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Copper (II) complexes with commercial antibiotics, amoxicillin (AMX), azithromycin (AZT) and ciprofloxacin (CFL) were synthesized and isolated as solids. Structures of the isolated products were determined by FTIR spectroscopy. Antibacterial activities were determined on reference bacterial strains from the ATCC collection by diffusion technique. The results show that AMX and CFL coordinate Cu (II) ion as bidentate O-donor ligand. AZT coordinates metal center as bidentate NO-donor ligand. A difference in the morphology of antibiotic crystals and the synthesized complexes was found. Complex of Cu (AMX)2 show complete absence of antibacterial activity, while the other com-plexes show the same or even lower activity than the parent ligands.  

Jessica Rahman, A. Brankovic, Mark Tracy, Sankalp Khanna

Background Computational signal preprocessing is a prerequisite for developing data-driven predictive models for clinical decision support. Thus, identifying the best practices that adhere to clinical principles is critical to ensure transparency and reproducibility to drive clinical adoption. It further fosters reproducible, ethical, and reliable conduct of studies. This procedure is also crucial for setting up a software quality management system to ensure regulatory compliance in developing software as a medical device aimed at early preclinical detection of clinical deterioration. Objective This scoping review focuses on the neonatal intensive care unit setting and summarizes the state-of-the-art computational methods used for preprocessing neonatal clinical physiological signals; these signals are used for the development of machine learning models to predict the risk of adverse outcomes. Methods Five databases (PubMed, Web of Science, Scopus, IEEE, and ACM Digital Library) were searched using a combination of keywords and MeSH (Medical Subject Headings) terms. A total of 3585 papers from 2013 to January 2023 were identified based on the defined search terms and inclusion criteria. After removing duplicates, 2994 (83.51%) papers were screened by title and abstract, and 81 (0.03%) were selected for full-text review. Of these, 52 (64%) were eligible for inclusion in the detailed analysis. Results Of the 52 articles reviewed, 24 (46%) studies focused on diagnostic models, while the remainder (n=28, 54%) focused on prognostic models. The analysis conducted in these studies involved various physiological signals, with electrocardiograms being the most prevalent. Different programming languages were used, with MATLAB and Python being notable. The monitoring and capturing of physiological data used diverse systems, impacting data quality and introducing study heterogeneity. Outcomes of interest included sepsis, apnea, bradycardia, mortality, necrotizing enterocolitis, and hypoxic-ischemic encephalopathy, with some studies analyzing combinations of adverse outcomes. We found a partial or complete lack of transparency in reporting the setting and the methods used for signal preprocessing. This includes reporting methods to handle missing data, segment size for considered analysis, and details regarding the modification of the state-of-the-art methods for physiological signal processing to align with the clinical principles for neonates. Only 7 (13%) of the 52 reviewed studies reported all the recommended preprocessing steps, which could have impacts on the downstream analysis. Conclusions The review found heterogeneity in the techniques used and inconsistent reporting of parameters and procedures used for preprocessing neonatal physiological signals, which is necessary to confirm adherence to clinical and software quality management system practices, usefulness, and choice of best practices. Enhancing transparency in reporting and standardizing procedures will boost study interpretation and reproducibility and expedite clinical adoption, instilling confidence in the research findings and streamlining the translation of research outcomes into clinical practice, ultimately contributing to the advancement of neonatal care and patient outcomes.

Maria Rejane Calheiros da Virgem, Tatiane Batista dos Santos, Enoque Chaves de Almeida Junior, Felipe Santos Rocha, G. D. Silva, C. Costa, Marcio Valeiro Costa, Daniela Droppa Almeida et al.

Devido à falha dos protocolos de biossegurança nas cooperativas de reciclagem, os separadores de resíduos se expõem a agentes biológicos, como vírus, fungos e bactérias, tornando-se mais susceptíveis a infecções por estes agentes. Este estudo objetivou estudar o risco biológico ao qual estão expostos os cooperados na atividade de triagem/separação dos resíduos recicláveis, avaliando o uso de equipamentos de proteção individual e a ocorrência de acidentes e da prática da higienização das mãos. Para isso, realizou-se um estudo descritivo quantitativo no Estado de Alagoas, nas Cooperativas de Reciclagem de Resíduos COOPREL e COOPLUM. A ocorrência de microrganismos, provenientes do manuseio dos resíduos foi investigada através da coleta de material das mãos dos cooperados, com auxílio de swab, antes e após do processo de higienização habitual, seguida da orientada. O material coletado foi transportado e analisado quanto à presença de bactérias aeróbias e anaeróbias, bolores e leveduras. Após o cultivo e análise microbiológica, verificou-se a presença de microrganismos da família Enterobacreriaceae, bolores e leveduras. Entretanto, a coleta realizada após a higienização orientada houve significativa redução do número de bactérias em 88%; em relação à amostra inicial da coleta antes ou depois da higienizaçao habitual. Referente à presença de bolores e leveduras observou-se uma redução de 37,50%. Logo, este estudo identificou que 54% dos cooperados sofreram acidentes com material perfurocortante nos últimos doze meses, e identificou bactérias da família Enterobacteriaceae nas mãos dos cooperados (56,41%), refletindo além do risco biológico, a exacerbação do risco social representado pelas precárias condições de trabalho.

A. Kovačič, Martin Rafael Gulin, C. Nannou, L. Koronaiou, T. Kosjek, D. Heath, Mark S. Maier, D. Lambropoulou et al.

Davide Piaggio, Marianna Zarro, S. Pagliara, Martina Andellini, Abdulaziz Almuhini, A. Maccaro, L. Pecchia

T. Brčina, M. Vilušić, Melisa Zahirović

Syneresis represents the appearance of separation of whey on the surface of the product and is considered an important parameter of the quality of fermented dairy products. For the production of the fermented milk drink, kombucha was used as a non-traditional starter. Two sweeteners were used, honey and sucrose.The aim of the work was to examine the influence of starter and sweetener on changes in the subsequent acidity and intensity of syneresis of the samples during storage. The results were compared with a control sample obtained by inoculation with a conventional starter culture. During storage, there was a drop in pH value and an increase in titratableacidity, as a resultof the constant metabolic activity of the microflora and the production of lactic acid in the produced samples. Honey, as a sweetener, had an effect on the lower pH value of the fermented milk drink samples. The analysis of variance showed a statistically significant difference in the titratable acidity results and the intensity of syneresis of the samples during storage.Samples that were produced with kombucha as a starter showed better structure stability during storage and better quality. During storage, sample kb4 showed the best structural stability and the lowest intensity of syneresis. KEYWORDS:stinging nettle extract;bioactive components;extraction;antioxidant

E. Smith, A. Aggarwal, J. Ainsworth, E. Al-Abadi, T. Avčin, L. Bortey, J. Burnham, C. Ciurtin et al.

Objective: To achieve a consensus-based definition of Low Disease Activity (LDA) for use in cSLE trials. Methods: The International cSLE T2T Task Force, comprising of paediatric rheumatologists/nephrologists, and adult rheumatologists undertook a series of Delphi surveys/consensus meetings to discuss, refine, and vote upon cSLE LDA criteria. Results: The Task Force agreed that LDA should be based upon the adult-SLE Lupus Low Disease Activity State definition (LLDAS), with modifications to make it applicable to cSLE (cLLDAS). They agreed upon five cLLDAS criteria: (1) SLE Disease Activity Index (SLEDAI)-2 K ≤4, with no activity in major organ systems; (2) no new features of lupus disease activity compared with the last assessment; (3) Physician Global Assessment score of ≤1 (0–3 scale); (4) prednisolone dose of ≤0.15 mg/kg/day, 7.5 mg/day/maximum; while on (5) stable antimalarials, immunosuppressives, and biologics. Conclusions: A cSLE-appropriate definition of cLLDAS has been generated, maintaining alignment with the adult-SLE definition to promote life-course research.

Marija Levic, N. Bogavac-Stanojević, D. Lakić, D. Krajnović

Introduction: Obtaining, understanding, interpreting, and acting on health information enables people with diabetes to engage and make health decisions in various contexts. Hence, inadequate health literacy (HL) could pose a problem in making self-care decisions and in self-management for diabetes. By applying multidimensional instruments to assess HL, it is possible to differentiate domains of functional, communicative, and critical HL. Objectives: Primarily, this study aimed to measure the prevalence of inadequate HL among type 2 diabetes mellitus patients and to analyze the predictors influencing health literacy levels. Secondly, we analyzed if different self-reported measures, unidimensional instruments (Brief Health Literacy instruments (BRIEF-4 and abbreviated version BRIEF-3), and multidimensional instruments (Functional, Communicative and Critical health literacy instrument (FCCHL)) have the same findings. Methods: The cross-sectional study was conducted within one primary care institution in Serbia between March and September 2021. Data were collected through Serbian versions of BRIEF-4, BRIEF-3, and FCCHL-SR12. A chi-square test, Fisher’s exact test, and simple logistic regression were used to measure the association between the associated factors and health literacy level. Multivariate analyses were performed with significant predictors from univariate analyses. Results: Overall, 350 patients participated in the study. They were primarily males (55.4%) and had a mean age of 61.5 years (SD = 10.5), ranging from 31 to 82 years. The prevalence of inadequate HL was estimated to be 42.2% (FCCHL-SR12), 36.9% (BRIEF-3) and 33.8% (BRIEF-4). There are variations in the assessment of marginal and adequate HL by different instruments. The highest association was shown between BRIEF-3 and total FCCHL-SR12 score (0.204, p < 0.01). The total FCCHL-SR12 score correlates better with the abbreviated BRIEF instrument (BRIEF-3) than with BRIEF-4 (0.190, p < 0.01). All instruments indicated the highest levels for the communicative HL domain and the lowest for the functional HL domain with significant difference in functional HL between the functional HL of FCCHL-SR12 and both BRIEF-3 and BRIEF-4 (p = 0.006 and 0.008, respectively). Depending on applied instruments, we identified several variables (sociodemographic, access to health-related information, empowerment-related indicators, type of therapy, and frequency of drug administration) that could significantly predict inadequate HL. Probability of inadequate HL increased with older age, fewer children, lower education level, and higher consumption of alcohol. Only high education was associated with a lower probability of inadequate HL for all three instruments. Conclusions: The results we obtained indicate that patients in our study may have been more functionally illiterate, but differences between functional level could be observed if assessed by unidimensional and multidimensional instruments. The proportion of patients with inadequate HL is approximately similar as assessed by all three instruments. According to the association between HL and educational level in DMT2 patients we should investigate methods of further improvement.

Sanja D. Tomić, Slobodan Tomić, Goran Malenković, Jelena Malenkovic, Armin Šljivo, E. Mujičić

The COVID-19 pandemic has had a significant impact on mental health, particularly among students, due to COVID-19-related fear and also the transition from traditional to online lectures. In this questionnaire-based study, the COVID-19 Stress Scales (CSS), the Fear of COVID-19 Scale (FCV-19S), and the Online Teaching Satisfaction Scale were used to assess COVID-19-related fear, stress, and overall satisfaction with online teaching during the COVID-19 pandemic among nursing students in Serbia. A total of 167 students participated in the study, whose mean age was 21.3 ± 5.3, and the majority of whom were female and first-year students. Overall, most students experienced moderate to extremely high COVID-19-related stress levels. Overall, first-year and fourth-year students scored significantly lower regarding the Xenophobia and Traumatic stress subscales than second-year and third-year students, whereas first-year students also scored significantly lower on the Danger and Contamination subscales. First-year students experienced less COVID-19-related fear compared to senior students. Students were reasonably satisfied with online teaching. A stratified program is needed to prevent further decline of students’ mental health and to improve their adaptation through public, health, and educational changes.

A. Ahmetspahić, Dragana Jankovic, E. Burazerovic, B. Rovčanin, Amina Sahbaz, Esma Hasanagić, A. Džurlić, Nermir Granov et al.

Abstract Background  The initial clinical status after aneurysm rupture, whether primary or secondary, determines the final outcome. The most common cause of patient deterioration is a high Hunt and Hess (HH) score, which correlates closely with a high mortality rate. Poor-grade aneurysmal subarachnoid hemorrhage (SAH) is determined as an HH score 4 or 5. The aim of this study was to evaluate the clinical characteristics of poor graded aneurysmal SAH at our institution. Patients and Methods  During the 5-year period, 415 patients with intracranial aneurysm were admitted to our institution. Patients with poor-grade aneurysmal SAH accounted 31.08% ( n  = 132) of the total number of ruptured aneurysms. Interventional treatment was predominantly in the form of surgery, whereas conservative treatment included medication and external ventricular drainage. Final outcome was assessed with a modified Rankin score (mRs). Statistical analysis was performed using SPSS version 23.0 with a significance level set to 5% (α = 0.05). Results  The majority of patients (57.6%) were in the age range from 51 to 69 years. Twenty-five patients (18.9%) had an HH score of 4, whereas 107 patients (81.1%) had an HH score of 5. Depending on the location, the majority of patients ( n  = 43) had an aneurysm on the medial cerebral artery (MCA). The final aneurysm occlusion was performed in 71 patients, of whom 94.36% were treated surgically. A positive outcome (mRs 0–4) was found in 49.25% of patients who underwent primarily surgical, treatment with a mortality of 42.3%. Although the outcome was better in patients with an HH score 4, both groups benefited from surgical treatment. Conclusion  Poor-grade aneurismal SAH is a condition of the middle and older age, with most patients with an HH 5 score and deep comatose state. There was better outcome in patients with an HH score of 4 compared to an HH score of 5 and both groups benefited from surgical treatment, which resulted in a positive outcome in almost 50% of surgically treated patients.

Zhaohui Su, Barry L. Bentley, A. Cheshmehzangi, D. McDonnell, S. Šegalo, C. D. da Veiga, Y. Xiang

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