Risk factors of emerging multidrug resistant Acinetobacter baumannii in burn patients at burn Unit of Dr. Soetomo Hospital.

INTRODUCTION: Burn injury patients are at high risk of infection as a result of the nature of the burn injury itself, including prolonged hospital stays, antibiotics use, treatment procedures, etc. In this era, nosocomial infections caused by Acinetobacter baumannii (A.ba) have increased significantly. This study was conducted to investigate the micro-organism pattern and the risk factors for burn patients with multi-drug resistant (MDR) Acinetobacter baumannii (A.ba) in the Burn Unit at Dr. Soetomo Hospital. MATERIALS AND METHODS: We conducted a retrospective, observational study among burn patients with A.ba admitted to the Burn Unit at Dr. Soetomo Hospital from January 2020 to December 2021. Potential risk factors for MDR-A.ba were analysed by univariate and multivariate analysis. The patients diagnosed with MDR-A.ba wound infection were included in the case group. The patients diagnosed with non MDR, these are: (1) the patients isolated micro-organisms other than A.ba, (2) sterile isolates, and (3) the patients isolated as A.ba but not MDR, were included in the control group. RESULTS: A total of 120 burn patients were included in this study. During this study, 24% burn patients were found to have Acinetobacter baumannii and 79% (from 24% of Acinetobacter baumannii) had MDR-A.ba. According to univariate analysis, risk factors that significant were: Abbreviated Burn Severity Index (ABSI) (p = 0,002; OR: 6.10; CI: 1,68 - 21,57); hospital Length Of Stay (LOS) (p < 0,000; OR: 6.95; CI: 2,56 - 18,91) and comorbid (p = 0,006; OR: 3,72; CI: 1,44 - 9,58). But, after analysed by multivariate analysis, only ABSI was the significant factor (p = 0,010; OR: 1,70; CI: 1,23 - 2,36). CONCLUSION: Based on univariate analysis, the significant risk factors for MDR-A.ba were: ABSI, hospital length of stay and comorbid. But after adjusted by multivariate analysis, only ABSI was the significant factor.

An exploration of the Indonesian lay mental health workers' (cadres) experiences in performing their roles in community mental health services: a qualitative study.

BACKGROUND: Volunteers trained to support community mental health programs in Indonesia are known as 'mental health cadres.' These are lay people trained to provide basic support for people with mental illness in their local communities. The role of cadres in community mental health services is to provide health promotion activities and support for people with mental illness, such as home visits and family assistance. Their contribution can potentially address the challenges health services currently face in remote and resource-limited settings. However, little is currently known about implementing this form of the lay workforce and the experiences of mental health cadres in Indonesia in particular. This study aimed to explore the experience of cadres when performing their roles in community mental health services in Indonesia from the cadres' perspective. METHODS: The study employed a descriptive qualitative design. Purposive sampling was employed to recruit cadres with at least one year of experience handling those diagnosed with schizophrenia across four geographical areas in Java and Sumatra, Indonesia. Data were collected utilising focus groups undertaken between July and November 2020. Due to COVID-19 restrictions, eight focus group sessions for mental health cadres were carried out virtually via Zoom and non-virtual, facilitated by local moderators. Data were analysed using thematic analysis. RESULTS: The study involved 71 cadres in four regions: Aceh, Jakarta, West Java and East Java. The majority of participants were looking after their families with a minimum of high school-level qualifications. Four themes were interpreted from the data: (1) Motivation for volunteering, (2) The role of cadres in supporting mental health services, (3) Training and support needs in carrying out cadre roles, and (4) Barriers and facilitators to the implementation of cadre roles in local communities. CONCLUSIONS: Cadres reported a motivation to help people improve their mental health and reduce the stigma associated with mental illness. Cadres also contributed to secondary and primary prevention of mental illness with some limitations. This study's results are relevant to those wishing to understand and optimise the implementation of lay workforces in resource-limited settings.

Holistic Nursing and Quran Recitation and its Impact on Floods Survivors in Indonesia.

Purpose: The purpose of the study was aimed to explore the trajectory of thoughts and feelings related to religiosity and spirituality using a holistic approach following attendance at group-Quran Recitation (QR) sessions among annual flood victims. Design: This is a qualitative study with an in-depth retrospective interview conducted data in 2019. Methods: The purposive sampling was applied to conduct face-to-face individual video-recorded semistructured interviews. Seventeen participants followed six QR chanting sessions in Bandung, Indonesia. Data were transcribed verbatim and analyzed using inductive analysis. Findings: After extracting evidence expressions of participants, the research team generated the central theme of "Holism of Religiosity and Spirituality," using three influential sub-themes, including obedience to God's will, growing a positive mindset through spirituality and life started to be delighting from nine categories. Conclusion: The relationship of body-mind concepts of holism through QR among flood sufferers was explored. The effect of QR chanting is beneficial to change awareness about the wisdom of spirituality. The holistic approach of religiosity and spirituality in nursing care is recommended to promote all service settings, especially community and disaster nursing in the Indonesian context. Future research is needed to develop QR chanting activities among multiethnic and socio-cultural groups as alternative therapy quantitatively.

The relationship of educational environment and preparedness to practice - perceptions of Malaysian dental graduates.

Gauging dental graduates' perceptions of their university training and of how it prepares them for professional practice is useful in measuring the quality and adequacy of the curriculum to which they were exposed. OBJECTIVES: This study aimed to evaluate the perceptions of dental graduates' educational environment as well as preparedness to practice, and how these two components are correlated. METHODS: A self-administered, validated questionnaire, developed from previous studies, was distributed to dental graduates of a public Malaysian university (n = 178, response rate = 60%) via online and postal surveys. Bivariate analyses were carried out using Spearman's rank-order correlation (Spearman's Rho, significance level p < .01) to determine the correlation between (1) Global Preparedness Score and Global DREEM Score, (2) domains of DREEM Inventory and perceived preparedness, and (3) domains of perceived preparedness and DREEM Score. RESULTS: The Global Preparedness Score was 191.52, with more than 90% of respondents feeling well prepared in the "General Patient Management," "Drug and Emergency Management" and "Practice Management" domains. The Global DREEM Score was 148.99/200, interpreted as "more positive than negative." The DREEM Inventory domains with the highest and lowest scores were "Students' Academic Self-Perception" (78.03%) and "Students' Social Self-Perception" (71.86%), respectively. A moderate positive correlation was found between Global Preparedness Score and Global DREEM Score (p < .01). In addition, moderate to large positive correlations were noted between perceived preparedness and "Student Perception of Learning," "Student Perception of Atmosphere" and "Student Academic Self-Perception" (p < .01). Moderate positive correlations were also found between the DREEM Score and most domains of perceived preparedness (p < .01). CONCLUSIONS: The majority of graduates were well prepared to perform in most areas of clinical practice and perceived their overall educational environment as positive. In particular, those who viewed the educational environment in a positive light were also found to possess a good level of preparedness.

Wetting Properties of the CO2-Water-Calcite System via Molecular Simulations: Shape and Size Effects.

Assessment of the risks and environmental impacts of carbon geosequestration requires knowledge about the wetting behavior of mineral surfaces in the presence of CO2 and the pore fluids. In this context, the interfacial tension (IFT) between CO2 and the aqueous fluid and the contact angle, θ, with the pore mineral surfaces are the two key parameters that control the capillary pressure in the pores of the candidate host rock. Knowledge of these two parameters and their dependence on the local conditions of pressure, temperature, and salinity is essential for the correct prediction of structural and residual trapping. We have performed classical molecular dynamics simulations to predict the CO2-water IFT and the CO2-water-calcite contact angle. The IFT results are consistent with previous simulations, where simple point charge water models have been shown to underestimate the water surface tension, thus affecting the simulated IFT values. When combined with the EPM2 CO2 model, the SPC/Fw water model indeed underestimates the IFT in the low-pressure region at all temperatures studied. On the other hand, at high pressure and low temperature, the IFT is overestimated by ∼5 mN/m. Literature data regarding the CO2/water/calcite contact angle on calcite are contradictory. Using our new set of force field parameters, we performed NVT simulations at 323 K and 20 MPa to calculate the contact angle of a water droplet on the calcite {10.4} surface in a CO2 atmosphere. We performed simulations for both spherical and cylindrical droplet configurations for different initial radii to study the size dependence of the water contact angle on calcite in the presence of CO2. Our results suggest that the contact angle of a cylindrical droplet, is independent of droplet size, for droplets with a radius of 50 Å or more. On the contrary, spherical droplets make a contact angle that is strongly influenced by their size. At the largest size explored in this study, both spherical and cylindrical droplets converge to the same contact angle, 38°, indicating that calcite is strongly wetted by water.

The effect of solvation and temperature on the adsorption of small organic molecules on calcite.

We performed density functional theory calculations to investigate the effect of solvation and temperature on the adsorption of small organic molecules on calcite. The Conductor like Screening Model for Real Solvents (COSMO-RS) solvation model was used to describe a multicomponent mixture consisting of both hydrophobic and hydrophilic phases. The results demonstrate that the combination of solvation and temperature significantly influences adsorption, with the effect of temperature dominating over the effect of solvation. At 25 °C, carboxylic acids and methanol are stable on calcite with free energy of adsorption <0 in the hydrophobic phase. None of the molecules considered in this study remain on the surface in the hydrophilic phase.

Ab initio calculation of energy levels for phosphorus donors in silicon.

The s manifold energy levels for phosphorus donors in silicon are important input parameters for the design and modeling of electronic devices on the nanoscale. In this paper we calculate these energy levels from first principles using density functional theory. The wavefunction of the donor electron's ground state is found to have a form that is similar to an atomic s orbital, with an effective Bohr radius of 1.8 nm. The corresponding binding energy of this state is found to be 41 meV, which is in good agreement with the currently accepted value of 45.59 meV. We also calculate the energies of the excited 1s(T 2) and 1s(E) states, finding them to be 32 and 31 meV respectively.

Ab Initio electronic properties of monolayer phosphorus nanowires in silicon.

Epitaxial circuitry offers a revolution in silicon technology, with components that can be fabricated on atomic scales. We perform the first ab initio calculation of atomically thin epitaxial nanowires in silicon, investigating the fundamental electronic properties of wires two P atoms thick, similar to those produced this year by Weber et al. For the first time, we catch a glimpse of disorder-related effects in the wires--a prerequisite for understanding real fabricated systems. Interwire interactions are made negligible by including 40 ML of silicon in the vertical direction (and the equivalent horizontally). Accurate pictures of band splittings and the electronic density are presented, and for the first time the effective masses of electrons in such device components are calculated.

Protein flexibility: multiple molecular dynamics simulations of insulin chain B.

Multiple molecular dynamics simulations totaling more than 100 ns were performed on chain B of insulin in explicit solvent at 300 K and 400 K. Despite some individual variations, a comparison of the protein dynamics of each simulation showed similar trends and most structures were consistent with NMR experimental values, even at the elevated temperature. The importance of packing interactions in determining the conformational transitions of the protein was observed, sometimes resulting in conformations induced by localized hydrophobic interactions. The high temperature simulation generated a more diverse range of structures with similar elements of secondary structure and populated conformations to the simulations at room temperature. A broad sampling of the conformational space of insulin chain B illustrated a wide range of conformational states with many transitions at room temperature in addition to the conformational states observed experimentally. The T-state conformation associated with insulin activity was consistently present and a possible mechanism of behavior was suggested.

Effect of external stresses on protein conformation: a computer modelling study.

The increasing use of digital technologies such as mobile phones has led to major health concerns about the effects of non-ionizing pulsed radiation exposure. We believe that the health implications of exposure to radiation cannot be fully understood without establishing the molecular mechanisms of biological effects of pulsed microwaves. We aim to establish methods for studying the molecular mechanisms of protein structural and energetic changes occurring due to external stresses related to non-ionizing radiation by using a combination of experimental and theoretical approaches. In this paper, we present the results from our fully atomistic simulation study of chemical and thermal stress response of a prototype protein, insulin. We performed a series of molecular dynamics simulations of insulin in solution under equilibrium conditions, under chemical stress (imitated by reducing the disulfide bonds in the protein molecule), and under short-lived thermal stress (imitated by increasing simulation temperature for up to 2 ns). The resultant protein conformational behaviour was analysed for various properties with the aim of establishing analysis routines for classification of protein unfolding pathways and associated molecular mechanisms.