Behavioral diversity as a potential positive indicator of animal welfare in bottlenose dolphins

Accredited zoological facilities are committed to fully understanding the behavioral, mental, and physical needs of each species to continuously improve the welfare of the animals under their professional care and detect when welfare has diminished. In order to accomplish this goal, internally consistent and externally valid indicators of animal welfare are necessary to advance our understanding of the current welfare status of individual animals. Historically, efforts have focused on monitoring visible or observable signs of poor health or problem behavior, but lack of signs or problems does not necessarily demonstrate that an individual animal is thriving. The current study examined fecal hormone metabolite levels and behavior for two species of bottlenose dolphins (Tursiops truncatus and Tursiops aduncus) from 25 different accredited zoological facilities. At the time of the study, all facilities were accredited by the Alliance of Marine Mammal Parks and Aquariums and/or the Association of Zoos and Aquariums. This was part of the multi-institutional study ‘Towards understanding of the welfare of cetaceans in zoos and aquariums” commonly referred to as the Cetacean Welfare Study. Behavioral diversity was calculated using the Shannon Diversity Index on species-appropriate behavioral events. Behavioral diversity was compared to the fecal metabolites of cortisol, aldosterone, and the ratio of cortisol to dehydroepiandrosterone (DHEA) as well as the stereotypic behavior of route tracing. Similar to previous studies on other species, there was a significant inverse relationship between behavioral diversity and both fecal cortisol metabolites and route tracing. Additionally, a significant inverse relationship also exists between behavioral diversity and the ratio of fecal cortisol to DHEA metabolites. Behavioral diversity and fecal aldosterone metabolites were not associated. Additional research is still needed to validate behavioral diversity as an indicator of positive animal welfare for bottlenose dolphins and across species. However, based on current results, facilities could utilize behavioral diversity combined with other measures of welfare to more comprehensively evaluate the welfare of bottlenose dolphins.

It matters to be in good hands: the relationship between good governance and pandemic spread inferred from cross-country COVID-19 data

This study examines the relationship between good governance and pandemic control using month-wise COVID-19 pandemic data within a time window from April to September 2020. The study argues that countries with better governance are more capable of adopting and implementing appropriate policies and that such governments are considered more trustworthy by their people. Combined, these factors enable such countries to better control a pandemic like COVID-19. Using several measures of good governance and two measures of pandemic spread, namely the COVID-19 positive rate and the COVID-19 growth rate, this paper tests its argument econometrically in a sample of 185 countries. The results show the existence of a significant inverse relationship between all measures of good governance, and the COVID-19 positive and growth rates. The significant inverse relationship largely persists even after controlling for continent-fixed effects and a host of geographic, demographic, and socio-economic factors. This indicates the presence of a strong systemic linkage between quality of governance and pandemic control. The findings empirically strengthen the argument of eminent medical historians concerning the importance of effective governmental intervention for epidemic control. The study reveals that the quality of governance is a key factor in a country’s success in pandemic management and encourages further investigation.

Investigating the Impact of Regional Temperature on COVID-19 Pandemic during 2020

Several studies have attempted to uncover the impact of weather parameters on the coronavirus (COVID-19) pandemic during the initial stage of its outbreak. However, they reported contradicting findings due to limited data available at an earlier stage of the outbreak. Therefore, in this study, we investigate the impact of regional temperature on the pandemic in 34 different locations of the globe by defining two main objectives. The first objective is focused on pattern analysis of an earlier stage of the pandemic. The conducted analysis suggests that the spread of the COVID-19 outbreak during its initial stage was slower in the regions experiencing extreme temperatures. The second objective is about understanding the impact of temperature on new cases (NC) and new deaths (ND) of COVID-19 reported per day by using linear regression (LR) as a statistical tool. For most of the locations, under simple LR analysis, a significant inverse relationship has been observed between average temperature and NC or ND. However, a few locations, including Pakistan, India, Singapore, Bahrain, and Qatar, have shown a significant positive relationship between average temperature and NC with a 99.9% confidence level. Furthermore, Pakistan, Thailand, Bahrain, and Qatar have shown a significant positive relationship between average temperature and ND with a 95% confidence level. Although most of these locations experienced temperatures with a mean greater than 22 °C and standard deviation greater than 5 °C, excluding India, the number of total COVID-19 cases reported in these locations is small. Moreover, the results of multiple LR analysis reveal a significant inverse relationship between average temperature and NC or ND with a 95% confidence level.

Macronutrient Quality and All-Cause Mortality in the SUN Cohort

No previous study has assessed the relationship between overall macronutrient quality and all-cause mortality. We aimed to prospectively examine the association between a multidimensional macronutrient quality index (MQI) and all-cause mortality in the SUN (Seguimiento Universidad de Navarra) (University of Navarra Follow-Up) study, a Mediterranean cohort of middle-aged adults. Dietary intake information was obtained from a validated 136-item semi-quantitative food-frequency questionnaire. We calculated the MQI (categorized in quartiles) based on three quality indexes: the carbohydrate quality index (CQI), the fat quality index (FQI), and the healthy plate protein source quality index (HPPQI). Among 19,083 participants (mean age 38.4, 59.9% female), 440 deaths from all causes were observed during a median follow-up of 12.2 years (IQR, 8.3–14.9). No significant association was found between the MQI and mortality risk with multivariable-adjusted hazard ratio (HR) for the highest vs. the lowest quartile of 0.79 (95% CI, 0.59–1.06; Ptrend = 0.199). The CQI was the only component of the MQI associated with mortality showing a significant inverse relationship, with HR between extreme quartiles of 0.64 (95% CI, 0.45–0.90; Ptrend = 0.021). In this Mediterranean cohort, a new and multidimensional MQI defined a priori was not associated with all-cause mortality. Among its three sub-indexes, only the CQI showed a significant inverse relationship with the risk of all-cause mortality.

Gender Matter, Social Phobia and High-Risk Behaviors in Young Medical Students

BACKGROUND፡ Young is one of the most sensitive stages of human life. Social phobia and high-risk behaviors are factors that enhance young crises. This study aimed to determine the relationship between gender role, social phobia and high-risk behaviors among young medical students.METHODS: In this descriptive correlational study, 400 students were selected by quota sampling method from a medical university in Southeastern Iran. For data collection, the demographic information questionnaire, Gender Trait Index (GTI), Social Phobia Inventory (SPIN), and Iranian Adolescent and Young Risk-Taking Scale (IAYRS) were used. Data were analyzed using descriptive statistics including mean and SD and analytic statistics such as Kolmogorov–Smirnov, Mann-Whitney U and Kruskal- Wallis tests using SPSS 25 and p ≤ .05.RESULTS: The mean scores of masculinity and femininity gender roles were 38.98 ± 7.92 and 44.12 ± 7.76, respectively. Also, 70.5% of the students had dominant feminine traits, and the gender identity was high in 58.8% of the students and moderate in 40.2% of them. Social phobia (37.12 ± 12.61) and high-risk behaviors (81.77± 26.08) were moderate. A significant inverse relationship was found between masculine traits and social phobia (p <0.001). Another significant inverse relationship was observed between feminine traits and high-risk behaviors (p <0.05).CONCLUSION: Given the poor relationship between gender role, social phobia and high-risk behaviors, it is essential to conduct further studies to determine the predictors of social phobia and high-risk behaviors in medical students.

Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

Background Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. Objective For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. Methods This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mobile EMR, and we merged data using doctors’ deidentification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests. Results A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=–0.19; 95% CI –0.32 to –0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests (coefficient=–0.18; 95% CI –0.30 to –0.04; P=.009). Conclusions Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

DNA fragmentation index, pAKT and pERK1/2 in cumulus cells are related to oocyte competence in patients undergoing in vitro fertilization programme

SummaryActivated pERK1/2 and pAKT are key players in supporting cell survival and proliferation pathways. Translocation of pERK1/2 into the nucleus, where it interacts with transcription factors and DNA itself, is instrumental in exerting an anti-apoptotic effect. In this study, pAKT levels, pERK1/2 nuclear localization and DNA fragmentation index (DFI) in cumulus cells of single cumulus–oocyte complexes of patients undergoing in vitro fertilization programmes were evaluated and correlated with the clinical outcome of the related embryos. For a positive clinical outcome of blastocyst development, pERK1/2 nuclear localization and DFI value had a significant inverse relationship, whereas the former and the intracellular accumulation of pAKT had a significant direct relationship. This relationship was not observed for the negative clinical outcome of the arrested embryos. Moreover, intracellular accumulation of pAKT and DFI value had a significant inverse relationship in all samples examined. The obtained data suggest that the intranuclear relocation of pERK1/2, along with an enhanced intracellular accumulation of pAKT, may exert a survival effect and increase cell viability, therefore providing a novel marker tool to choose the best oocyte to be fertilized and submitted to an intracytoplasmic sperm injection cycle.

Frequent Mobile Electronic Medical Records (EMR) Users Respond More Quickly to Emergency Department Consultation Requests (Preprint)

BACKGROUND Specialty consultation is a critical aspect of an emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen the ED overcrowding. Although mobile electronic medical records (mEMR) are being increasingly utilized and are known to improve the workflow of healthcare providers, limited studies have evaluated its effectiveness in real-life clinical scenarios. OBJECTIVE We aimed to determine the association between response duration to ED specialty consultation request and frequency of mEMR use. METHODS This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mEMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from the PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mEMR. We merged both data using doctors’ de-identification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mEMR usage and time interval from ED request to the completion of the consultation by specialty doctors. Secondary outcome was the relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests. RESULTS A total of 25,454 consultations requests were made for 15,555 patients, and 271 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mEMR, 212 doctors used mEMR in specialty consultation process. According to the mEMR usage pattern, the average usage frequency of all users was 13.3/day, and the average duration of the completion of the specialty consultation was 51.0 min. For 21,885 completed consultations, there was a significant inverse relationship between the frequency of mEMR usage and time interval from ED request to consultation completion by specialty doctors. (Coefficient: -0.19 (-0.32 to -0.06), P<.01) Of 23,692 consultations had response time stamp among inclusions. There was also a significant inverse relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests (coefficient: -0.17 (-0.30 to -0.04), P=.01). CONCLUSIONS Our findings suggest that frequent mEMR usage is associated with quicker response time to ED consultation requests.

Relationship between nurses’ moral sensitivity and the quality of care

Background: To provide care with high quality, nurses face a number of moral issues requiring them to have moral abilities in professional performance. Moral sensitivity is the first step in moral performance. However, its relation to the quality of care patients receive is controversial. Research objective: This study aims to determine the relationship between the moral sensitivity of nurses and the quality of care received by patients in the medical wards. Research design: A descriptive correlational study using validated tools, including Moral Sensitivity Questionnaire and the Quality Patient Quality Scale. Participants and research context: In total, 198 nurses and 198 patients in 17 medical wards of hospitals affiliated with Tabriz University of Medical Sciences, Iran. Ethical considerations: The study was reviewed and approved by the Ethics Committee of Tabriz University of Medical Sciences. Findings: The mean values of nurses’ moral sensitivity and nurses’ quality care were 136.47 ± 13.30 and 196.36 ± 44.10, respectively. There was no significant relationship between the patient care quality and nurses’ moral sensitivity ( r = −.14, p = .5). However, there was a significant inverse relationship between the dimension of “Experiencing moral conflicts” and the overall score of quality care ( r = −.50, p = .04), the dimensions of “psychosocial ( r = −.50, p = .04)” and “physical ( r = −.50, p = .03).” Conclusion: Considering the significant inverse relationship between the score of patient quality care and the dimension of moral conflict experience, it seems when nurses make moral decisions, they experience a conflict between personal and professional values in their careers and thus experience moral tension. If this tension is not resolved properly, it can provide a way for them to distance themselves from patients, thereby making nurses indifferent to moral care.

Use of a Textured Insole to Improve the Association Between Postural Balance and Ankle Discrimination in Young Male and Female Dancers

Ballet dancers require a high level of postural balance (PB) and proprioception ability during performance. As textured insoles inserted into ballet shoes were found to improve proprioception ability, and better proprioceptive acuity was associated with better PB, the aim of the present study was to investigate whether the association between ankle inversion movement discrimination (AIMD) and PB changed following wearing textured insoles in young male and female dancers. METHODS: Forty-four dancers from the Australian Ballet School, ages 14–19 yrs, were tested for static and dynamic PB and AIMD under two conditions: in ballet shoes, and in ballet shoes with textured insoles inserted. RESULTS: Female dancers demonstrated a significant inverse relationship between AIMD and static PB in the medio-lateral direction when wearing ballet shoes, but not when wearing textured insoles. Male dancers showed a non-monotonic relationship when tested with ballet shoes only, but a significant inverse relationship between AIMD and dynamic PB in the vertical direction and with the waist/head cross-correlation acceleration in the three movement directions when they were tested with textured insoles. CONCLUSIONS: Male dancers demonstrated an improved association between dynamic PB and proprioception ability when using textured insoles, suggesting that the increased afferent information from the plantar surface had a beneficial effect on proprioception feedback about their PB. Conversely, for female dancers, that association was present when wearing ballet shoes, but not when using textured insoles, suggesting that the increased afferent information for female dancers who already had high proprioception ability was “overloaded” by wearing the textured insoles.