A retrospective study of perioperative clinical seizures and epilepsy in children after operation for CHD

This study investigated the incidence and risk factors of perioperative clinical seizure and epilepsy in children after operation for CHD. We included 777 consecutive children who underwent operation from January 2013 to December 2016 at Kanagawa Children’s Medical Center, Kanagawa, Japan. Perinatal, perioperative, and follow-up medical data were collected. Elastic net regression and mediation analysis were performed to investigate risk factors of perioperative clinical seizure and epilepsy. Anatomic CHD classification was performed based on the preoperative echocardiograms; cardiac surgery was evaluated using Risk Adjustment in Congenital Heart Surgery 1. Twenty-three (3.0%) and 15 (1.9%) patients experienced perioperative clinical seizure and epilepsy, respectively. Partial regression coefficient with epilepsy as the objective variable for anatomical CHD classification, Risk Adjustment in Congenital Heart Surgery 1, and the number of surgeries was 0.367, 0.014, and 0.142, respectively. The proportion of indirect effects on epilepsy via perioperative clinical seizure was 22.0, 21.0, and 33.0%, respectively. The 15 patients with epilepsy included eight cases with cerebral infarction, two cases with cerebral haemorrhage, and three cases with hypoxic-ischaemic encephalopathy; white matter integrity was not found. Anatomical complexity of CHD, high-risk cardiac surgery, and multiple cardiac surgeries were identified as potential risk factors for developing epilepsy, with a low rate of indirect involvement via perioperative clinical seizure and a high rate of direct involvement independently of perioperative clinical seizure. Unlike white matter integrity, stroke and hypoxic-ischaemic encephalopathy were identified as potential factors for developing epilepsy.

Economic Analysis of Pearl Millet Cultivation in Rainfed Ecosystem of Thoothukudi District, Tamil Nadu, India

The Pearl millet is the staple and nutritive diet of farm households in developing and underdeveloped countries. It is grown as dual-purpose; grain and forage in drylands, marginal lands, and unirrigated lands of the Indian subcontinent. This study analysed the cost and returns, profitability, and resource productivity of the pearl millet growing farmers in a rainfed ecosystem of Thoothukudi District. Primary data were collected in selected blocks namely Vilathikulam and Pudur, based on the maximum area under pearl millet cultivation. The sampling design used in the study was Purposive random sampling. Totally 61 farmers were personally interviewed using a well-structured questionnaire. The Cost-C was Rs. 41115.65 per hectare. The proportionate expenditure of Hired Human Labour was 19.05 per cent to total costs. The net income was Rs. 4974.2 per hectare. The BCR was higher in small followed by medium and large farms. The partial regression coefficient of hired labour and fertilizers was 0.103, and 0.793 respectively, which were positive and highly significant. It indicated that gross return was increased by 0.793 per cent by increasing one per cent of expenses on fertilizers. The summation of all partial coefficients was 0.656 which indicated a decreasing return to scale. When the production function's returns to scale decrease, the average cost of production rises. Input prices have a significant impact on the economic profitability of farmers' crop cultivation. Rainfed pearl millet cultivation is unprofitable at market values in the Thoothukudi district. The current scenario requires the revising of minimum support prices and regulation in input market, particularly for crops grown in rainfed ecosystems.

Delays in Presentation Time Under the COVID-19 Epidemic in Patients With Transient Ischemic Attack and Mild Stroke: A Retrospective Study of Three Hospitals in a Japanese Prefecture

Background: Coronavirus Disease 2019 (COVID-19) has spread worldwide with collateral damage and therefore might affect the behavior of stroke patients with mild symptoms seeking medical attention.Methods: Patients with ischemic stroke who were admitted to hospitals within 7 days of onset were retrospectively registered. The clinical characteristics, including onset-to-door time (ODT), of patients with a transient ischemic attack (TIA)/mild stroke (National Institutes of Health Stroke Scale [NIHSS] score of ≤ 3 on admission) or moderate/severe stroke were compared between those admitted from April 2019 to March 2020 (pre-COVID-19 period) and from April to September 2020 (COVID-19 period). Multivariable regression analysis was performed to identify factors associated with the ODT.Results: Of 1,100 patients (732 men, median age, 73 years), 754 were admitted during the pre-COVID-19 period, and 346 were admitted during the COVID-19 period. The number and proportion of patients with TIA/minor stroke were 464 (61.5%) in the pre-COVID-19 period and 216 (62.4%) during the COVID-19 period. Among patients with TIA/mild stroke, the ODT was longer in patients admitted during the COVID-19 period compared with that of the pre-COVID-19 period (median 864 min vs. 508 min, p = 0.003). Multivariable analysis revealed the COVID-19 period of admission was associated with longer ODT (standardized partial regression coefficient 0.09, p = 0.003) after adjustment for age, sex, route of arrival, NIHSS score on admission, and the presence of hypertension, diabetes mellitus, and wake-up stroke. No significant change in the ODT was seen in patients with moderate/severe stroke.Conclusions: The COVID-19 epidemic might increase the ODT of patients with TIA/mild stroke.

Stressors of Nursing Interns and Their Influencing Factors: A Cross-Sectional Study

Objective. It is still unknown whether the stress level and stressors in Chinese nursing interns are influenced by teacher-related factors. This research was carried out for better understanding of the stress in nursing interns and distribution of stressors during their clinical practice and targeted measures to unwind the stress of nursing interns. Methods. A questionnaire survey, titled Questionnaire on Stressors of Nursing Interns during Clinical Practice, was conducted on nursing interns at a 3A Grade Hospital in Shandong Province. Characteristics of the nursing interns and stressors of nursing interns were collected. A multiple-linear regression model was used to explore the influencing factors of nursing interns’ scores. Results. A total of 132 nursing interns were investigated in this study, and the overall stress scores were calculated. The stressors during the internship include the nature and content of the job, role orientation, workload, conflict between study and work, practice preparation, and interpersonal relationships. Gender, education level, instructor encouragement, and parents engaged in the medical industry were adjusted in the multiple-linear regression model as covariates. All of these factors had significant impacts on the scores of stressors ( P < 0.05), with the partial regression coefficient values of 13.38, −10.52, −5.02, 3.4, −9.89, −14.77, and −15.83 for factors like female, undergraduates, graduate students, never obtained encouragement from teachers, obtained encouragement from teachers occasionally, obtained encouragement from teachers frequently, and parents engaged in the medical industry, respectively. Conclusion. The stressors of nursing interns are mostly work-wise, and teachers’ encouragement is an important protective factor for nursing interns to reduce stress. Therefore, clinical instructors should take targeted measures in teaching methods and work arrangements according to the needs of interns.

Analysis of the regional difference in the number of multi-drug prescriptions and its predictors in Japan, 2015–2018

Objective Polypharmacy and multi-drug prescription are major public health problems in Japan, but only a few studies have investigated the regional differences. By revealing regional differences in the multi-drug prescriptions, we can infer regions with high rates of multimorbidity or inappropriate prescribing. This study revealed regional differences in multi-drug prescriptions (the number of simultaneous prescriptions of seven or more internal medicines) and investigated the factors affecting the difference using the National Database of Health Insurance Claims and Specific Health Checkups of Japan data. Results The standardized claim ratio (SCR) of the number of multi-drug prescriptions, which corrected the difference in sex and age distribution of prefectures, varied depending on prefectures. A panel data analysis investigating the association between the SCR and explanatory variables (Medical institutions, socioeconomic factors, and physical characteristics of people in prefectures) revealed that the number of public assistance recipients per 1,000 persons was positively and significantly associated with the SCR (Standardized partial regression coefficient = 0.244, p-value = 0.038). In conclusion, regional differences in the number of the multi-drug prescriptions were revealed in Japan, suggesting that public assistance recipients tend to experience multi-drug prescriptions.

Model penguatan loyalitas mahasiswa melalui kualitas pelayanan bimbingan akademik dan kepuasan mahasiswa

This study aims to examine the effect of academic guidance service quality, student satisfaction and the interaction between service quality and student satisfaction in strengthening student loyalty. The sample was determined by convenience sampling and purposive sampling methods. The data was collected by quisioner providing a list of questions to the respondents which contained the quality of service, student satisfaction and student loyalty. The analytical tool used is Moderator Regression Analysis. Meanwhile, to test the hypothesis put forward, the t test and F test are used.. Meanwhile, to find out how much the variables of academic guidance service quality, student satisfaction and the interaction between service quality and student satisfaction were able to explain the student loyalty variables used the coefficient of determination analysis. The results of the partial regression coefficient test with the t test explain that the quality of academic guidance services, student satisfaction and the interaction between service quality and academic guidance with student satisfaction affect student loyalty. Meanwhile, the regression coefficient test simultaneously results that the quality of academic guidance services, student satisfaction and the interaction between the quality of academic guidance services and student satisfaction have an effect on student loyalty.

Effect of Improvement in Sarcopenia on Functional and Discharge Outcomes in Stroke Rehabilitation Patients

This cross-sectional study investigated the proportion of patients’ recovery from sarcopenia status and the relationship between improvement in sarcopenia (IS) and function and discharge outcome in hospitalized patients with stroke. This study included patients with stroke, aged 65 years or more, with a diagnosis of sarcopenia, who were admitted to a convalescent rehabilitation ward. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Patients were divided according to the presence or absence of sarcopenia at discharge: IS group and non-improvement in sarcopenia (NIS) group. Among the 227 participants (mean age: 80.5 years; 125 females), 30% (69/227) of the patients were in the IS group, while 70% (158/227) were in the NIS group. The IS group showed a higher Functional Independence Measure (FIM) than the NIS group (median 112 vs. 101, p = 0.003). The results demonstrated that IS was independently associated with higher FIM (partial regression coefficient, 5.378; 95% confidence interval (CI), 0.709–10.047). The IS group had higher odds of home discharge than the NIS group (odds ratio, 2.560; 95% CI, 0.912–7.170). In conclusion, recovery from sarcopenia may be associated with better function in patients with stroke.

Causes of anxiety among teachers giving face-to-face lessons after the reopening of schools during the COVID-19 pandemic: a cross-sectional study

Background Coronavirus infections are spreading rapidly worldwide, and primary and middle schools are closed in many countries. After the state of emergency was lifted in Japan, schools have reopened, and teachers are conducting face-to-face classes while maintaining safety precautions. This study aimed to assess the factors contributing to infection-related anxiety and educational anxiety among teachers conducting face-to-face classes during the COVID-19 pandemic after schools reopened. Methods This questionnaire-based cross-sectional study was conducted with 263 primary and middle school teachers in the Shinagawa area of Tokyo (October 10–30, 2020). The questionnaire assessed the type of school (primary or middle school), sex, age, and factors contributing to infection-related anxiety and educational anxiety that arose from the pandemic. The levels of anxiety and the factors contributing to anxiety were assessed using a 5-point Likert scale ranging from 1 (not at all) to 5 (very anxious). Results In an analysis of the data of 237 participants excluding the missing data, many teachers reported feeling infection- and education-related anxiety. A majority of the participants were women (n = 152, 64.1%), and the mean age of the participants was 39.8 ± 11.3 years. A stepwise multiple regression analysis identified six factors for infection-related anxiety as significant (R2 = 0.61, p < 0.001). Among these variables, the largest partial regression coefficient value was reported for the following reason: “I feel anxious because we cannot ensure the safety of teachers themselves or of their families” (β = 0.37, p < 0.001). For educational anxiety, four of six reasons were identified as significant (R2 = 0.64, p < 0.001). Among these, “anxiety about the students’ home situations” (β = 0.41, p < 0.001) and “delay in education (students’ side)” (β = 0.27, p < 0.001) had stronger associations with anxiety compared to the others. Conclusion In-person education during the COVID-19 pandemic has caused teachers to experience anxiety. This report provides useful information by highlighting the reasons for infection-related anxiety and educational anxiety that teachers experience in face-to-face classes during a pandemic. Even if the coverage of a COVID-19 vaccine becomes widespread worldwide, we will still be combating COVID-19 infections for at least a few years. Given concerns regarding such infections, to ensure students’ right to education, it is essential to understand why teachers feel anxious and to determine appropriate measures to decrease such anxiety.

THE EFFECT OF DIVERSIFICATION LEVEL, NUMBER OF SEGMENTS, AND INDUSTRY SECTOR TYPE ON COMPANY PERFORMANCE

The high competition in the business world with many competitors has forced the company to develop its business, one of them by diversification. This study aims to investigate the influence of diversification level, the number of segments, and type of industrial sector on firm performance measured by the excess value. The theory underlying this research is agency theory, which describes the relationship between the company owners with the company management. The number samples of this study are 333 companies from the miscellaneous industry sector, consumer goods sector, and basic industry and chemicals sector listed on the Indonesia Stock Exchange throughout 2017 – 2018. The results showed that data can be pooled for 3 years, all classic assumption tests are fulfilled, and partial regression coefficient test found that variable diversification level and the variable number of segments > 0.05, then H01 and H02 rejected, while the type of miscellaneous industry sector and type of consumer goods sector <0.05, then H03 and H04 received. The conclusion showed that variable diversification level and number of segments has not sufficient evidence of a negative effect on excess value, while the type of miscellaneous industry sector and type of consumer goods sector sufficient evidence of a negative effect on excess value.

Pengaruh ekspor, tingkat inflasi dan nilai tukar mata uang terhadap cadangan devisa (studi di Indonesia dan Malaysia)

This study aims at the implications of the development of foreign exchange reserves, exports, inflation, and the exchange rate of the rupiah and Malaysian ringgit for the period 2000-2017, the implications of the effect of exports, inflation, and the rupiah exchange rate on foreign exchange reserves in Indonesia and the effect of exports, inflation and the value of the rupiah. exchange rate ringgit against Foreign Exchange Reserves in Malaysia. The type of data used in this study is secondary data which is periodic data from 2000 – 2017, hypothesis testing itself using multiple linear regression equations. The analytical tools used are the joint test (F-Test), Partial Regression Coefficient Test (t-test), and Classical Assumption Test. Based on the t-test analysis, it can be seen that exports cannot affect foreign exchange reserves. Meanwhile, inflation has a negative and significant effect on foreign exchange reserves with a coefficient of 0.159% and the exchange rate has a positive and significant effect on foreign exchange reserves with a coefficient of 1.446%. Keywords: Exports, Inflation, Exchange rates, Foreign reserves