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Aims: Patients with proximal femoral fractures (PFFs) are often multimorbid, thus unplanned readmissions following surgery are common. We therefore aimed to analyze 30-day and one-year readmission rates, reasons for, and factors associated with, readmission risk in a cohort of patients with surgically treated PFFs across Austria. Methods: Data from 11,270 patients with PFFs, treated surgically (osteosyntheses, n = 6,435; endoprostheses, n = 4,835) at Austrian hospitals within a one-year period (January to December 2021) was retrieved from the Leistungsorientierte Krankenanstaltenfinanzierung (Achievement-Oriented Hospital Financing). The 30-day and one-year readmission rates were reported. Readmission risk for any complication, as well as general medicine-, internal medicine-, and surgery/injury-associated complications, and factors associated with readmissions, were investigated. Results: The 30-day and one-year readmission rates due to any complication were 15% and 47%, respectively. The 30-day readmission rate (p = 0.001) was higher in endoprosthesis than osteosynthesis patients; this was not the case for the one-year readmission rate (p = 0.138). Internal medicine- (n = 2,273 (20%)) and surgery/injury-associated complications (n = 1,612 (14%)) were the most common reason for one-year readmission. Regardless of the surgical procedure, male sex was significantly associated with higher readmission risk due to any, as well as internal medicine-associated, complication. Advanced age was significantly associated with higher readmission risk after osteosynthesis. In both cohorts, treatment at mid-sized hospitals was significantly associated with lower readmission risk due to any complication, while prolonged length of stay was associated with higher one-year readmission risks due to any complication, as well as internal-medicine associated complications. Conclusion: Future health policy decisions in Austria should focus on optimization of perioperative and post-discharge management of this vulnerable patient population. Cite this article: Bone Jt Open 2024;5(4):294–303.

Introduction: Neurosurgery is considered a technically demanding specialty; nonetheless, it also requires non-technical skills (NTSs) to reach mastery. Research question: This study seeks to understand how important NTSs are perceived by neurosurgeons across diverse roles and socio-economic backgrounds. The objective is to identify key NTSs and explore their role in surgical precision, teamwork, and collaboration. Material and method: An international survey involving 372 neurosurgeons from various socio-economic and cultural contexts was conducted. The extensive sample and inclusive methodology provide a comprehensive perspective on the perceived importance of NTSs in neurosurgery. Results: The survey results highlight the universal significance of NTSs among neurosurgeons. Attention to detail, humility, and self-awareness are considered essential for surgical precision, effective teamwork, and collaboration. The findings underscore the necessity for integrated training programs that combine NTSs with technical skills. Discussion and conclusion: The study emphasizes the importance of effective training methods such as simulations, mentorship, and role-playing in equipping neurosurgeons to navigate the complexities of their profession. Future research should focus on optimizing teaching methods for NTSs, comparing traditional courses, online modules, and hybrid training programs. Addressing the global disparity in neurosurgical care, particularly in low- and middle-income countries, is crucial for improving patient outcomes worldwide.

Background: Nurses provide 90% of health care worldwide, yet little is known of the experiences of nurses and midwives in policy development in low- and middle-income countries (LMICs). Objective: To identify, appraise and synthesize the qualitative evidence on the experiences of nurses’ and midwives’ involvement in policy development LMICs. Design: A qualitative systematic review using modified Joanna Briggs Institute (JBI) methodology. Setting: Low and middle-income countries. Participants: Nurses’ and midwives’ involved in policy development, implementation, and/or evaluation. Methods: A systematic search was undertaken across nine databases to retrieve published studies in English between inception and April of 2021. Screening, critical appraisal, and data extraction was undertaken by two independent reviewers. Results: Ten articles met inclusion criteria. All studies were published between 2000 to 2021 from a variety of LMICs. The studies were medium to high quality (70–100% critical appraisal scores). Four major themes were identified related to policy development: 1) Marginal representation of nurses; 2) Determinants of nurses’ involvement (including at the individual, organization, and systematic level); 3) Leadership as a pathway to involvement; 4) Promoting nurses’ involvement. Conclusion: All studies demonstrated that nurses and nurse midwives continue to be minimally involved in policy development. Findings reveal reasons for nurses’ limited involvement and strategies to foster sustained engagement of nurses in policy development in LMICs. To enhance their involvement in policy development in LMICs, change is needed at multiple levels. Systemic power relations need to be reconstructed to facilitate more collaborative interdisciplinary practices with nurses co-leading and co-developing health care policies.

Illicium verum, commonly known as star anise, represents one of the notable botanical species and is recognized for its rich reservoir of diverse bioactive compounds. Beyond its culinary application as a spice, this plant has been extensively utilized in traditional medicine. Given the contemporary emphasis on incorporating natural resources into food production, particularly essential oils, to enhance sensory attributes and extend shelf life, our study seeks to elucidate the chemical composition and evaluate the antibacterial (in vitro, in situ) and insecticidal properties of Illicium verum essential oil (IVEO). Also, microbiological analyses of pumpkin sous vide treated with IVEO after inoculation of Salmonella enterica were evaluated after 1 and 7 days of study. GC/MS analysis revealed a significantly high amount of (E)-anethole (88.4%) in the investigated EO. The disc diffusion method shows that the antibacterial activity of the IVEO ranged from 5.33 (Streptococcus constellatus) to 10.33 mm (Citrobacter freundii). The lowest minimal inhibition concentration was found against E. coli and the minimum biofilm inhibition concertation was found against S. enterica. In the vapor phase, the best antimicrobial activity was found against E. coli in the pears model and against S. sonei in the beetroot model. The application of the sous vide method in combination with IVEO application decreased the number of microbial counts and eliminated the growth of S. enterica. The most isolated microbiota identified from the sous vide pumpkin were Bacillus amyloliquefaciens, B. cereus, B. licheniformis, and Ralstonia picketii. Modifications to the protein composition of biofilm-forming bacteria S. enterica were suggested by the MALDI TOF MS instigations. The IVEO showed insecticidal potential against Harmonia axyridis. Thanks to the properties of IVEO, our results suggest it can be used in the food industry as a natural supplement to extend the shelf life of foods and as a natural insecticide.

New goals for industry and science have led to increased awareness of food safety and healthier living in the modern era. Here, one of the challenges in food quality assurance is the presence of pathogenic microorganisms. As planktonic cells can form biofilms and go into a sessile state, microorganisms are now more resistant to broad-spectrum antibiotics. Due to their proven antibacterial properties, essential oils represent a potential option to prevent food spoilage in the search for effective natural preservatives. In this study, the chemical profile of Citrus limon essential oil (CLEO) was evaluated. GC-MS analysis revealed that limonene (60.7%), β-pinene (12.6%), and γ-terpinene (10.3%) are common constituents of CLEO, which prompted further research on antibacterial and antibiofilm properties. Minimum inhibitory concentration (MIC) values showed that CLEO generally exhibits acceptable antibacterial properties. In addition, in situ antimicrobial research revealed that vapour-phase CLEO can arrest the growth of Candida and Y. enterocolitica species on specific food models, indicating the potential of CLEO as a preservative. The antibiofilm properties of CLEO were evaluated by MIC assays, crystal violet assays, and MALDI-TOF MS analysis against S. enterica biofilm. The results of the MIC and crystal violet assays showed that CLEO has strong antibiofilm activity. In addition, the data obtained by MALDI-TOF MS investigation showed that CLEO altered the protein profiles of the bacteria studied on glass and stainless-steel surfaces. Our study also found a positive antimicrobial effect of CLEO against S. enterica. The anti-Salmonella activity of CLEO in vacuum-packed sous vide carrot samples was slightly stronger than in controls. These results highlight the advantages of the antibacterial and antibiofilm properties of CLEO, suggesting potential applications in food preservation.

The essential oil of Pelargonium graveolens (PGEO) is identified in the literature as a rich source of bioactive compounds with a high level of biological activity. This study aimed to examine the chemical profile of PGEO as well as its antioxidant, antibacterial, antibiofilm, and insecticidal properties. Its chemical composition was analyzed using gas chromatography–mass spectrometry (GC-MS), achieving comprehensive identification of 99.2% of volatile compounds. The predominant identified compounds were β-citronellol (29.7%) and geraniol (14.6%). PGEO’s antioxidant potential was determined by means of DPPH radical and ABTS radical cation neutralization. The results indicate a higher capacity of PGEO to neutralize the ABTS radical cation, with an IC50 value of 0.26 ± 0.02 mg/mL. Two techniques were used to assess antimicrobial activity: minimum inhibitory concentration (MIC) and disk diffusion. Antimicrobial evaluation using the disk diffusion method revealed that Salmonella enterica (14.33 ± 0.58 mm), which forms biofilms, and Priestia megaterium (14.67 ± 0.58 mm) were most susceptible to exposure to PGEO. The MIC assay demonstrated the highest performance of this EO against biofilm-forming S. enterica (MIC 50 0.57 ± 0.006; MIC 90 0.169 ± 0.08 mg/mL). In contrast to contact application, the assessment of the in situ vapor phase antibacterial activity of PGEO revealed significantly more potent effects. An analysis of antibiofilm activity using MALDI-TOF MS demonstrated PGEO’s capacity to disrupt the biofilm homeostasis of S. enterica growing on plastic and stainless steel. Additionally, insecticidal evaluations indicated that treatment with PGEO at doses of 100% and 50% resulted in the complete mortality of all Harmonia axyridis individuals.

In this study, we aimed to use high‐throughput sequencing technology to systematically analyze the bacterial community structure during the box wheat Qu–making process to understand the succession of bacterial communities. To our knowledge, this is the first study in which mature Qu, raw materials, and the complete fermentation process of the box wheat Qu were analyzed. Significant differences in the distribution and abundance of the dominant bacteria were observed among these samples. Bacterial diversity was lowest in residual mature Qu, gradually increasing after moistening and fermentation and declining after reaching its peak on the fourth day. The predominant bacteria observed in residual mature Qu were Saccharopolyspora (81.64%), Weissella (3.39%), and Staphylococcus (3.06%). The most abundant bacteria in the moistened material were Pantoea (48.50%), Staphylococcus (12.10%), and Saccharopolyspora (11.61%). However, a rapid decline in Pantoea and Staphylococcus in box wheat Qu was observed on the first day of fermentation. Following fermentation, the most abundant bacteria were Saccharopolyspora (68.85%), Bacillus (19.94%), and Thermoactinomyces (4.70%). Nonmetric multidimensional scale and linear discriminant analysis effect size analyses revealed a significant difference in the bacterial community structure between the raw materials and samples obtained at the end of fermentation. These findings underscore the significant effect of the bacterial community structure of residual mature Qu on box wheat Qu. [ABSTRACT FROM AUTHOR]

A unique species of pine, Cedrus deodara is known for its wood oil. Its traditional therapeutic use is mainly antibacterial and anti-inflammatory. The aim of this study was to investigate the antibacterial properties of Cedrus deodara essential oil (CDEO) obtained from the crushed wood. The antimicrobial activity of CDEO was evaluated against Gram-negative (G-) bacteria which included Pseudomonas aeruginosa CCM 1595, Salmonella enterica subs. enterica CCM 3807 and Gram-positive (G+) bacteria Yersinia enterocolitica CCM 5671. Listeria monocytogenes CCM 4699, Staphylococcus aureus subs. aureus CCM 2461 and Streptococcus consellatus CCM 4043 in vitro and in situ. The best antimicrobial activity for the disc diffusion method ranged from 4.67 to 9.67 mm and the minimum inhibitory concentration ranged from 1.48 to 5.44 mg.mL-1. The most effective antimicrobial effect was found against S. aureus and L. monocytogenes. The vapour phase used showed the best antimicrobial effect against P. aeruginosa in the kiwifruit model and L. monocytogenes in the banana model at a lower CDEO concentration of 62.5 µg.L-1 and against P. aeruginosa in the potato model and Y. enterocolitica in the cucumber model at a higher CDEO concentration of 500 µg.L-1. CDEO showed good antimicrobial activity against bacteria on vegetable and fruit model and may be a new preservative for storage of vegetables and fruits. [ABSTRACT FROM AUTHOR]

Among the genera in this family, Styrax is unique in that it yields benzoin resin, a resinous substance. Usually, when sharp items lacerate the bark, this resin is secreted. Because of its fragrant qualities, it has been used for centuries in cosmetics and fragrances all over the world. Additionally, Styrax species have long been employed in herbal remedies for a variety of ailments. The antibacterial characteristics of Styrax tonkinensis essential oil (STEO) were the focus of this study. The antimicrobial activity was compared to bacteria, both Gram-positive (G+) and Gram-negative (G-), using inhibition zones in agar media, minimum inhibitory concentration (MIC) bioassays and in vapour phase on fruits and vegetables model. The findings showed that STEO was very successful in inhibiting bacteria that were G+ (Bacillus sutbtilis subsp. Spizizenii CCM 1999, Bacillus thuringiensis CCM 19, and Priestia (Bacillus) megaterium CCM 2007) as well as G- (Citrobacter koseri CCM 2535, Enterobacter aerogenes CCM 2531, Escherichia coli CCM 3954). The range of maximal inhibition zones and MIC values was determined to be 4.67 to 8.33 mm and 3.49 to 7.71 mg.mL-1, respectively. Furthermore, B. thiriangensis, P. megaterium, and E. coli were all susceptible to the antimicrobial effects of the (STEO) on the fruit and vegetable model. According to research findings, STEO is a valuable source of organic chemicals that have the potential to be innovative antibacterial agents against microbes. [ABSTRACT FROM AUTHOR]

There is a lack of dietary fiber and some essential amino acids in instant noodles. Enriching this popular food with protein‐ and fiber‐rich sources is important to improve the nutritional quality of noodles. The current study is aimed at enriching instant noodles by substituting wheat flour with lentil flour (7%–35%: L7%, L21%, and L35%), soy‐protein isolate (1%–5%: S1%, S3% and S5%), egg‐white protein (1–5: E1%, E3%, and E5%) and Spirulina platensis (1%–5%: S.p1%, S.p3% and S.p5%). The physicochemical, microbial, textural, and sensorial properties of noodle samples were investigated. The spatial relationship between parameters was also evaluated based on principal component analysis (PCA) to select the suitable noodle formulation. The highest protein (17.06%) and lowest carbohydrate contents (76.44%) were for L35%. The lowest (1.69%) and highest fat contents (2.04%) were for S5% and S.p5%m, respectively (p > 0.05). Energy values varied from 394.83 (E5%) to 396.37 kcal/100 g (S.p5%). There was no significant difference between the microbial quality of noodle samples (p > 0.05). The hardness of noodles with 1%–5% soy protein, 21% or more lentil flour, and 3% or more egg‐white/Spirulina was higher than the control/unenriched group (p < 0.05). The color difference of E1 and E3% with the control sample was not obvious (ΔE∗ < 3). Although all the ingredients improved the nutritional value of the noodles, the overall acceptance of samples with 3% or more of Spirulina was lower than the acceptable limit (a score of 3). According to PCA, when the nutritional value and sensory acceptance are important, the L35% may be a better choice. E1%, E3%, S1%, S5%, and L7% noodles received almost the same sensory score as the control sample, while they had more nutritional values. A combination of animal, plant, and microalgae protein sources may provide a noodle with high nutritional value, containing a wide range of essential amino acids and bioactive compounds. More research is needed to optimize such a formulation. [ABSTRACT FROM AUTHOR]

The school, with its activities as an upbringing and educational institute, influences all segments of a pupil's effective development. Besides teaching as its basic activity, the school should take over part of the care and responsibility for the pupil's free time and "use" it for "prolonged" upbringing activity. Today children and young people "spend" their free time on the Internet and little or almost no time in the development of social competences. Confronted with technology as an inevitable challenge of the present day, we are also confronted with new issues in our upbringing and education practice. Due to unpreparedness in participating in joint activities and the impossibility of communication, pupils show numerous manifestations in behavioral disorder, which often determine school success. Participation in extracurricular activities reduces the action area of risk factor in children and youth in their free time, which effects school success in particular. Numerous researches have confirmed how the engagement of pupils in extracurricular activities is one of the factors that influences school success. In Croatia, extracurricular activities are quite neglected for numerous reasons. It is necessary to bring them back to the school and to modernize them and make them challenging and attractive for pupils. Research results on 970 elementary school pupils of Zadar and Šibenik-Knin counties are elaborated in this work. Their participation in extracurricular and out-of-school activities and their connection to school success was examined. The results confirm the presumption that children who participate in extracurricular and out-of-school activities achieve better school success.

Purpose: The purpose of this paper is to examine university students' attitudes towards the concept of sustainable development and towards the need for the implementation of education for sustainable development into the higher education system. To that end, the paper explores in a process-oriented focus which drivers and barriers are experienced as being the most important ones and how they relate to one another. Design/methodology/approach: The study is based on the questionnaire for the evaluation of attitudes towards the concept of sustainable development. This instrument consists of 9 batteries with 83 items presented in the form of the five-point Likert scale. The questionnaire evaluated different aspects of respondents' attitudes towards the concept of sustainable development, but students' attitudes in relation to the items from the following subscales will be presented for this paper: understanding the concept of sustainable development, position of sustainable development in the system of higher education, sources of information about sustainable development and entities responsible for sustainable development. The study sample consisted of students from the University of Novi Sad, specifically from the faculties with accredited programs in the field of humanities and technological sciences. Findings: In general, students recognized the main determinants of sustainable development and they support an integral approach to sustainability, i.e. the need to include the knowledge, values and skills for sustainable development in the higher education programs. In addition, they identified a number of obstacles and the uncertainties of overcoming them. In this regard, the students did not recognize the responsibility of the higher education institutions as the key responsibility or their own responsibility in relation to sustainable development, which can be related to their feeling of marginalization and the doubt that their behaviour and decisions can influence the development of the local society, as well as the development of the society as a whole. On the other hand, the respondents acknowledged the role, the importance and the responsibility of the mass media in the process of developing the attitudes towards and opinions about the problems related to environmental protection and sustainable development. Practical implications: The results of the study indicate the students' attitudes towards sustainable development, thus making the directions for higher education reform clearer and in line with the present needs for sustainable development in Serbia. The obtained results can serve as a recommendation to the governing structures, i.e. to the relevant ministries of education and environmental protection, as well as to the universities in terms of which direction their process of planning and creating paths of sustainability should take. This is particularly important in the case of the Republic of Serbia, which is currently in the process of joining the European Union and responding to the requirements set by the process of negotiation for Chapter 27 in terms of improving the strategic framework and plans for the education for sustainable development and building the capacities in response to climate change. On the other hand, linking the results of this research with the results of similar studies around the world contributes to the further enrichment of the scientific knowledge base in this field and confirms the need for stronger and united efforts on the path to a sustainable future. It is a fact that, regardless of the national, economic, socio-political and cultural context, there is a global lack of success in shaping a humane and sustainable relationship between man and nature. Therefore, the results of this research should be considered as an invitation for new research initiatives regarding the ways to support the positive attitudes of students towards the concept of sustainable development and to facilitate their further development in the educational process, as well as in other academic domains. Originality/value: This research is inspired by the fact that, in the Balkan countries, education for sustainable development has not been extensively discussed within the scientific discourse on higher education for sustainable development. This is one of the first papers to provide data about students' attitudes towards the concept of sustainable development and the need for its implementation in the higher education system in Serbia. The value of the paper lies in its potential to help understand the role that different drivers and barriers play in higher education for sustainable development.