BACKGROUND

Determination of serum bicarbonate (HCO3 - ) using arterial blood gas analysis in patients with diabetic ketoacidosis allows for the evaluation of the severity of the condition, determines whether HCO3 - therapy is required, and tracks the progression and resolution of the disease. Serum carbon dioxide combining power (CO2CP) from venous chemistry analysis has often been used as an indicator of metabolic acidosis. This study investigated the relationship between HCO3 - and CO2CP and developed an approximation formula for serum bicarbonate concentration using its predictor variables, as this may lessen the need to repeat arterial blood gas analysis or be used in settings in which blood gas analyzers are unavailable.

METHODOLOGY

This single-center, retrospective, cross-sectional study investigated a total of 77 patients diagnosed with diabetic ketoacidosis. Assessment of the bivariate correlations between serum HCO3 - and serum CO2CP as well as other potential predictor variables was done via Pearson’s correlation coefficient. Predictor variables that were significantly correlated with serum HCO3 - were identified and an approximation formula was developed by regression analysis. Evaluation of the correlation between the approximated HCO3 - value and the actual serum HCO3 - concentration was performed using correlation coefficient and residual statistics to assess agreement.

RESULTS

Serum CO2CP had significant correlation with serum HCO3 - (r = 0.768, p < 0.05). By multiple regression analysis, the following approximation formula was therefore expressed: HCO3 - = 12.682 + (0.612 x CO2CP) – [ketones] + (0.085 x BUN) - (0.026 x SGPT) – (1.23 x Creatinine) - (0.067 x Chloride). Examination of residuals revealed a mean of zero (0), indicating no significant difference between the actual and approximated levels of serum HCO3 -

CONCLUSION

The predictor variables included in the formula collectively contribute significantly to the approximation of serum HCO3 - . The approximated serum HCO3 - values also showed significant correlation with actual serum HCO3 - concentration; thus, the formula may be utilized to derive an approximation of serum bicarbonate concentration in patients with diabetic ketoacidosis.

Human ; Male ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Attention ; Bicarbonates ; Carbon Dioxide ; Diabetic Ketoacidosis ; Ketosis ; Patients ; Carbon ; Power (psychology) ; Power, Psychological ; Serum

AIM

This study explored the developmental process of self-advocacy among nurses and proposed a conceptual framework, The Nurse Becoming Model of Self-Advocacy, to contribute to middle-range theory development.

METHODS

A constructivist grounded theory design guided this study. Data was gathered from 29 nurses through in-depth individual and group interviews across academe, hospitals, and professional organizations in Region I and the Cordillera Administrative Region. Theoretical and disconfirming sampling was used to refine categories. Data was analyzed using constant comparative methods.

FINDINGS

Self-advocacy emerged as a developmental trajectory comprising four interrelated stages: self-preservation, selfdevelopment, self-actualization, and self-transcendence. Novice nurses often relied on protective strategies such as silence and conformity, while experienced nurses engaged in assertiveness, credibility-building, leadership, and collective advocacy. Nurses emphasized that self-advocacy extended beyond the individual to encompass patients, the profession, and society, while highlighting its relational and collective nature.

CONCLUSION

Self-advocacy is a dynamic process and core dimension of professional identity. It evolves through stages of growth, integrating self-care, competence, engagement, and transcendence. Supporting self-advocacy through education, mentoring, reflective practice, and enabling organizational structures enhance nurses' well-being and strengthens their capacity to advocate for patients, advance the profession, and contribute to societal transformation. The Nurse Becoming Model of Self-Advocacy offers a transferable framework to guide nursing research, education, and policy toward empowerment and resilience.

Human ; Nursing ; Grounded Theory ; Empowerment ; Leadership ; Resilience ; Resilience, Psychological

Background and Objective: In the Philippines, patients are constrained from accessing their own records, restricting their ability to freely choose who to seek care from. To address this, the study makes a case for the development of the health smart card in the Philippines, an integrative tool unique to each citizen carrying their lifetime medical record. Methods: The prototype is developed using no-code programming technology and validated through a series of focus group discussions and stakeholder consultations with patients (n=4), healthcare administrators (n=4), and hospital personnel (n=13). It was then revised based on the collected insights and recommendations. Results: Findings report that the current facility-centric model utilizing paper records constrains patients’ access to their records due to long wait times, slow turnaround periods, constant intra- and inter-hospital transfers, and even charging of fees to acquire a copy of their own data. The health smart card alternative was widely accepted by the participants, particularly for its contribution to increasing data accessibility, patient empowerment, and advancing patient data ownership. Nevertheless, several considerations for the upscale implementation of the health smart card emerged, including creating an interoperable environment through harmonizing standards and capacity-building programs, and ensuring data security through robust cybersecurity measures. Issues on scalability and funding of the project were also raised, centering on the critical role of the government in stepping up as regulator and potential funder. Concerns over potential abuse, dataveillance, and the digital divide are tackled, highlighting the need to account for socioeconomic factors to ensure that no one is left behind in the implementation. Conclusion The study makes a case for the development and adoption of a health smart card to address the inaccessibility of records to patients. The study concludes by recommending the conduct of a pilot implementation to comprehensively demonstrate and analyze the features of the proposed scheme.
health smart card ; patient empowerment ; patient participation ; Philippines

Macaque is a common animal model in drug safety assessment. Its behavior reflects its health condition before and after drug administration, which can effectively reveal the side effects of drugs. At present, researchers usually rely on artificial methods to observe the behavior of macaque, which cannot achieve uninterrupted 24-hour monitoring. Therefore, it is urgent to develop a system to realize 24-hour observation and recognition of macaque behavior. In order to solve this problem, this paper constructs a video dataset containing nine kinds of macaque behaviors (MBVD-9), and proposes a network called Transformer-augmented SlowFast for macaque behavior recognition (TAS-MBR) based on this dataset. Specifically, the TAS-MBR network converts the red, green and blue (RGB) color mode frame input by its fast branches into residual frames on the basis of SlowFast network and introduces the Transformer module after the convolution operation to obtain sports information more effectively. The results show that the average classification accuracy of TAS-MBR network for macaque behavior is 94.53%, which is significantly improved compared with the original SlowFast network, proving the effectiveness and superiority of the proposed method in macaque behavior recognition. This work provides a new idea for the continuous observation and recognition of the behavior of macaque, and lays the technical foundation for the calculation of monkey behaviors before and after medication in drug safety evaluation.
Animals ; Electric Power Supplies ; Macaca ; Recognition, Psychology

Leukemia is a common, multiple and dangerous blood disease, whose early diagnosis and treatment are very important. At present, the diagnosis of leukemia heavily relies on morphological examination of blood cell images by pathologists, which is tedious and time-consuming. Meanwhile, the diagnostic results are highly subjective, which may lead to misdiagnosis and missed diagnosis. To address the gap above, we proposed an improved Vision Transformer model for blood cell recognition. First, a faster R-CNN network was used to locate and extract individual blood cell slices from original images. Then, we split the single-cell image into multiple image patches and put them into the encoder layer for feature extraction. Based on the self-attention mechanism of the Transformer, we proposed a sparse attention module which could focus on the discriminative parts of blood cell images and improve the fine-grained feature representation ability of the model. Finally, a contrastive loss function was adopted to further increase the inter-class difference and intra-class consistency of the extracted features. Experimental results showed that the proposed module outperformed the other approaches and significantly improved the accuracy to 91.96% on the Munich single-cell morphological dataset of leukocytes, which is expected to provide a reference for physicians' clinical diagnosis.
Humans ; Blood Cells ; Leukocytes ; Leukemia ; Electric Power Supplies ; Recognition, Psychology

BACKGROUND: Social dynamics, specifically personalities, power dynamics, and emotions, have been shown to influence the methods, outputs, and quality of multi-stakeholder processes, especially the development of a national health research agenda.

OBJECTIVE AND METHODS: Using a case analysis approach utilizing related conceptual frameworks, the paper determined how personalities, power dynamics, and emotions affected the research priority-setting exercise, identified lessons learned, and recommended how to effectively manage these social dynamics in consultations. Data gathering methods were participant observation and process documentation, results of which were codified and analyzed.

RESULTS: Dominant personalities, stakeholders with power, and stakeholders that openly expressed dissatisfaction were most likely to attempt to change the methods and final outputs of the consultation, with varying level of success. Other dominant personalities used their power constructively for a smooth flow of generating and agreeing on ideas.

CONCLUSION: In this case, social dynamics was shown to heavily influence the decision-making process, thus underlining its importance in organizing multisectoral representation. Effectively managing social dynamics may thus have to consider building trust and respect between participants, mediating discussions, reaching a mutually beneficial solution, and establishing and implementing mutually agreed house rules. The significant role of facilitators in developing a climate for truly inclusive participation must also be recognized.

Power (psychology) ; Expressed Emotion ; Consensus ; Personality ; Emotions

PURPOSE: The purpose of this study was to explore the effects of head nurses' authentic leadership and empowerment on job satisfaction, and nursing performance of nurses and to identify the mediating effect of empowerment in the relationships of head nurses' authentic leadership, with nurses' job satisfaction, and nursing performance. METHODS: The sample for this study was 149 nurses from 2 general hospitals located in Busan. Data were collected using self-administered questionnaires and the SPSS/WIN 23.0 program was used for analysis. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: Head nurses' authentic leadership showed positive correlations with empowerment, job satisfaction, and nursing performance. Empowerment showed partial mediating effects in the relationship between head nurses' authentic leadership and nurses job satisfaction, and a perfect mediating effect in the relationship between head nurses' authentic leadership and the performance of nursing. CONCLUSION: The results indicate that it is necessary to develop strategies and applications to enhance nurses' empowerment for improved job satisfaction and nursing performance.
Busan ; Head ; Hospitals, General ; Job Satisfaction ; Leadership ; Methods ; Negotiating ; Nursing ; Power (Psychology) ; Work Performance

PURPOSE: The objective of this study was to verify a mediating effect of followership in the relationship of organizational citizenship behavior and nurse managers' empowering leadership as perceived by nurses. METHODS: The study was a descriptive research involving 222 nurses working on nursing units in a university hospital. Data were analyzed using independent t-test, one way ANOVA, Mann-Whitney U, Scheffé test, Pearson correlation coefficients, and simple and multiple regression techniques with the SPSS 23.0 program. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: Nurse managers' empowering leadership and followership showed a positive correlation (r=.22, p=.001), and a significantly positive correlation with organizational citizenship behavior (r=.32, p<.001). Also, followership and organizational citizenship behavior showed a positive correlation (r=.52, p<.001). The results of the study verified that nurses' followership had a mediating effect on organizational citizenship behavior in nurse unit managers' empowering leadership, a positive effect on organizational citizenship behavior and ultimately an increase in organizational achievement. CONCLUSION: Nurse managers need to be aware of the importance of empowering leadership, and endeavor to enhance it further. As for the organizational level, support to strengthen empowering leadership is required.
Humans ; Leadership ; Methods ; Negotiating ; Nurse Administrators ; Nursing ; Power (Psychology)

OBJECTIVES: The present study aimed to compare the quality of life of elderly menopause living in urban/rural areas of Abadeh, Iran. METHODS: This descriptive and cross-sectional study was conducted on 312 urban and 68 rural elderly population using the two-stage (systematic random classification) and objective-based sampling methods. Data were collected by Leiden-Padua questionnaire for assessment of quality of life in elderly menopause. SPSS software (version 21) and descriptive-analytical tests were used for data analysis. RESULTS: The results showed that the overall quality of life was 37.5 and 34.2 in rural and urban areas, respectively, and no statistically significant difference was observed between them. However, there was statistically significant difference in the mean score of depression and anxiety, cognitive function, social function, life satisfaction, and sexual activity in urban and rural elderly menopause (P < 0.001). CONCLUSIONS: It seems necessary to pay more attention to the elderly menopause to improve their quality of life and consider proper planning for their empowerment and coping skills training.
Adaptation, Psychological ; Aged ; Anxiety ; Cognition ; Cross-Sectional Studies ; Depression ; Female ; Humans ; Iran ; Menopause ; Power (Psychology) ; Quality of Life ; Rural Population ; Sexual Behavior ; Statistics as Topic ; Urban Population

PURPOSE: This research was conducted to identify the effects of providing support programs to families of elderly with dementia on family empowerment and attitudes toward dementia. METHODS: A nonequivalent control group pre- and post-test design was used. Participants were 49 family caregivers, experimental (24) and control (25), recruited from families through a dementia support center in Y district. This program implemented Haearim, a support program for family caregivers of demented elders developed by the National Institute of Dementia in 2016. Outcome measures were empowerment and attitudes toward to dementia. Data were analyzed with a χ2-test, independent t-test, Fisher's exact probability test, paired t-test, and repeated measures ANOVA with SPSS/PC version 20.0. RESULTS: Family empowerment (F=6.84, p=.002) and family caregivers' attitudes (F=16.48, p < .001) toward dementia in the experimental group improved significantly more than that of the control group after intervention. CONCLUSION: Results indicate that support programs for families of elderly with dementia are effective in positively changing empowerment and attitudes toward dementia among family caregivers.
Aged ; Caregivers ; Dementia ; Humans ; Outcome Assessment (Health Care) ; Power (Psychology)