Assessing child satisfaction and expectations for developing a child-friendly environment at the pediatric department in a general hospital in Qatar.

Background: "Patient-centered" care positions the patient at the core and emphasizes fulfilling their unique needs, preferences, and values. This approach is particularly significant in the context of children. Although widely recognized as necessary, this approach is not universally implemented. The children find themselves in hospital wards where they are required to follow protocols and systems designed primarily for adults. In the appropriate atmosphere, children often express themselves more effectively through words, body language, and play, leading to a richer understanding of their needs. There is growing recognition of the importance of addressing children's concerns regarding hospital environments. Aim: This study investigates children's satisfaction with the physical aspect of the hospital environment. Insights from this exploration could provide valuable input for creating hospital environments centered around children's needs and preferences. Methods: This mixed-methods study involves children aged 6-14 years with parental consent from a premiere healthcare provider in the state of Qatar. The survey used nine items to gauge satisfaction with the existing hospital environment as a "child-friendly hospital" and another nine items to explore their expectations for such environments. The Mann-Whitney U and Kruskal-Wallis tests as well as thematic analyses were employed to assess the statistical significance of differences in satisfaction levels and children's expectations of the hospital's physical environment. Results: A total of 398 children participated in the study. Of them, 40.3% were aged 6-8 years; 60.3% had experienced two to five hospital visits; 55.8% of children participated during their outpatient service visit; and 31.7% were Asian. Children's satisfaction levels with various aspects of the hospital environment-including its physical appearance, signage, lounge, consultant rooms, corridors, bedrooms, TV content, toys, and staff uniforms-were in the range of 42.9%-59%. The children expressed a desire for a hospital environment that is spacious, colorful, attractive, and filled with cartoon characters and toys in the children's hospital from the front lounge to the inpatient units. Conclusion: The findings underline the importance of considering the perspectives of children in evidence-based healthcare design. The study reveals that children's satisfaction with the hospital environment is generally average or below average. Ultimately, a "child-friendly hospital environment" integrates children's rights into healthcare to significantly improve outcomes.

ANN based prediction of ligand binding sites outside deep cavities to facilitate drug designing.

The ever-changing environmental conditions and pollution are the prime reasons for the onset of several emerging and re-merging diseases. This demands the faster designing of new drugs to curb the deadly diseases in less waiting time to cure the animals and humans. Drug molecules interact with only protein surface on specific locations termed as ligand binding sites (LBS). Therefore, the knowledge of LBS is required for rational drug designing. Existing geometrical LBS prediction methods rely on search of cavities based on the fact that 83% of the LBS found in deep cavities, however, these methods usually fail where LBS localize outside deep cavities. To overcome this challenge, the present work provides an artificial neural network (ANN) based method to predict LBS outside deep cavities in animal proteins including human to facilitate drug designing. In the present work a feed-forward backpropagation neural network was trained by utilizing 38 structural, atomic, physiochemical, and evolutionary discriminant features of LBS and non-LBS residues localized in the extracted roughest patch on protein surface. The performance of this ANN based prediction method was found 76% better for those proteins where cavity subspace (extracted by MetaPocket 2.0, a consensus method) failed to predict LBS due to their localization outside the deep cavities. The prediction of LBS outside deep cavities will facilitate in drug designing for the proteins where it is not possible due to lack of LBS information as the geometrical LBS prediction methods rely on extraction of deep cavities.

A mixed methods evaluation of the impact of ECHO® telementoring model for capacity building of community health workers in India.

INTRODUCTION: India has the largest cohort of community health workers with one million Accredited Social Health Activists (ASHAs). ASHAs play vital role in providing health education and promoting accessible health care services in the community. Despite their potential to improve the health status of people, they remain largely underutilized because of their limited knowledge and skills. Considering this gap, Extension for Community Healthcare Outcomes (ECHO)® India, in collaboration with the National Health System Resource Centre (NHSRC), implemented a 15-h (over 6 months) refresher training for ASHAs using a telementoring interface. The present study intends to assess the impact of the training program for improving the knowledge and skills of ASHA workers. METHODS: We conducted a pre-post quasi-experimental study using a convergent parallel mixed-method approach. The quantitative survey (n = 490) assessed learning competence, performance, and satisfaction of the ASHAs. In addition to the above, in-depth interviews with ASHAs (n = 12) and key informant interviews with other stakeholders (n = 9) examined the experience and practical applications of the training. Inferences from the quantitative and qualitative approaches were integrated during the reporting stage and presented using an adapted Moore's Expanded Outcomes Framework. RESULTS: There was a statistically significant improvement in learning (p = 0.038) and competence (p = 0.01) after attending the training. Participants were satisfied with the opportunity provided by the teleECHO™ sessions to upgrade their knowledge. However, internet connectivity, duration and number of participants in the sessions were identified as areas that needed improvement for future training programs. An improvement in confidence to communicate more effectively with the community was reported. Positive changes in the attitudes of ASHAs towards patient and community members were also reported after attending the training. The peer-to-peer learning through case-based discussion approach helped ensure that the training was relevant to the needs and work of the ASHAs. CONCLUSIONS: The ECHO Model ™ was found effective in improving and updating the knowledge and skills of ASHAs across different geographies in India. Efforts directed towards knowledge upgradation of ASHAs are crucial for strengthening the health system at the community level. The findings of this study can be used to guide future training programs. Trial registration The study has been registered at the Clinical Trials Registry, India (CTRI/2021/10/037189) dated 08/10/2021.

New Vision of Cell Walls in Aspergillus fumigatus from Solid-State NMR Spectroscopy.

The fungal cell wall plays a critical role in regulating cellular integrity and communication, and serves as a frontline defense against stress. It is also a prime target for the development of antifungal agents. The cell wall is comprised of diverse polysaccharides and proteins and poses a challenging target for high-resolution structural characterization. Recently, the solid-state nuclear magnetic resonance (ssNMR) analysis of intact Aspergillus fumigatus cells has provided atomic-level insights into the structural polymorphism and functional assembly principles of carbohydrate components within the cell wall. This physical perspective, alongside structural information from biochemical assays, offers a renewed understanding of the cell wall as a highly complex and dynamic organelle. Here, we summarize key conceptual advancements in the structural elucidation of A. fumigatus mycelial and conidial cell walls and their responses to stressors. We also highlight underexplored areas and discuss the opportunities facilitated by technical advancements in ssNMR spectroscopy.

Evaluation of psychological distress, burnout and structural empowerment status of healthcare workers during the outbreak of coronavirus disease (COVID-19): a cross-sectional questionnaire-based study.

BACKGROUND: In light of several recent studies, there is evidence that the coronavirus disease 2019 (COVID-19) pandemic has caused various mental health concerns in the general population, as well as among healthcare workers (HCWs). The main aim of this study was to assess the psychological distress, burnout and structural empowerment status of HCWs during the COVID-19 outbreak, and to evaluate its predictors. METHODS: This multi-center, cross-sectional web-based questionnaire survey was conducted on HCWs during the outbreak of COVID-19 from August 2020 to January 2021. HCWs working in hospitals from 48 different countries were invited to participate in an online anonymous survey that investigated sociodemographic data, psychological distress, burnout and structural empowerment (SE) based on Depression Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI) and Conditions for work effectiveness questionnaire (CWEQ_II), respectively. Predictors of the total scores of DASS-21, MBI and CWEQ-II were assessed using unadjusted and adjusted binary logistic regression analysis. RESULTS: Out of the 1030 HCWs enrolled in this survey, all completed the sociodemographic section (response rate 100%) A total of 730 (70.9%) HCWs completed the DASS-21 questionnaire, 852 (82.6%) completed the MBI questionnaire, and 712 (69.1%) completed the CWEQ-II questionnaire. The results indicate that 360 out of 730 responders (49.3%) reported severe or extremely severe levels of stress, anxiety, and depression. Additionally, 422 out of 851 responders (49.6%) reported a high level of burnout, while 268 out of 712 responders (37.6%) reported a high level of structural empowerment based on the DASS-21, MBI, and CWEQ-II scales, respectively. In addition, the analysis showed that HCWs working in the COVID-19 areas experienced significantly higher symptoms of severe stress, anxiety, depression and higher levels of burnout compared to those working in other areas. The results also revealed that direct work with COVID-19 patients, lower work experience, and high workload during the outbreak of COVID-19 increase the risks of negative psychological consequences. CONCLUSION: Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.

Construction of prophage-free and highly-transformable Limosilactobacillus reuteri strains and their use for production of 1,3-propanediol.

The lactic acid bacterium Limosilactobacillus reuteri (formerly Lactobacillus reuteri) is a desirable host for the production of 1,3-propanediol (1,3-PDO) from glycerol when 1,3-PDO is used in the food or cosmetic industry. However, the production is hindered by strain instability, causing cell lysis, and difficult gene manipulation. This study reveals that the stability of L. reuteri DSM 20016 and its 1,3-PDO production, especially in the alcohol dehydrogenases (ADHs)-deletion mutants, are greatly enhanced after the deletion of two prophages (Φ3 and Φ4) present in the L. reuteri's chromosome. The resulting phage-free and ADHs-deletion mutant could produce >825 mM 1,3-PDO in 48 h without cell lysis at the theoretical maximum yield on glucose of ~2 mol/mol. Compared to the wild-type strain, the mutant exhibited a 45.2% increase in 1,3-PDO production titer and a 2.1-fold increase in yield. In addition, this study reports that the transformation efficiency of L. reuteri Δadh2Δadh6 mutant strains were greatly enhanced by >300-fold after the deletion of prophage Φ3, probably due to the removal of a restriction-modification (RM) system which resides in the phage genome. With improved stability and higher transformation efficiency, recombinant L. reuteri DSM 20016 Δadh2Δadh6ΔΦ3ΔΦ4 can be a more reliable and amenable host for industrial applications.

Comparing trimodal therapy with radical cystectomy in muscle-invasive bladder cancer: an updated meta-analysis.

Background: We conducted this meta-analysis to compare the two muscle-invasive bladder cancer (MIBC) treatment modalities in terms of cancer-specific survival (CSS) and other outcome indicators. Method: A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. The search was conducted using various academic databases including Scopus, PubMed, Cochrane database, EMBASE, Chinese biomedical literature database, Wan fang databases, and China National Knowledge Internet databases between 1966 and December 2023. This review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) No. (CRD42023398977). Result: This study included a total of 54,816 patients diagnosed with bladder cancer from 14 studies, of which 6,228 patients were assigned to the trimodal therapy (TMT) group and 48,588 patients were assigned to the radical cystectomy (RC) group. Based on the results, the RC group exhibited a higher rate of survival than the TMT group [pooled hazard ratio (HR) = 1.23, 95% CI: 1.18-1.28, Z = 1.46, P < 0.001]. In terms of CSS, patients in the RC group had a longer CSS compared with those in the TMT group (pooled HR = 1.47, 95% CI: 1.29-1.67, Z = 5.893, P < 0.001). Compared with RC, TMT is significantly associated with an increased risk of both types of mortality (pooled HR: 1.30, P < 0.001). Conclusion: Overall, the findings of this meta-analysis suggest that RC treatment may be associated with improved overall survival. Moreover, it was observed that cancer-specific survival was significantly prolonged among patients in the RC group as opposed to those who received TMT. In addition, it was shown that patients who received TMT exhibited a higher risk of all-cause mortality when compared with those who underwent RC.

Psychosocial impact of COVID-19 pandemic: experience of healthcare workers in Qatar.

Background: The COVID-19 pandemic has had a profound and global impact on healthcare systems worldwide, presenting unprecedented challenges for healthcare workers (HCWs) on the front. We aimed to evaluate the prevalence of anxiety and depression symptoms during the coronavirus pandemic among healthcare professionals in Qatar. Methods: A cross-sectional study where an electronic questionnaire containing demographics, and psychosocial questions were made on Google Docs and Microsoft Team, and were sent through email and WhatsApp to healthcare workers, including doctors, nurses, allied health and others working at Hamad Medical Corporation in Qatar, from June 1, 2021, to January 1st 2023. ANOVA, t-test and multiple linear regression were used to see the association between the psychological factors and sociodemographic variables using STATA version 17 software. Results: A total of 829 participants were included in this study (response rate: 55%). The average age of the participants is 36.0 ± 7.1; 65.9% were males; 2.3% were doctors and 53% were nurses, 38.7% were allied healthcare professionals and 6% were others. Psychological, social effects, and workplace were shown to significantly related to their marital status, career, and hospital setting (p < 0.01 for each). Similar to this, dealing with COVID-19 patients and their education level with the length of time working at the designated facility were all connected with the health professional safety score (p < 0.05). Conclusion: During the COVID-19 epidemic, healthcare workers in Qatar experienced a high incidence of negative psychosocial symptoms. To alleviate these outcomes, it would be useful to implement screening procedures for such symptoms and to devise preventive measures accordingly.

Assessment of nurse's perceived just culture: a cross-sectional study.

BACKGROUND: The non-punitive approach to error investigation in most safety culture surveys have been relatively low. Most of the current patient safety culture measurement tools also lack the ability to directly gauge concepts important to a just culture (i.e. perceptions of fairness and trust). The purpose of this study is to assess nurses' perceptions of the six just culture dimensions using the validated Just Culture Assessment Tool (JCAT). METHODS: This descriptive, cross-sectional study was conducted between November and December 2020. Data from 212 staff nurses in a large referral hospital in Qatar were collected. A validated, self-reported survey called the JCAT was used to assess the perception of the just culture dimensions including feedback and communication, openness of communication, balance, quality of event reporting process, continuous improvement, and trust. RESULTS: The study revealed that the overall positive perception score of just culture was (75.44%). The strength areas of the just culture were "continuous improvement" dimension (88.44%), "quality of events reporting process" (86.04%), followed by "feedback and communication" (80.19%), and "openness of communication" (77.55%) The dimensions such as "trust" (68.30%) and "balance" (52.55%) had a lower positive perception rates. CONCLUSION: A strong and effective just culture is a cornerstone of any organization, particularly when it comes to ensuring safety. It places paramount importance on encouraging voluntary error reporting and establishing a robust feedback system to address safety-related events promptly. It also recognizes that errors present valuable opportunities for continuous improvement. Just culture is more than just a no-blame practice. By prioritizing accountability and responsibility among front-line workers, a just culture fosters a sense of ownership and a commitment to improve safety, rather than assigning blame.

Development and validation of the Nursing Journal Club Perception Scale (NJCPS).

BACKGROUND: The Journal Club is an excellent platform for participants to engage in the critical evaluation of articles and the extraction of evidence to support evidence-based nursing practices. The study aims to develop and validate a reliable instrument, the Nursing Journal club perception scale (NJCPS), for assessing the perceived educational value and the perception of virtual journal club experiences. MATERIALS AND METHODS: The current study is a scale development and validation study. The scale-level content validity indices (S-CVI) and item-level content validity indices (I-CVI) were assessed by eight experts. Eleven experts from various nursing fields evaluated the instrument regarding its relevance, clarity, meaningfulness, and completeness. Finally, the scale was introduced to 90 clinical nurses from two facilities to assess the internal consistency during the period of March- April 2022. RESULTS: The content validity of the scale S-CVI/average and S-CVI/UA was 0.97 and 0.86, respectively, which indicates adequate relevance of the questionnaire content. Principal component analysis indicated that the construct validity of the perceived educational value and the perception of the virtual journal club domain was 67.8% and 66.5%, respectively. In the two domains of the perception of educational value (supporting clinical practice and supporting research), Cronbach's Alpha was 0.93 and 0.91, respectively. Similarly, for the two domains of virtual JC (learning experience and benefits of virtual journal club)), Cronbach' Alpha was 0.95 and 0.74, respectively. CONCLUSIONS: The NJCPS tool is a valid and reliable scale to measure the educational value and virtual journal club experience of the participants from various fields of healthcare.

Molecular Characterization of Rotavirus C from Rescued Sloth Bears, India: Evidence of Zooanthroponotic Transmission.

The present study reports the detection and molecular characterisation of rotavirus C (RVC) in sloth bears (Melursus ursinus) rescued from urban areas in India. Based on an RVC VP6 gene-targeted diagnostic RT-PCR assay, 48.3% (42/87) of sloth bears tested positive for RVC infection. The VP6, VP7, and NSP4 genes of three sloth bear RVC isolates (UP-SB19, 21, and 37) were further analysed. The VP6 genes of RVC UP-SB21 and 37 isolates were only 37% identical. The sequence identity, TM-score from structure alignment, and selection pressure (dN/dS) of VP6 UP-SB37 with pig and human RVCs isolates were (99.67%, 0.97, and 1.718) and (99.01%, 0.93, and 0.0340), respectively. However, VP6 UP-SB21 has an identity, TM-score, and dN/dS of (84.38%, 1.0, and 0.0648) and (99.63%, 1.0, and 3.7696) with human and pig RVC isolates, respectively. The VP7 genes from UP-SB19 and 37 RVC isolates were 79.98% identical and shared identity, TM-score, and dN/dS of 88.4%, 0.76, and 5.3210, along with 77.98%, 0.77, and 4.7483 with pig and human RVC isolates, respectively. The NSP4 gene of UP-SB37 RVC isolates has an identity, TM-score, and dN/dS of 98.95%, 0.76, and 0.2907, along with 83.12%, 0.34, and 0.2133 with pig and human RVC isolates, respectively. Phylogenetic analysis of the nucleotide sequences of the sloth bear RVC isolates assigned the isolate UP-SB37 to genotype G12, I2 for RVC structural genes VP7 and VP6, and E1 for NSP4 genes, respectively, while isolates UP-SB19 and UP-SB21 were classified as genotype G13 and GI7 based on the structural gene VP7, respectively. The study suggests that the RVCs circulating in the Indian sloth bear population are highly divergent and might have originated from pigs or humans, and further investigation focusing on the whole genome sequencing of the sloth bear RVC isolate may shed light on the virus origin and evolution.

Identification and characterization of RuvBL DNA helicase genes for tolerance against abiotic stresses in bread wheat (Triticum aestivum L.) and related species.

Recombination UVB (sensitivity) like (RuvBL) helicase genes represent a conserved family of genes, which are known to be involved in providing tolerance against abiotic stresses like heat and drought. We identified nine wheat RuvBL genes, one each on nine different chromosomes, belonging to homoeologous groups 2, 3, and 4. The lengths of genes ranged from 1647 to 2197 bp and exhibited synteny with corresponding genes in related species including Ae. tauschii, Z. mays, O. sativa, H. vulgare, and B. distachyon. The gene sequences were associated with regulatory cis-elements and transposable elements. Two genes, namely TaRuvBL1a-4A and TaRuvBL1a-4B, also carried targets for a widely known miRNA, tae-miR164. Gene ontology revealed that these genes were closely associated with ATP-dependent formation of histone acetyltransferase complex. Analysis of the structure and function of RuvBL proteins revealed that the proteins were localized mainly in the cytoplasm. A representative gene, namely TaRuvBL1a-4A, was also shown to be involved in protein-protein interactions with ten other proteins. On the basis of phylogeny, RuvBL proteins were placed in two sub-divisions, namely RuvBL1 and RuvBL2, which were further classified into clusters and sub-clusters. In silico studies suggested that these genes were differentially expressed under heat/drought. The qRT-PCR analysis confirmed that expression of TaRuvBL genes differed among wheat cultivars, which differed in the level of thermotolerance. The present study advances our understanding of the biological role of wheat RuvBL genes and should help in planning future studies on RuvBL genes in wheat including use of RuvBL genes in breeding thermotolerant wheat cultivars.

The Association of Hypertension with Increased Mortality Rate During the COVID-19 Pandemic: An Update with Meta-analysis.

BACKGROUND AND AIM: The impact of multiple risk factors on COVID-19 mortality has been previously reported in multiple systematic reviews and meta-analyses. The aim of this review is to provide a comprehensive update on the association between hypertension (HTN) and mortality in patients with COVID-19. METHODS: A systematic review and meta-analysis were performed and followed the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. A search was achieved using PubMed, Scopus, and Cochrane Databases for research publications on hypertension, COVID-19, and mortality published between December 2019 and August 2022. RESULTS: A total of 23 observational studies involving 611,522 patients from 5 countries (China, Korea, the UK, Australia, and the USA) were included in our study. The confirmed number of COVID-19 with HTN cases in each study ranged from 5 to 9964. The mortality ranged from 0.17% to 31% in different studies. Pooled results show that the mortality rate of COVID-19 among the included studies ranges from a minimum of 0.39 (95% CI 0.13-1.12) to a maximum of 5.74 (95% CI 3.77-8.74). Out of the 611,522 patients, 3119 died which resulted in an overall mortality prevalence of 0.5%. Subgroup analyses indicated that patients with COVID-19 who have hypertension and male patients had slightly less risk of mortality than female patients [the percentage of men > 50%; OR 1.33: 95% CI (1.01, 1.76); the percentage of men ≤ 50%: OR 2.26; and 95% CI (1.15, 4.48)]. Meta-regression analysis results also showed a statistically significant association between hypertension and COVID-19 mortality. CONCLUSION: This systematic review and meta-analysis suggest that hypertension may not be the only risk factor associated with the increased mortality rate during the COVID-19 pandemic. In addition, a combination of other comorbidities and old age appears to increase the risk of mortality from COVID-19. The impact of hypertension on mortality rate among COVID-19 patients.

Nurse's experience working 12-hour shift in a tertiary level hospital in Qatar: a mixed method study.

BACKGROUND: The use of 12-h shifts for nursing staff has become common in many healthcare settings, including tertiary hospitals, due to its potential benefits such as reduced handover time and increased continuity of care. However, there is limited research on the experiences of nurses working 12-h shifts, particularly in the context of Qatar, where the healthcare system and nursing workforce may have unique characteristics and challenges. This study aimed to explore the experiences of nurses working 12-h shifts in a tertiary hospital in Qatar, including their perceptions of physical health, fatigue, stress, job satisfaction, service quality, and patient safety. METHODS: A mixed method study design was applied consisting of a survey and semi-structured interviews. Data was collected from 350 nurses through an online survey and from 11 nurses through semi-structured interviews. Data was analyzed using Shapiro-Wilk test and the difference between demographic variables and scores were examined using Whitney U test and Kruskal- Wallis test. Thematic analysis was used for qualitative interviews. RESULTS: The results from quantitative study revealed nurses perception in working 12-h shift has negative impact in their wellbeing, satisfaction as well as patient care outcomes. Thematic analysis revealed real stress and burnout and experienced an enormous amount of pressure going for work. CONCLUSIONS: Our study provides an understanding of the nurse's experience working 12-h shift in a tertiary level hospital in Qatar. A mixed method approach informed us that, nurses are not satisfied with the 12-h shift and interviews revealed high level of stress and burnout among nurses resulting in job dissatisfaction and negative health concerns. Nurses also reported that it is challenging to stay productive and focused throughout their new shift pattern.

Association between serum interleukin-6, leptin and insulin in gestational diabetes mellitus - a cross- sectional study.

Purpose: Gestational diabetes mellitus (GDM) is a state of leptin resistance which develops a vicious cycle of hyperinsulinemia and hyperleptinemia leading to aggravation of an inflammatory situation. This study was done to find out the association between IL-6, leptin and insulin in gestational diabetes among North Indian women. Method: This cross-sectional study included 100 GDM, 100 non-GDM and 50 non-pregnant women. DIPSI (Diabetes in Pregnancy Study Group India) criteria was used for screening GDM among pregnant women. GDM and non-GDM pregnant women were further categorized into three groups according to the trimester of pregnancy. Serum IL-6, leptin and insulin were measured in all the enrolled women. Results: Serum IL-6 levels were significantly higher among GDM women as compared to non-GDM and non-pregnant women. Although the mean serum leptin and insulin levels were higher in GDM, but the difference was not statistically significant. When GDM and non-GDM women were categorized into three trimester, serum leptin levels were found to be significantly higher in 3rd trimester (p < 0.002) and IL-6 in 1st trimester (p < 0.017) among GDM women. No correlation was found between serum IL-6, leptin and insulin in GDM. Conclusion: Absence of any significant association between leptin and IL-6 signifies that leptin may not be associated with inflammation in gestational diabetes. However, IL-6 may serve as an early marker for screening glucose intolerance during pregnancy. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01188-3.

Comprehensive Analysis of the Effect of Maternal and Paternal Demographics and Lifestyle Factors on the Embryo Quality and In Vitro Fertilization Outcomes: A Retrospective Study in North Eastern India.

Background Lifestyle habits and demographic characteristics are strongly associated with sperm and oocyte quality and are important co-variates in fertility. However, their effect on the pre-implantation embryo quality in in vitro fertilization (IVF) has not been explored widely. The present retrospective study aimed to explore the effect of maternal and paternal demographic and lifestyle factors on the pre-implantation embryo quality in IVF. Methodology Women in the age group of 21 to 40 years undergoing IVF (n=105) in the Department of Reproductive Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, and their partners were recruited in the study. Maternal and paternal charts were reviewed, and the demographic, lifestyle habit related data, and data related to oocyte retrieval, oocyte quality, and embryo quality were retrieved in a predesigned spreadsheet. Appropriate statistical analysis was conducted using SPSS Version 21 to evaluate the association of the studied maternal and paternal factors with oocyte and embryo quality. P-values less than 0.05 were considered to be significant. Results Maternal factors such as tubal blockage (p=0.02) and residence in an industrial locality (p=0.001) were found to be significantly associated with the quality of oocytes. None of the maternal factors studied were associated with embryo quality; however, day 3 and day 5 embryo quality was significantly associated with educational status of the male partners (p=0.02), smoking (p=0.05), and chewing tobacco (p=0.01). Day 5 embryo quality was also associated with residence in an industrial locality of the male partners (p=0.04). Conclusions Paternal lifestyle habits such as smoking, chewing tobacco, and demographic characteristics such as education and proximity to an industrial area were all related to poor embryo quality. Maternal factors such as tubal blockage and residence of industrial locality were found to be significantly associated with the quality of oocytes.

Yoga Programme for Type 2 Diabetes Prevention (YOGA-DP) Among High-Risk People in India: A Multicenter Feasibility Randomized Controlled Trial.

INTRODUCTION: Many Indians are at high risk of type 2 diabetes mellitus (T2DM). The blood glucose level can be improved through a healthy lifestyle (such as physical activity and a healthy diet). Yoga can help in T2DM prevention, being a culturally appropriate approach to improving lifestyle. We developed the Yoga Programme for T2DM Prevention (YOGA-DP), a 24-week structured lifestyle education and exercise (Yoga) program that included 27 group Yoga sessions and self-practice of Yoga at home. In this study, the feasibility of undertaking a definitive randomized controlled trial (RCT) was explored that will evaluate the intervention's effectiveness among high-risk individuals in India. METHODS: A multicenter, two-arm, parallel-group, feasibility RCT was conducted in India. The outcome assessors and data analysts were blinded. Adults with a fasting blood glucose level of 100-125 mg/dL (i.e., at high risk of T2DM) were eligible. Participants were randomized centrally using a computer-generated randomization schedule. In the intervention group, participants received YOGA-DP. In the control group, participants received enhanced standard care. RESULTS: In this feasibility trial, the recruitment of participants took 4 months (from May to September 2019). We screened 711 people and assessed 160 for eligibility. Sixty-five participants (33 in the intervention group and 32 in the control group) were randomized, and 57 (88%) participants were followed up for 6 months (32 in the intervention group and 25 in the control group). In the intervention group, the group Yoga sessions were continuously attended by 32 (97%) participants (median (interquartile range, IQR) number of sessions attended = 27 (3)). In the intervention group, Yoga was self-practiced at home by 30 (91%) participants (median (IQR) number of days per week and minutes per day self-practiced = 2 (2) and 35 (15), respectively). In the control group, one (3%) participant attended external Yoga sessions (on Pranayama) for 1 week during the feasibility trial period. There was no serious adverse event. CONCLUSIONS: The participant recruitment and follow-up and adherence to the intervention were promising in this feasibility study. In the control group, the potential contamination was low. Therefore, it should be feasible to undertake a definitive RCT in the future that will evaluate YOGA-DP's effectiveness among high-risk people in India. FEASIBILITY TRIAL REGISTRATION: Clinical Trials Registry-India (CTRI) CTRI/2019/05/018893; registered on May 1, 2019.

Leadership styles and transformational leadership skills among nurse leaders in Qatar, a cross-sectional study.

AIM: There is a continuing need to implement strategies that create opportunities to develop leadership in Qatar, and to build institutions that can produce effective health managers and leaders. The scarcity of information and studies relating to leadership in this major healthcare corporation must be addressed. This article aims to explore nursing leadership styles and transformational leadership skills among nursing leaders, in Qatar. The study was conducted from October 2020 to January 2021. DESIGN: A cross-sectional Study. METHODS: A validated survey was administered to explore the prevalence of leadership styles and transformational leadership skills. Subsequent statistical data analysis achieved the research objectives. The Multi-Factor Leadership Questionnaire (Western Journal of Nursing Research, 1996) was used as an online de-identified validated questionnaire. RESULTS: Eighty-nine nurses completed the survey. The nurse leaders in this study exhibited leadership traits or qualities that confirm transformational leadership. Some nurse leaders also exhibited transactional and autocratic leadership styles. Directors of nursing exhibit higher levels of transformational leadership style than head nurses, while the latter is more likely to manifest an autocratic leadership style. This study indicates that a development roadmap is needed to transform more nursing leaders into transformational leaders, particularly head nurses, and to universally improve transformational leadership skills among all nursing staff members.