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Abstract Background Postoperative delirium (POD), an acute and variable disturbance in cognitive function, is an intricate and elusive phenomenon that occurs after cardiac surgery. Despite progress in surgical techniques and perioperative management, POD remains a formidable challenge, imposing a significant burden on patients, caregivers, and healthcare systems. Methods This prospective observational study involved 307 patients who underwent cardiac surgery. Data on the occurrence of delirium, clinical parameters, and postoperative characteristics were collected. A multivariate analysis was performed to assess the relationship between POH and POD. Results Sixty-one patients (21%) developed delirium, with an average onset of approximately 5 days postoperatively and a duration of approximately 6 days. On multivariate analysis, POH was significantly associated with POD, and the adjusted odds ratios indicated that patients with POH were more likely to develop delirium (OR, 5.61; p = 0.006). Advanced age (OR, 1.11; p = 0.002), emergency surgery (OR, 8.31; p = 0.001), and on-pump coronary artery bypass grafting were identified as risk factors of POD. Patients who developed delirium were typically older, more likely to be male, and had higher morbidity rates than those who did not. Conclusion POH is significantly associated with delirium in critically ill patients after cardiac surgery. Surgical complexity and advanced age contribute to the risk of developing POD and poor postoperative outcomes.

Abstract Background The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally. Methods An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations. Results A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15–2.02)], having an academic appointment [2.45 (1.78–3.27)], having multiple co-morbidities [1.86 (1.41–2.48)], perceived burnout [1.99 (1.54–2.56)] and moderate to very high level of psychological distress [1.68 (1.18–2.39)]. Perceived burnout was associated with being female [1.35 (1.12–1.63)], having multiple co-morbidities [1.53 (1.20–1.97)], perceived job insecurity [1.99 (1.55–2.57)], and moderate to very high levels of psychological distress [3.23 (2.42–4.30)]. Staff with multiple co-morbidities [1.46 (1.11–1.92)], mental health issues [2.73 (1.79–4.15)], perceived job insecurity [1.61 (1.13–2.30)], and perceived burnout [3.22 (2.41–4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69–4.19)] were more likely to have medium to high resilient coping. Conclusions Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing.

Phenolic compounds are important compounds responsible for many therapeutic, pharmacological, and biological activities. They are compounds that do not have nutritional properties but are very important from a medical point of view. In this review, general properties, derivatives and biosynthesis, pharmacological and therapeutic effects, biological activities, and toxic and side effects of gallic acid were reviewed. As a result of the literature research, it has been seen that it has pharmacological and therapeutic effects such as gastrointestinal diseases, cardiovascular disease, neuropsychological and neuroprotective conditions, metabolic diseases, allergic skin, antianxiety, wound healing activity, rheumatoid arthritis, colitis, obesity. It has also been reported to have biological activities such as antioxidant, anti-melanogenic, antimicrobial, anti-ageing, antidiabetic, antiapoptotic, anticancer, anti-inflammatory, hepatoprotective, antiviral, cytotoxic, antidepressant. In this context, it has been determined that gallic acid is an important phenolic compound.

Organizational agility has become essential and its importance has increased after COVID-19. There are inconsistent findings regarding the factors that affect organizational agility. This study focuses on the effect of technological innovation and the knowledge management process by reviewing the literature related to these variables. Three databases, Scopus, Web of Science (WoS), and Google Scholar, were used using certain search keywords, and a total of 30 articles were identified between 2010 and 2022 and reviewed. The findings showed that the number of articles has increased sharply during and after the COVID-19 pandemic. However, the use of theories to explain organizational agility is still emerging, with the resource-based view, the dynamic capability, and the knowledge-based view being the most used theories. The sample size is increasing to meet the structural equation modeling requirements. The effect of technological innovation and the knowledge management process is positive in most studies. More studies are needed to examine organizational agility as a dependent variable in different countries, contexts, and industries. In addition, future studies should examine other moderating variables in this context.

Background and Aim: Antimicrobial resistance (AMR) has become a significant global concern. Epidemiological data do not provide a robust description of the potential risks associated with AMR in the integrated agroforestry-livestock systems in Indonesia. Thus, the present study investigated the phenotypic and multidrug resistance (MDR) profiles of Escherichia coli strains isolated from the feces of livestock raised in the agro-silvopastoral system in Deli Serdang Regency, North Sumatra Province. Materials and Methods: A standard microbiological culture procedure was followed to isolate the organism and test antibiotic susceptibility using the Kirby-Bauer disk diffusion protocol. Furthermore, the multiple antibiotic resistance index was determined. Univariate analysis was conducted to identify the risk factors associated with AMR. Results: The vast majority (77.5%) of livestock farmers were aged >30 years. All farmers were men and had no higher education (100% of them). The majority of the animal species managed were cattle and goats (37.5% each) and the livestock grazing pasture system (67.5%). In addition, the majority of farmers reported high antimicrobial use on their farms (87.5%). Of the samples (n = 142) analyzed, n = 70 were positive, with an overall prevalence of 44.4%. The species-specific prevalences of E. coli were 32.5%, 47.8%, and 50% in buffalo, goat, and cattle, respectively. Ampicillin and tetracyclines exhibited high resistance levels among the studied animal species. A relatively lower MDR for E. coli was associated with grazing on the pasture. Conclusion: The findings from the current study provide baseline epidemiological information for future robust studies aimed at elucidating the drivers and patterns of AMR in agro-silvopastoral systems in the study area or elsewhere.

هدفت الدراسة إلى بناء برنامج قائم على الارشاد بالقراءة وقياس فاعليته في تنمية الوعي الذاتي لدى طالبات المرحلة الثانوية في منطقة القصيم، ولتحقيق أهداف الدِّراسة والإجابة عن أسئلتها والتحقُّق من فروضها تم استخدام المنهج شبه التجريبي، وتكوَّنَت أدوات الدِّراسة وموادها من برنامج قائم على الارشاد بالقراءة يتكون من (12) جلسة من إعداد الباحثة، ومقياس الوعي الذاتي للغزواني (2017م)، وتم حساب صدقها وثباتها قبل اعتمادها للتطبيق، وطُبِّقت الدراسة على (31) طالبة من طالبات المرحلة الثانوية في منطقة القصيم، وتم تقسيمهن إلى مجموعة ضابطة وعددها (17) ، ومجموعة تجريبية وعددها (14) ، .وتوصلت الدِّراسة إلى: فاعلية البرنامج القائم على الإرشاد بالقراءة وذلك بناءً على نتائج الدِّراسة التي كشفت عن وجود فروق ذات دلالة إحصائية بين متوسطي درجات الطالبات في المجموعة التجريبية قبل تطبيق البرنامج وبعد التطبيق على مقياس الوعي الذاتي لصالح التطبيق البعدي ، وأيضا وجود فروق ذات دلالة إحصائية بين متوسطي درجات طالبات المجموعتين التجريبية والضابطة على ‏مقياس الوعي ‏الذاتي في القياس البعدي، وقد كانت الفروق لصالح المجموعة التجريبية، وعدم وجود فروق ذات دلالة إحصائية بين التطبيقين البعدي والتتبعي (بعد مرور فترة المتابعة ثلاثين يوماً) على مقياس الوعي الذاتي.

The potential of renewable energy sources to lower greenhouse gas emissions and lessen our reliance on fossil fuels has accelerated their integration globally, and especially that of solar photovoltaic (PV) systems. Malaysia has shown great progress in the adoption of photovoltaic systems thanks to its plentiful solar resources. On the other hand, energy storage systems (ESSs) are becoming more and more necessary in order to guarantee grid stability and fully realize the benefits of PV systems. This study attempts to assess the current condition of PV installations in Malaysia with an emphasis on their economic feasibility, regulatory compliance, technological capabilities, and compatibility with various energy storage technologies. Malaysian photovoltaic (PV) systems’ readiness to integrate energy storage systems (ESSs) using second-life electric vehicle batteries (SLEVBs) is examined in this article. Integrating PV systems with SLEVBs in residential ESSs shows economic viability, with a 15-year payback and 25% return on investment (ROI). Therefore, for every 1 MW of installed PV capacity, with ESS integration it is estimated to reduce approximately 3504 metric tons of CO2 emissions annually in Malaysia. The homeowner benefits from large electricity bill savings, net metering revenue, and various incentives or financing alternatives that make the project financially attractive despite the extended payback time. Energy storage solutions are needed to improve grid stability, energy usage, and solar power generation in Malaysia as renewable energy adoption increases. Reusing retired EV batteries for stationary storage could solve environmental and economic issues. This study examines the feasibility, regulatory frameworks, and economic viability of combining second-life EV batteries with PV installations in Malaysia.

The hospitality industry is well-known for its challenging and high-pressure work settings. In this context, employees commonly face a multitude of stressors originating from their roles and job responsibilities, which can significantly impact their psychological wellbeing. Hence, based on the job demands-resources (JD-R) model and the spillover theory, this study aims to empirically explore the direct and indirect effect of work stress (assessed by role overload, ambiguity, and conflict) on psychological distress among frontline employees in 3- and 4-star Egyptian resorts while considering the mediating influence of work-family conflict (WFC). Four hypotheses were put to the test through the application of the PLS-SEM 4.0 version (4.0.9.9). Based on the findings from 563 frontline employees who participated in this research, the study supports the four hypotheses affirming that work-related stressors significantly contributed to employees' psychological distress. Further, the findings highlighted that these stressors significantly spill over into employees' family lives, generating conflicts between work and family roles. In addition, the results emphasized the significance of WFC as a contributing factor to employees' psychological distress. Finally, the study concluded that WFC partially mediates the link between work stress and employees' psychological distress. Based on these findings, some theoretical and practical implications for hospitality scholars, resort management, and policymakers were suggested to enhance the employees' wellbeing and mitigate psychological distress in this vital sector.

Abstract Purpose We aimed to compare the impact of urethral transection after different techniques of bulbar urethroplasty on erectile function outcome. Materials and methods We retrospectively reviewed the records for 245 patients who underwent different urethroplasty techniques for bulbar urethral stricture between February 2013 and January 2021. The comparison between the transecting and non-transecting cohorts included patients’ demographics, clinicopathological features of the urethral stricture, post-urethroplasty erectile function, and success of urethroplasty. Outcomes were erectile function status verified by IIEF5-15 score at preoperative, three months, and 12 months post-surgery. We defined Post-urethroplasty ED as a decrease of 5 points or more. Results The urethroplasty success rate of the entire cohort was 86.9% after a mean follow-up of 45.59 ± 21 months. Out of 245 patients, 18 (7.3%) experienced 90-day complications. Transecting bulbar urethroplasty techniques were performed in 74 patients (30.2%), while non-transecting techniques were performed in 171 patients (69.8%). there were no differences between the cohorts regarding urethroplasty success (87.8% Vs. 86.5%, Mantel-Cox test p = 0.93) or postoperative complications (8.1% Vs. 7%, p = 0.73). Transient ED was evident in the transecting cohort as reported in 8.1% compared to 2.9% for the non-transecting (p = 0.07).Still, but de novo permanent ED was comparable (4.1% Vs. 2.9%, p = 0.65), for transecting and non-transecting, respectively. Conclusions Unfortunately, some patients who undergo transecting techniques of bulbar urethroplasty experience transient erectile dysfunction that can improve within the first post- urethroplasty year; however, de novo permanent erectile dysfunction is uncommon after different techniques of bulbar urethroplasty and is not predisposed by urethral transection.