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Clustering is essential in data analysis, with K-means clustering being widely used for its simplicity and efficiency. However, several challenges can affect its performance, including the handling of outliers, the transformation of non-spherical data into a spherical form, and the selection of the optimal number of clusters. This paper addressed these challenges by developing and enhancing specific models. The primary objective was to improve the robustness and accuracy of K-means clustering in the presence of these issues. To handle outliers, this research employed the winsorization method, which uses threshold values to minimize the influence of extreme data points. For the transformation of non-spherical data into a spherical form, the KROMD method was introduced, which combines Manhattan distance with a Gaussian kernel. This approach ensured a more accurate representation of the data, facilitating better clustering performance. The third objective focused on enhancing the gap statistic for selecting the optimal number of clusters. This was achieved by standardizing the expected value of reference data using an exponential distribution, providing a more reliable criterion for determining the appropriate number of clusters. Experimental results demonstrated that the winsorization method effectively handles outliers, leading to improved clustering stability. The KROMD method significantly enhanced the accuracy of converting non-spherical data into spherical form, achieving an accuracy level of 0.83 percent and an execution time of 0.14 per second. Furthermore, the enhanced gap statistic method outperformed other techniques in selecting the optimal number of clusters, achieving an accuracy of 93.35 percent and an execution time of 0.1433 per second. These advancements collectively enhance the performance of K-means clustering, making it more robust and effective for complex data analysis tasks.

Background Primary cam morphology, an acquired bony prominence at the head-neck junction of the femur, is highly prevalent in athlete populations, and causally associated with femoroacetabular impingement syndrome and early hip osteoarthritis. Experts agreed on key elements for primary cam morphology and a prioritised research agenda for the field. This research agenda will require higher-quality research to achieve meaningful progress on the aetiology, prognosis and treatment of primary cam morphology in athletes. Aim To explore stakeholders’ perspectives of high-quality research in the research field of primary cam morphology and its natural history. Methods Grounded in interpretive description, we used semi-structured interviews to explore stakeholders’ perspectives of high-quality research in the primary cam morphology research field. The framework for INcreasing QUality In patient-orientated academic clinical REsearch (INQUIRE) informed the interview guide. Audio-recorded interviews were transcribed and analysed using thematic analysis. We recruited a heterogenous and purposive maximum variation sample, drawing from a network of research contacts. Results Fifteen individuals, several with multiple perspectives on research quality in the field, participated. Exploring stakeholders’ perspectives on research quality through an established research quality framework (INQUIRE) illuminated areas for immediate action for research communities in the field of primary cam morphology and its natural history. We crafted five action inviting themes: research communities should: partner with athletes/patients; champion equity, diversity and inclusion; collaborate with one another; pursue open science; and nurture young scholars. Conclusion The findings of this study could inform concrete actions by research communities to pursue higher quality research—more research value and less waste—in the field of primary cam morphology and its natural history. Although the five action-inviting themes reflect contemporary trends in research, and could therefore be transferable to other areas of research, their practical application remains context- and field-specific.

The traditional cubic B-spline method offers limited local control over the curve solution. Adjusting the position of a control point affects the entire curve, making it challenging to make localized changes, e.g., smoothness. Moreover, the basis functions vanish on one side by the cubic B-spline method near the end conditions where the initial and boundary conditions are applied. To address these limitations, this research proposes a new basis by including a free parameter γ with the purpose of modifying the weights of nearby control points. This free parameter γ can influence the curve’s behavior in specific regions as well as the entire curve. This modification of the cubic B-spline method was used to approximate the second-order derivative at each collocation point. The convergence test showed that the proposed method was second-order convergent. Numerical examples of ordinary differential equations were used with different step values to evaluate the accuracy of the proposed method. The findings persistently indicated that the proposed technique provided better error estimates as compared to the other methods discussed in the literatures.

Abstract One of the most fascinating 2D nanomaterials (NMs) ever found is various members of MXene family. Among them, the titanium‐based MXenes, with more than 70% of publication‐related investigations, are comparatively well studied, producing fundamental foundation for the 2D MXene family members with flexible properties, familiar with a variety of advanced novel technological applications. Nonetheless, there are still more candidates among transitional metals (TMs) that can function as MXene NMs in ways that go well beyond those that are now recognized. Systematized details of the preparations, characteristics, limitations, significant discoveries, and uses of the novel M‐based MXenes (M‐MXenes), where M stands for non‐Ti TMs (M = Sc, V, Cr, Y, Zr, Nb, Mo, Hf, Ta, W, and Lu), are given. The exceptional qualities of the 2D non‐Ti MXene outperform standard Ti‐MXene in several applications. There is many advancement in top‐down as well as bottom‐up production of MXenes family members, which allows for exact control of the M‐characteristics MXene NMs to contain cutting‐edge applications. This study offers a systematic evaluation of existing research, covering everything in producing complex M‐MXenes from primary limitations to the characterization and selection of their applications in accordance with their novel features. The development of double metal combinations, extension of additional metal candidates beyond group‐(III–VI)B family, and subsequent development of the 2D TM carbide/TMs nitride/TM carbonitrides to 2D metal boride family are also included in this overview. The possibilities and further recommendations for the way of non‐Ti MXene NMs are in the synthesis of NMs will discuss in detail in this critical evaluation.

Background: With the increasing integration of artificial intelligence (AI) technologies into healthcare systems, there is a growing emphasis on privacy and ethical considerations. Nurses, as frontline healthcare professionals, are pivotal in-patient care and offer valuable insights into the ethical implications of AI adoption. Objectives: This study aimed to explore nurses' perspectives on privacy and ethical concerns associated with the implementation of AI in healthcare settings. Methods: We employed Van Manen's hermeneutic phenomenology as the qualitative research approach. Data were collected through purposive sampling from the December 7, 2023 to the January 15, 2024, with interviews conducted in Bengali. Thematic analysis was utilized following member checking and an audit trail. Results: Six themes emerged from the research findings: Ethical dimensions of AI integration, highlighting complexities in incorporating AI ethically; Privacy challenges in healthcare AI, revealing concerns about data security and confidentiality; Balancing innovation and ethical practice, indicating a need to reconcile technological advancements with ethical considerations; Human touch vs. technological progress, underscoring tensions between automation and personalized care; Patient-centered care in the AI era, emphasizing the importance of maintaining focus on patients amidst technological advancements; and Ethical preparedness and education, suggesting a need for enhanced training and education on ethical AI use in healthcare. Conclusions: The findings underscore the importance of addressing privacy and ethical concerns in AI healthcare development. Nurses advocate for patient-centered approaches and collaborate with policymakers and tech developers to ensure responsible AI adoption. Further research is imperative for mitigating ethical challenges and promoting ethical AI in healthcare practice.

Unsupervised learning, particularly K-means clustering, seeks to partition data into clusters with distinct intra-class cohesion and inter-class disparity. However, the arbitrary selection of clusters in K-means introduces challenges, leading to trial and error in determining the Optimal Number of Clusters (ONC). To address this, various methodologies have been devised, among which the Gap Statistic is prominent. Gap Statistic reliance on expected values for reference data selection poses limitations, especially in scenarios involving diverse scale, noise, and overlapping data.To tackle these challenges, this study introduces Enhanced Gap Statistic (EGS), which standardizes reference data using an exponential distribution within the Gap Statistic framework, integrating an adjustment factor for a more dependable estimation of the ONC. Application of EGS to K-means clustering facilitates accurate ONC determination. For comparison purposes, EGS is benchmarked against traditional Gap Statistic and other established methods used for ONC selection in K-means, evaluating accuracy and efficiency across datasets with varying characteristics. The results demonstrate EGS superior accuracy and efficiency, affirming its effectiveness in diverse data environments.

Abstract Childhood experiences are known to shape individuals' development and can influence various aspects of life later on. Understanding the long‐term effects is crucial for informing interventions and policies aimed at promoting healthy aging. This review aimed to explore the long‐term effects of childhood experiences on older individuals. This systematic review comprised three distinct phases. Firstly, a systematic review was conducted, exploring databases such as Google Scholar, PubMed, EMBASE, PsycINFO, and the Web of Science. Out of the 2116 studies initially identified, 24 studies were selected based on the inclusion criteria. Secondly, these inclusion criteria were applied to ensure that the chosen studies specifically delved into the connection between childhood experiences and outcomes in older individuals. Finally, data extraction and synthesis techniques were employed to analyze findings, facilitating the drawing of conclusions concerning the enduring impacts of childhood experiences on the well‐being of older individuals. The review's findings revealed how negative experiences in childhood continue to affect older individuals in various ways. These early‐life events have far‐reaching consequences, profoundly impacting their physical health, making them more susceptible to chronic diseases and weakening their immune system. Additionally, they affect mental health, leading to conditions like depression, anxiety, and substance abuse. Cognitive function is also affected, resulting in memory problems and cognitive decline. Furthermore, these experiences impact social relationships, affecting trust, emotional control, and social isolation in later life. This review highlighted the enduring influence of childhood circumstances on the health and well‐being of older individuals. Policymakers and health care practitioners should consider these findings when developing strategies to support healthy aging and mitigate the long‐term effects of adverse childhood experiences.

In this work, Co0.5Zn0.5LaxFe2-xO4 (0.00 ≤ x ≤ 0.10) spinel ferrites were synthesized using the sol-gel auto-combustion method. X-ray diffraction (XRD) analysis and Rietveld refinement confirmed the presence of a cubic spinel structure. The crystallite size was estimated to be between 17.5 nm and 26.5 nm using Scherrer’s method and 31.27 nm–54.52 nm using the Williamson–Hall (W-H) method. Lattice constants determined from XRD and Rietveld refinement ranged from (8.440 to 8.433 Å and 8.442 to 8.431 Å), respectively. Scanning electron microscopy (SEM) revealed a non-uniform distribution of morphology with a decrease in particle size. The bandgap values decreased from 2.0 eV to 1.68 eV with increasing rare earth (La3+) doping concentration. Fourier-transform infrared (FT-IR) spectroscopy confirmed the presence of functional groups and M-O vibrations. The dielectric constant and dielectric loss exhibited similar behavior across all samples. The maximum tan δ value obtained at lower frequencies. Regarding magnetic behavior, there was a decrease in magnetization from 55.84 emu/g to 22.08 emu/g and an increase in coercivity from 25.63 Oe to 33.88 Oe with higher doping concentrations. Based on these results, these materials exhibit promising properties for applications in microwave and energy storage devices.

Abstract Background With the ever‐increasing integration of artificial intelligence (AI) into health care, it becomes imperative to gain an in‐depth understanding of how health care professionals, specifically nurse practitioners, perceive and approach this transformative technology. Objectives This study aimed to gain insights into nurse practitioners' perceptions and attitudes toward AI adoption in health care. Methods This qualitative research employed a descriptive and phenomenological approach using in‐depth interviews. Data were collected through a semi‐structured questionnaire with 37 nurse practitioners selected through purposive sampling, specifically Maximum Variation Sampling and Expert Sampling techniques, to ensure diversity in characteristics. Trustworthiness of the research was maintained through member checking and peer debriefing. Thematic analysis was employed to uncover recurring themes and patterns in the data. Results The thematic analysis revealed nine main themes that encapsulated nurse practitioners' perceptions and attitudes toward AI adoption in health care. These included nurse practitioners' perceptions of AI implementation, attitudes toward AI adoption, patient‐centered care and AI, quality of health care delivery and AI, ethical and regulatory aspects of AI, education and training needs, collaboration and interdisciplinary relationships, obstacles in integrating AI, and AI and health care policy. While this study found that nurse practitioners held a wide range of perspectives, with many viewings AI as a tool to enhance patient care. Conclusions This research provides a valuable contribution to the evolving discourse surrounding AI adoption in health care. The findings underscore the necessity for comprehensive education and training in AI, accompanied by clear and robust ethical and regulatory guidelines to ensure the responsible integration of AI in health care practice. Furthermore, fostering collaboration and interdisciplinary relationships is pivotal for the successful incorporation of AI in health care. Policymakers should also address the challenges and opportunities that AI presents in the health care sector. This study enhances the ongoing conversation on AI adoption in health care by shedding light on the perspectives of nurses, thereby shaping future strategies for AI integration.

Objectives To investigate retired elite female rugby players’ health outcomes (and their relationships) in five key areas (musculoskeletal, cognitive, mental, reproductive/endocrinological and cardiovascular) and how those compare with the general population.Methods Female rugby players aged ≥18 years old and retired from elite competition ≥2 years were recruited via email or social media to complete a 179-item online questionnaire and neurocognitive assessment. Data from general population controls (matched for age and sex) were obtained where available.Results 159 participants responded (average age 43 (±5) years). 156 (98%) reported a hip/groin, knee, foot/ankle or lower back injury during their career, of which 104 (67%) reported ongoing pain. Participants reported worse hip and knee outcomes compared with the general population (p

Background Patient engagement (PE) or involvement in research is when patient partners are integrated onto teams and initiatives (not participants in research). A number of health research funding organisations have PE frameworks or rubrics but we are unaware of them applying and reporting on their own internal PE efforts. We describe our work at the Canadian Institutes of Health Research’s Institute of Musculoskeletal Health and Arthritis (CIHR IMHA) to implement, evaluate and understand the impact of its internal PE strategy.Methods A co-production model was used involving patient partners, a PE specialist and staff from IMHA. A logic model was co-developed to guide implementing and evaluating IMHA’s PE strategy. Some of evaluating the PE strategy and understanding its impact was a collaboration between the Public and Patient Engagement Collaborative (McMaster University) and IMHA.Results IMHA convened a PE Research Ambassador (PERA) group which co-led this work with the support of a PE specialist. In doing so, PERA had a number of meetings since 2020, set its own priorities and co-produced a number of outputs (video, publications, webinars, blog and modules called the How-to Guide for PE in Research). This work to evaluate and measure impacts of IMHA’s PE strategy revealed positive results, for example, on PERA members, Institute Advisory Board members and staff, as well as beyond the institute based on uptake and use of the modules. Areas for improvement are mainly related to increasing the diversity of PERA and to improving accessibility of the PE outputs (more languages and formats).Conclusions Implementing a PE strategy within CIHR IMHA resulted in several PE activities and outputs with impacts within and beyond the institute. We provide templates and outputs related to this work that may inform the efforts of other health research funding organisations. We encourage health research funders to move beyond encouraging or requiring PE in funded projects to fully ‘walk the talk’ of PE by implementing and evaluating their own PE strategies.

Abstract Background El Niño events disrupt atmospheric and oceanic interactions, leading to shifts in precipitation, temperature, and extreme weather events. Such alterations have the potential to exacerbate heatwaves, increase vector-borne and waterborne diseases, and compromise air quality. Understanding the connection between El Niño and public health vulnerabilities is crucial for effective mitigation and preparedness. Main body of the abstract This article aimed to investigate the impact of El Niño on public health and its preparedness measures. A comprehensive literature review was conducted, involving systematic searches across academic databases, scientific journals, and relevant grey literature. Inclusion criteria encompassed studies that explored the link between El Niño and public health outcomes, as well as strategies for enhancing preparedness. Thematic analysis was employed to synthesize findings and identify key themes. This article revealed that El Niño events contribute to a spectrum of public health challenges, including heat-related illnesses and compromised air quality. Vulnerable populations, such as the elderly, children, and those with pre-existing medical conditions, are particularly at risk. Early warning systems, health infrastructure readiness, communication strategies, and collaborative efforts emerged as vital preparedness measures. Short conclusion El Niño’s impact on public health and preparedness measures is a complex and multifaceted issue that requires a unified and proactive approach. By understanding the interplay between El Niño events and health vulnerabilities, communities can better prepare for and mitigate the health risks posed by these climatic fluctuations. Strengthened early warning systems, improved healthcare infrastructure, effective communication strategies, and collaborative efforts between various stakeholders are crucial in enhancing preparedness and safeguarding public health in the face of El Niño’s capricious influence.

Background: Cervical cancer remains the third most common cancer among women in Pakistan. Human Papilloma Virus is a major cause of cervical cancer. This study aimed to access knowledge regarding cervical cancer, awareness about the vaccine against Human Papilloma Virus (HPV), to compare the differences in the attitude of different groups of women and factors that may help to improve acceptance of the vaccine. Methods: A cross-sectional study was carried out among 491 female students of Karachi. Participants were selected on random in the age group of 18 to 30; from different universities with the majority of the sample being medical students. Pearson Chi-squares and Mann Whitney U tests were applied for the key statistical analysis and p-value ≤0.05 was considered significant. Results: In total of 343(69.9%) females were aware of the availability of the Human Papilloma Virus vaccine. Whereas, 60(19.3%) of the females were vaccinated against Human Papilloma Virus while, 239(77.1%) of the females said that they intend to get vaccinated against the virus in the future. A significant relationship was found between the recommendation of HPV vaccine and the intention to get the vaccination (p = 0.002). Awareness of the HPV vaccine was more common among medical university students (p

Artificial intelligence (AI) has recently emerged as a unique developmental influence that is playing an important role in the development of medicine. The AI medium is showing the potential in unprecedented advancements in truth and efficiency. The intersection of AI has the potential to revolutionize drug discovery. However, AI also has limitations and experts should be aware of these data access and ethical issues. The use of AI techniques for drug discovery applications has increased considerably over the past few years, including combinatorial QSAR and QSPR, virtual screening, and denovo drug design. The purpose of this survey is to give a general overview of drug discovery based on artificial intelligence, and associated applications. We also highlighted the gaps present in the traditional method for drug designing. In addition, potential strategies and approaches to overcome current challenges are discussed to address the constraints of AI within this field. We hope that this survey plays a comprehensive role in understanding the potential of AI in drug discovery.

A significant amount of energy can be produced using renewable energy sources; however, storing massive amounts of energy poses a substantial obstacle to energy production. Economic crisis has led to rapid developments in electrochemical (EC) energy storage devices (EESDs), especially rechargeable batteries, fuel cells, and supercapacitors (SCs), which are effective for energy storage systems. Researchers have lately suggested that among the various EESDs, the SC is an effective alternate for energy storage due to the presence of the following characteristics: SCs offer high-power density (PD), improvable energy density (ED), fast charging/discharging, and good cyclic stability. This review highlighted and analyzed the concepts of supercapacitors and types of supercapacitors on the basis of electrode materials, highlighted the several feasible synthesis processes for preparation of metal oxide (MO) nanoparticles, and discussed the morphological effects of MOs on the electrochemical performance of the devices. In this review, we primarily focus on pseudo-capacitors for SCs, which mainly contain MOs and their composite materials, and also highlight their future possibilities as a useful application of MO-based materials in supercapacitors. The novelty of MO’s electrode materials is primarily due to the presence of synergistic effects in the hybrid materials, rich redox activity, excellent conductivity, and chemical stability, making them excellent for SC applications.

Background The rapid integration of artificial intelligence (AI) into healthcare has raised concerns among healthcare professionals about the potential displacement of human medical professionals by AI technologies. However, the apprehensions and perspectives of healthcare workers regarding the potential substitution of them with AI are unknown. Objective This qualitative research aimed to investigate healthcare workers’ concerns about artificial intelligence replacing medical professionals. Methods A descriptive and exploratory research design was employed, drawing upon the Technology Acceptance Model (TAM), Technology Threat Avoidance Theory, and Sociotechnical Systems Theory as theoretical frameworks. Participants were purposively sampled from various healthcare settings, representing a diverse range of roles and backgrounds. Data were collected through individual interviews and focus group discussions, followed by thematic analysis. Results The analysis revealed seven key themes reflecting healthcare workers’ concerns, including job security and economic concerns; trust and acceptance of AI; ethical and moral dilemmas; quality of patient care; workforce role redefinition and training; patient–provider relationships; healthcare policy and regulation. Conclusions This research underscores the multifaceted concerns of healthcare workers regarding the increasing role of AI in healthcare. Addressing job security, fostering trust, addressing ethical dilemmas, and redefining workforce roles are crucial factors to consider in the successful integration of AI into healthcare. Healthcare policy and regulation must be developed to guide this transformation while maintaining the quality of patient care and preserving patient–provider relationships. The study findings offer insights for policymakers and healthcare institutions to navigate the evolving landscape of AI in healthcare while addressing the concerns of healthcare professionals.

Introduction Burns are most prevalent in low- and middle-income countries but the risk factors for burn contractures in these settings are poorly understood. There is some evidence from low- and middle-income country studies to suggest that non-medical factors such as socio-economic and health system issues may be as, or possibly more, important than biomedical factors in the development of post-burn contractures. Methods Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a cross-sectional study which examined risk factors for contracture in Bangladesh. Discussion The two cases had similar burns but different standards of care for socio-economic reasons, leading to very different contracture outcomes The two cases both had access to specialist care but had very different contracture outcomes for non-medical reasons. The risk factors and contracture outcomes in each case are documented and compared. Conclusion The impact of non-biomedical factors in contracture development after burns in low- and middle-income countries is highlighted and discussed. Lay Summary Burns are common in low- and middle-income countries (LMICs) but the risk factors for burn contractures in these settings are poorly understood. Burn contractures are formed when scarring from a burn injury is near or over a joint and results in limited movement. There is some evidence from LMIC studies which suggests that non-medical factors such as socio-economic (e.g., household income, level of education) and health system issues (e.g., whether specialist burn care could be accessed) may be as, or possibly more, important than non-medical factors (such as the type and depth of burn and the treatments received) in the development of contractures following burn injuries. Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a larger study which examined risk factors for contracture in Bangladesh. Two cases had similar burns but different standards of care and different outcomes. Two cases had similar access to specialist care but very different outcomes for non-medical reasons. The risk factors present and contractures outcomes in each case are documented and compared. The importance of non-biomedical factors in contracture development after burns in LMICs is highlighted and discussed.

Colistin is a last-resort antimicrobial for treating multidrug-resistant Gram-negative bacteria. Phenotypic colistin resistance is highly associated with plasmid-mediated mobile colistin resistance (mcr) genes. mcr-bearing Enterobacteriaceae have been detected in many countries, with the emergence of colistin-resistant pathogens a global concern. This study assessed the distribution of mcr-1, mcr-2, mcr-3, mcr-4, and mcr-5 genes with phenotypic colistin resistance in isolates from diarrheal infants and children in Bangladesh. Bacteria were identified using the API-20E biochemical panel and 16s rDNA gene sequencing. Polymerase chain reactions detected mcr gene variants in the isolates. Their susceptibilities to colistin were determined by agar dilution and E-test by minimal inhibitory concentration (MIC) measurements. Over 31.6% (71/225) of isolates showed colistin resistance according to agar dilution assessment (MIC > 2 μg/mL). Overall, 15.5% of isolates carried mcr genes (7, mcr-1; 17, mcr-2; 13, and mcr-3, with co-occurrence occurring in two isolates). Clinical breakout MIC values (≥4 μg/mL) were associated with 91.3% of mcr-positive isolates. The mcr-positive pathogens included twenty Escherichia spp., five Shigella flexneri, five Citrobacter spp., two Klebsiella pneumoniae, and three Pseudomonas parafulva. The mcr-genes appeared to be significantly associated with phenotypic colistin resistance phenomena (p = 0.000), with 100% colistin-resistant isolates showing MDR phenomena. The age and sex of patients showed no significant association with detected mcr variants. Overall, mcr-associated colistin-resistant bacteria have emerged in Bangladesh, which warrants further research to determine their spread and instigate activities to reduce resistance.

Abstract Aim This study aimed to explore the coping strategies adopted by frontline nurses in dealing with COVID‐19 patients during the pandemic in Bangladesh. Design A qualitative descriptive study. Methods Purposive sampling was used to recruit seventeen frontline nurses from three COVID‐19‐specific hospitals in Dhaka City. In‐depth online interviews and semi‐structured questionnaires were used to collect data through the Google Meet platform. Interview sessions audio–video were recorded, interpreted, analysed, verbatim transcribed and quotes of the participants were verified by member checking. Thematic analysis was used in this research. The study's reporting guidelines were based on the consolidated criteria for reporting qualitative research. Results Seven themes were identified after careful data analysis: (i) A positive attitude in dealing with challenging situation, (ii) Intimate partner's influence, (iii) Self‐emotional regulation, (iv) The tendency to avoid negativity, (v) Motivated by professional obligations, (vi) Religious influence, (vii) Recreational activities. No patient or public contribution This study explored various coping strategies employed by frontline nurses in caring for COVID‐19 patients. No patient or public contribution was investigated.

Background: The devastating COVID-19 outbreak has considerably influenced basic human healthcare needs. Due to healthcare organizational limitations, workload, and a shortage of healthcare professionals, particularly military nurses in developing countries, faced critical situations in dealing with COVID-19 patients. However, little is known about the survival strategies military nurses used while caring for coronavirus-infected patients. Aims: This study aimed to investigate the survival strategies that inspired military nurses to manage COVID-19 patients in Bangladesh. Methods: This study employed the phenomenology of practice framework developed by Max van Manen. Fourteen military nurses were purposefully selected to participate in this study. Semi-structured online interviews were conducted individually from January to February 2023 in three divisional (Dhaka, Chittagong, and Sylhet) COVID-19 dedicated military hospitals in Bangladesh. The study was reported using the COREQ checklist. Audio-video sessions of discussions were recorded, analyzed, and transcribed verbatim. Dataset analysis was performed using thematic analysis. Results: Eight themes were developed: (i) Nurses' self-strategies; (ii) colleagues' strategies; (iii) Nurse managers' strategies; (iv) Feelings about nursing ethical values; (v) Employers' strategies; (vi) Government strategies; (vii) Family members' strategies; (viii) Strategies of social people. Conclusions: The study's findings would inspire healthcare professionals to use various survival strategies when facing critical clinical situations. Additionally, this study encourages nurses to develop survival skills to avoid depression, fear, and anxiety and to learn how to deal with work-related stress situations.

Background: The healthcare landscape is rapidly evolving, with artificial intelligence (AI) emerging as a transformative force. In this context, understanding the viewpoints of nursing professionals regarding the integration of AI in future nursing care is crucial. Aims: This study aimed to provide insights into the perceptions of nursing professionals regarding the role of AI in shaping the future of healthcare. Methods: A cohort of 23 nursing professionals was recruited between April 7, 2023, and May 4, 2023, for this study. Employing a thematic analysis approach, qualitative data from interviews with nursing professionals were analyzed. Verbatim transcripts underwent rigorous coding, and these codes were organized into themes through constant comparative analysis. The themes were refined and developed through the grouping of related codes, ensuring an authentic representation of participants' viewpoints. Results: After careful data analysis, ten key themes emerged including: (I) Perceptions of AI readiness; (II) Benefits and concerns; (III) Enhanced patient outcomes; (IV) Collaboration and workflow; (V) Human-tech balance: (VI) Training and skill development; (VII) Ethical and legal considerations; (VIII) AI implementation barriers; (IX) Patient-nurse relationships; (X) Future vision and adaptation. Conclusion: This study provides valuable insights into nursing professionals' perspectives on the integration of AI in future nursing care. It highlights their enthusiasm for AI's potential benefits while emphasizing the importance of ethical and compassionate nursing practice. The findings underscore the need for comprehensive training programs to equip nursing professionals with the skills necessary for successful AI integration. Ultimately, this research contributes to the ongoing discourse on the role of AI in nursing, paving the way for a future where innovative technologies complement and enhance the delivery of patient-centered care.

Antibiotic resistant pathogens are affecting the community and healthcare institutions all over the world. Pakistan is a developing country and resistance to drugs is the main issue and is of great importance. Current study is focused on isolation and identification of bacterial pathogens, i.e. member of Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii for the evaluation of prevalence, distribution of sensitivity and antibiogram of different antibiotics and carbapenem resistance isolates with phenotypic detection of resistant gene. Total 200 samples of different sources were collected and tested for bacterial pathogens. Out of 200 samples, 83 (41.5%) were found positive for different bacterial pathogens while 117 (58.5%) were negative. Among these 83 positive samples, Urine 43 (51.8%), Pus 22 (26.5%), Blood 8 (9.8%), Tissue 3 (3.6%), wound swab 2 (2.4%), Sputum 3 (3.6%) and HVS 2 (2.4%). E. coli 37 (44.6%), Klebsiella species 23 (27.7%), Proteus vulgaris 8 (9.6%), Ps. aeruginosa 4 (4.8%), Acinetobacter baumannii 4 (4.8%), C. freundii 2 (2.4%), S. typhi 2 (2.4%), P. mirabilis 1 (1.2%), M. morganii 1 (1.2%) and member of Enterobacteriaceae 1 (1.2%) were identified. Out of 83 (41.5%) positive samples there are 17 samples which showed resistance against Imipenem (IPM) and were further processed by phenotypic method Modified Hodge Test MHT. After Modified Hoge Test (MHT) among all these 17 samples there were only 07 (39%) positive and the remaining 11 (61%) were negative, its mean there was no gene involve in 11 samples.

Background. With the global trend of increasing life expectancy, the health-related quality of life of older people haspersonalised become an area of significant interest. It is crucial to comprehend the advancements and identify the ongoing challenges in this domain for better health management and policy formation. Objectives. This scoping review aimed to comprehensively investigate the existing challenges and recent advancements associated with the quality of health among older people. Methods. We utilized Arksey and O’Malley’s scoping review framework for this study. A systematic literature search was performed across multiple databases, namely, PubMed, Scopus, and Google Scholar, targeting publications from 2018 to 2023. Selected studies were then rigorously examined based on predefined inclusion and exclusion criteria, followed by an in-depth thematic analysis. Results. Of the initial 406 identified studies, 72 were included in the final review. The analysis underscored enduring challenges in physical and medical issues, psychological difficulties, socioeconomic obstacles, and policy-related challenges. Meanwhile, significant advancements were noted in several areas, including technology, medicine, social and societal facets, and policy. Conclusions. Despite noteworthy improvements in the health-related quality of life of older individuals, the continued presence of substantial challenges emphasizes the need for more targeted initiatives. These results suggest an immediate requirement for revising policies and implementing interventions that specifically address identified challenges, with a particular emphasis on ensuring equitable health care access, effectively managing chronic conditions, and enhancing the training of geriatric health care professionals. This comprehensive review serves as a roadmap for guiding future research and shaping policy directions in the health care of older people.

Abstract Aim This article aimed to explore the role of AI in advancing nursing practice, focusing on its impact on readiness for the future. Design and Methods A position paper, the methodology comprises three key steps. First, a comprehensive literature search using specific keywords in reputable databases was conducted to gather current information on AI in nursing. Second, data extraction and synthesis from selected articles were performed. Finally, a thematic analysis identifies recurring themes to provide insights into AI's impact on future nursing practice. Results The findings highlight the transformative role of AI in advancing nursing practice and preparing nurses for the future, including enhancing nursing practice with AI, preparing nurses for the future (AI education and training) and associated, ethical considerations and challenges. AI‐enabled robotics and telehealth solutions expand the reach of nursing care, improving accessibility of healthcare services and remote monitoring capabilities of patients' health conditions.

Abstract Background and Aims The influence of temperature on various aspects of daily life is often underestimated, and its effects on mental health are not widely recognized. Understanding and addressing the relationship between temperature and mental well‐being is crucial in the context of climate change and rising global temperatures. This perspective aimed to investigate the effects of high temperatures on mental health and identify proactive strategies to mitigate these effects. Methods This perspective adopted a twofold approach, including a comprehensive literature review and socioecological framework. The literature review involved extensive searches across Google Scholar, PubMed, and Scopus to identify relevant, peer‐reviewed articles, and reports from diverse disciplines. Results The perspective emphasized the significance of recognizing heat stress and its consequences on mental well‐being. Chronic heat stress can lead to increased stress, anxiety, and cognitive impairment. Vulnerable populations include, the very young, older adults, and individuals with pre‐existing mental health conditions. Socioeconomic factors can further exacerbate vulnerability, highlighting the need for tailored strategies to manage mental health challenges during high temperatures. Additionally, the article identified and discussed proactive coping strategies to minimize both the psychological and physical impacts of heat stress. Mindfulness, stress management techniques, and therapy are suggested as effective means for individuals to manage psychological distress. Conclusion Implementing preventive measures are essential steps in promoting mental wellness in high temperatures. Proactive strategies by addressing the physiological and psychological effects of heat and considering the specific needs of vulnerable populations can help individuals and communities navigate the challenges posed by rising temperatures and promote resilience and preserve their mental well‐being.

To estimate COVID-19 infections and deaths in healthcare workers (HCWs) from a global perspective during the early phases of the pandemic. Systematic review. Two parallel searches of academic bibliographic databases and grey literature were undertaken until 8 May 2020. Governments were also contacted for further information where possible. There were no restrictions on language, information sources used, publication status and types of sources of evidence. The AACODS checklist or the National Institutes of Health study quality assessment tools were used to appraise each source of evidence. Publication characteristics, country-specific data points, COVID-19-specific data, demographics of affected HCWs and public health measures employed. A total of 152 888 infections and 1413 deaths were reported. Infections were mainly in women (71.6%, n=14 058) and nurses (38.6%, n=10 706), but deaths were mainly in men (70.8%, n=550) and doctors (51.4%, n=525). Limited data suggested that general practitioners and mental health nurses were the highest risk specialities for deaths. There were 37.2 deaths reported per 100 infections for HCWs aged over 70 years. Europe had the highest absolute numbers of reported infections (119 628) and deaths (712), but the Eastern Mediterranean region had the highest number of reported deaths per 100 infections (5.7). COVID-19 infections and deaths among HCWs follow that of the general population around the world. The reasons for gender and specialty differences require further exploration, as do the low rates reported in Africa and India. Although physicians working in certain specialities may be considered high risk due to exposure to oronasal secretions, the risk to other specialities must not be underestimated. Elderly HCWs may require assigning to less risky settings such as telemedicine or administrative positions. Our pragmatic approach provides general trends, and highlights the need for universal guidelines for testing and reporting of infections in HCWs.

Introduction Monkeypox (Mpox) is an infectious illness that can spread to humans through infected humans, animals, or contaminated objects. In 2022, the monkeypox virus spread to over 60 countries, raising significant public health concerns. Nurses play a vital role in patient care and have critical responsibilities in managing infected patients and being aware of the potential impact on the general population. Objective This study aimed to investigate the knowledge and attitudes (KAs) of Bangladeshi nurses regarding monkeypox infectious disease. Methods A cross-sectional study was conducted between October 2022 and March 2023 to evaluate the KA of nurses. Semi-structured and self-administered questionnaires were used, distributed via Google Form, and a convenient sampling technique was implemented. The dataset was analyzed using the Chi-square test, multivariable logistic regression, and Pearson correlation coefficient. Results A total of 1047 datasets were included in the final analysis. Overall, 57.97% of the participants demonstrated good knowledge, and 93.12% of the respondents had a positive attitude towards monkeypox disease. Female nurses exhibited better knowledge (adjusted odds ratio (AOR) 1.36; 95% confidence interval (CI) 0.88–1.98) and a more positive attitude (AOR 1.64; 95% CI 1.12–3.00) than male nurses. Furthermore, a strong correlation was observed between good knowledge of monkeypox disease and a positive attitude (r = 0.76, p

Abstract Introduction Adherence to daily oral antiretroviral therapy (ART) and regular clinic appointments can be challenging for individuals who experience adverse social determinants of health. Long-acting injectable ART administered outside of traditional clinic settings may be a promising solution to adherence barriers, but additional research is needed to assess patients’ perspectives. This study assessed perspectives of people living with HIV (PLWH) who had difficulty with adherence to traditional HIV care models and evaluated feasibility and acceptability of receiving a long-acting ART injection at a location outside of a traditional HIV clinic to address barriers to HIV care. Methods Qualitative interviews (n = 26) were conducted with PLWH who had experienced barriers to adherence. Participants were referred to the study by staff from Project Trust, a drop in harm reduction and sexually transmitted infection/HIV clinic. The interviews were conducted between May and November 2021. Interviews were recorded, professionally transcribed, coded, and analyzed qualitatively using the integrated-Promoting Action on Research Implementation in Health Services framework. Results We identified 6 main themes regarding the acceptability of receiving a long-acting injection to treat HIV, and the acceptability and feasibility of receiving injections at an alternative care site. Participants specified that they: (1) have a general understanding about their HIV care and the importance of ART adherence, (2) prefer a long-acting injection over a daily pill regimen, (3) expressed concerns about injection safety and efficacy, (4) had specific logistical aspects around the delivery of long-acting injections, including location of injection administration, that they believed would improve their ability to adhere, (5) have confidence that they can become undetectable and then complete the oral lead-in required to begin receiving the injection, and (6) see potential barriers that remain a concern for successful adherence to long-acting injections. Conclusion To better treat HIV among people who are living with challenging social determinants of health, interventions that include a long-acting injection in a non-traditional care setting may prove to be a promising treatment option.

The chief aim of this study is to investigate Shadab Zeest Hashmi’s poem “THE GREEN WALLS” through the level of lexical deviation. The study focuses solely on Code-switching in lexical deviation that is employed to unfold the concealed meanings of the text and to showcase the different layers of meanings that code-switched words carry in this poem. The study is examined by employing the tool of lexical deviation in order to find out how lexical-deviated choices unravel the miserable conditions of child labourers. Therefore, through the use of lexical deviation, the vicious or inhumane attitude and behaviours of the owners, impatience of the customers and owners, the greedy nature of the owners, the payment of a debt in the form of sacrificing life, class distinction, cultural similarities, and new forms of child labour such as forced labour and child soldiers are badly exposed. The study suggests that statistics are alarming all over the world, especially in Pakistan so there is a dire need to take stern measures to eradicate the issue. The study is vital for future scholars as it will encourage them to conduct research in the field of Stylistics because this study is unique regarding its innovative linguistic interpretation. The poetry of Shadab may be explored through various tools such as Cognitive and Feminist Stylistics.

Abstract To avoid the complexity of the circuit for in‐memory computing, simultaneous execution of multiple logic gates (OR, AND, NOR, and NAND) and memory behavior are demonstrated in a single device of oxygen plasma‐treated gallium selenide (GaSe) memtransistor. Resistive switching behavior with RON/ROFF ratio in the range of 104 to 106 is obtained depending on the channel length (150 to 1600 nm). Oxygen plasma treatment on GaSe film created shallow and deep‐level defect states, which exhibit carriers trapping/de‐trapping, that lead to negative and positive photoconductance at positive and negative gate voltages, respectively. This distinguishing feature of gate‐dependent transition of negative to positive photoconductance encourages the execution of four logic gates in the single memory device, which is elusive in conventional memtransistor. Additionally, it is feasible to reversibly switch between two logic gates by just adjusting the gate voltages, e.g., NAND/NOR and AND/NAND. All logic gates presented high stability. Additionally, memtransistor array (1×8) is fabricated and programmed into binary bits representing ASCII (American Standard Code for Information Interchange) code for the uppercase letter “N”. This facile device configuration can provide the functionality of both logic and memory devices for emerging neuromorphic computing.

Ultrasound (US) is considered as a secure external stimulation for different biomedical applications because it is non-invasive, non-toxic and it brings no radiation pollution. Compared with traditional ultrasonography application, US has now attracted more and more attention for cancer therapy. It treats cancer in deeper tissues because it penetrates far than light does. New types of nanomaterials have been developed for US triggered cancer therapy. The study on emerging cancer therapeutic modality triggered by US is also increasing, e.g., high intensity-focused ultrasound (HIFU) therapy, sonodynamic therapy (SDT), and US-mediated drug delivery. The research on current advances in nanomaterials-based and US-triggered cancer treatments have been discussed in detail in this review, especially the underlying mechanisms for better therapeutic effectiveness. Furthermore, challenges and prospective in the evolution of nanomaterials for the US-based cancer therapy fields were also explained. It is anticipated that our manifestation in this expanding discipline will aid in the advancement of US-based basic research and therapeutic applications.

Abstract Background Community-based harm reduction programs reduce morbidity and mortality associated with drug use. While hospital-based inpatient addiction consult services can also improve outcomes for patients using drugs, inpatient clinical care is often focused on acute withdrawal and the medical management of substance use disorders. There has been limited exploration of the integration of community-based harm reduction programs into the hospital setting. We conducted a qualitative study to describe provider perspectives on the implementation of a harm reduction in-reach program. Methods We conducted 24 semi-structured interviews with providers from three different primary work sites within a safety net hospital in Boston, MA, in 2021. Interviews explored perceived facilitators and barriers to the implementation of the harm reduction in-reach program in the hospital setting and solicited recommendations for potential improvements to the harm reduction in-reach program. Interviews were analyzed using an inductive approach that incorporated principles of grounded theory methodology to identify prevailing themes. Results Twenty-four participants were interviewed from the harm reduction in-reach program, inpatient addiction consult service, and the hospital observation unit. Thematic analysis revealed seven major themes and multiple facilitators and barriers to the implementation of the harm reduction in-reach program. Participants highlighted the impact of power differences within the medical hierarchy on inter-team communication and clinical care, the persistence of addiction-related stigma, the importance of coordination and role delineation between care team members, and the benefits of a streamlined referral process. Conclusions Harm reduction programs offer accessible, patient-centered, low-barrier care to patients using drugs. The integration of community-based harm reduction programs into the inpatient setting is a unique opportunity to bridge inpatient and outpatient care and expand the provision of harm reduction services. Trial registration: Not applicable.

Families are an important factor to consider when trying to understand if and when labor migrants decide to return to the origin. Research has mainly focused on how families provide incentives to return. During the COVID-19 pandemic, however, stories about return migration decisions among male South Asian migrants in the Gulf reveal that families can exert substantial pressure on migrants to stay abroad, even during times of crisis. Using in-depth interviews with migrants in the UAE, returnees and family members between 2020 and 2022, we find that social expectations of migrants to maintain or build family reputation through actions abroad, in the context of broader communities of origin, is a key factor in deterring migrants from returning. Migrants and their families in the origin often seek to continue signaling a successful migration project, particularly by telling stories of entrepreneurial success or of being embedded in the destination through strong and resourceful networks. Returning early from a migration project, even during the pandemic, can be interpreted as a failure and risks negatively impacting the family's reputation. We observe that those who return early, despite family pressure to stay, face significant social sanctions from family and community. [ABSTRACT FROM AUTHOR]

Objectives: There is emerging evidence of the benefits of Benincasa hispida in improving metabolic profiles in people with diabetes. This study was conducted to analyze the effect of B. hispida aqueous extract on the metabolic control of patients with type 2 diabetes in Malaysia. Methods: A powdered drink formulated with 2.5 g of B. hispida extract was prepared as a test food. An intervention study was conducted with 50 participants randomly assigned to an intervention or a control group. Anthropometric, biochemical, and clinical variables were assessed at baseline and week 12 after intervention. Paired T-tests were applied to compare the mean differences between the baseline and postintervention for each variable. Results: The intervention group presented a significant reduction in diastolic blood pressure (∆ −7.0 mmHg, 95% confidence interval [CI]: −11.4, −2.5). Mean fasting plasma glucose (∆ −0.8 mmol/L, 95% CI: −1.8, 0.2) showed a greater reduction in the intervention group compared to the control group (∆ −0.4 mmol/L, 95% CI: −1.2, 0.4). Mean lean body mass showed a favorable trend of increment at week 6 (∆ 0.05 kg, 95% CI: −0.40, 0.49) and week 12 (∆ 0.16 kg, 95% CI: −0.33, 0.64) as compared to baseline in the intervention group but not in the control group which manifested decreasing lean body mass. Conclusion: The use of B. hispida extract may potentially improve blood pressure and glycemic control in patients with type 2 diabetes and it may be an attractive candidate for the development of functional food products. [ABSTRACT FROM AUTHOR]