BACKGROUND

The COVID-19 pandemic disrupted education worldwide, prompting a rapid shift to emergency remote teaching that challenged students’ learning and mental health. Nursing students, in particular, faced heightened pressures due to the suspension or online adaptation of essential clinical experiences, alongside the need to master theoretical and practical competencies. Emerging evidence indicates that such stressors adversely affect students’ emotional and psychological well-being, potentially influencing academic outcomes. Understanding the relationship between mental health and academic performance among nursing students is crucial for developing targeted interventions that support their well-being and professional readiness.

OBJECTIVE

This study analyzed the mental health status and academic performance of graduating nursing students during the challenging period of remote learning amid the pandemic in a government school in Leyte.

METHODS

The study utilized a descriptive correlational design to explore the relationships between mental health status and academic performance among nursing students. A modified self-administered questionnaire was utilized to gather data. Ethical approval from Eastern Visayas Health Research and Development ConsortiumEthics Review with ERC number 2023-024 was secured, and data collection occurred through various methods. Data analysis used SPSS version 24, emphasizing the importance of understanding these relationships in educational settings.

RESULTS

The study assessed the demographic profile, online learning attributes, mental health status, and academic performance of 20 nursing students during the pandemic. All students passed their courses, despite reporting moderate emotional loneliness and irritability, but minimal fear of COVID-19. Significant correlations were found between demographic factors and mental health indicators. The null hypothesis, suggesting no relationship between demographic factors and mental health, is void, as significant associations were identified. Recommendations include enhancing mental health support in nursing education to address these challenges.

CONCLUSION

This study highlights the experiences of 20 nursing students from a government college in Leyte during the COVID-19 pandemic. Predominantly young women from rural, low-income backgrounds, these students faced challenges like poor internet access but successfully completed their academic requirements, showcasing resilience. While they reported low fear of COVID-19, moderate emotional loneliness and irritability indicated underlying mental health issues. The findings stress the need for educational institutions to provide mental health support and address the digital divide to enhance student well-being and success.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Statistics As Topic ; Psychological Well-being ; Indicators And Reagents ; Students, Nursing ; Suspensions ; Academic Performance ; Learning ; Pandemics ; Nursing ; Education, Nursing ; Covid-19 ; Mental Health

OBJECTIVES

This study aimed to evaluate the psychometric properties of the Tagalog version of the PsAQoL to assess its reliability and consistency.

METHODS

This is a prospective validation study involving 47 patients with PsA from June to August 2023. The
psychometric properties tested were internal consistency (Cronbach’s alpha coefficients), test-retest reliability, convergent validity (Spearman’s rank correlation), and known group validity (Mann-Whitney U Test or Kruskal- Wallis One-Way Analysis of Variance).

RESULTS

The PsAQoL on both week 0 and week 2 had Cronbach’s alpha coefficients of 0.926 indicating high
internal consistency. Test-retest reliability was 0.929, which demonstrates excellent reliability and low level of random measurement error. The PsAQoL scores highly correlated with the Health Assessment Questionnaire-Disability Index (r=0.754, pCONCLUSION

The Tagalog version of the PsAQoL demonstrates excellent psychometric properties and is recommended for monitoring of Tagalog-speaking patients with psoriatic arthritis in healthcare settings.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Analysis Of Variance ; Aptitude ; Health ; Index ; Patients ; Psychometrics ; Reproducibility Of Results ; Statistics, Nonparametric ; Validation Study

OBJECTIVES

Clinical pathways (CPs) ensure adherence to heart failure (HF) management guidelines. To optimize quality care in a low resource setting, an evidence-based care pathway for the management of acute HF was implemented at the emergency department (ED) of the Philippine General Hospital (PGH), the designated national tertiary hospital and referral center. This study aimed to describe the characteristics of adults with acute HF admitted at the ED and evaluate the quality of care they received, measured using physician adherence to the hospital’s acute heart failure CP.

METHODS

This was a retrospective, descriptive cohort study. We reviewed the inpatient charts of all adult patients with acute HF admitted to the ED of the PGH and referred to the Division of Cardiovascular Medicine between December 1, 2022 and May 31, 2023. Quality of care was assessed based on adherence to quality indicators adapted from routine and conditional order sets detailed in the pathway. Descriptive statistics was utilized to describe patient characteristics, quality of care, and outcomes.

RESULTS

Two hundred thirty-six (236) patients were included, with a mean age of 51.8 years. Majority were male (53.4%); hypertension (61.4%) and ischemic heart disease (53.8%) were the most common comorbidities, and infection the most common precipitant of decompensation (60.6%). There were optimal adherence rates to routine orders, which included referrals to Internal Medicine and Cardiology, baseline vital signs monitoring, fluid intake and output monitoring, chest radiograph, complete blood count, blood urea nitrogen, sodium, potassium, prothrombin time, partial thromboplastin time, arterial blood gas, urinalysis, and N-terminal pro b-type natriuretic peptide. Conditional orders, such as oxygen support, focused echocardiography, thyroid - stimulating hormone, and the use of vasopressors, diuretics, and venous thromboembolism prophylactic agents, were optimally performed when warranted. However, we noted suboptimal adherence to certain resource-intensive conditional orders, such as hourly monitoring of urine output (61.4%), hooking to cardiac monitor (53.8%), and performance of 12-lead ECG within 10 minutes (56.8%). Further, only 43.9% of patients were referred to the intensive care unit. Troponin I, calcium, magnesium, and albumin were ordered in excess.

CONCLUSION

Overall adherence rate of physicians to the hospital’s Acute Heart Failure Pathway was satisfactory. Work is needed to improve adherence to hourly urine output monitoring, consistent hooking to cardiac monitor, and timely performance of 12-lead ECG – an effort that begins with expanding in-hospital diagnostic equipment and human resource supply. We recommend continuous pathway implementation with periodic evaluation and stakeholder feedback to further improve quality of care.

Human ; Male ; Female ; Middle Aged: 45-64 Yrs Old ; Adult ; Albumins ; Blood ; Blood Urea Nitrogen ; Calcium ; Cardiology ; Chart ; Charts ; Cohort Studies ; Critical Care ; Critical Pathways ; Diagnostic Equipment ; Disease ; Diuretics ; Echocardiography ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Equipment And Supplies ; Evaluation Studies As Topic ; Feedback ; Heart ; Heart Diseases ; Heart Failure ; Hormones ; Hospitals ; Hospitals, General ; Humans ; Hypertension ; Indicators And Reagents ; Infection ; Infections ; Inpatients ; Intensive Care Units ; Internal Medicine ; Lead ; Magnesium ; Male ; Medicine ; Myocardial Ischemia ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Nitrogen ; Overall ; Oxygen ; Partial Thromboplastin Time ; Patients ; Peptides ; Philippines ; Physicians ; Potassium ; Prothrombin ; Prothrombin Time ; Quality Of Health Care ; Referral And Consultation ; Sodium ; Statistics ; Tertiary Care Centers ; Thorax ; Thromboembolism ; Thromboplastin ; Thyroid Gland ; Time ; Troponin ; Troponin I ; Universities ; Urea ; Urinalysis ; Urine ; Venous Thromboembolism ; Vital Signs ; Work ; Workforce

OBJECTIVES

This study aims to explore the perceptions of UST Occupational Therapy students regarding AI chatbots in the context of school-related activities. It will further focus on their concerns, utility, and perceived effects of AI on learning related to school activities

METHODS

A qualitative descriptive design will be used and will utilize three focus group discussions, one for each year level (first, second, and third-year students), to gather extensive and accurate accounts of students’ perceptions. Thematic analysis, using manual coding and following Braun and Clarke’s six-phase analytic framework, will be employed for data analysis.

RESULTS

The study is expected to generate themes describing students’ perceived usefulness, concerns, and learning-related impacts of AI, providing insights that may support the responsible and informed integration of AI in occupational therapy education.

Human ; Statistics As Topic ; Therapeutics ; Students ; Occupational Therapy ; Focus Groups

OBJECTIVES: To explore the synthesis of high-quality CT (sCT) from cone-beam CT (CBCT) using PE-CycleGAN for adaptive radiotherapy (ART) for nasopharyngeal carcinoma. METHODS: A perception-enhanced CycleGAN model "PE-CycleGAN" was proposed, introducing dual-contrast discriminator loss, multi-perceptual generator loss, and improved U-Net structure. CBCT and CT data from 80 nasopharyngeal carcinoma patients were used as the training set, with 7 cases as the test set. By quantifying the mean absolute error (MAE), peak signal-to-noise ratio (PSNR), structural similarity index (SSIM), as well as the dose gamma pass rate and the relative dose deviations of the target area and organs at risk (OAR) between sCT and reference CT, the image quality and dose calculation accuracy of sCT were evaluated. RESULTS: The MAE of sCT generated by PE-CycleGAN compared to the reference CT was (56.89±13.84) HU, approximately 30% lower than CBCT's (81.06±15.86) HU (P<0.001). PE-CycleGAN's PSNR and SSIM were 26.69±2.41dB and 0.92±0.02 respectively, significantly higher than CBCT's 21.54±2.37dB and 0.86±0.05 (P<0.001), indicating substantial improvements in image quality and structural similarity. In gamma analysis, under the 2 mm/2% criterion, PE-CycleGAN's sCT achieved a pass rate of (90.13±3.75)%, significantly higher than CBCT's (81.65±3.92)% (P<0.001) and CycleGAN's (87.69±3.50)% (P<0.05). Under the 3 mm/3% criterion, PE-CycleGAN's sCT pass rate of (90.13±3.75)% was also significantly superior to CBCT's (86.92±3.51)% (P<0.001) and CycleGAN's (94.58±2.23)% (P<0.01). The mean relative dose deviation of the target area and OAR between sCT and planned CT was within ±3% for all regions, except for the Lens Dmax (Gy), which had a deviation of 3.38% (P=0.09). The mean relative dose deviations for PTVnx HI, PTVnd HI, PTVnd CI, PTV1 HI, PRV_SC, PRV_BS, Parotid, Larynx, Oral, Mandible, and PRV_ON were all less than ±1% (P>0.05). CONCLUSIONS PE-CycleGAN demonstrates the ability to rapidly synthesize high-quality sCT from CBCT, offering a promising approach for CBCT-guided adaptive radiotherapy in nasopharyngeal carcinoma.
Humans ; Cone-Beam Computed Tomography/methods* ; Nasopharyngeal Neoplasms/diagnostic imaging* ; Nasopharyngeal Carcinoma/radiotherapy* ; Radiotherapy Planning, Computer-Assisted/methods* ; Radiotherapy Dosage ; Signal-To-Noise Ratio ; Radiotherapy, Intensity-Modulated

OBJECTIVES: We propose a segmented backprojection tensor degradation feature encoding (SBP-MAC) model for motion artifact correction in dental cone beam computed tomography (CBCT) to improve the quality of the reconstructed images. METHODS: The proposed motion artifact correction model consists of a generator and a degradation encoder. The segmented limited-angle reconstructed sub-images are stacked into the tensors and used as the model input. A degradation encoder is used to extract spatially varying motion information in the tensor, and the generator's skip connection features are adaptively modulated to guide the model for correcting artifacts caused by different motion waveforms. The artifact consistency loss function was designed to simplify the learning task of the generator. RESULTS: The proposed model could effectively remove motion artifacts and improve the quality of the reconstructed images. For simulated data, the proposed model increased the peak signal-to-noise ratio by 8.28%, increased the structural similarity index measurement by 2.29%, and decreased the root mean square error by 23.84%. For real clinical data, the proposed model achieved the highest expert score of 4.4221 (against a 5-point scale), which was significantly higher than those of all the other comparison methods. CONCLUSIONS The SBP-MAC model can effectively extract spatially varying motion information in the tensors and achieve adaptive artifact correction from the tensor domain to the image domain to improve the quality of reconstructed dental CBCT images.
Cone-Beam Computed Tomography/methods* ; Artifacts ; Humans ; Motion ; Image Processing, Computer-Assisted/methods* ; Signal-To-Noise Ratio ; Algorithms

OBJECTIVES: To explore the effects of exogenous trigger (hCG/GnRHa) versus endogenous LH surge in natural cycle IVF/ICSI (NC-IVF/ICSI) for patients with diminished ovarian reserve (DOR). METHODS: A retrospective analysis was conducted on 1,118 NC-IVF/ICSI cycles from two reproductive centers between 2013 and 2024. Propensity score matching (PSM) and multivariate logistic regression were used to adjust for confounding factors. The trigger-day hormone threshold was determined using receiver operating characteristic (ROC) curve analysis. Outcome measures included oocyte retrieval rate, 2PN fertilization rate, clinical available embryo rate, high-quality embryo rate, fresh cycle clinical pregnancy rate (CPR), and live birth rate (LBR). RESULTS: After adjusting for confounders via PSM and logistic regression, the exogenous trigger group demonstrated significantly better outcomes across all the evaluated parameters (oocyte retrieval rate, 2PN fertilization rate, transferable embryo rate, high-quality embryo rate, fresh cycle CPR, and LBR) than the endogenous LH surge group (P<0.05). Age-stratified analysis revealed that for the entire cohort, exogenous triggering significantly increased the number of transferable embryos and high-quality embryos (P<0.001). In the 35-39 years old subgroup, exogenous triggering showed significant advantages in oocyte yield, high-quality embryo rate, CPR, and LBR (P<0.05) and resulted in the most pronounced improvement in LBR (OR=6.25, 95% CI: 1.34-29.23). ROC analysis established a decision-day LH threshold of 19.055 mIU/mL (AUC=0.945, specificity=93.3%) for precise stratification of the clinical pathways. CONCLUSIONS For DOR patients undergoing NC-IVF/ICSI, exogenous triggering comprehensively improves the treatment outcomes, particularly providing significant live birth benefits for women aged 35-40 years. An individualized protocol incorporating the LH threshold (19.055 mIU/mL) effectively enhances embryonic developmental potential and live birth rates.
Humans ; Female ; Ovarian Reserve ; Pregnancy ; Propensity Score ; Retrospective Studies ; Fertilization in Vitro ; Sperm Injections, Intracytoplasmic ; Chorionic Gonadotropin ; Pregnancy Rate ; Logistic Models ; Ovulation Induction/methods* ; Gonadotropin-Releasing Hormone ; Adult ; Oocyte Retrieval

OBJECTIVES: To analyze the trends of disease burden of lip and oral cancers in East Asia from 1990 to 2021 and its future projections. METHODS: We used the Global Burden of Disease 2021 database to conduct a comprehensive analysis of disease burden data from China (including Taiwan Province of China), Japan, Republic of Korea, Democratic People's Republic of Korea and Mongolia. The data were stratified by age, gender and major risk factors, and a Bayesian age-period-cohort model was employed to predict the future trends. RESULTS: From 1990 to 2021, the burden of lip and oral cancers in East Asian countries exhibited a steady increase. Taiwan Province of China experienced the most significant increases in incidence, prevalence, mortality, and disability-adjusted life years (DALYs), while Mongolia saw a decline in both mortality and DALYs. In 2021, Taiwan Province of China reported the highest rates of lip and oral cancer incidence (27.50 per 100 000), prevalence (137.92 per 100 000), mortality (9.59 per 100 000), and DALYs (292.07 person-years per 100 000), particularly among male and elderly populations. Tobacco use and alcohol consumption significantly exacerbated the disease burden in Taiwan Province of China and Japan. Future projections indicate that the incidence and prevalence of lip and oral cancer in China (excluding Taiwan Province of China) will continue to rise, while their mortality rates are expected to decline in most regions, except for Taiwan Province of China and Democratic People's Republic of Korea. CONCLUSIONS By the year 2035, the disease burden of lip and oral cancers in East Asia is expected to continue to increase, especially in Taiwan Province of China. To address this challenge, it is essential to implement effective measures to control major risk factors, promote early screening, and ensure equitable distribution of healthcare resources.
Humans ; Mouth Neoplasms/epidemiology* ; Incidence ; Lip Neoplasms/epidemiology* ; Asia, Eastern/epidemiology* ; Male ; Disability-Adjusted Life Years ; Prevalence ; Female ; Forecasting ; Risk Factors ; Cost of Illness ; Middle Aged ; Global Burden of Disease ; Aged ; Bayes Theorem

OBJECTIVES: To investigate the incidence of ipsilateral upper urinary tract stones after partial nephrectomy and its risk factors. METHODS: We retrospectively analyzed baseline patient characteristics (age, gender, and body mass index), smoking, alcohol consumption, comorbidities (hypertension, diabetes, hypertriglyceridemia, hyperuricemia, and cardiovascular diseases), preoperative tumor conditions (tumor diameter, multiple foci, location, hemorrhage, necrosis, cystic changes, and endophytic growth), preoperative glomerular filtration rate and intraoperative factors (renal collecting system damage, ischemia time, operation time, surgical approach, and estimated intraoperative blood loss) to identify the risk factors for ipsilateral upper urinary tract stones following partial nephrectomy in our center. RESULTS: The overall incidence of upper urinary tract stones following partial nephrectomy was 7.80% (112/1435). The incidence of ipsilateral upper urinary tract stones was significantly higher than those of contralateral stones (4.95% vs 1.46%, P<0.001) and bilateral stones (4.95% vs 1.39%, P<0.001). Intraoperative damage to the renal collecting system was identified as a significant risk factor for ipsilateral upper urinary tract stones (OR=4.550, 95% CI: 2.237-9.252, P<0.001). Diabetes was a probable risk factor for secondary ipsilateral upper urinary tract stones after partial nephrectomy (OR=2.419, 95% CI: 0.973-6.012, P=0.057). CONCLUSIONS The incidence of ipsilateral upper urinary tract stones after partial nephrectomy is higher than that of contralateral and bilateral stones. Intraoperative renal collecting system damage is a risk factor for secondary ipsilateral upper urinary tract stones after partial nephrectomy.
Humans ; Nephrectomy/methods* ; Retrospective Studies ; Risk Factors ; Male ; Female ; Case-Control Studies ; Middle Aged ; Aged ; Kidney Neoplasms/surgery* ; Adult ; Intraoperative Complications ; Kidney Tubules, Collecting/injuries* ; Propensity Score ; Incidence ; Kidney Calculi/etiology* ; Urinary Calculi/epidemiology*

OBJECTIVES: To conduct a comprehensive analysis of the global burden of diarrheal diseases in children under 5 years. METHODS: The data from the Global Burden of Disease (GBD) 2021 were analyzed to assess the incidence, mortality rates and average annual percentage changes (AAPC) of diarrhea among children under 5 years across nations(regions) and GBD regions from 1990 to 2021 using joinpoint regression. Smoothed curve regression was employed to explore the correlation of diarrheal disease burden with the Social Development Index (SDI) and for analyzing the burden of specific diarrheal pathogens. The Slope and Concentration Indices quantified disparities across SDI levels and the future trend were projected by the Bayesian Age-Period-Cohort (BAPC) model. RESULTS: From 1990 to 2021, the global incidence (AAPC: -3.65) and mortality (AAPC: -5.15) rates of diarrheal diseases declined steadily in children below 5 years. In 2021, neonates (<28 days) were the most affected, with an incidence rate of 138 058.74 per 100 000 and a mortality rate of 251.14 per 100 000. Rotavirus was the leading cause of death. The incidence rate of diarrheal diseases was negatively correlated with SDI, and the Concentration Index decreased from -0.293 in 1990 to -0.314 in 2021 without a significant gender difference. The BAPC model suggested that the global incidence rate of diarrheal diseases tends to decrease progressively from 2022 to 2050, with a predicted rate of 23 448.04 per 100 000 for male and 29 932.59 per 100 000 for female by 2050. CONCLUSIONS Despite the reduction in the global burden of diarrhea and the projection of its further decline, diarrheal diseases disproportionately affect neonates and low-SDI regions. While rotavirus remains the primary etiological agent worldwide, the predominant pathogens vary by nations (regions) and GBD regions, and strengthened interventions targeting vulnerable populations are needed.
Humans ; Child, Preschool ; Diarrhea/mortality* ; Infant ; Incidence ; Infant, Newborn ; Global Burden of Disease/trends* ; Global Health ; Male ; Bayes Theorem ; Female