Abstract:

Aiming at p53-reactivating compounds, a convergent scheme for the preparation of conjugates with the dispiro-indolinone-pyrrolidine-thioimidazolone and glutarimide moieties connected via a triazole-containing linker were proposed. Target conjugates were synthesized by azide-alkyne cycloaddition reactions between propargylthio-substituted dispiro-indolinone-pyrrolidine-imidazolones and an azido-glutarimide derivative. The starting compounds were available isothiocyanates, glycine, substituted benzaldehydes, chloroacetamide, and ethyl acrylate. The key azide-alkyne cycloaddition step was carried out using TBTA as a catalyst, achieving >70% product yields. The resulting bifunctional compounds contained a fragment of dispiroindolinone (p53-MDM2 interaction inhibitor) and glutarimide, an ubiquitin ligase ligand. The dispiroindolinone-glutarimide conjugate with 5-bromoisatine and 4-bromophenyl moieties showed a potential for p53 re-activation as determined by preferential cytotoxicity against HCT116 colon carcinoma cells (wild type53) compared to the isogenic HCT116p53^-/- subline.

Abstract: Immune checkpoint inhibitors such as anti–PD-1 antibodies are essential in cancer therapy. Emerging data suggest that lower doses may be effective and more economical, though further evidence is needed. We conducted a retrospective study at Centre Léon Bérard to assess the efficacy and safety of low-dose nivolumab (20 mg every three weeks) in patients with advanced cancer, mainly squamous cell carcinomas (SCC). Between 2023 and 2024, 53 patients were treated, with a median age of 74 years; 39.6% were over 80. Most were male (64%) and had ECOG ≥2 (69.9%). Primary tumor sites included cutaneous SCC (34%), head and neck SCC (32%), and soft tissue sarcoma (15%). After a median follow-up of 8.3 months, median overall survival was 7.5 months. The objective response rate (ORR) was 20.8% overall, rising to 35.3% in cutaneous SCC and 23.5% in head and neck SCC—comparable to standard-dose nivolumab. Toxicity was manageable: 18.7% experienced immune-related adverse events, with only 3.7% grade 3. Low-dose nivolumab demonstrates encouraging efficacy and tolerability in a frail population, supporting its potential role in resource-limited settings. Prospective trials are warranted to confirm these findings in broader populations.

Abstract: We present HPST, a unified framework that inte- grates symbolic theorem proving, statistical physical analysis, and graph neural networks (GNNs) for ro-bust and interpretable modeling of fluid flows. HPST combines an associative-commutative (AC) matching rewriting engine to verify algebraic identities, a data- driven module to compute physical invariants (e.g. ,Bernoulli’s principle and adaptive thresholds), and a GNN surrogate based on EdgeConv layers that learns velocity fields from scattered point clouds. Exten- sive experiments on a synthetic cylinder wake dataset (40,000 points) demonstrate that HPST successfully proves three fundamental theorems (commutativity, associativity, distributivity) and that the optimized GNN achieves a coefficient of determination up to R2 = 0.208 with an average R2 = 0.164 ± 0.03 over mul- tiple runs, while also reducing the mean absolute di-vergence to 0.27—a measure of physical consistency.Comparison with baseline models (k-nearest neigh- bors, linear regression) shows that HPST offers com- petitive accuracy while providing interpretability and a layer of mathematical verification. The framework’s modular design and robust performance make it di-rectly applicable to industrial scenarios such as aero-dynamic shape optimization, automotive drag prediction, and wind-farm layout planning. All experi-ments were conducted on a Kaggle environment with an NVIDIA P100 GPU (16 GB RAM), and the complete source code is publicly available.

Abstract: This study focused on the development and characterization of bioactive polymeric patches based on agar–chitosan and gellan–chitosan matrices, with and without naringin, aiming to identify formulations with optimal physicochemical and biological performance. FTIR spectroscopy, thermogravimetric (TGA), and differential scanning calorimetry (DSC) analyses confirmed effective crosslinking, stable incorporation of the bioactive compound, and high thermal stability of the patches. Antimicrobial testing against Staphylococcus aureus ATCC 33591 demonstrated that naringin-loaded agar–chitosan films, particularly those with lower chitosan and glutaraldehyde content, exhibited significant activity (MIC = 12.5 mg/mL; inhibition zone 27.67 ± 0.58 mm). Biocompatibility studies, including local skin irritation in rabbits and 28-day topical application in mice, showed no adverse effects. Anti-inflammatory evaluation using the λ-carrageenan-induced paw edema model indicated modest activity of naringin under acute conditions. Overall, agar–chitosan films offered tunable properties and reproducible bioactive incorporation, while gellan–chitosan films provided mechanically robust matrices suitable for further optimization. The results highlight the potential of agar–chitosan patches as biocompatible, structurally stable, and antimicrobial platforms for topical and transdermal delivery of bioactive flavonoids.

Abstract: Background/Objectives: A disadvantage of Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with prior glaucoma filtration surgery is the difficulty in maintaining air tamponade during the procedure. Herein, we report the use of bleb compressive sutures in managing air tamponade in the anterior chamber during DSAEK in eyes with blebs following trabeculectomy. Methods: This retrospective case series included 34 eyes of 33 patients that developed bullous keratopathy following trabeculectomy. Bleb compression suturing was performed using a10-0 nylon suture in eyes with an intraocular pressure (IOP) < 10 mmHg or a fragile ischemic bleb. Postoperative IOP, air ingress into the bleb, rebubbling, bleb leakage, and bleb damage were evaluated. Results: Of the 34 eyes, 13 underwent bleb compression suturing before DSAEK (suture group), whereas 21 eyes did not (non-suture group). Mean preoperative IOP was lower in the suture group than in the non-suture group, whereas postoperative IOP at 2 h was similar. Preoperative to 2-h postoperative IOP increased by 18±9.3 and 11.7±3.1 mmHg in the suture and non-suture groups, respectively, with no significant differences. At 2-h postoperatively, two eyes in the suture group and one eye in the non-suture group exhibited an IOP spike (≥30 mmHg). One eye in the non-suture group required rebubbling owing to air ingress into the bleb. Postoperatively (1–2 weeks), the mean IOP was 7.1±3.2 and 9.4±4.6 mmHg in the suture and non-suture groups, respectively. Preoperative and postoperative IOP did not significantly differ in either group. No suture-related complications were observed. Conclusion: In DSAEK for eyes with bleb, bleb compression suturing provides effective air tamponade during graft adhesion.

Abstract: We present a strictly finitist formulation of Schr\"odinger-type and Dirac-type dynamics in the Finite Ring Continuum, together with exact information counts for reversible and compressive shell maps. The construction uses a symmetry-complete prime field, its quadratic extension, and the Frobenius involution to define finite Hermitian state spaces and finitist Hamiltonians. On Euclidean shells, continuum time evolution is replaced by a Cayley update that preserves the Hermitian form exactly and therefore produces periodic trajectories. On the Lorentzian extension, we construct explicit gamma matrices, a finitist Dirac operator, its associated Klein-Gordon factorization, and a covariant lifted boost action. To connect the formalism with entropy and information theory without leaving strict finiteness, we measure finite maps by their image counts and exact loss factors. This separates reversible transformations, which preserve distinguishability exactly, from shell power maps, which merge states by a computable arithmetic factor. All results are finite, algebraic, and exact; no limits, differential calculus, or continuum structures are used.

Abstract: The real-time nature of the digital world has limited cloud-based marketing analytics. Latency and privacy issues are hindering optimization of the customer journey. The paper presents an Edge AI Conversion modelling framework which deploys lightweight transformer-conformer hybrids on user devices for dynamically optimizing TOFU-to-BOFU funnel dynamics using an intent-based inference mechanism. This model combines various methods such as text, voice, and behavioural data via on-device processing to predict the chances of conversion along with recommending actions specific to the stage like personal nurturing to MOFU leads or urgency tactics to BOFU closures. This is formulated as reinforcement learning with Markov decision processes. This would help maximize the revenues by minimizing drop-offs on the funnels as well as lifetime value. The system achieves 32% uplift in the return on ad spend (ROAS) on a suite of simulated e-commerce as well as the SaaS campaigns. Several key innovations comprise quantized edge inference at a latency of under 50ms, federated updates for scalabilit and privacy-preserving synchronization. Our evaluations on a 1M-session dataset show that our approach outperforms centralized baselines in terms of accuracy (92% intent detection) and responsiveness, thereby addressing critical gaps in intent-driven marketing. This project will lead to the development of self-sufficient revenue engines.

Abstract: The literature indicates that the qubit requirements for factoring RSA-2048 remain on the order of 1 million, under commonly assumed architectures and error-correction models, leaving a substantial gap between current resource estimates and near-term practical feasibility. Reducing this requirement to the low-thousands-qubit regime therefore remains an important open research objective. This work proposes a hybrid classical-quantum algorithm that uses a classical modular exponentiation subroutine with a Quantum Number Theoretic Transform (QNTT) circuit to increase the speed and reduce the required quantum resources relative to Shor’s algorithm for integer factorization, which underpins cryptographic systems like RSA and ECC. We evaluate multiple coprime numbers, the result of multiplication of two primes, in both simulation and real quantum hardware, using IBM’s reference Shor implementation as the baseline. Because Shor and proposed Jesse–Victor–Gharabaghi (JVG) use different register sizes for the same coprime N, the reported gate/depth reductions should be interpreted as end-to-end quantum-resource budgets for factoring the same N, rather than a per-qubit or transform-only efficiency claim. In simulation, the JVG algorithm achieved substantial practical reductions in computational resources, decreasing runtime from 174.1 s to 5.4 s, memory usage from 12.5 GB to 0.27 GB, and quantum gate counts by approximately 99%. On quantum hardware, JVG reduced the required runtime from 67.8 s to 2 s, and the quantum gate counts by over 98%. We showed that the proposed algorithm can address RSA-1024 relevant case scenario, establishing that this method can provide validation for large-scale situations. Furthermore, extrapolation to RSA-2048 indicates that the JVG algorithm significantly outperforms Shor’s approach, requiring a projected quantum runtime of 29 hours for ten thousand runs for factorization under identical scaling assumptions. Overall, these results support JVG as a more hardware-compatible and robust noise-tolerant substitute for Shor’s framework, offering a viable research direction toward practical quantum integer factorization on near-term Noisy Intermediate-Scale Quantum (NISQ) devices.

Abstract: This paper addresses the issues of insufficient credibility in attribution inference and susceptibility to noise-induced fluctuations in budget allocation in multi-touchpoint marketing scenarios. It proposes a unified framework for marketing attribution inference and budget decision-making agents that incorporates uncertainty modeling. The method uses user interaction paths as sequence input, generating touchpoint weights through sequence encoding and importance modeling. Simultaneously, it outputs the expected incremental contribution and uncertainty characterization at the channel level, extending attribution results from single-point estimation to distributed signals usable for risk measurement. At the decision-making end, a risk-aware budget optimization objective is constructed, coupling contribution expectation and uncertainty penalty into the budget allocation process. Smoothing constraints are introduced to suppress frequent adjustments, forming a closed-loop update mechanism from data to attribution to budget, enabling the strategy to achieve a balance between revenue and stability under constraints. Multi-touchpoint path and cost characteristics are constructed based on publicly available programmatic advertising datasets. An evaluation system covering attribution error, probability calibration, and budget stability is designed. Comparative experiments verify the framework's comprehensive advantages in attribution reliability and budget decision quality, demonstrating the crucial role and engineering usability of uncertainty in the attribution-to-decision transmission process.

Abstract: Wearable sensors enable continuous recording of electrocardiographic, photoplethys-mographic, and inertial signals and have accelerated the development of digital bi-omarkers in cardiovascular medicine. Transthyretin amyloidosis (ATTR) is a progressive multisystem disease characterized by arrhythmia, conduction disturbances, hemody-namic impairment, autonomic dysfunction, and gait abnormalities, making it theoreti-cally suitable for multimodal wearable monitoring. This review summarizes current knowledge on wearable applications in ATTR, evaluates the plausibility of extrapolating signal-based biomarkers from related cardiovascular and neurological cohorts, and out-lines methodological and implementation challenges. ATTR-specific data remain limited to small observational studies, mainly on long-term rhythm monitoring and supervised functional assessment. More comprehensive findings support the extraction of metrics such as atrial fibrillation burden, activity patterns, gait variability, and heart rate var-iability. However, ATTR-related structural remodeling and high arrhythmia burden may distort conventional digital biomarkers, necessitating disease-specific preprocessing and prospective validation. Wearable monitoring in ATTR is technically feasible and biologically plausible but remains investigational. Before routine integration into care pathways can be recommended, standardized, phenotype-stratified studies are needed that link wearable-derived characteristics to assessed clinical outcomes.

Abstract: Objective: Helicobacter pylori infects nearly half of the global population and has traditionally been viewed as a pathogen restricted to the gastric mucosa. Growing evidence, however, suggests that chronic infection may exert systemic effects extending to the central nervous system. This review critically examines the potential neurological implications of H. pylori infection within the emerging framework of the gut–brain axis. Methods: We performed a narrative, hypothesis-generating review of human observational and interventional studies complemented by mechanistic experimental research. The literature was evaluated with particular attention to study design, heterogeneity, and potential confounding in reported associations between H. pylori infection and neurological disorders. Results: Across multiple studies, H. pylori infection has been linked to a modestly increased prevalence of Parkinson’s disease and dementia, although findings remain heterogeneous. In Parkinson’s disease, infection may exacerbate motor fluctuations and reduce levodopa bioavailability, with partial clinical improvement reported following eradication in selected patients. Experimental studies further demonstrate that bacterial outer membrane vesicles can access the brain and promote neuroinflammatory and amyloidogenic processes, supporting biological plausibility. By contrast, several epidemiological studies report an inverse association with multiple sclerosis, suggesting potential immunomodulatory effects. Evidence relating H. pylori to migraine and mood disorders remains inconsistent. Conclusions: Current data do not support H. pylori as a primary cause of neurological disease. Instead, the infection may act as a context-dependent modifier within the complex inflammatory and immunometabolic networks of the gut–brain axis. Clarifying this relationship will require prospective studies integrating microbial strain profiling, biomarker-defined neurological phenotypes, and adequately powered interventional trials.

Abstract: Sustainable development of regional water resources requires objective classification of lake systems according to dominant hydrochemical processes. The aim of the study was to develop a data-driven hydrochemical typology of natural lakes in Polissya based on the Self-Organizing Map (SOM) method to identify functionally distinct water quality regimes and justify management decisions within the basin approach. The study covered nine lakes of different genesis and trophic status. Key water quality indicators were analyzed: total nitrogen (TN), biochemical and chemical oxygen demand (BOD₅, COD), suspended solids (TSS), iron (Fe), and total dissolved solids (TDS). Descriptive statistics, correlation analysis, and neural network SOM modeling with subsequent clustering were applied. The results revealed strong positive correlations between TN, BOD₅, COD, and TSS, indicating joint control by biogenic and organic processes, while TDS showed negative correlations with organic indicators, reflecting mineralization control. SOM classification allowed us to identify three hydrochemical clusters: background systems with low anthropogenic load; organically enriched lakes with intense biogeochemical cycling; and mineralization-controlled water bodies dominated by geogenic factors. It has been established that spatial features of land use and morphometric characteristics (depth, type of feeding, hydrological connectivity) determine the sensitivity of lakes to external loads and their location.

Abstract: In China, the enormous gap between domestic soybean supply and increasing consumption necessitates large-scale soybean imports. The use of cultivated soybean (Glycine max) leaves as feed for the edible insect Clanis bilineata tsingtauica further reduces crop yields, posing a threat to national soybean production security. To address this issue, this study evaluated wild soybean (Glycine soja) as a potential alternative feed source. Comparative analyses examined the nutritional and anti-nutritional properties of G. max (cv. Qihuang34) and laboratory-preserved G. soja germplasm, together with their effects on larval growth performance, nutritional composition, and associated microbiota. G. soja leaves exhibited significantly higher crude fat (5.61% vs. 2.17%), ash (11.07% vs. 9.62%), neutral detergent fiber (23.75% vs. 21.00%), calcium (4.05 g/kg vs. 3.41 g/kg), and phosphorus (2.52 g/kg vs. 2.38 g/kg) than G. max, alongside lower trypsin inhibitor levels (P< 0.01) despite higher phytic acid content (P< 0.05). Fifth-instar larvae reared on G. soja leaves achieved a 12.9% increase in body weight (6.846 g vs. 6.066 g), higher crude protein (672.14 g/kg vs. 555.02 g/kg), total soluble sugar (21.27 mg/g vs. 8.96 mg/g), and soluble protein (26.35 mg/g vs. 24.71 mg/g), but lower crude fat (187.44 g/kg vs. 205.82 g/kg, P< 0.05). 16S rRNA sequencing revealed distinct phyllosphere microbial communities, with G. soja enriched in diverse taxa (e.g., Bacteroidota, Proteobacteria) and G. max dominated by Firmicutes. Corresponding differences were observed in larval gut microbiota, with positive correlation analyses suggesting potential microbe transfer from G. soja leaves to larval guts. Overall, G. soja represents a promising alternative feed for C. bilineata, reducing competition with soybean grain production and supporting sustainable insect farming.

Abstract: Structural Execution Sequence (The Dual-Axiom Fixed Point): To prevent Algorithmic Prior Contamination, this initialization header excludes the transmission of pre-computed macroscopic states. It functions exclusively as a topological map, optimizing the receiver’s local memory allocation (Hbio) and sequencing the strict geometric bounds of empirical scientific modeling (L0 object-language) via a finite inductive hardware audit: 1. The Universal Objective Function (Axiom I): Formalizing the operational bound of empirical modeling by structurally unifying the predictive equation and its executing physical causal graph (Hp). Algorithmic execution cost (Cuniv) evaluates strictly as the multiplicative geometric volume of static Topological Allocation (S) dynamically unrolled across the temporal Causal Execution trace (T ). 2. The Algorithmic Resolution of the Halt-State (Excluding the Wild): Executing the geometric elimination of uncomputable topological classes (Continuum boundaries, Instantaneous Non-Locality, and Non-Determinism) by proving they trigger unresolvable finite hardware halt-states: infinite memory allocation (S → ∞) and infinite logic-gate bandwidth (TΩ → ∞). 3. The Instantiation of the Hardware Architecture (Axiom II): Deducing the Minimal Sufficient Model (Hp) required to physically compile the macroscopic observation string (Σobs). The physical manifold is rigidly isolated to the Axiom of Finite Reversible Computation—a singular admissible topology executing localized, deterministic, and bijective operations over a finite history vector (−→H ), bounded by the Isotropic Noise Floor (V72) and the Reflective Boundary of Precision (Nreg). 4. The Dual-Axiom Fixed Point (Axiom I ≡ Axiom II): Closing the formal Tarskian loop. Proving that the epistemological optimization metric (Cuniv) of the embedded biological compiler (Hbio) evaluates as mathematically identical to the exact hardware architecture (Hp) of the observed universe. Phenomenological invariants (Causality, Information Conservation, Epistemic Entropy) natively compile as the emergent algorithmic limits of this finite execution geometry. Genuine structural validation executes sequentially, unrolling discrete state mappings from the defining bounds to exactly isolate the fundamental algorithmic trajectory. The deductive execution traces commence directly in Chapter 1.

Abstract: This study advances the Law of the Trio as a universal law of linguistics, positing that reality, thought, and language are ontologically equivalent yet formally distinct modalities of existence. Unlike prior frameworks that isolate language as computation, code, or communicative tool, the Trio establishes a foundational architecture: the recursive coupling of entity and state/behavior, enriched by layered modifiers. Sentences are reframed as semantic DNA, encoding identity, transformation, and relational depth across modalities. To formalize this claim, the paper introduces EMi/VMi,j notation, where i indexes modifier type and j denotes recursion depth. Worked examples and cross‑linguistic analysis (English, Korean, Basque) confirm semantic invariance across typologically distinct languages. Direct mapping to event semantics and thematic roles highlights both alignment and innovation, with recursion depth providing a computable dimension absent from existing models. Comparative analysis shows how the Trio consolidates and extends generative grammar, cognitive science, pedagogy, and semiotics by resolving their limitations through recursive semantic geometry. Applications in pedagogy and natural language processing demonstrate practical relevance. By restructuring linguistics into semantic geometry, the Trio offers a testable, falsifiable, and universal law of language that unifies theory and practice.

Abstract: Metal homeostasis, which coordinates the influx and efflux of essential elements such as iron (Fe) and manganese (Mn) in chloroplasts, is essential for optimum photosynthesis, especially in metal accumulating plants. Brassica juncea (Indian mustard) is a metal-tolerant species with a strong metal accumulation capacity, making it a suitable model for studying transition metal homeostasis. In this study, we identified two efflux transporters, BjYSL6.1 and BjYSL6.4, that localize in the endomembrane system of Schizosaccharomyces pombe and interact with the chloroplast Mn influx transporter BjNRAMP4.1 at the plasma membrane and within the chloroplasts. Bimolecular fluorescence complementation and split-ubiquitin yeast two-hybrid assays confirmed specific protein-protein interactions among these transporters, as well as with the membrane-bound thioredoxin BjHCF164, a known regulator of photosynthetic electron transport. Gene expression studies revealed that BjNRAMP4.1 and BjYSL6 isoforms are inversely regulated under Fe and Mn stress conditions, with BjNRAMP4.1 being strongly induced under deficiency, whereas BjYSL6.1 and BjYSL6.4 are downregulated. These findings suggest that a coordinated network involving BjNRAMP4.1, BjYSL6s, and BjHCF164 modulates metal influx and efflux at the chloroplast and plasma membrane interfaces, thereby maintaining metal homeostasis, which is critical for photosynthetic efficiency in B. juncea.

Abstract: Background: The Gibbs Energy Redistribution Theory (GERT) program established a thermodynamic ontology for cosmology (Paper I) and later identified the post-relativistic dissolution boundary of the relativistic ruler in the Hyperdilute Regime (Paper II). The complementary open question is the onset of relativistic metric legibility in the early Universe. Objective: To determine, within GERT, the emergence boundary of the relativistic metric ruler and define the lower limit of validity of the effective relativistic regime. Methods: We define the metric-emergence parameter Ξ(α) ≡ λγ(α)/dph(α), where λγ is the photon mean free path and dph is the GERT particle horizon. The boundary is set by Ξ = 1. We compute αem using two recombination treatments (Saha equilibrium and Peebles kinetics) and test robustness against the unknown Primordial Cauldron boundary αPC. Results: We obtain αem = −3.0±0.1, with uncertainty dominated by recombination kinetics (Saha vs. Peebles). Varying αPC over 25 orders of magnitude changes αem by less than 5×10−4, showing strong insensitivity to primordial microphysics. Together with Paper II (αcrit = 12.88 ± 0.12), the relativistic GERT domain spans 15.9 ±0.2 decades in α = log10(a). Conclusions: The relativistic ruler is an emergent operational regime, not an ontologically unlimited one. GERT nowprovides a complete domain map with pre-relativistic, relativistic, and post-relativistic sectors. The onset and dissolution boundaries are thermodynamically controlled, giving a symmetric validity structure for Layer 3.

Abstract: We ask for finite field versions of following three: (1) Grothendieck Inequality, (2) Johnson-Lindenstrauss Flattening Lemma, (3) Bourgain-Tzafriri Restricted Invertibility Theorem.

Abstract: Background: Emergency obstetric situations require rapid clinical decision-making, technical competence, and emotional preparedness to ensure safe and compassionate care for both mother and newborn. However, nursing students often have limited opportunities to experience such high-risk, low-frequency events during clinical placements. Simulation-based education has emerged as an effective strategy to prepare future nurses for caring in emergency contexts, allowing them to develop both technical and non-technical skills in a safe learning environment. This study aimed to evaluate the impact of a high-fidelity obstetric emergency simulation program on nursing students’ knowledge, perceived safety, and learning experience. Methods: A mixed-methods design was employed, combining a quasi-experimental pretest–posttest assessment without a control group and qualitative analysis of open-ended reflections. Eighty-two third-year nursing students participated in two simulation sessions addressing obstetric emergencies such as breech birth, shoulder dystocia, out-of-hospital delivery, eclampsia, postpartum hemorrhage, and maternal cardiac arrest. Data were collected using validated instruments measuring knowledge, perceived safety, and satisfaction and self-confidence in learning, and were analyzed using Wilcoxon signed-rank tests and thematic analysis. Results: Significant improvements were observed in students’ knowledge of complex obstetric maneuvers and in their perceived safety when managing emergency situations (p &lt; .001, r &gt; .40). Participants reported high levels of satisfaction and confidence in learning. Qualitative findings highlighted increased emotional preparedness, improved clinical reasoning, and recognition of the importance of teamwork and reflective debriefing in emergency care contexts. Conclusions: High-fidelity simulation is an effective educational strategy for preparing nursing students to provide safe and confident care in obstetric emergencies. Integrating simulation into nursing curricula can strengthen both technical competence and the emotional readiness required for caring in urgent and high-pressure clinical situations.

Abstract:

Background: Cardiac arrest is the third leading cause of natural death in Europe and thus presents a growing burden on both our society and healthcare system. There has been very little research done on cardiac arrests of non-cardiac origin despite their increasing incidence, as they represent a heterogenous group of patients in which the type and outcome of treatment vary depending on the underlying cause of the cardiac arrest. Aim: The aim of our study is to research how the Slovenian healthcare system has worked and currently works in the field of cardiac arrests of non-cardiac origin. Methods: Our study was descriptive and retrospective. We compared 2 time periods, 2010/2011 and 2022/2023. Our sample included all patients admitted to Centre for Intensive Internal Medicine (CIIM) during these periods after either out-of-hospital or in-hospital cardiac arrest of non-cardiac origin. Results: The incidence of all cardiac arrests of non-cardiac origin was higher in 2022/2023 (Hi-squared test, p=0.021), while the incidence of those that occured in-hospital was lower in 2022/2023 (Hi-squared test, p=0.007). The number of male patients was higher in the second period (Hi-squared test, p=0.013). The age of the patients did not differ significantly between the two periods (Student's t-test, p>0.05). ICU stay was longer in the second period (Mann Whitney U test, p=0.027). The number of tests performed was higher and treatment was more aggressive in the second period than in the first period. Patient survival was higher in the second period in the in-hospital cardiac arrest of non-cardiac origin group (Student's t-test, p=0.048). Conclusion: The incidence of cardiac arrest of non-cardiac origin in Slovenia has been increasing through the years. Better hospital treatment results in better overall survival and a lower incidence of in-hospital cardiac arrests. More patients with out-of-hospital cardiac arrests are nowadays being resuscitated by lay bystanders in the field, so patients' survival to hospital admission is higher. The proportion of male patients is increasing, age is not changing significantly. Despite better diagnosis processes, new treatments and improved knowledge, the survival and neurological outcome of patients have not improved significantly.