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This study reviews the studies utilizing Artificial Intelligence (AI) and AI-driven tools and methods in managing Acute Kidney Injury (AKI). It categorizes the studies according to medical specialties, analyses the gaps in the existing research, and identifies opportunities for future research directions. PRISMA guidelines were adopted using the three most common databases (PubMed, Scopus, and EBSCO), which resulted in 27 eligible studies, published between 2012 and 2023. The study showed significant heterogeneity in the design of the models, with variations in clinical settings, patient characteristics, cohort regions, and statistical methods. Most models were developed for AKI in hospitalized patients, particularly those undergoing surgery or in intensive care units. Compact models with a subset of significant predictors were deemed more clinically applicable than full models with all predictors. The findings suggest that AI tools, such as machine learning (ML) algorithms, have high prediction capabilities despite the dynamic and complex association among the influencing factors and AKI. Based on these findings and the recognized need for broader inclusivity, future studies should consider adopting a more inclusive approach by incorporating diverse healthcare settings, including resource-limited or developing countries. This inclusivity will lead to a more holistic understanding of AKI management challenges and facilitate the development of adaptable and universally applicable AI-driven solutions. Additionally, further investigations should focus on refining AI models to enhance their accuracy and interpretability, promoting seamless integration and implementation of AI-based tools in real-world clinical practice. Addressing these key aspects will elevate the effectiveness and impact of AI-driven approaches in managing AKI. [ABSTRACT FROM AUTHOR]

We would like to extend our sincere thanks to us beloved parents who were the source of our inspiration and strength, who gave us all their giving and their continuous moral, spiritual, emotional and financial support for us whatever we say and do we will not fulfill their full right so thank you until the pens dry and the newspapers are full. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the impact of Law No. 11 of 2018 on Islamic Financial Institutions in Aceh, Indonesia. It also aims to understand the balance between the economic rights of individuals under Shariah law and the broader concept of God's rights, as interpreted by this legislation. In addition, the research argues that the implementation of Law No. 11 of 2018 is untimely, with a focus on examining its influence on the cumulative abnormal return (CAR) of Shariah banks and its slight contribution to the direct economic impact. Design/methodology/approach: This study adopts a mixed-methods approach that integrates qualitative and quantitative analyses. The qualitative aspect uses a black-letter law approach for legislative scrutiny, whereas the quantitative aspect assesses economic indicators and firm performance using an event study analysis. The study also includes a two-tailed assessment to test hypotheses related to the law's direct impact on institutional performance. Findings: The study reveals that Law No. 11 of 2018 had minimal impact on national-scale corporate performance and a notable increase in poverty indices in Aceh, indicating a potential misalignment between the law's intention and its economic consequences. The results also show the law's ineffectiveness in significantly influencing the CAR of Islamic banks, highlighting a clash of norms and a lack of substantial economic substance in the implementation of Shariah compliance. Research limitations/implications: This research is geographically and legally focused on Aceh, Indonesia, with a short-term analysis that may not fully capture the long-term impacts. It primarily considers the stock price performance of specific institutions for quantitative analysis and identifies potential clashes and disharmony-in-law implementation from a qualitative perspective. Practical implications: The findings suggest the need for legal frameworks that better comply Shariah principles with economic realities. Regional governments should consider modifying policies to balance religious values and economic objectives. Social implications: This research highlights the importance of balancing religious obligations with economic rights, indicating that strict interpretations of religious law can lead to adverse socioeconomic effects. Originality/value: This study is unique in its comprehensive analysis of the convergence between religious law and economic rights, offering insights into the challenges faced in implementing Shariah-based economic policies in diverse economies, such as Indonesia. [ABSTRACT FROM AUTHOR]

Background: Toxoplasmosis is a chronic protozoan parasitic infection that affects nearly one-third of the global population. During the COVID-19 pandemic, cases were observed in patients with COVID-19 and toxoplasmosis. Therefore, this systematic review and meta-analysis aimed to determine the frequency of Toxoplasma gondii exposure in patients with COVID-19. Methods: A literature search was conducted in six databases or search tools (PubMed, Scopus, Embase, Web of Science, ScienceDirect, and Google Scholar) until March 3, 2024. Study selection, quality assessment, and data extraction were performed independently by three investigators. Statistical analysis was performed using R version 4.3, applying a random-effects model. The quality of the included observational studies was assessed using the "JBI-MAStARI". Results: A total of 5,936 studies were retrieved, 13 of which were included in the final meta-analysis. The sample included a total of 2,947 patients with COVID-19 from four countries, of whom approximately 43.3% were men and 49.4% were women. Among the patients, 1,323 showed evidence of exposure to T. gondii through IgG detection, while 1,302 COVID-19 patients were explicitly examined for T. gondii by IgM detection, and 36 positive cases were identified. The frequency of exposure to T. gondii, determined by the presence of IgG in patients with COVID-19, reached 49% (95% CI: 34–63%; 2,947 participants; 13 studies; I2 = 98%, p < 0.01). In addition, the frequency of exposure to T. gondii, evaluated by IgM presence in patients with COVID-19, was 2% (95% CI: 0–6%; 1,302 participants; 6 studies; I2 = 94%, p < 0.01). Conclusion: It was shown that almost half of COVID-19 patients had previous exposure to T. gondii through the presence of IgG, and a small percentage, 2%, showed active infection through IgM detection. Although the results indicate a possible correlation between exposure to T. gondii and the presence of COVID-19, it is essential to note that this study is based on observational research, which precludes establishing a causal relationship. Consequently, further research is required to deepen understanding of the interaction between the two conditions. Terms used: The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI), Prospective International Registry of Systematic Reviews (PROSPERO), and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). [ABSTRACT FROM AUTHOR]

Nowadays, one of the major goals for the sustainable development, especially in the water-stressed countries, is to overcome the shortage of clean drinking water. So, it is the need of the hour to develop strategies to lower the water contamination level mainly caused by nitro compounds and dyes. For this purpose, we synthesized a nanocomposite by decorating copper nanoparticles on reduced graphene oxide to catalyze the chemical reduction of nitro compounds and industrial dyes for their fast decontamination from water. The prepared nanocomposite material was characterized using Fourier transform infrared spectroscopy, X-ray diffraction, UV–visible spectroscopy, scanning electron microscopy, and transmission electron microscopy. The nanocomposite was found to remain intact up to 200 °C as affirmed by TGA analysis. The prepared nanocomposite was observed to catalyze the borohydride reduction reactions of 4-nitrophenol, 2-nitrophenol, and 2-nitroaniline with rate constants as 0.265, 0.072, and 0.233 min−1, respectively. The catalyst performed equally well for the reduction of organic dyes, i.e., methyl orange, eosin Y, and methylene blue with rate constants as 0.206, 0.108, and 0.094 min−1, respectively. To ascertain kinetic feasibility for each of these reactions, activation parameters were also calculated. Afterward, the re-usability of the catalyst was examined and observed to be reduced to 46% in the third catalytic cycle. [ABSTRACT FROM AUTHOR]

Background: Despite the growing volume of neighborhood-level health disparity research, there remains a paucity of prospective studies investigating the relationship between Area Deprivation Index (ADI) and functional outcomes for patients undergoing hip arthroscopy. Purpose: To investigate the relationship between neighborhood-level socioeconomic status and functional outcomes after hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis of prospectively collected data was performed on patients aged ≥18 years with minimum 1-year follow-up who underwent hip arthroscopy for the treatment of symptomatic labral tears. The study population was divided into ADILow and ADIHigh cohorts according to ADI score: a validated measurement of neighborhood-level socioeconomic status standardized to yield a score between 1 and 100. Patient-reported outcome measures (PROMs) included the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports-Specific Subscale, 33-item International Hip Outcome Tool, visual analog scale for pain, and patient satisfaction. Results: A total of 228 patients met inclusion criteria and were included in the final analysis. After patients were stratified by ADI score (mean ± SD), the ADILow cohort (n = 113; 5.8 ± 3.0; range, 1-12) and ADIHigh cohort (n = 115; 28.0 ± 14.5; range, 13-97) had no differences in baseline patient demographics. The ADIHigh cohort had significantly worse preoperative baseline scores for all 5 PROMs; however, these differences were not present by 1-year follow-up. Furthermore, the 2 cohorts achieved similar rates of the minimal clinically important difference for all 5 PROMs and the Patient Acceptable Symptom State for 4 PROMs. When controlling for patient demographics, patients with higher ADI scores had greater odds of achieving the minimal clinically important difference for all PROMs except the 33-item International Hip Outcome Tool. Conclusion: Although hip arthroscopy patients experiencing a greater neighborhood-level socioeconomic disadvantage exhibited significantly lower preoperative baseline PROM scores, this disparity resolved at 1-year follow-up. In fact, when adjusting for patient characteristics including ADI score, more disadvantaged patients achieved greater odds of achieving the minimal clinically important difference. The present study is merely a first step toward understanding health inequities among patients seeking orthopaedic care. Further development of clinical guidelines and health policy research is necessary to advance care for patients from disadvantaged communities. [ABSTRACT FROM AUTHOR]

The Malaysian government reinforced smoking restrictions at public venues to protect nonsmokers from secondhand smoke (SHS) exposure. This study examined whether smokers' reports about smoking restrictions and psychosocial beliefs were associated with quit intentions among Malaysian smokers. Data from 1047 cigarette smokers (103 females and 944 males) aged 18 and older from the 2020 International Tobacco Control (ITC) Malaysia Wave 1 Survey were analyzed with bivariate and multivariable logistic regression models. Most Malaysian smokers (85.2%) reported having quit intentions. Smoking was completely restricted in 34.8% of the nighttime venues, 85.3% of air-conditioned (AC) food and beverage (F&B) venues (restaurants, food courts, coffee shops), 87.3% of non-AC F&B, and 69.4% of indoor workplaces. Smokers who visited nighttime entertainment venues where smoking was fully restricted were less likely to have quit intentions. There was no significant association found with quit intentions for smokers who visited AC and non-AC F&B venues and indoor workplaces where smoking was fully restricted. All five psychosocial beliefs assessed, age, and education were positively associated with quit intentions. Malaysian smokers are interested in quitting and psychosocial beliefs were positively associated with quit intentions. There is a need for the Malaysian government to implement and reinforce comprehensive smoking restrictions in all public venues and indoor workplaces to protect nonsmokers from SHS exposure and to encourage smokers to think about quitting, which may influence their quit intentions. [ABSTRACT FROM AUTHOR]

Objective: To study the histomorphological changes in postmortem needle biopsy/autopsy lung in COVID-19 Patients. Study Design: This was an observational study done at Shri Atal Bihari Vajpayee Medical College & Research Institute, Bengaluru, and Karnataka from March 2021 to May 2021. Methodology: A total of 30 patients who died of Covid-19 were included and all of them were diagnosed to be Covid -19 positive by RT-PCR testing. Post-mortem transthoracic needle biopsy was done to obtain lung tissue by using B-Bard biopsy gun in midaxillary approach. The biopsy samples were grossed and processed after fixing for 48hrs. The slides obtained were stained by routine hematoxylin and eosin stain, studied for morphology of the lung tissue and findings were recorded. Results: We obtained consent for post-mortem transthoracic needle biopsy/autopsy of lung in 30 deceased cases. All these cases were positive for SARS -COV2 on RT-PCR. The age of the cases was ranging from 26-72 years and median age is 53years, males (63.3%) were affected more than females (36.7%). Most deceased had comorbidities, among them diabetes mellitus (26.6%) and hypertension (26.6%) were most common. Lung biopsy samples were taken from 30 deceased patients. Histomorphological feature of diffuse alveolar damage was seen in 90% (27 out of 30) cases. Other findings noted on microscopy were chronic interstitial inflammation in 6.7% cases, pulmonary edema (3.33%), intra alveolar haemorrhage (3.33%) and viral cytopathic changes (3.33%). Conclusion: This study highlighted the pulmonary morphological changes which are most prominent in COVID-19 infections, but it was a difficult to ascertain that the findings are related to viral infection or due to associated coomorbidities. [ABSTRACT FROM AUTHOR]

Background: We performed an analysis of a large intensive care unit electronic database to provide preliminary estimates of various blood pressure parameters in patients with acute stroke receiving intravenous (IV) antihypertensive medication and determine the relationship with in-hospital outcomes. Methods: We identified the relationship between pre-treatment and post-treatment systolic blood pressure (SBP) and heart rate (HR)–related variables and in-hospital mortality and acute kidney injury in patients with acute stroke receiving IV clevidipine, nicardipine, or nitroprusside using data provided in the Medical Information Mart for Intensive Care (MIMIC) IV database. Results: A total of 1830 patients were treated with IV clevidipine (n = 64), nicardipine (n = 1623), or nitroprusside (n = 143). The standard deviations [SDs] of pre-treatment SBP (16.3 vs. 13.7, p ≤ 0.001) and post-treatment SBP (15.4 vs. 14.4, p = 0.004) were higher in patients who died compared with those who survived, particularly in patients with intracerebral hemorrhage (ICH). The mean SBP was significantly lower post treatment compared with pre-treatment values for clevidipine (130.7 mm Hg vs. 142.5 mm Hg, p = 0.006), nicardipine (132.8 mm Hg vs. 141.6 mm Hg, p ≤ 0.001), and nitroprusside (126.2 mm Hg vs. 139.6 mm Hg, p ≤ 0.001). There were no differences in mean SDs post treatment compared with pre–treatment values for clevidipine (14.5 vs. 13.5, p = 0.407), nicardipine (14.2 vs. 14.6, p = 0.142), and nitroprusside (14.8 vs. 14.8, p = 0.997). The SDs of pre-treatment and post-treatment SBP were not significantly different in patients with ischemic stroke treated with IV clevidipine, nicardipine, or nitroprusside or for patients with ICH treated with IV clevidipine or nitroprusside. However, patients with ICH treated with IV nicardipine had a significantly higher SD of post-treatment SBP (13.1 vs. 14.2, p = 0.0032). Conclusions: We found that SBP fluctuations were associated with in-hospital mortality in patients with acute stroke. IV antihypertensive medication reduced SBP but did not reduce SBP fluctuations in this observational study. Our results highlight the need for optimizing therapeutic interventions to reduce SBP fluctuations in patients with acute stroke. [ABSTRACT FROM AUTHOR]

Over the past decade, boldine, a naturally occurring alkaloid found in several plant species including the Chilean Boldo tree, has garnered attention for its efficacy in rodent models of human disease. Some of the properties that have been attributed to boldine include antioxidant activities, neuroprotective and analgesic actions, hepatoprotective effects, anti-inflammatory actions, cardioprotective effects and anticancer potential. Compelling data now indicates that boldine blocks connexin (Cx) hemichannels (HCs) and that many if not all of its effects in rodent models of injury and disease are due to CxHC blockade. Here we provide an overview of boldine's pharmacological properties, including its efficacy in rodent models of common human injuries and diseases, and of its absorption, distribution, pharmacokinetics, and metabolism. [ABSTRACT FROM AUTHOR]

Background and context: Providing care to the elderly is an emerging area of interest due to the increase in elderly population not only in the developed world but also in low and middle income countries. In Pakistan a country with an overall population of over 200 million, the elderly population amounts to 11.3 million. Caregiving of the elderly tends to occur within the kinship motivated by sociocultural norms as well as absence of government support facilities. While quantitative literature exists in Pakistan describing the "caregiver's burden," an in-depth analysis into the experiences of familial caregivers is missing. Methods: The research used qualitative methods with the aim to explore the lived experiences of 7 daughters and 3 daughters-in-law, living in Karachi, Pakistan providing care to the elderly requiring assistance in at least two tasks of daily living. Results: Five themes were developed inductively through the phenomenological method. All participants were Muslim and belonged to the upper economic strata of the society. Findings reveal that obligations to care are dominant in kinship circles particularly among women. Participants highlighted the importance of elderly in the Pakistani society, especially due to the religious lens that considers them as blessings. Daughter caregivers spoke about caregiving of their parents as a form of role reversal, emphasizing also upon the life-long emotional bond that served as a strong motivator. On the other hand, for daughter-in-law caregivers, motivations to care also stemmed from social expectations and kinship obligations. All participants reported multiple difficulties during the caregiving experience, despite existence of paid formal help, with respect to balancing multiple role demands and the nature of caregiving that requires constant effort. Results also illustrate that despite the desire to care for the elderly within a collectivist and patrilocal society, participants experienced multiple physical and emotional effects. However, a few also reported an increase in self-mastery and self-worth. Conclusion: This study reveals that despite increasing urbanization and more women working outside the home, providing care to the elderly appears to be centered within the kinship circle. The research makes important contributions to the ageing literature in Pakistan with relevance to other South Asian contexts. [ABSTRACT FROM AUTHOR]

Drug-induced gene expression profiles can identify potential mechanisms of toxicity. We focus on obtaining signatures for cardiotoxicity of FDA-approved tyrosine kinase inhibitors (TKIs) in human induced-pluripotent-stem-cell-derived cardiomyocytes, using bulk transcriptomic profiles. We use singular value decomposition to identify drug-selective patterns across cell lines obtained from multiple healthy human subjects. Cellular pathways affected by cardiotoxic TKIs include energy metabolism, contractile, and extracellular matrix dynamics. Projecting these pathways to published single cell expression profiles indicates that TKI responses can be evoked in both cardiomyocytes and fibroblasts. Integration of transcriptomic outlier analysis with whole genomic sequencing of our six cell lines enables us to correctly reidentify a genomic variant causally linked to anthracycline-induced cardiotoxicity and predict genomic variants potentially associated with TKI-induced cardiotoxicity. We conclude that mRNA expression profiles when integrated with publicly available genomic, pathway, and single cell transcriptomic datasets, provide multiscale signatures for cardiotoxicity that could be used for drug development and patient stratification. Using a new computational pipeline for identification of drug-selective transcriptomic responses and FAERS data, the authors identified potential pathways and genomic variants indicative of cancer drug cardiotoxicity in iPSC-derived cardiomyocytes. [ABSTRACT FROM AUTHOR]

Introduction: Over the past few decades, there has been growing concern about the concurrent trends of increasing Autism Spectrum Disorder (ASD) prevalence and declining sperm quality. These trends represent significant public health challenges that warrant thorough investigation of their underlying causes and implications. Objectives: The primary objectives of this study are to analyze trends in ASD prevalence and sperm quality parameters from 2000 to 2024, assess the statistical significance and effect size of these trends, explore potential correlations between ASD prevalence and sperm quality parameters, and identify significant predictors among sperm quality parameters that influence ASD prevalence. Methods: This study employed a longitudinal approach using multiple regression, time series analysis, ANOVA, Principal Component Analysis (PCA), hierarchical clustering, logistic regression, and cross-correlation analysis. Data on ASD prevalence were sourced from the CDC Autism and Developmental Disabilities Monitoring Network, while sperm quality data were collected from various published studies. Results: The findings reveal significant negative associations between ASD prevalence and sperm quality parameters such as sperm concentration and motility, suggesting that better sperm quality is linked to lower ASD rates. Conversely, parameters like sperm DNA fragmentation (SDF), volume of ejaculate, pH level, and semen viscosity show positive associations with ASD prevalence, indicating higher values in these parameters correlate with higher ASD rates. Conclusion: The study highlights the importance of maintaining reproductive health to potentially mitigate ASD risk and calls for further research to elucidate the underlying mechanisms driving these trends. These findings support the hypothesis that reproductive health factors play a crucial role in ASD etiology and suggest potential biological markers for assessing ASD risk. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2, has caused a pandemic of acute respiratory disease, 'coronavirus disease 2019' (Covid-19), posed a major threat to health and the international economy during past few years. It is believed that vaccine can stop the rapid spread of the disease. The aim of this study was to evaluate the effect of the Sinopharm vaccine in terms of mortality and severity of the disease among Covid-19 positive patients. This observational cross-sectional study was done at the Department of Medicine and Department of Pathology Shaikh Khalifa Bin Zayed Al-Nahyan/CMH Teaching Hospital (Poonch Medical College), Rawalakot AJK Pakistan from July 2021 to September 2021. Total 350 individuals with greater than or equal to 18 years of age, who were tested positive for Covid-19, were included. Patients who had received two doses of the vaccine at least 28 days apart were considered as vaccinated. The Sinopharm vaccination status was checked among patients. The severity of Covid-19 was categorized as mild, moderate and severe. A log rank regression test was applied to determine significant difference in disease severity and survival rate. The patients age range was 25-60 years (the patients mean age was 55 years). The majority of participants, 69.1% (n=242), were vaccinated by Sinopharm, and 30.9% (n=108) were non-vaccinated. Most patients had mild disease 80% (n=280) followed by moderate disease 9.7% (n=34), and severe disease 6.6% (n=23), and stratification analysis had significant (p ≤ 0.05) association between vaccinated individuals and disease severity. The overall mortality rate was 3.7%. The mortality rate was 8% (n=9) in none vaccinated individuals, whereas 1.65% (n=4) in vaccinated individuals. The Sinopharm vaccine after both doses was found effective in reducing mortality and disease severity by 98.3% and 94.4%. The study concluded that Sinopharm vaccine after two doses at least 28 days apart given to patients, after two weeks of vaccination is highly effective in reducing the mortality, disease severity and hospital admission in Covid-19 positive patients. [ABSTRACT FROM AUTHOR]

During the COVID‐19 pandemic, healthcare professionals around the world were driven by universal values of solidarity and duty to provide care. However, local societal norms and existing healthcare systems influenced interactions among physicians, and with patients and their families. An exploratory qualitative study design using in‐depth interviews was undertaken with physicians working at two public sector hospitals in Karachi, Pakistan. Using the constant comparison method of data analysis, several key themes were identified highlighting norms of kinship and interdependencies characteristic of collectivistic societies that influenced professional interactions. The role of seniors in the hierarchical society of Pakistan played a major role in provision of care. Physicians reported numerous challenges in dealing with patients and their families amidst public denial fueled due to ill‐formed government policies. This included interruption of funeral rites which undermined public trust. The study provides insights into the local moral world of two healthcare institutions in Pakistan. [ABSTRACT FROM AUTHOR]

This study explores ICT profiles of teacher educators to understand personal, pedagogical and organisational factors affecting technology use in teacher education. After delineating latent profiles based on survey data, 12 teacher educators were interviewed on technology integration in educational settings for a deeper insight. Based on the Synthesis of Qualitative Research model developed to outline strategies for preparing preservice teachers to integrate technology, findings revealed key issues including teacher educators' classroom stance as role models for effective technology use, importance of technological-pedagogical content knowledge in designing technology-enriched learning environments, peer collaboration and avoidance of using technology regardless of pedagogical concerns. Issues related to assessment, professional development, attitudes and ICT competency were raised. Findings are discussed considering potential consequences for current practices and areas of future research. [ABSTRACT FROM AUTHOR]

Purpose: Develop a true real‐time implementation of MR signature matching (MRSIGMA) for free‐breathing 3D MRI with sub‐200 ms latency on the Elekta Unity 1.5T MR‐Linac. Methods: MRSIGMA was implemented on an external computer with a network connection to the MR‐Linac. Stack‐of‐stars with partial kz sampling was used to accelerate data acquisition and ReconSocket was employed for simultaneous data transmission. Movienet network computed the 4D MRI motion dictionary and correlation analysis was used for signature matching. A programmable 4D MRI phantom was utilized to evaluate MRSIGMA with respect to a ground‐truth translational motion reference. In vivo validation was performed on patients with pancreatic cancer, where 15 patients were employed to train Movienet and 7 patients to test the real‐time implementation of MRSIGMA. Dice coefficients between real‐time MRSIGMA and a retrospectively computed 4D reference were used to evaluate motion tracking performance. Results: Motion dictionary was computed in under 5 s. Signature acquisition and matching presented 173 ms latency on the phantom and 193 ms on patients. MRSIGMA presented a mean error of 1.3–1.6 mm for all phantom experiments, which was below the 2 mm acquisition resolution along the motion direction. The Dice coefficient over time between MRSIGMA and reference contours was 0.88 ± 0.02 (GTV), 0.87 ± 0.02(duodenum‐stomach), and 0.78 ± 0.02(small bowel), demonstrating high motion tracking performance for both tumor and organs at risk. Conclusion: The real‐time implementation of MRSIGMA enabled true real‐time free‐breathing 3D MRI with sub‐200 ms imaging latency on a clinical MR‐Linac system, which can be used for treatment monitoring, adaptive radiotherapy and dose accumulation mapping in tumors affected by respiratory motion. [ABSTRACT FROM AUTHOR]

Continuous Renal Replacement Therapy (CRRT) serves as an intervention strategy for the management of acute kidney injury (AKI) in critically ill patients. However, owing to its complex nature and the potential for complications, the implementation of CRRT demands continuous monitoring to prevent patient safety risks. This study aims to identify and validate prevalent risks linked to CRRT within a real-world clinical setting, intending to propose preventive measures grounded in expert insights. To systematically categorize and visually depict the risks, their consequences, preventive measures, and recovery controls, our study employed the Bowtie method in conjunction with the Systems Engineering Initiative for Patient Safety (SEIPS) model. In addition to considering patient-related factors that exhibit variability among critically ill individuals, our key findings showed that the most influential risks impacting the effective delivery of CRRT are incidents of clotted filters, bleeding risks arising from the necessity of anticoagulation for filter efficacy, vascular catheter-related bloodstream infections, variations in proficiency levels among healthcare professionals regarding CRRT modalities, especially in operating the CRRT machines, high nursing workload, frequent nursing turnover, occurrences of hypophosphatemia, variability in CRRT prescribing patterns, and issues related to communication among stakeholders. This research sheds light on the primary risks associated with CRRT and provides practical and viable strategies for effective management. Furthermore, the Bowtie diagram developed as part of this study serves as a valuable tool for visually representing the healthcare system and facilitating the identification of system-related risks within healthcare settings. [ABSTRACT FROM AUTHOR]

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Smoke-free laws (SFL) are more effective with public support. This study investigated the smoking prevalence, public perceptions of smoking rules, and support for comprehensive SFL among 1047 people who smoke (PWS) and 206 people who do not smoke (PNS) aged ≥18 in the 2020 International Tobacco Control Malaysia Survey. Smoking prevalence was highest in nighttime entertainment venues (85.7%), non-air-conditioned eateries (49.7%), and indoor workplaces (34.6%). Respondents reported that smoking was banned in most indoor workplaces (81.7% PNS, 69.2% PWS), air-conditioned eateries (84.7% PNS, 75.7% PWS), and non-air-conditioned eateries (81.2% PNS, 78.7% PWS), but much less so in nighttime entertainment venues (30.1% PNS, 24.6% PWS). Support for comprehensive SFL in public venues was highest among PNS (≥84.9%) but still substantial among PWS (≥49.9%). PWS under 40, Malay, married, and aware of smoking rules supported SFL more. Robust SFL enforcement is essential in Malaysia to reduce secondhand smoke exposure in public places. [ABSTRACT FROM AUTHOR]

The TiO2/AC nanosorbent was prepared via the impregnation method. The prepared material was characterised by using X-ray diffraction (XRD), Fourier transform Infra-Red (FT-IR), Thermal gravimetric analysis (TGA) and Scanning electron microscopy (SEM) equipped with energy dispersive X-rays (EDX) to examine crystalline size and structure, purity, morphology, surface area and thermal stability. The prepared TiO2/AC nanosorbent exhibits enhanced surface area and high porosity. The adsorption capacity of the TiO2/AC nanosorbent was evaluated at both laboratory and industrial scales. The effect of contact time, adsorbent dose and heavy metals' initial concentration on the adsorption rate of Pb (II) and Cd (II) were also examined to optimise the adsorption performance of nanosorbent. Under the optimised condition, the percent removal efficiency for Pb (II) and Cd (II) was 91.48 and 93.13, respectively. Different isotherms and kinetic models have been applied to study the adsorption mechanism which suggested that adsorption is exothermic and physical in nature. The maximum adsorption capacity for Pb (II) and Cd (II) obtained by the Langmuir adsorption isotherm was found to be 101.01 and 24.45 mg/g, respectively. Among different kinetic models, Elovich and Weber-Morris intraparticle diffusion fitted well which suggested that the adsorption involves intraparticle diffusion. In addition, the fixed bed column prototype was designed to treat steel industry samples. [ABSTRACT FROM AUTHOR]

The chemical composition of the essential oil of Lindera subumbelliflora (Lauraceae) was investigated for the first time. The essential oil was obtained by hydrodistillation and fully characterised by gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS). The antifungal activity of L. subumbelliflora essential oil was tested against Candida albicans and Streptococcus mutans using the broth microdilution assay, whereas the microbial biofilms were determined using a semi-quantitative static biofilm. A total of 28 components (99.6%) were successfully identified, which were characterised by β-eudesmol (14.6%), cis-α-bergamotene (11.0%), α-copaene (8.5%), dodecen-1-ol (8.5%), and (E)-nerolidol (8.3%). The essential oil exhibited activity against Candida albicans and Streptococcus mutans with MIC values of 250 and 500 µg/mL, respectively. The essential oil increased the biofilm of Candida albicans by 38.25%, however, decreased the biofilm of Streptococcus mutans by 47.89% when treated with 500 µg/mL. Thus, the essential oil has a promising application in dentistry via inhibition of the growth of Candida albicans and Streptococcus mutans. However, the antibiofilm activity of the essential oil is only applicable for cariogenic Streptococcus mutans. [ABSTRACT FROM AUTHOR]

Site-specific multidisciplinary team (MDT) tumor boards are valuable resources for medical students, enabling them to familiarize themselves with the latest evidence-based cancer management strategies and observe effective teamwork in action. In this study, we looked at the awareness and perceptions of medical students about incorporating MDT tumor boards in the medical curriculum. A cross-sectional study was conducted among medical students from year 1 to year 5 at the Aga Khan University after exemption from ethical review committee. A 20-item self-administered questionnaire was used to evaluate the awareness and perceptions of medical students regarding MDT tumor boards. A total of 285 medical students participated in this study, with their mean age (± standard deviation) being 21.91 ± 1.67 years. A majority of 183 (64.2%) had no prior knowledge of the existence of a site-specific MDT tumor board for cancer management. Of the 285 students, 252 (88.4%) demonstrated sufficient awareness of the effectiveness of MDT tumor boards; similarly, 232 (81.4%) responded positively to the idea of mandatory tumor board rotations being incorporated into the undergraduate curriculum. No significant association was found between the student's year of study (χ2 = 6.03, p = 0.20) or gender (χ2 = 35, p = 0.84) and their perceptions of the effectiveness of MDT tumor boards. However, it was found that students who had prior knowledge of their existence had a stronger association with sufficient awareness (χ2 = 4.2, p = 0.04). The results indicate that while the majority of the medical students have no prior attendance or knowledge regarding MDT tumor boards, there is an overwhelming willingness among students to incorporate them into the medical curriculum. [ABSTRACT FROM AUTHOR]

The reported work is focused on the solubility of Rhodamine B (cationic dye), as an important methodology to investigate the extent of incorporation or penetration of dye inside the micelles spectroscopically, so the solubilised dye can be filtered via Micellar-enhanced ultrafiltration process to keep our environment safe from toxic effects of industrial effluent. Solutions were prepared by using micellar media of anionic surfactants i.e. Sodium dodecyl sulphate (SDS), Sodium Oleate (SO) as well as mixed micellar media of said anionics with non-ionic surfactant i.e. Triton X-100 (TX-100). The extent of solubilisation has been, quantitatively, calculated using data of differential spectroscopy, in terms of partition coefficient Kx and Gibbs energy of partition, ∆Gp. It has been observed that mixed micellar media has better solubilisation capacity than micellar solution of individual surfactants. A better micellar solubilisation and ultimately the high Gibbs energy of partition, ∆Gp with SO/TX-100 system i.e. −40.89 as compared to SDS/TX-100 system (−37.03) has been observed due to the presence of long carbon chain in SO. [ABSTRACT FROM AUTHOR]

Background: The increase in mpox incidence underscores the crucial need to understand and effectively address prevention, early detection, and agile response to this disease. Therefore, the present study aims to determine the knowledge and attitude towards mpox. Methods: A systematic review and comprehensive literature meta-analysis were conducted using prominent databases such as PubMed, Scopus, Web of Science, Embase, and ScienceDirect, with an updated search until June 25, 2023. The quality of the included observational studies was assessed using the Joanna Briggs Institute's Statistical Meta-Analysis Review Instrument. The collected data were recorded in a Microsoft Excel spreadsheet, and analyses were conducted using R software version 4.2.3. Additionally, Cochran's Q statistics were applied to assess the heterogeneity of the included studies. Results: A total of 299 articles were retrieved from 5 databases. This study included 27 cross-sectional articles with a total sample of 22,327 participants, of which 57.13% were women. The studies were conducted in 15 countries through an online survey. All studies had a moderate level of quality. The combined prevalence of a good level of knowledge about mpox was 33% (95% CI: 22%-45%; 22,327 participants; 27 studies; I2 = 100%), and the combined prevalence of a positive attitude towards mpox was 40% (95% CI: 19%-62%; 2,979 participants; 6 studies; I2 = 99%). Additionally, as a secondary outcome, the combined prevalence of the intention to vaccinate against mpox was 58% (95% CI: 37%-78%; 2,932 participants; 7 studies; I2 = 99%). Conclusion: Good knowledge and a positive attitude towards mpox were found to be low. The findings of this study highlight the need to identify gaps and focus on implementing educational programs on mpox. Terms used: Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI), Prospective International Registry of Systematic Reviews (PROSPERO), and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [ABSTRACT FROM AUTHOR]

Present study assessed the growth of two plant species and ion uptake by them grown on different proportion of industrial solid waste and garden soil. The industrial waste having high concentration of chemicals were used with garden soil at different proportion i.e. 0% (T0), 5% (T1), 10% (T2), 15% (T3) and 20% (T4). Two species namely Conocarpus erectus (alien plant) and Dodonaea viscosa (indigenous) were used as test plants in pot study. Different parameters including growth, physiology, and anatomy of plants and concentration of cations (Na+, K+, Ca2+, and Mg2+) in the plant shoot and root were measured at different time duration (initial, 1st, 2nd, 3rd and 4th month). The key objective of the study was to use these plants to establish their plantations on the barren lands where industrial solid wastes were being disposed of. C. erectus showed better growth than D. viscosa, as well as more uptake of ions. A significant increase in plant growth was observed in fourth month in T1, where plant height reached 24.5% and 46% for C. erectus and D. viscosa, respectively. At harvest, in C. erectus, no significant difference in the fresh (65–78 g) and dry weight (24–30 g) of the shoot was observed across treatments compared to the control. In D. viscosa, at the time of harvest, the fresh and dry weights of the root and shoot showed a strong, significantly decreasing pattern across T1, T2, and T3, leading to the death of the plant at T3 and T4. Further, optimum ratio of waste soil to garden soil was found as 10:90 and 20:80 to establish the plantations of D. viscosa and C. erectus, respectively in areas where such solid waste from industries are disposed. Findings can be used for the restoration of such solid waste for the sustainable management of industrial areas and their associated ecosystems. [ABSTRACT FROM AUTHOR]

Nonlinear electrostatic waves on the ion time scale have been studied in a quantum magnetoplasma in the presence of relativistically degenerate electrons. In this regard, Zakharov Kuznetsov (ZK) equation has been derived using the reductive perturbation technique. The single and two soliton solutions of the ZK equation have been obtained by employing Hirota formalism. The nonrelativistic and ultrarelativistic limits of the relativistically degenerate electrons have been studied and discussed in detail for important plasma parameters both for the single and two soliton solutions of the ZK equation. We have applied our study for the plasma parameters that are found in the white dwarfs. It has been noticed that the interaction of the ZK solitons depends on the propagation vectors in the predominant direction of propagation. Importantly, it has been found that the spatial and temporal scales over which the interaction of solitons occur are different for the nonrelativistic and ultrarelativistic cases. [ABSTRACT FROM AUTHOR]

Employee retention plays a very important role for companies because the decreasing number of employees who want to leave a job may have a good impact on the companies to achieve their organizational goals. The purpose of this study is to investigate the link between workplace compassion, social support, and altruism on employee retention in the context of highly competitive business sector. The respondents in this research include employees in competitive companies with a total of 250 respondents. The data were collected using paper-based questionnaires. Drawing on multiple linear regression analysis, validity testing, reliability testing and hypothesis testing (T Test), this research found that workplace compassion, social support, and altruism predict employee retention. This reseacrh provides strategic insight for companies in improving compassion, social support, and altruism to strengthen overall employees' sense of home. [ABSTRACT FROM AUTHOR]

This study aims to explore the relationship of transformational leadership roles, team effectiveness, and well-being with employee innovation behavior in the context of the culinary sector marked as city branding product. This study uses quantitative methods by collecting data through the distribution of questionnaires to employees of culinary sector businesses where the culinary includes city branding products. The results of the data analysis showed that transformational leadership and team effectiveness had a positive relationship with employee innovation behavior, while employee well-being has no relationship with employee innovation behavior. These findings provide important insights for managers and leaders in the culinary sector in understanding the factors influencing employee innovative behaviour in the organizations producing products marked as an icon of the city. [ABSTRACT FROM AUTHOR]

The development of science in the field of robotics has made many heavy jobs that cannot be done by humans replaced by robots, especially in the factory industry. In modern factories, most of them have a warehouse or similar facility that contains heavy equipment for use in a factory, for example, forklift heavy equipment. Based on an interview with one of the forklift operators, the problem of using forklifts is usually when there are items that must be moved that cannot be lifted by humans which must be done immediately according to the route where the item is stored. To answer the existing problems, a robot prototype was made which is useful to help facilitate the work of factory workers. This robot prototype was built using the User Centered Design (UCD) method. This robot prototype uses the main components of Arduino UNO, L293D Motor Driver, and PWM Servo Motor Driver. Based on the overall testing that has been done, it can be said that the robot prototype can follow the route according to the program and can lift and remove objects in front of it with a score of 80%. So that workers can be helped to facilitate their work. [ABSTRACT FROM AUTHOR]

Piper baccatum is a woody climber and grows throughout the tropics mostly in Southeast Asia such as Thailand, Malaysia, Singapore, and Indonesia. The studies on essential oil composition and anticholinesterase activities were performed, along with molecular docking of all components. The essential oil was obtained by hydrodistillation and analyzed by GC-FID and GC-MS, while anticholinesterase activity was assessed using Ellman method. A total of 14 components were identified, representing 98.1% of the total composition of the essential oil. The major identified components were β-caryophyllene (30.7%), camphene (22.1%), eucalyptol (14.9%), γ-muurolene (6.9%), and α-pinene (5.3%). A moderate inhibitory effect was observed for acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) with IC50 values of 80.5 and 96.4 μg/mL, respectively. Molecular docking studies of P. baccatum components with AChE and BChE revealed binding energy ranges of -5.6 to -8.5 Kcal/mol and -5.2 to -7.8 Kcal/mol, respectively, predominantly involving hydrophobic interactions with active site residues. Notably, β-caryophyllene and γ-muurolene exhibited superior binding energy profiles with both AChE and BChE compared to other components. The docking results underscore the potential of P. baccatum essential oil components as cholinesterase inhibitors, with implications for applications in food, aromatherapy, and pharmaceutical industries. The identified components, particularly β-caryophyllene and γ-muurolene, showcase promising attributes for further exploration in developing therapeutic interventions targeting cholinesterase-related conditions. This essential oil in general could be potentially used as a cholinesterase inhibitor with possible applications in food, aromatherapy, and pharmaceutical industries. [ABSTRACT FROM AUTHOR]

In this study, a simple two step method is employed to sequentially synthesize bimetallic core/shell nanoparticles (NPs). In the first step, pure mono Au and Ag NPs are prepared via 1064 nm pulsed laser ablations in liquid. In the second step, the Au/Ag substrate immersed in the Au/Ag colloidal solution is exposed to the nanosecond laser at 1064 nm wavelength using various laser energies and ablation periods. The crystalline phase and morphology of the bimetallic core/shell NPs (Au/Ag, Ag/Au) are examined by x-ray diffraction and scanning electron microscopy, respectively. The results showed that highly crystalline, well-dispersed spherical monometallic and bimetallic core/shell NPs can be synthesized via pulse laser ablation in liquid. The average diameter of Au, Ag, Au/Ag, and Ag/Au NPs is 34, 40, 58, and 43 nm, respectively. With increasing laser energy, the plasmonic absorption peak of Au NPs redshifts and that of Ag NPs blueshifts. For core/shell, two plasmonic peaks were observed, each of which shifted with increasing ablation time for shell material. Organic dyes with concentrations of 10 − 5 M of methylene-blue with NaBH 4 of 0.05M and methylene-orange with NaBH 4 of 0.1M are used to examine the catalytic performance of the NPs. The core/shell NPs performed better than monometallic NPs. In particular, the catalytic degradation efficiency of Au/Ag and Ag/Au NPs is approximately 90% in significantly less time than monometallic Au and Ag NPs. [ABSTRACT FROM AUTHOR]

This study investigates the dynamics of interfaith communication among religious leaders in Bandung, focusing on their role in fostering religious harmony in Jamika Tolerance Village. Employing a qualitative case study approach, data were gathered through in-depth interviews, participant observations, and document analysis to address three primary research questions: (1) the psychographic backgrounds influencing interfaith communication, (2) the evolution of tolerance, equality, and cooperation among interfaith leaders over time, and (3) the specific roles of these leaders in building religious harmony. The findings reveal that the psychographic profiles of religious communities significantly influence communication dynamics. Over time, there has been notable progress in fostering tolerance, equality, and cooperation, facilitated by regular interfaith dialogues and collaborative activities. Religious leaders emerge as pivotal figures in this process, actively mediating conflicts, organizing interfaith events, and promoting mutual understanding. The implications of this study are multifaceted. Theoretically, it contributes to the understanding of social constructs in interfaith communication and offers a framework for analyzing the dynamics of religious dialogue. Practically, the research provides insights into effective interfaith communication strategies that can be applied to address religious conflicts in urban settings. This study serves as a valuable reference for future research on interfaith relations and offers practical recommendations for government bodies, religious leaders, and community organizations to enhance religious harmony in diverse societies. [ABSTRACT FROM AUTHOR]

Background: Despite focus on surgical preservation of the chondrolabral junction (CLJ), the transition zone between the acetabular cartilage and labrum, the association between severity of CLJ breakdown and functional outcomes after hip arthroscopy remains unexplored. Purpose: To assess the influence of CLJ breakdown on patient-reported outcome measures (PROMs) at a 24-month follow-up after hip arthroscopy for symptomatic labral tears. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of prospectively collected data was conducted to identify patients ≥18 years of age with a minimum 24-month follow-up who underwent hip arthroscopy by a single surgeon for the treatment of symptomatic labral tears secondary to femoroacetabular impingement. The Beck classification of transition zone cartilage was used to grade CLJ damage; patients with grades 0 to 2 were stratified into the mild CLJ damage cohort, and those with grades 3 and 4 were stratified into the severe CLJ damage cohort. PROMs were collected at baseline and at 3, 6, 12 months, and annually thereafter postoperatively. Linear mixed-effects models were used to compare PROMs. Rates of achieving clinically meaningful thresholds and subsequent surgery rates were also compared. Results: In total, 198 patients met the inclusion criteria, with a mean follow-up of 3.54 ± 1.26 years. A total of 95 patients with severe CLJ damage (mean age, 34.9 ± 10.5 years) were compared with 103 patients with mild CLJ damage (mean age, 38.2 ± 11.9 years). Hip Outcome Score–Activities of Daily Living (HOS-ADL), Non-Arthritic Hip Score (NAHS), and visual analog score for pain were inferior in the severe CLJ group at enrollment and all follow-up time points (P ≤.05). However, patients with severe CLJ breakdown exhibited greater improvements in HOS-ADL and NAHS at the 24-month follow-up and achieved clinically meaningful thresholds at equivalent rates to patients with mild CLJ breakdown. Subsequent surgery rates were 6.8% and 12.6% in patients with mild versus severe CLJ damage, respectively (P =.250). Conclusion: Severe CLJ breakdown is associated with increased pain and decreased functional level preoperatively and up to 24 months after hip arthroscopy. Despite this, patients with severe CLJ breakdown experienced greater improvements in functional outcomes at a 24-month follow-up and achieved clinical thresholds at similar rates to patients with mild CLJ damage. Thus, while worse baseline pain and functional levels may indicate severe CLJ breakdown, these patients still benefit substantially from hip arthroscopy. [ABSTRACT FROM AUTHOR]

The genus Knema Lour. is distributed mainly in Southeast Asian and widely used in folk medicine for treating diseases such as jaundice, chronic fever, and inflammation. The chemical composition, acetylcholinesterase inhibition, and molecular docking studies of essential oil from Knema hookeriana Warb. were investigated in this study. The essential oil was achieved through hydrodistillation and was characterised using gas chromatography (GC-FID) and gas chromatography-mass spectrometry (GC-MS). The acetylcholinesterase inhibitory activity was evaluated using Ellman method while molecular docking studies were carried out using Autodock v.4.3.2. The results revealed that the essential oil examined consisted mainly of β-caryophyllene (26.2%), germacrene D (12.5%), δ-cadinene (9.2%), germacrene B (8.8%) and bicyclogermacrene (5.5%). The essential oil showed acetylcholinesterase activity with IC50 value of 70.5 µg/mL. The enzyme-ligand molecular docking study showed that β-caryophyllene and δ-cadinene exhibited good binding affinities towards AChE with docking scores −8.1 kcal/mol and −8.3 kcal/mol, respectively. [ABSTRACT FROM AUTHOR]

Objectives: A prior study investigating 2-year patient-reported outcomes (PROs) following hip arthroscopy found that patients with coxa profunda and acetabular overcoverage report worse improvements yet similar overall outcomes scores. Regarding conversion to total hip arthroplasty (THA), however, patients with coxa profunda and overcoverage experienced significantly lower rates of survivorship (88.9% vs 100%; p = 0.04). When considering long-term outcomes, a recent study by Domb et al. found an 85.7% 10-year survivorship in patients after hip arthroscopy. Currently, there remains a paucity of literature on the effects of a deep acetabular socket and pincer-type femoroacetabular impingement on patient outcomes beyond 2-years follow-up. The objective of the present study was to report the long-term survivorship, revision surgery rate, patient satisfaction, pain level, and functional outcome scores in patients with coxa profunda and acetabular overcoverage following hip arthroscopy. Methods: This was an institutional review board-approved retrospective cohort study of patients with coxa profunda and a LCE angle > 40° who underwent hip arthroscopy for labral tears or FAI between November 2002 and May 2013. After failing conservative management, all patients were treated by a single surgeon and received the same capsulotomy technique and postoperative protocol. Patients with a minimum 8-years follow-up, complete PROs, the presence of coxa profunda as indicated by the acetabular wall projecting medial to the ilioischial line, and a LCE angle > 40° were included (Figure 1). Patients with severe osteoarthritis (Tönnis osteoarthritis grade > 2) or any previous hip surgeries were excluded. Patients meeting inclusion and exclusion criteria represented the overcoverage cohort (OC) and were matched 1:1 by sex, age within 8 years, body mass index (BMI) within 5 kg/m2, Tönnis grade, and labral treatment (repair vs debridement) to a matched control (MC) cohort that had a LCE angle between 25° and 40°. Collected postoperative outcomes include conversion to THA, revision hip arthroscopy, patient satisfaction, pain level (0-100), number of corticosteroid injections, and 6 PROs (modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Lower Extremity Functional Scale (LEFS), Hip Outcome Score (HOS)–Activities of Daily Living (HOS-ADL), HOS–Sports Specific subscale (HOS-SSS), and 33-item International Hip Outcome Tool (iHOT-33). Pearson χ2 test and Fisher exact test were used to compare categorical variables; two-sample t-tests were used to compare continuous variables. The threshold for statistical significance was set to 0.05. A survival analysis was performed using Kaplan-Meier curves. All statistical analyses were performed using Stata software (version 18.0; StataCorp). Results: A total of 38 patients in the OC cohort were 1:1 matched with 38 patients in the MC cohort. There were no differences in patient demographics including age, BMI, sex, Tönnis grade, labral treatment, follow-up duration, and Beck classification of labral damage or transition zone (chondrolabral junction) cartilage damage (Table 1). At an average of 11.3 years postoperatively (minimum 8-years follow-up), patients in the OC and MC cohort experienced similar rates of conversion to THA (OC: 11 [28.9%] vs MC: 6 [15.8%]; p =.169) and revision hip arthroscopy (OC: 4 [10.5%] vs MC: 1 [2.6%]; p =.165). The average time from primary hip arthroscopy to conversion to THA was 8.0 ± 6.5 years for OC and 3.7 ± 3.0 years for MC (p =.144) with the OC cohort converting to THA between 6.5 months to 17.14 years while the MC cohort ranged from 4.8 months to 7.8 years. Age at conversion to THA was 54.3 ± 8.0 years for the OC cohort and 59.0 ± 4.0 years for the MC cohort (p =.195). By Kaplan-Meier survival analysis, patients showed similar rates of survivorship (84.2%) at 12 years after hip arthroscopy; however, OC patients showed a 13.1% decrease in long-term survivorship (71.1%) between years 12 and 18 (Figure 2). Additionally, OC and MC patients showed similar levels of patient satisfaction, pain level, postoperative corticosteroid injections, and scores for all 6 PROs (Table 2). Conclusions: Patients with coxa profunda and overcoverage (LCE angle > 40°) showed similar levels of survivorship, revision arthroscopy, patient satisfaction, pain level, number of corticosteroid injections, and PROs to a 1:1 matched cohort of patients with normal acetabular coverage (LCE angle between 25° and 40°) at a minimum 8-years after primary hip arthroscopy. When analyzing long-term survivorship after 12 years, however, patients with overcoverage showed a 13.1% decrease in long-term survivorship (71.1%) compared to a matched control cohort. Overall, a greater focus on extended follow-up care after hip arthroscopy is needed to improve long-term survivorship in patients with a deep acetabular socket and pincer-type femoroacetabular impingement. [ABSTRACT FROM AUTHOR]

Objectives: Intraarticular hip pathologies in non-arthritic hips, including acetabular labral tears and osseous deformities or femoroacetabular impingement (FAI) of the femoral head and acetabulum, have detrimental effects on hip biomechanics, synovial fluid dynamics, and the acceleration of early osteoarthritis. Consequently, prompt treatment of persistent symptoms from labral tears and/or FAI that fail conservative management frequently requires hip arthroscopy. Prior literature has identified older age and more advanced radiographic (e.g., high Tönnis grade) and/or arthroscopic (e.g., higher Outerbridge grade) osteoarthritis as risk factors for poor outcomes following hip arthroscopy. In addition, studies have discussed the significance of "chondrolabral junction" (CLJ) damage on hip arthroscopy outcomes; however, prior literature has considered CLJ damage with reference to chondral or labral damage separately. The specific impact of damage to the transition zone cartilage between the labrum and articular cartilage—the chondrolabral junction—has not been explored. We propose that assessment of CLJ damage through a validated classification system is essential to understand the prognostic impact of this region on functional outcomes following hip arthroscopy and potentially guide future surgical modalities. Thus, the purpose of this study was to conduct a cohort analysis to assess the impact of CLJ damage on clinical functional outcomes at minimum two years following hip arthroscopy. Methods: An institutional review board-approved retrospective review of a prospectively collected, single-surgeon database was performed to identify patients who underwent hip arthroscopy for treatment of symptomatic labral tears secondary to FAI. Included patients had failed conservative treatment and had a minimum of two-year follow-up. Patients were excluded if they had any previous hip surgery or advanced osteoarthritis (Tönnis>2). Operative notes and arthroscopic images for consecutive patients were reviewed for evaluation of intraoperative findings, including, most notably, CLJ damage. The previously published Beck classification of transition zone cartilage injury was used to grade CLJ damage for all patients; patients with a grade of 0-2 were stratified into the "mild CLJ damage" cohort, and those with a grade of 3-4 were stratified into the "severe CLJ damage" cohort. Other operative findings collected included Outerbridge classification of the articular cartilage and the Beck classification of labral tears. Preoperative hip and pelvic radiographs were reviewed for all patients. The following patient reported outcome measures (PROMs) were assessed for all patients: International Hip Outcome Tool-33 (iHOT-33), Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), Modified Hip Harris Score (mHHS), and visual analog score (VAS) for pain. Linear mixed effects models adjusted for age, sex, body mass index (BMI), Beck labrum score, labral treatment (debridement versus repair), FAI type, and use of adjuvant treatment for cartilage damage (BMAC or microfracture) were used to compare PROM scores at enrollment, 3 months, 6 months, 1 year, 2 years, and 5 years. Results: Overall, 200 patients met inclusion/exclusion criteria, with average follow-up time of 3.63 ± 1.21 years. A total of 96 patients with severe CLJ damage (age: 34.8 ± 10.5 years, BMI: 25.3 ± 3.3 kg/m2, 33.3% female) were compared with 104 patients with mild CLJ damage (age: 38.4 ± 11.8 years, BMI: 25.5 ± 4.4 kg/m2, 48.0% female) (Table 1). Patients with severe CLJ damage had significantly larger labral tear sizes, higher Beck labrum grades, and higher rates of combined FAI which were surgically treated (P < 0.05 for each; Table 2). Linear mixed effects modeling showed that HOS-ADL, NAHS, and VAS scores were significantly inferior in the severe CLJ group at enrollment and 3-month follow-up; HOS-ADL and NAHS remained significantly lower for the severe CLJ cohort at 6-month and 1-year follow-up. However, by 2-year follow-up, the severe CLJ group only had lower NAHS scores; by 5-year follow-up, there were no differences between cohorts in any reported PROMs (Table 3). Furthermore, at 2- and 5-year follow-up, there were no differences between mild versus severe CLJ cohorts in percentage of patients achieving any clinical thresholds, including minimally clinically important difference (MCID), patient acceptable symptomatic state (PASS), or substantial clinical benefit (SCB) (P > 0.05 for each) (Table 4). Conclusions: While patients with severe CLJ damage had worse functional metrics at baseline and through 12 months postoperatively following hip arthroscopy, these differences decreased at 2 years and were mitigated entirely at 5 years. These improvements are further supported by 78 (iHOT-33), 66 (HOS-ADL), 71 (HOS-SSS), 79 (NAHS), and 76 (mHHS) percent of patients with severe CLJ damage achieving MCID for these functional metrics, at 2 years; these percentages did not differ significantly from patients with mild CLJ damage. These data suggest that while significant CLJ breakdown may account for significantly increased pain and decreased functional status upon initial clinical presentation and up to 1 year postoperatively, these patients can improve significantly beyond 1 year and achieve satisfactory functional outcomes at 2 and up to 5 years. These findings have implications for managing patient expectations prior to hip arthroscopy for FAI. Although it may take more than 12 months, patients with severe CLJ damage can be counseled that they are still likely to attain clinically meaningful midterm improvements in functional outcomes following hip arthroscopy for FAI. [ABSTRACT FROM AUTHOR]

This exploratory study is aimed to investigate the impact of good governance practices of transparency and accountability on project performance in public health sector hospitals of Peshawar, Khyber Pakhtunkhwa. The research signifies a noteworthy advancement in a sequence of healthcare industry studies designed to illustrate the influence of effective governance on the performance of healthcare projects. Transparency and accountability are the major determinants of good governance having impact on healthcare project outcomes in the hospitals of Peshawar. The study will focus on three significant healthcare projects in the KP province: the "Sehat Card," "RBC," and "Insulin D - Talk." The study selected a sample size of N= 121, using a simple random sampling technique to choose the project planning, monitoring, and implementing authorities, including administrators, project leaders, heads of hospital departments, doctors, and other project staff members. Standardized surveys were conducted to gather quantitative data on the prevalence, frequency, and perceived effectiveness of selected governance practices among project staff members. The study revealed that transparency and accountability significantly influence project outcomes. The project demonstrated strong performance, and the study is significant as it represents the initial use of an international evaluation standard to measure the effectiveness of healthcare projects in Pakistan. The UNDP's principles of good governance were utilized to assess their influence on the performance of healthcare projects. Hence, the recommendations of the study show the importance of transparency and information in decision-making. They also emphasize coordinating with policymakers, healthcare managers, and project managers to improve governance practices and project outcomes. Similarly, such research initiatives are encouraged in private healthcare and other industries. [ABSTRACT FROM AUTHOR]

Introduction: The implementation of smoke-free regulations is an effort to create a clean and healthy environment in the Blitar District, Indonesia. The main purpose of this research is to analyze public opinion on the smoke-free regulations drafting in the Blitar District. Methods: To analyze public opinion about the smoke-free regulations, we used a cross-sectional design with a RAPID survey conducted in 2015. The research involved distributing questionnaires to 1,008 respondents, with the sample size proportionally divided across 22 districts. For the implementation of the regulation, we conducted observational research over four years. The effort to draft the smoke-free regulations continued until 2019, and the implementation of the regulations is ongoing until 2023. Results and Discussion: Results showed that 94.5% supported the regulations. The RAPID survey results provided evidence for drafting the smoke-free regulations. This evidence was used to advocate for stakeholder support in drafting and implementing the regulations in the Blitar District. Although the smoke-free regulations were released in 2019, their implementation has been very challenging and requiring significant effort. Conclusion: A RAPID survey showed that almost all people in Blitar support the drafting and implementation of the smoke-free regulations. The implementation requires significant effort to ensure it proceeds smoothly and needs support from all stakeholders in the Blitar District. [ABSTRACT FROM AUTHOR]