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The antibiotic stewardship programme (ASP) is a new concept initiated by WHO, but nurses are not yet ready to adopt the program. The training and empowerment of nurses are the best strategies for enhancing their knowledge and engagement in ASP. This mixed-method study was used to assess perceived roles and barriers of nurses' involvement in ASP. An online survey was conducted among 420 clinical nurses to identify their role, and 23 individual interviews were performed among nurses and infection control practitioners to explore the barriers and recommendations to overcome the identified barriers. The majority of the nurses agreed with the sixteen identified roles in ASP, of which 'antibiotic dosing and de-escalation' (82.61%), 'IV to PO conversion of antibiotic, outpatient antibiotic therapy' (85.23%), and 'outpatient management, long-term care, readmission' of the patients (81.19%) had the lowest agreement from the participants. The major themes generated through the qualitative interviews were a lack of knowledge about ASP, poor communication between multidisciplinary teams, lack of opportunity and multidisciplinary engagement, lack of formal education and training about ASP, lack of ASP competency and defined roles in policy, role conflict or power/position, availability of resources, and lack of protected time. Nurses play an integral role in the successful implementation of antibiotic stewardship programs. The empowerment of nurses will help them to adopt the unique role in ASP. Nurses can significantly contribute to antibiotic stewardship efforts and improve patient outcomes through addressing these challenges. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify self-compassion among staff nurses after the COVID-19 pandemic in Qatar. Design: Descriptive cross-sectional survey design. Methods: Anonymous data were collected through an online survey using Microsoft Forms from 300 nurses in 14 health facilities in Qatar. The organization had almost 10,000 nursing staff working in different facilities. Data were gathered using a structured online questionnaire and included socio-demographic information, and the Self-Compassion Scale—Short Form was used to collect the remaining data. Correlation, t-test, and ANOVA analyses were conducted. Results: Nurses in the study showed high self-compassion. Among the sub-domain 'mindfulness', they showed comparatively high scores (7.96 ± 1.55), and the lowest score was for 'isolation' (6.15 ± 1.99). The score for 'self-kindness' was 7.29 ± 1.55, that for 'self-judgement' was 6.79 ± 2.01, that for 'common humility' was 6.62 ± 1.47, and that for the sub-domain 'over-identified' was 6.47 ± 1.91. Mindfulness scores were high among the nurse leaders. Moreover, over-identified scores were high among the nurses who were currently working under COVID-19 at the time of data collection. Conclusions: Nurses faced many difficulties while working during the COVID-19 pandemic, including a heavy workload and tension. The current study's findings add to our understanding of how COVID-19 affected the development of self-compassion. A rise in mindfulness, which aids nurses in managing stress at work and building resilience, further underscores an increase in nurses' acceptance of the COVID-19 pandemic. The findings also highlight how crucial it is to encourage self-compassion in individuals and offer them emotional support at such times, especially when there is a significant risk factor for mental health, such as COVID-19. [ABSTRACT FROM AUTHOR]

Background. The phenomenon of theory‐practice gap has endured within the field of nursing from the era of Florence Nightingale until today, persistently manifesting negative consequences within the profession by accentuating the dichotomy between theoretical understanding and the practical dimensions of nursing. This prevalent issue necessitates comprehensive examination to unveil all the circumstances and variables that fuel the gap, along with exploring viable resolutions to bridge these divides. Objective. To identify, summarize, and synthesize literature on the causes leading to theory‐practice gaps and solutions in nursing profession. Methods. MEDLINE, PubMed, Scopus, CINAHL, EMCARE, ERIC, and Ovid were searched from 2012 to December 2022. Eligible reviews addressed causes of the theory to practice gap in nursing. Extracted data from included reviews were synthesized using guidelines for meta‐synthesis along with the JBI Critical Appraisal Checklist for qualitative research. Result. The analysis of studies yielded 22 significant findings, subsequently categorized into six thematic areas based on their contextual similarity. Following this, a meta‐aggregation process combined these categories, generating two synthesized findings: (1) barriers for the gap and (2) facilitators for the gap. Barriers for the gap had three subcategories: "clinical life challenges," "misconception of clinical nursing," and "lack of collaboration between universities and clinical settings." The second synthesis was "Facilitators for the gap" which had two subcategories: "create clinically culture‐based content" and "develop clinically based curriculum." Conclusion. This review provides a comprehensive summary of the current understanding of barriers and facilitators influencing the theory‐practice gap in the field of nursing. To effectively reduce this gap in nursing care, stakeholders such as regulatory bodies, healthcare professionals, and academic institutions must take into account various contextual factors while recognizing the ever‐evolving nature of the healthcare environment. [ABSTRACT FROM AUTHOR]

BackgroundWhile data from the latter part of the twentieth century consistently showed that immigrants to high-income countries faced higher cardio-metabolic risk than their counterparts in low- and middle-income countries, urbanization and associated lifestyle changes may be changing these patterns, even for conditions considered to be advanced manifestations of cardio-metabolic disease (e.g., chronic kidney disease [CKD]).Methods and findingsUsing cross-sectional data from the Center for cArdiometabolic Risk Reduction in South Asia (CARRS, n = 5294) and Mediators of Atherosclerosis in South Asians Living in America (MASALA, n = 748) studies, we investigated whether prevalence of CKD is similar among Indians living in Indian and U.S. cities. We compared crude, age-, waist-to-height ratio-, and diabetes- adjusted CKD prevalence difference. Among participants identified to have CKD, we compared management of risk factors for its progression. Overall age-adjusted prevalence of CKD was similar in MASALA (14.0% [95% CI 11.8-16.3]) compared with CARRS (10.8% [95% CI 10.0-11.6]). Among men the prevalence difference was low (prevalence difference 1.8 [95% CI -1.6,5.3]) and remained low after adjustment for age, waist-to-height ratio, and diabetes status (-0.4 [-3.2,2.5]). Adjusted prevalence difference was higher among women (prevalence difference 8.9 [4.8,12.9]), but driven entirely by a higher prevalence of albuminuria among women in MASALA. Severity of CKD--i.e., degree of albuminuria and proportion of participants with reduced glomerular filtration fraction--was higher in CARRS for both men and women. Fewer participants with CKD in CARRS were effectively treated. 4% of CARRS versus 51% of MASALA participants with CKD had A1c < 7%; and 7% of CARRS versus 59% of MASALA participants blood pressure < 140/90 mmHg. Our analysis applies only to urban populations. Demographic--particularly educational attainment--differences among participants in the two studies are a potential source of bias.ConclusionsPrevalence of CKD among Indians living in Indian and U.S. cities is similar. Persons with CKD living in Indian cities face higher likelihood of experiencing end-stage renal disease since they have more severe kidney disease and little evidence of risk factor management.

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

In many smart systems, such as cloud computing, networked control, manufacturing, and telecommunication, the effects of time delays are unavoidable. Saturation nonlinearity is common in many smart systems (e.g. electric systems with limited actuator power supplies, mechanical systems with position and speed constraints, fixed-point digital filters, etc.). Therefore, the study of stability of discrete-time systems (DTSs) with time delay and saturation is of high importance in practice. The global asymptotic stability (GAS) problem of such systems is investigated in this paper. The saturation nonlinearity is constrained by a convex hull with a free matrix whose infinity norm is smaller than or equal to unity. A new Lyapunov-based GAS criterion for DTSs with time-varying delay and state saturation is established. The GAS problem for DTSs with constant delay and saturation is also discussed. The obtained results can be used to ensure the absence of overflow oscillations in the considered system. In comparison to several existing criteria, the approach yields improved stability results. An example is provided to demonstrate the importance of the presented results. [ABSTRACT FROM AUTHOR]

Introduction: Momordica balsamina is the closest wild species that can be crossed with an important fruit vegetable crop, Momordica charantia, has immense medicinal value, and placed under II subclass of primary gene pool of bitter gourd. M. balsamina is tolerant to major biotic and abiotic stresses. Genome characterization of Momordica balsamina as a wild relative of bitter gourd will contribute to the knowledge of the gene pool available for improvement in bitter gourd. There is potential to transfer gene/s related to biotic resistance and medicinal importance from M. balsamina to M. charantia to produce high-quality, better yielding and stress tolerant bitter gourd genotypes. Methods: The present study provides the first and high-quality chromosomelevel genome assembly of M. balsamina with size 384.90 Mb and N50 30.96 Mb using sequence data from 10x Genomics, Nanopore, and Hi-C platforms. Results: A total of 6,32,098 transposons elements; 2,15,379 simple sequence repeats; 5,67,483 transcription factor binding sites; 3,376 noncoding RNA genes; and 41,652 protein-coding genes were identified, and 4,347 disease resistance, 67 heat stress-related, 05 carotenoid-related, 15 salt stress-related, 229 cucurbitacin-related, 19 terpenes-related, 37 antioxidant activity, and 06 sex determination-related genes were characterized. Conclusion: Genome sequencing of M. balsamina will facilitate interspecific introgression of desirable traits. This information is cataloged in the form of webgenomic resource available at http://webtom.cabgrid.res.in/mbger/. Our finding of comparative genome analysis will be useful to get insights into the patterns and processes associated with genome evolution and to uncover functional regions of cucurbit genomes. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate the effects of yoga-based cardiac rehabilitation (Yoga-CaRe) on the endothelial system, oxidative stress, and inflammatory markers in patients with acute myocardial infarction (MI). Methods: A sub-study was conducted in two clinical sites of the Yoga-CaRe trial (a multicenter randomized controlled trial). Participants with acute MI were randomized and allocated to either the Yoga-CaRe program (13 sessions with encouragement to home practice) or enhanced standard care (three educational sessions). Endothelial function, oxidative stress, and inflammatory biomarkers were assessed using biomarkers such as asymmetric dimethylarginine (ADMA), endothelial nitric oxide synthase (eNOS), endothelin-1 (ET-1), E-selectin, P-selectin, vascular cell adhesion molecule (VCAM), intercellular cell-adhesion molecule-1, total nitric oxide concentration (NOx), oxidized low-density lipoprotein (Oxd-LDL), superoxide dismutase, total antioxidant capacity (TAOC), tumor necrosis factor-alpha (TNFα), and C-reactive protein (CRP) at baseline and 12 weeks. Laboratory and statistical analysis were done by staff blinded to group allocation. Results: Eighty-two patients (of the 110 patients recruited) completed the study. The mean age was 53.1 ± 10.6 and 51.9 ± 10.7 years in enhanced standard care and Yoga-CaRe group, respectively. At 12 weeks, Yoga-CaRe significantly reduced ADMA, ET-1, and ICMA-1 than the enhanced standard care group. Although E-selectin and VCAM at 12 weeks were reduced in both groups, enhanced standard care had a significantly higher reduction than the Yoga-CaRe group. Among markers of oxidative stress, TAOC increased in the Yoga-CaRe group. We found no difference in eNOS, NOx, P-selectin, TNFα, CRP, and Oxd-LDL between the two groups. Conclusion: Yoga-CaRe improved the endothelial function (through a reduction in ET-1 and modulating adhesion molecules) and enhanced antioxidant capacity. [ABSTRACT FROM AUTHOR]