compared to in-person encounters (OR, 0.28; 95% CI, 0.26–0.29). Black and Hispanic patients, as well as those with Medicaid, had higher no-show odds relative to their counterparts, even when using telehealth. Mental health specialty had the highest telehealth usage rate and the highest no-show odds (OR, 2.99; 95% CI, 2.84–3.14) relative to other specialties included in the study. Moreover, specialty type had differential effects on no-shows for telehealth. These results underscore the variability in telehealth use by specialty type and pervasive disparities telehealth use and no-shows. As we move beyond the pandemic, our findings can inform policymakers to tailor policies and incentives to reach different patient groups as well as specialties, with varying needs, to promote equitable telehealth utilization.

The Association of Sociodemographic Factors and Utilization of Diabetes Technologies with Diabetes Management: An Investigation in Children and Adolescents with Type 1 Diabetes.

We aimed to investigate the relationship between sociodemographic and clinical characteristics, as well as the utilization of diabetes technologies, with diabetes management in individuals with type 1 diabetes (T1D). Our study included 134 cases diagnosed with T1D who were followed for at least 1 year with T1D. Of the cases, 67.2% were using insulin pens as their insulin regimen, while 37.8% were using insulin pumps. The rate of continuous glucose monitoring (CGM) usage was 29.9%. The rate of CGM usage was 5% in families with low income levels. Glycosylated hemoglobin A1c(HbA1c) level of children with working mothers was found to be higher compared to those with non-working mothers (median 9.2% vs. 8%; P = .009). Cases with 3 or more siblings had higher HbA1c levels compared to those with 2 or fewer siblings (median 8.7% vs. 8.1%; P = .044).The median HbA1c was 8.7% in cases using insulin pens and checking fingerstick blood glucose (SMBG); 8.3% in cases using insulin pumps and SMBG; 7.6% in cases using insulin pens with CGM, and 7.5% in cases using insulin pumps with CGM (P = .003). The utilization of insulin pumps with CGM in T1D cases exhibited lower HbA1clevels. Similarly, even the usage of insulin pens with CGM demonstrated improved diabetes management. Maternal employment and having a higher number of siblings may negatively affect diabetes management due to increased caregiver burden. We believe that personalized healthcare delivery tailored to the individual needs of T1D patients based on family and clinical characteristics could have positive effects on diabetes management.

A comprehensive analysis of contraceptive safety: Implications for gynecological health and education levels

The use of contraceptives is essential for lowering the net reproduction rate and stabilizing population growth. Developing countries are characterized by high birth rates and rapid population growth. With lower contraceptive usage rates among eligible couples and resistance towards family planning methods, achieving population stabilization seems challenging. Therefore, this study aims to study the effects of various contraceptive methods on gynecological health and their safety profiles, The present observational study, was conducted in Department Obstetrics and Gynaecology at tertiary health care centre, Panjab, India. A total of 450 women were evaluated with the help of a pre-designed and pre-tested questionnaire to address knowledge, awareness, and perception of contraception among the rural and urban population in Punjab. The data were collected and analysed.All the participants were known to the traditional contraception and only few were aware about the modern contraception. Participants preferred tubal ligation (43.78%) over vasectomy (75.78%) and rarely considered hysterectomy (1.11%). Most knew about male condoms (99.56%) but fewer about female condoms (0.44%). Among the participants, 59.78% were aware of contraception side effects. Regarding condom use, opinions were divided, with 48.67% in favor and 51.33% against. Educated individuals were aware of contraception but not its major side effects. Therefore, we suggest investigating social, cultural, and knowledge aspects to improve understanding.

A proposal for a comprehensive protocol to develop and provide user-tailored assistive technology

BACKGROUND: Various models, frameworks, and systems have been established to support persons with disabilities in accessing assistive technology (AT). This paper highlights the commonalities and complementary aspects of these resources for the optimal selection of the most appropriate AT for a particular user. The selection process considers the user characteristics, abilities, needs, and environment. However, it does not provide a specific methodology for tailoring this technology to individual users. OBJECTIVE: This study reports on the experience of an interdisciplinary team formed in 2001 to develop user-tailored AT. The team established a systematic methodology, detailed as a step-by-step protocol. METHODS: A survey was conducted to validate the protocol’s effectiveness and assess the impact of user-tailored AT. Participants included users and stakeholders. Quantitative data were requested and complemented with qualitative information. RESULTS: Eighty-one participants were involved, with 92.6% reliant on augmentative and alternative communication (AAC) systems. A user-tailored AT was developed for this cohort, with a sustained usage rate of 56.4%. Quantitative analysis revealed a 40% reduction in reported difficulties, and Individually Prioritized Problem Assessment (IPPA) scores demonstrated a corresponding 40% improvement in overall effectiveness. The qualitative data corroborated these findings, highlighting positive user feedback and underlining the significance of family support and interdisciplinary collaboration. CONCLUSIONS: The proposed methodology offers a step-by-step protocol that complements current models and frameworks and aims to guide individuals and teams that develop user-tailored AT for persons with disabilities. Additionaly, this study reflects the importance of applying user-tailored AT to improve the quality of life of persons with disabilities.

A Study on the Use of Personal Protective Equipment among Construction Workers in Türkiye

This study examines the habits and attitudes of construction sector employees in Türkiye regarding the use of personal protective equipment (PPE). A comprehensive face-to-face survey was conducted with 398 randomly selected employees from small- and medium-sized construction companies across various regions of Türkiye. The survey aimed to identify the frequency of PPE usage and the factors influencing its use and to provide actionable suggestions for improving PPE compliance. The results indicate that while a majority of workers recognize the importance of PPE, actual usage rates are inconsistent. Key factors affecting PPE use include the ergonomics and comfort of the equipment as well as worker perceptions and attitudes. Notably, the study found that the discomfort associated with PPE and the belief that it slows down work pace are significant barriers to its regular use. Additionally, the research highlights the need for a robust punishment–reward system to enforce PPE compliance and suggests that more stringent legislative measures are required to enhance occupational health and safety (OHS) standards in the construction industry. This study contributes to the existing body of knowledge by providing a detailed analysis of PPE usage in the Turkish construction sector and offering practical recommendations for policymakers and industry stakeholders. Implementing these suggestions can lead to improved worker safety and reduced occupational accidents.

Linking Survey and LinkedIn Data: Understanding Usage and Consent Patterns

Abstract Linking social media and survey data allows researchers to create novel metrics, track survey respondents longitudinally, and capture real-time intricate data. LinkedIn is a social networking platform with a strong emphasis on employment and business interactions which has not been explored in a survey data linkage context previously. Using a nationally representative panel survey, we explore the feasibility of linking survey and LinkedIn data. Our analysis focuses first on understanding the demographic profile of LinkedIn users in the UK, as understanding this context shows the coverage of who can be asked to consent. We then explore consent outcomes, assessing the impact of question placement and wording on participants’ willingness to link data, and identifying other factors associated with LinkedIn consent. Our findings reveal that a notable proportion of respondents have a LinkedIn account, indicating a higher usage rate compared to previous research. Employment status, education level, and income are key determinants of having a LinkedIn account. Unlike previous studies, consent placement and wording does not have a significant influence on participants’ willingness to link LinkedIn and survey data. However, social media posting frequency and possessing a university degree are associated with higher consent rates. Although LinkedIn users differ on certain demographic characteristics, the platform’s unique focus on professional networking and career-related activities presents valuable opportunities for investigating employment and economic outcomes.

Dynamic Simulation Model and Performance Optimization of a Pressurized Pulsed Water Jet Device

Pulsed water jet technology has broad application prospects in the field of rock breaking. The pressurized pulsed water jet (PPWJ) is a new type of pulsed jet that offers high-amplitude pressurization, variable pulse pressure and frequency, and a high energy usage rate. To achieve a more destructive and powerful pulsed water jet, a dynamic simulation model of the device was established by using the AMESim software (v1400) based on the operational principle of PPWJs, and the simulation model was validated against the experimental results. The relationships between the key structural parameters of the PPWJ device and the pulse parameters were quantitatively investigated. The pulse pressure and frequency can be increased by appropriately increasing the nozzle diameter or boost ratio, and the pulse pressure will drop if the nozzle diameter or boost ratio exceeds a threshold value. Increasing the maximum displacement or action area of the piston will increase pulse length while decreasing pulse frequency; a proper match of the maximum displacement or action area of the piston will assure pulse peak pressure. The maximum outer diameter of the piston only affects the pulse frequency. The key structural parameters of the device were optimized on that foundation. Compared to the original device, the optimized device resulted in an increase in pulse frequency and jet output energy, leading to larger diameter and volume of erosion pits at the same stand-off distance and erosion time. The findings of this study offer valuable scientific insights for achieving efficient rock breaking with PPWJ.

Determining Perioperative Mortality in Patients with Ruptured Abdominal Aortic Aneurysm: Insights from a Retrospective Cohort Study

Objective: Analyzing factors determining perioperative mortality in patients with ruptured abdominal aortic aneurysm (rAAA) undergoing open surgical repair (OSR) and endovascular aneurysm repair (EVAR).Materials and Methods: Inclusion of 147 consecutive rAAA patients who underwent OSR (n=37) or EVAR (n=110) between 2000 and 2017. Assessment of patients' demographic data, intraoperative details, and perioperative complications. Investigation of comparative outcomes between OSR and EVAR. Employing logistic regression analysis to identify factors associated with perioperative mortality.Results: Perioperative mortality rate of 19.04% (28/147), with 8.1% (3/37) for OSR and 22.7% (25/110) for EVAR (p=0.139). Higher prevalence of unfit patients in the non-survived group (82.1% vs. 47.9%, p=0.002). Non-survived group had significantly higher preoperative serum creatinine levels (1.8 ± 1.74 vs. 1.4 ± 5.89, p=0.011). Intraoperatively, non-survived group had higher rates of aortic balloon usage and cardiac arrest (64.3% vs. 22.7% and 28.6% vs. 3.4%, p < 0.001). Multivariable analysis identified age > 80 years old, unfit patient status, aortic balloon usage, postoperative myocardial infarction, postoperative congestive heart failure, and abdominal compartment syndrome as independent predictors of 30-day mortality.Conclusions: No significant difference in perioperative mortality between OSR and EVAR in rAAA patients. Independent predictors of 30-day mortality include age > 80 years old, unfit patient status, aortic balloon usage, postoperative myocardial infarction, congestive heart failure, and abdominal compartment syndrome. Valuable insights for clinicians in predicting outcomes and improving patient care in rAAA cases.

On-chip based power estimation for CMOS VLSI circuits using support vector machine

Power estimation has a major impact on the reliability of very-large-scale integration (VLSI) circuits. As a results power estimation is highly needed in VLSI circuits at the early stages. One of the evident challenges in integrated circuit (IC) industry is development and investigation of techniques for the reduction of design complexity due to the growing process variations and reduction of chip manufacturing turnaround time. Under these conditions, the higher design levels of average power estimation before the chip manufacturing process is highly essential for the calculation of power budget and to take the necessary steps for the reduction of power consumption. Over the years, most of the approaches were designed to estimate the power usage, however, most of the conventional techniques are time consuming, resource-intensive and largely manual. Machine learning techniques have received much attention in many of the engineering applications and are capable for modelling the complex systems through historical data. Hence, in this work on chip-based power estimation for complementary metal-oxide-semiconductor (CMOS) VLSI using support-vector machine (SVM) is presented to estimate the power. The SVM is employed to estimate the usage of power at runtime. The performance of this model is evaluated in terms of Power usage, delay, data accuracy and error rate.

Longitudinal Use Patterns of Technology Subtypes During the Transition Into Early Adolescence: Results From the Adolescent Brain Cognitive Development Study

PurposeAdolescents encounter a complex digital environment, yet existing data on youth technology use rarely differentiates technology subtypes. This study maps the evolution and intricacies of youth engagement with technology subtypes. MethodsN = 11,868 participants in the Adolescent Brain Cognitive Development study followed from ages ∼9/10 to ∼13/14. We examined youths' self-reported hours per day (hr/day) of technology subtypes: TV/Movies, video games, YouTube, social media, video chat, and texting. We used descriptive statistics and multilevel logistic regression to assess cross-sectional and longitudinal use patterns of technology subtypes, agreement between child and parent reports on the child's technology use, and associations between each technology subtype and sociodemographics (child's biological sex, parent education, income, and marital status). ResultsAt age 9/10, ∼75% of youth reported minimal (<30 min/day) social technology use (social media, video chat, texting) and up to ∼1.5 hr/day of TV, video games, and YouTube. By age 13/14, TV trajectories were converging to >2 hr/day, but social technology trajectories “fanned out” into a wide range of usage rates. Child and parent reports were weakly correlated (rs range: 0.13–0.29). Using child-reported hours of technology use, increases in the subject-specific odds of using a technology >2 hr/day ranged from 25% (YouTube; 95% CI: 1.16–1.35) to 234% (social media; 95% CI: 3.14–3.55). Compared with males, females had ∼100–200% greater odds of >2 hr/day of social technologies, but ∼40–80% reduced odds of >2 hr/day of video games and YouTube. Higher parent education and income predicted significantly lower odds of >2 hr/day of use – regardless of technology subtype. DiscussionDistributions of youths' self-reported technology engagement are highly contingent on technology subtype, age, and biological sex. Future research on youth development and technology may benefit from considering youths' varied digital experiences.

Effects of PCSK9 Inhibitors on Early Neurologic Deterioration in Patients with Acute Non-Cardioembolism without Hemorrhagic Transformation After Intravenous Thrombolysis.

END (Early Neurologic Deterioration) significantly elevates the risk of morbidity and mortality. While numerous studies have investigated END following hemorrhagic transformation post-thrombolysis in acute cerebral infarction research on END without hemorrhagic transformations in patients with acute cerebral infarction due to non-cardiogenic embolism remains scarce. This study aimed to elucidate the impact of PCSK9 inhibitors on early neurological deterioration (END) in patients with acute non-cardioembolism cerebral infarction without hemorrhagic transformation post-intravenous thrombolysis. Additionally it aimed to identify risk factors associated with END in patients suffering from this type of stroke. The objective of this study is to investigate the effect of PCSK9 inhibitors on early neurologic deterioration (END) in patients with acute non-cardiogenic cerebral infarction without hemorrhagic transformation after intravenous thrombolysis and identify associated risk factors for END in this patient population. In this retrospective case-control study the data of consecutive patients who underwent intravenous thrombolysis after AIS (acute ischemic stroke) without hemorrhagic transformation during hospitalization at the Stroke Center of The Fifth Affiliated Hospital of Sun Yat-sen University between January 2018 to February 2023 were retrieved and assessed. An increase of >2 in the National Institutes of Health Stroke Scale (NIHSS) within 7 days after admission was defined as END. This study included 250 patients (56 males 22.4%) they were 63.34±12.901 years old. There were 41 patients in the END group and 209 in the non-END group. The usage rate of PCSK9 inhibitors was significantly different between the END group and non-END group (29.268% vs 58.852% P<0.001). The White blood cell count (WBC) and homocysteine levels showed a significant difference between the two groups (all P<0.05). Patients not using PCSK9 inhibitors (OR=0.282 95%CI: 0.127-0.593) and white blood cell count (OR=1.197, 95%CI: 1.085-1.325) were independently associated with END. Receiver-operating characteristic curve analysis suggested that the sensitivity specificity and area under the curve for PCSK9 inhibitors used for END were 88.9%, 80.7% and 0.648 respectively. The use of PCSK9 inhibitors can reduce the incidence of early neurological deterioration in patients with acute non-cardioembolism and non-hemorrhagic transformation after intravenous thrombolysis.

Effective process quality control management for constipation prevention in hospitalized patients with acute coronary syndrome: An observational study.

To evaluate the effectiveness of monitoring and managing process quality control indicators in the prevention of constipation among hospitalized patients with acute coronary syndrome (ACS). A total of 512 hospitalized patients diagnosed with ACS between January and June 2022 were screened for inclusion in the study. Ultimately, 456 eligible participants were enrolled and divided into two groups based on the chronological order of admission: the control group and the observation group. Upon admission, both groups of patients received routine constipation prevention measures in the department. However, the observation group was subjected to targeted process quality control management, which included monitoring and managing five indicators related to constipation prevention: correctness of bowel movement recording; usage rate of laxatives; execution rate of physical interventions; implementation rate of constipation prevention education; completion rate of dietary structure and habit assessments. Data were analyzed using SPSS, with t tests and χ 2 tests for group comparisons. In comparison to the control group, the observation group demonstrated significant advantages in terms of constipation incidence, completion rates of the five process quality control indicators, occurrence rates of adverse cardiac events during defecation, and PHQ-9 scores before discharge. These disparities demonstrated statistical significance with a p value < 0.05. Target-oriented process quality control management is shown to be effective in reducing constipation incidence and adverse cardiac events during constipation episodes, as well as alleviating depressive symptoms among ACS patients, thus providing a safe and effective approach to constipation prevention.

Exploring the Determinants of Tobacco Usage Among Adolescents: A Cross-Sectional Study in Western Maharashtra.

Introduction The widespread use of tobacco is a major global health threat, causing significant morbidity and mortality. The World Health Organization (WHO) estimates that annually, millions of people die prematurely due to tobacco use, with this number projected to increase significantly in the future. Developing countries, including India, bear a substantial burden of tobacco-related deaths, often beginning during adolescence. This study estimated the prevalence of tobacco use among adolescents in the 13-19 years age group, identified the types of tobacco products used, explored the reasons for initiation, and examined the influence of family, peers, and socio-demographic factors on tobacco use. Methods A community-based cross-sectional study was conducted from August 2022 to June 2024 in a medical college's urban and rural field practice areas in Pune district, Maharashtra. A total of 310 adolescents were surveyed using convenience sampling. Data were collected using a pre-designed, pre-tested questionnaire, and statistical analysis was performed using Jamovi software version 2.3.28. Chi-square and Fisher's exact tests were applied to assess associations between variables. Results Out of 310 participants, 94 (30.32%, 95% CI: 25.25%-35.77%) reported using tobacco. Among these 94 participants, 82 (87.23%) used smokeless tobacco, 19 (20.21%) used the smoked form of tobacco, and seven (7.45%) used both forms. The mean age of initiation was 15.94 years for smoking and 15.59 years for smokeless tobacco. The data indicate a higher percentage of tobacco use among females (50%) compared to males (24.8%). However, in terms of absolute numbers, more males (60) than females (34) reported using tobacco due to the larger number of males in the study sample. The most common reasons for initiation included curiosity (43.74%) and peer pressure (53.99%). Specifically, 49 individuals (42.6%) aged 13-15 were using tobacco, compared to 23 individuals (30.3%) aged 16-17, and only 22 individuals (18.5%) aged 18-19. Participants from urban areas reported higher tobacco use (48%) compared to those from rural areas (46.7%). Among those from joint families, about 24 (31.6%) reported tobacco use, while in nuclear families, it was slightly lower at about 70 (29.9%). Conclusion Factors such as peer pressure and curiosity played significant roles in the initiation of tobacco use, with more than half of the participants citing peer influence as the primary reason for starting. This study revealed differences in tobacco usage patterns across age groups, with younger participants showing higher usage rates. The findings highlight the need for targeted interventions, such as health education and anti-tobacco media campaigns, to reduce tobacco use among adolescents.

Association Between Xanthelasma Palpebrarum with Cardiovascular Risk and Dyslipidemia: A Case Control Study

ObjectiveTo determine whether Xanthelasma palpebrarum (XP) is associated with dyslipidemia, cardiovascular disease (CVD) and other systemic conditions in a large population. DesignCase-control study conducted at a single tertiary care center. ParticipantsIndividuals who were examined at a medical screening institute from 2001 to 2020. MethodsMedical records were reviewed to extract data on ophthalmic evaluations, blood tests, and systemic diagnoses. Patients identified with XP in at least one eye comprised the study group. A control group without XP was established matched by age and sex at a 10:1 ratio to allow robust statistical analysis. Main Outcome MeasuresAssociations between XP and dyslipidemia and CVD. Lipid profiles, diagnosis of dyslipidemia and CVD were compared between the case and control groups. ResultsThe database included 35,452 individuals, 24,287 males (69%), mean age 52.2±12.2 years. The study population included 203 XP patients (0.6%) and 2030 matched controls. The prevalence of dyslipidemia diagnosis and the usage rates of statins, fibrates, or other cholesterol-lowering medications was similar between the two groups. Lipid profiles were similar between the groups, including median total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglyceride levels (187 controls vs. 192 XP, 48 controls vs. 47 XP, 120 controls vs. 125 XP, 111 controls vs. 105 XP, respectively, P>0.05 for all). The rate of CVD was similar as well (10% controls vs. 8.9%, XP P=0.56). The prevalences of related conditions, including hypertension, diabetes mellitus, and history of cerebrovascular accident, were similar between groups (24% controls vs. 23% XP, 14% controls vs. 10% XP, 1.3% controls vs. 1% XP, respectively P>0.05). ConclusionsXP was not associated with increased rates of dyslipidemia or CVD. This questions the extent to which XP serves as an indicative marker for heightened systemic risk.Introduction

Cryopreserved testicular spermatozoa among patients with azoospermia.

To investigate cryopreserved testicular spermatozoa among patients with azoospermia. In this retrospective study spanning from October 1993 to December 2021, we examined men diagnosed with azoospermia who underwent testicular spermatozoa cryopreservation. Data from medical records included utilization and disposal of sperm samples, age at initial cryopreservation. We analyzed the data over 20 years using Kaplan-Meier curves, compared age with the log-rank test, and assessed hazard ratios (HR) with 95% confidence intervals (CI) using Cox regression analysis. A total of 356 patients with a mean age of 32.1 ± 6 were included. Of these, 225 patients utilized thawed testicular sperm for fertility treatments, with 118 patients using all their frozen straws and 107 patients partially using their stored straws. Additionally, 29 patients opted for disposal (six patients partially used their testicular spermatozoa before disposal), resulting in 108 patients who neither used nor disposed of their straws. From a laboratory standpoint, nearly 90% of patients contributed a single testicular sample, which was subsequently divided and cryopreserved as straws, with a median of 4 straws per sample. Notably, in the older age group (> 35 years old), there were a significantly lower usage rate and a higher disposal rate compared to the younger age groups (p < 0.05 for both), corroborated by univariable Cox analysis. This extensive study unveils unique patterns in the preservation and disposal of testicular spermatozoa among azoospermic patients. Most patients utilize a significant portion of their stored samples, while older patients tend to use their testicular spermatozoa less frequently.

Bridging the Divide: An Empirical Investigation of Artificial Intelligence and Generative Artificial Intelligence Integration Across Genders, Disciplines and Academic Roles

Abstract The burgeoning role of artificial intelligence (AI) and Generative AI (GenAI) in academia signifies a transformative shift in educational methodologies and research practices. This mixed-methods cross-sectional study investigates the differential familiarity, usage and attitudes towards AI and GenAI among 704 students and lecturers, supplemented by in-depth interviews with 12 industry and academic professionals. Findings indicate minimal familiarity with AI tools and low use, primarily attributing this to a lack of knowledge. Notably, despite a reported higher familiarity among men than women, actual usage rates did not significantly differ. Discrepancies were also observed between students and lecturers in familiarity and usage, with institutional factors and generational divides impacting AI integration. The study underscores the necessity for academia to bridge these gaps through targeted AI literacy initiatives, fostering equitable access and integrating AI into curriculum and training.

Factors Associated With the Use of Over-the-Counter Sleep Aids Among Jazan University Students.

Sleep aids, classified by their mechanisms of action, can promote sleep but may be misused, leading to harm. Exercise and pharmacological interventions like antihistamines, melatonin, and benzodiazepines also help manage sleep disorders. In Saudi Arabia, sleep disorders are prevalent, especially among university students. Our study examines the prevalence and usage of the medication containing diphenhydramine hydrochloride, among Jazan University students, aiming to inform better practices and highlight related risks and benefits. A cross-sectional design study was conducted among Jazan University students in Saudi Arabia. The sampling of data utilized random selection. Data was cleaned in Excel and analyzed using IBMSPSSStatistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York, United States). Our study comprised 437 participants from Jazan University aged 18-25 years. The majority reported earning less than 5000 SAR monthly and were unmarried (91.8%). Remarkably, 13.7% of participants were diagnosed with insomnia. Sleep aid containing diphenhydramine hydrochloride, utilized for mild to moderate pain relief and sleep induction, was the most prevalent medication, with 56.3% of participants having used itand 9.4% using it continuously for over 10 nights. Significant predictors for usage of sleep aids containing diphenhydramine hydrochloride included gender (p=0.041), with male students exhibiting higher usage rates, and college type (p<0.001), particularly medical students. Multivariate analysis confirmed male gender and enrollment in medical colleges as robust predictors. Age, income, marital status, and employment variables showed no significant associations. Our study highlights a considerable prevalence ofsleep aids containing diphenhydramine hydrochloride usage among Jazan University students, notably influenced by gender and college type. Male gender and enrollment in medical colleges emerged as significant predictors of their usage.

The effect of dexamethasone and bupivacaine on postoperative pain and nausea and vomiting by preperitoneal nerve blocking in laparoscopic cholecystectomy: a randomized clinical trial

Background: This study aims to examine the effects of preperitoneal administration of dexamethasone and bupivacaine surrounding laparoscopic trocars on postoperative pain (POP) and nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy (LC). Method: In this randomized triple-blinded trial with a 1:1 randomization ratio, 104 patients with chronic cholecystitis were candidates for elective LC. A total of 40 mg (8 ml) of bupivacaine was mixed with 8 mg (2 ml) of dexamethasone or normal saline. The solution was injected preperitoneally via an 18G needle parallel and lateral to trocars until a bulge in the interior surface of the parietal peritoneum was observed by the camera. Primary outcomes were severity of POP based on 0-10 Likert visual analog scale (VAS) and rates of PONV and secondary outcomes were rate of postoperative opioid usage and any side-effects. Result: The mean VAS score was significantly lower in the dexamethasone group (3.5 vs. 6.2, P&lt;0.001). The dexamethasone group had 46.2% and 26.9% lower rate of nausea and vomiting after LC compared to the other group (P=0.001 and 0.015, respectively). Postoperative opioid use was lower in the dexamethasone group, but its difference was insignificant (P=0.3). Conclusions: Preperitoneal dexamethasone injection around laparoscopic trocars may lower the intensity of POP and PONV rates. Perioperative local corticosteroids can be used as an effective, available, and inexpensive analgesic and antiemetic prevention for laparoscopic procedures.

Comparison of in-hospital outcomes of ST-elevation myocardial infarction patients with cardiogenic shock receiving left ventricular mechanical circulatory support devices based on transfer status.

We aimed to compare outcomes in patients who receive on-site left ventricular mechanical support versus those transferred to other facilities for mechanical support in ST-elevation myocardial infarction (STEMI) patients with cardiogenic shock. This retrospective study analyzed data from the 2016 to 2020 Nationwide Inpatient Sample (NIS) database. We identified patients with STEMIand cardiogenic shock who received Impella and LVAD placement during their hospital stay. They were divided into two groups: those with in-house (direct) placement and those transferred to higher-level medical centers. The primary goal was to compare mortality rates between these groups. During the study, 15,934 (75.2%) received in-house left ventricular support, while 5255 (24.8%) were transferred. Mean age (63 vs. 64 years) and female percentage (25 vs. 26%) were similar. The average time from admission to receiving LV support was 0.8 days for direct group versus 2.8 days for transfer group (p < 0.001). Transferred patients had a higher rate of prior heart failure (68 vs. 79%, p < 0.001) and peripheral vascular disease (10 vs. 14%, p < 0.001) but a lower rate of hypertension (23 vs. 17%, p = 0.003). There were no significant differences in other comorbidities. Primary outcome mortality did not significantly differ (44.9 vs. 44.2, p = 0.66). After multivariate analysis, transferred patients had higher rates of ECMO usage, acute kidney injury, renal replacement therapy, major bleeding, and ischemic stroke. Length of stay (8 vs. 15 days, p < 0.001) and total charges ($391,472 vs. $581,183, p < 0.001) were significantly higher in the transferred group. Among STEMI patients with cardiogenic shock, our study found no significant difference in mortality between patients transferred for and those with on-site LV support. Those transferred patients experienced more complications, longer length of stay, and increased hospital costs.

FACTORS EFFECTING PADDY PRODUCTIVITY IN THE MADA REGIONS, MALAYSIA

Rice commodity is becoming increasingly important for most countries worldwide, particularly those where rice is the main staple meal. This study examines the socioeconomic attributes of farmers, their perspectives on management practises, and the implementation of paddy machinery technology in the four MADA (Muda Agricultural Development Authority) regions in Malaysia. The study aims to determine the main factors effecting paddy productivity in the MADA regions. Primary data was collected from paddy farmers in the four MADA zones using a standardised questionnaire. The data was collected from 673 respondents from four regions of MADA. The analysis employed both descriptive statistics and regression analysis. The results indicate that variables such as land area, selection of paddy planting as the primary occupation, increased time spent on paddy farms, gender, and the educational background of farmers have a significant impact on paddy productivity in the MADA regions. The findings also show that, only a small percentage of respondents (6.2%) followed the crop schedule, and 93.8 percent of them were late. The utilisation of machinery in paddy cultivation achieved the following results: nine farmers achieved a success rate of 85.71 percent, while a majority of farmers (662 farmers) achieved a 71.43 percent utilisation rate, with one farmer earning the lowest usage rate of 57.14 percent. In conclusions the study has found that it is imperative to promote the use of management practises and advanced machinery technologies among paddy farmers to effectively increase productivity.