University of Medicine Mandalay

Performance reflects the level of success in carrying out organizational activities. Higher nurse performance facilitates the achievement of organizational goals, while poor performance hinders progress and disrupts planned activities. This study aims to identify factors influencing nurse performance in caring for patients with mental disorders at the Southeast Sulawesi Provincial Mental Hospital. Methods: This study used a quantitative, correlational analytic design with a cross-sectional approach. The population consisted of 56 nurses, with a sample of 36 respondents selected using total sampling based on the Slovin formula. Data were analyzed using the Chi-Square test. Results: The study found significant relationships between several factors and nurse performance in caring for patients with mental disorders. Work attitude (ρ = 0.001 < α = 0.05), workload (χ² = 13.107 ≥ χ²ₜₐᵦₗₑ = 5.591; ρ = 0.001 < α = 0.05), compensation (ρ = 0.000 < α = 0.05), and skills (ρ = 0.000 < α = 0.05) were all significantly associated with nurse performance. Conclusion: Work attitude, workload, compensation, and skills are significantly related to nurse performance in caring for patients with mental disorders at the Southeast Sulawesi Provincial Mental Hospital. Future research is recommended to explore additional factors, such as work motivation and work environment, that may influence nurse performance.

Natural language interfaces for querying structured databases are essential for making data accessible to non-technical users. This paper presents a comparative study of two approaches for semantic query conversion: a rule-based system and a Machine Learning (ML)-based system. The rule-based model uses handcrafted semantic rules, cosine similarity, and Part-Of-Speech (POS) tagging to match Natural Language Queries (NLQs) with Cypher query templates in a Neo4j graph database. The ML-based model leverages a fine-tuned BERT classifier to predict appropriate query templates based on NLQ intent. Both systems are tested on a corpus of 1,033 queries related to the cultural heritage of Myanmar. Evaluation results show that while the rule-based approach achieves higher accuracy (99.8%) and interpretability, the ML-based model offers faster execution and better scalability. This work highlights the trade-offs between interpretability and automation in semantic query systems and recommends a hybrid approach for real-world deployment.

Community-based agrotourism is increasingly recognized as a driver of local empowerment, yet its social sustainability dimensions remain underexplored in Southeast Asia. This study evaluates social sustainability at an organic vegetable-picking tourism site in Malang City using eleven indicators derived from the literature: availability, accessibility, connectivity, density, diversity, legibility, safety, versatility, participation, social actions, and equity. Field observations and semi-structured interviews with managers, community members, and visitors revealed strong performance in local participation, diversity of activities, and educational value creation. However, challenges remain in public transport accessibility, digital wayfinding, formalizing collaborations with nearby businesses, and managing peak-period congestion. This study contributes to the literature by operationalizing a multidimensional framework for social sustainability in a peri-urban agrotourism setting and offers practical recommendations to strengthen inclusivity, visitor flow management, and community linkages. The findings demonstrate how such initiatives can advance SDG 11 (Sustainable Cities and Communities) and SDG 12 (Responsible Consumption and Production) by integrating tourism development with local social objectives.

Objectives: Atopic dermatitis (AD) is a skin disorder affecting all age groups, but more common in toddlers and older children. This study aims to compare efficacy of topical treatment with oral vit D3 supplements plus standard topical treatment. Methods: An open-label comparative study was conducted at dermatology outpatient department of Pak Emirates Military Hospital, Rawalpindi from July 2024 till Dec 2024. Group A Received Topical Clobetasol Propionate 0.05% and Emolient while Group B received Topical Clobetasol Propionate 0.05%, Emolient and Vitamin D3 Supplement 800IU in form of oral drops. Mean SCORAD score before start of treatment and at the end of treatment was compared to measure efficacy of these treatment regimens. Percent decrease in mean score was calculated. Results: Vitamin D3 supplemetation yielded significant improvement in symptoms and severity of AD. Group A who received topical treatment only showed 60.2% reduction in mean SCORAD after 8 weeks of treatment while in Group B who received oral Vit D3 along with topical treatment, mean SCORAD was reduced by 72.2%. Difference in efficacy of these two treatment groups came out to be statistically significant. (p- value 0.037) Conclusion: Our study suggests that daily dose of oral vitamin D3 supplements might provide clinical improvement in children with AD. It should be considered as a relative adjuvant to the standard regimen of AD along with other oral and topical treatments.

Pitch can be evoked by a single sinusoidal component, a harmonic complex tone, or even from a mixture of multiple harmonic complex tones. An accurate model of pitch perception should account for human perception of all these stimuli. This line of inquiry includes research by Hartmann and colleagues testing pitch models for mistuned harmonics [Lin and Hartmann, J. Acoust. Soc. Am. 103, 2608–2617 (1998)]. Building on this body of research, our study tests pitch models for multiple simultaneous pitches using “rate-place metamers,” synthetic stimuli with rate-place representations matching those of pitch-evoking stimuli but altered temporal representations. We measured F0 difference limens (F0DLs) in 20 normal-hearing human listeners for original stimuli (ORIG) and their rate-place metamers (META), across a range of F0s and spectral regions, for single harmonic complexes and triads. We also measured perception of all three pitches in a triad, with an objective major-vs.-minor task and a subjective expectation rating task. We observed similar patterns of behavioral results for ORIG and META across all tasks, broadly supporting a rate-place view of multiple pitch perception. However, some observed differences between ORIG and META cannot be well explained by the rate-place model. [Work supported by NIH, Grant R00DC017472 (AHM)]

BackgroundOsteoarthritis is a prevalent musculoskeletal condition, but the role of specific serum biomarkers, such as calcium, vitamin D, and C-reactive protein (CRP), in predicting mortality among individuals with osteoarthritis remains unclear.MethodsThis observational study analyzed longitudinal data from over 500,000 participants in the UK Biobank, identifying those with osteoarthritis using ICD-9/10 codes or self-reported history. We performed multivariable cox-regression and flexible parametric survival model (FPSM) for survival analysis, with adjustments made through the inverse probability of treatment weight (IPTW) for baseline covariates identified by directed acyclic graphs (DAGs).ResultsOf the 49,082 osteoarthritis population, the average age was 60.69 years, with 58.7% being female. During the follow-up period exceeding 15 years, a total of 5,522 people with osteoarthritis died. High serum calcium levels, compared to normal serum calcium levels, were significantly associated with all-cause mortality (hazard ratio (HR) 1.33, 95% confidence interval (CI) 1.11, 1.59), cardiovascular diseases (CVD)-related deaths (HR 1.55, 95% CI 1.05, 2.29), and other deaths (HR 1.59, 95% CI 1.20, 2.11). Low serum calcium levels, compared to normal serum calcium levels, was linked with CVD-related deaths (HR 2.06, 95% CI 1.02, 4.14). Vitamin D insufficiency, compared to sufficient vitamin D levels, was correlated with all-cause mortality (HR 1.22, 95% CI 1.13, 1.33), CVD-related deaths (HR 1.43, 95% CI 1.20, 1.72), and other deaths (HR 1.26, 95% CI 1.09, 1.45) but not with cancer-related deaths. High serum CRP levels, compared to normal CRP levels, were associated with all outcomes (all-cause mortality: HR 1.22, 95% CI 1.12, 1.33; CVD-related death: HR 1.24, 95%CI 1.03, 1.49; cancer-related death: HR 1.23, 95% CI 1.09, 1.40; other deaths: HR 1.19, 95%CI 1.03, 1.38).ConclusionsBoth high and low serum calcium levels, elevated CRP, and vitamin D insufficiency are potential predictors of increased mortality risk in the osteoarthritis population. These findings emphasize the importance of monitoring and possibly addressing these serum biomarkers in osteoarthritis populations to improve long-term outcomes. Further studies are needed to understand the underlying mechanisms and to propose therapeutic interventions.

Follicular dendritic cell sarcoma of the parotid gland is an extremely rare tumor, with only six cases reported in the literature. A 51-year-old female had a 3.0cm tumor resected from the right parotid gland. The tumor exhibited solid sheets, whorls, fascicular pattern, and syncytium appearance with an indistinct cell border. The lymphocytic infiltrate was sprinkled throughout the neoplasm, with focal prominent perivascular cuffing. Immunohistochemically, it was positive for follicular dendritic cell markers CD21, CD23, and CD35. We aim to enhance the understanding of this neoplasm and alert pathologists to this rare entity in this region to avoid misdiagnosis.

The objective of the study is mentioned, but it could be further clarified by explicitly stating the aim to compare the effectiveness and safety of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) specifically in patients with atrial fibrillation (AF) and end-stage renal disease (ESRD).We conducted a thorough electronic search of the literature, encompassing databases such as PubMed, EMBASE, Cochrane Library, and Web of Science from their inception up to March 5, 2024. Furthermore, we meticulously examined the bibliographies of included studies to identify additional relevant literature. The reporting of this meta-analysis adhered to the guidelines outlined in the Preferred Reporting of Systematic Review and Meta-analysisguidelines. The endpoints evaluated in this meta-analysis included all-cause mortality, stroke or systemic embolism, and major bleeding. Data analysis was carried out utilizing RevMan Version 5.4 (Cochrane, London, United Kingdom). Dichotomous outcomes, including all-cause mortality, stroke or systemic embolism, and major bleeding, were presented as risk ratios (RRs) with corresponding 95% confidence intervals (CI). A total of 11 studies were incorporated in this meta-analysis, comprising a pooled sample size of 44,863 participants with AF. The pooled analysis revealed no significant disparity between DOACs and VKAs concerning stroke or systemic embolism (RR: 0.93, 95% CI: 0.77 to 1.14) and all-cause mortality (RR: 0.86, 95% CI: 0.74 to 1.00). However, there was a noteworthy reduction in the risk of major bleeding events associated with DOACs compared to VKAs (RR: 0.84, 95% CI: 0.73 to 0.96). Consequently, DOACs may be considered a viable alternative to warfarin in patients with ESRD. However, we need further larger clinical trials to validate these findings.