bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Neuro-Linguistic Programming Techniques in Organizational Leadership
Authors: Deshwal Vivek , Arora Shaina , Batta Kamal
Published: July 2024

he first objective of the paper is to explain Neuro-Linguistic Programming in the organizational context. The second objective is to find out the various applications of NLP in organizational leadership. The study reviews the selected literature from 1970 to date. A total of 74 studies were selected in the first wave then the most relevant research papers among them were selected for a thorough review. Along with this, four articles from ‘HBR's 10 Must Reads On Leadership' and three books on NLP were also studied for a deeper understanding of leadership and NLP techniques. The findings of the study state that there are many applications of NLP in organizational leadership. It is used for goal setting and managing groups and teams. It is also helpful in motivating and stimulating employees. Various NLP techniques make communication, negotiation, and other related aspects better. The findings of this paper can be beneficial for leaders in various professional and academic organizations and institutions.
A Study of Ambition to Create, Frankenstein (1931) and Bride of Frankenstein (1935)
Authors: Koç Nur Emine , Akaydın Aydın Ayşegül
Published: July 2024

British writer, Mary Shelley's book “Frankenstein, The Modern Prometheus” was based on the films Frankenstein and Bride of Frankenstein. This famous story tells of a human's curiosity to know and his/her ambition to create and to have an important characteristic of God's immortality. This study explores literature-cinema dynamics using structuralist narrative theories and also Vladimir Propp and Aristotle's narrative theories will be taken into consideration. British literary theorist Terry Eagleton has stated that each text builds on the texts written before it. The relationships between Frankenstein's texts will also be analyzed from an intertextual perspective. The story has a connection with the mythological story of Prometheus who stole the fire will also be mentioned. The story of Frankenstein is told through metaphors of human's use of science and technology in his/her struggle with nature and his/her succumbing to his/her ambition.
Meta-Heuristic Algorithms for Optimal Sizing of Hybrid Renewable Energy Systems
Authors: Chauhan Siddharthsingh K. , Chauhan Vineeta S.
Published: July 2024

The optimal sizing of hybrid renewable energy systems is a critical challenge in achieving sustainable and cost-effective energy solutions. This study explores the application of meta-heuristic algorithms to address this complex optimization problem. Meta-heuristic algorithms, inspired by natural and social phenomena, offer efficient and versatile approaches for determining the optimal combination of renewable energy sources and storage technologies. Genetic Algorithms mimic the process of natural selection, Particle Swarm Optimization replicates the social behavior of particles, and Ant Colony Optimization draws inspiration from ant foraging patterns. Simulated Annealing and Tabu Search provide mechanisms for escaping local optima, while Harmony Search reflects the improvisation process of musicians. This research investigates the adaptability and effectiveness of these meta-heuristic algorithms in optimizing the sizing of solar panels, wind turbines, and energy storage components within hybrid renewable energy systems.
Meta-Heuristic Optimization for Enhanced Sensor-Based Health Monitoring in Cloud Computing Environments
Authors: Seeniappan Kaliappan
Published: July 2024

In this research, the integration of meta-heuristic optimization into health monitoring systems is explored for its transformative potential. The study employs a comprehensive evaluation approach, focusing on Performance Metrics, Resource Utilization, and Scalability Testing. Results indicate a consistently high level of accuracy (90% to 97%) and swift response times (125 to 165 milliseconds), highlighting the reliability and efficiency of the enhanced system. Resource Utilization demonstrates optimal memory and CPU usage (110 to 130 MB and 30% to 47%, respectively), underscoring the sustainable and balanced operation of the system. Scalability Testing reveals the system's adaptability to changes in user numbers and data complexity, with response times ranging from 150 to 200 milliseconds. Meta-heuristic optimization emerges as a key enabler, fine-tuning predictive capabilities, optimizing resource usage, and ensuring seamless scalability.
Antecedents to the Adoption of Digital Marketing by Start-Ups Under Startup-India and E-Governance Initiatives
Authors: Kate Nilesh Tejrao , Chaudhary Prashant , Kumar Kumod , Raut Neelam , More Mahendra
Published: July 2024

India is witnessing a dual transformation marked by technological advancements and a surge in entrepreneurial activity following the launch of various e-governance schemes and the Startup India program. However, the high failure rate among startups remains a significant concern, often attributed to inadequate marketing efforts due to financial constraints. To address this issue, enhancing digital marketing initiatives under Startup India could offer cost-effective solutions with higher returns on ad spend (ROAS). This research, grounded in the Behavioral Reasoning Theory (BRT), utilized cross-sectional data analyzed through Partial Least Square-Structured Equation Modelling (PLS-SEM) using SmartPLS software. The study revealed that beliefs, values, reasons for and against adoption, and attitudes influence startups' adoption of digital marketing. The findings of this study aim to provide practical insights for Startup India programs, entrepreneurs, and policymakers to understand better the motivators and barriers to adopting digital marketing technologies.
Can Company Size and Region Shape the Sustainability Landscape?
Authors: Chen Chao , Panichakarn Boonsub
Published: July 2024

This research investigates the status of green innovation within the supply chain context, emphasizing the roles of organizational support, competitive pressure, and relative advantage. A total of 286 valid samples collected from employees within the supply chain of the manufacturing industry in China were analyzed. Findings reveal significant impacts of organizational support, competitive pressure, and relative advantage on green supply chain innovation adoption, with nuances observed based on organizational characteristics and regional differences. Competitive pressure is a key driver for small organizations to adopt green supply chain innovations, whereas the relative advantage significantly influences larger organizations' adoption intentions. Organizations in different regions exhibit different adoption intentions of green supply chain innovations. Practical implications for managers in different contexts are discussed, emphasizing the importance of tailored strategies to leverage strengths and mitigate challenges in fostering sustainable and innovative supply chains.
Care for Women's Health
Authors: Peng Lifang , Zhang Na , Huang Ling
Published: July 2024

The mechanisms by which Internet use influences rural women's health are explored in this paper using a mixed-methods approach. Findings indicate that internet use has a significant and positive effect on the health of rural women and hold up to endogenous and robustness testing. Additionally, the strength of the effects of internet use on self-rated health, depression, and cognition level decreases with age. Information accessibility and social trust as the important path mechanisms for Internet use to promote self-rated health and cognition level. We also investigated the impact of COVID-19 outbreak on this mechanism to further recognize the critical role of digital technology in global public health emergency preparedness and response efforts. These findings provide some insights for policy formulation by Governments and practical action by organizations to better improve women's health in rural areas and reduce rural health disparities.
Comprehensive Flow Cytometric, Immunohistologic, and Molecular Assessment of Thymus Function in Rhesus Macaques
Authors: Hale Laura P , Macintyre Andrew N , Bowles Dawn E , Kwun Jean , Li Jie , Theriot Barbara , Turek Joseph W
Published: July 2024

The critical importance of the thymus for generating new naive T cells that protect against novel infections and are tolerant to self-antigens has led to a recent revival of interest in monitoring thymic function in species other than humans and mice. Nonhuman primates such as rhesus macaques (Macaca mulatta) provide particularly useful animal models for translational research in immunology. In this study, we tested the performance of a 15-marker multicolor Ab panel for flow cytometric phenotyping of lymphocyte subsets directly from rhesus whole blood, with validation by thymectomy and T cell depletion. Immunohistochemical and multiplex RNA expression analysis of thymus tissue biopsies and molecular assays on PBMCs were used to further validate thymus function. Results identify Ab panels that can accurately classify rhesus naive T cells (CD3+CD45RA+CD197+ or CD3+CD28+CD95−) and recent thymic emigrants (CD8+CD28+CD95−CD103+CD197+) using just 100 µl of whole blood and commercially available fluorescent Abs. An immunohistochemical panel reactive with pan-cytokeratin (CK), CK14, CD3, Ki-67, CCL21, and TdT provides histologic evidence of thymopoiesis from formalin-fixed, paraffin-embedded thymus tissues. Identification of mRNAs characteristic of both functioning thymic epithelial cells and developing thymocytes and/or molecular detection of products of TCR gene rearrangement provide additional complementary methods to evaluate thymopoiesis, without requiring specific Abs. Combinations of multiparameter flow cytometry, immunohistochemistry, multiplex gene expression, and TCR excision circle assays can comprehensively evaluate thymus function in rhesus macaques while requiring only minimal amounts of peripheral blood or biopsied thymus tissue.
Association of Obstructive Sleep Apnea with co-morbidities in smokers versus non-smokers - an observational study
Authors: Haran Alamelu , Mamatha S. , Ashwini S.
Published: July 2024

Obstructive Sleep Apnea (OSA) and smoking are important global health issues that are widely prevalent. Both are independently associated with cardiovascular, respiratory, metabolic, neurological, psychiatric, and endocrinological abnormalities and cancer, leading to premature death. Whether coexistent OSA and smoking worsen multisystem abnormalities is inconclusive. Therefore, this study was done to find the association between OSA and other morbidities among smokers and non-smokers. The objectives of this study were i) to evaluate the association of OSA with co-morbidities in smokers and non-smokers and ii) to compare the severity of OSA in smokers and non-smokers.
“I’m better than you”: assessing the presence of optimistic bias among Italian hunters
Authors: Corradini Annafrancesca , Demartini Eugenio , Viganò Roberto , Marescotti Maria Elena , Gaviglio Anna
Published: July 2024

According to the latest scientific evidence, consumers appreciate hunted wild game meat (HWGM), but its consumption may expose them to some risks. Hunters produce HWGM, even if they may find it hard to identify themselves as food producers since in Western countries, hunting is practiced mostly as a leisure activity. Thus, hunters may underestimate the risk associated with HWGM handling, failing to preserve its safety during the production process. To test this hypothesis, our study aims to explore the presence of optimistic biases (OB) in a sample of Italian hunters. A sample of 408 hunters was asked to indicate their own risk and the perceived risk of their peers causing a foodborne disease to the final consumer, as well as the practices implemented during the phases of HWGM handling and preparation. Moreover, information about HWGM destinations, hunters' knowledge of basic principles of food safety, and risk perceptions of HWGM preparation were collected. Our results show that hunters generally tend to perceive themselves as "better than their peers" in performing actions to preserve HWGM safety, especially if the peers are unfamiliar to the respondent. Furthermore, OB correlates knowledge of basic principles of food safety with risk perceptions of HWGM preparation-related practices. Finally, hunters perceived themselves as "nature lovers" and "hunting enthusiasts" and did not recognize their role as food producers. Therefore, our findings emphasize the importance of improving hunters’ training to preserve public health, addressing the need for more targeted strategies able to enhance hunters’ awareness of their role as food producers.
Lychee cultivar fine-grained image classification method based on improved ResNet-34 residual network
Authors: Xiao Yiming , Wang Jianhua , Xiong Hongyi , Xiao Fangjun , Huang Renhuan , Hong Licong , Wu Bofei , Zhou Jinfeng , Long Yongbin , Lan Yubin
Published: July 2024

Lychee, a key economic crop in southern China, has numerous similar-looking varieties. Classifying these can aid farmers in understanding each variety's growth and market demand, enhancing agricultural efficiency. However, existing classification techniques are subjective, complex, and costly. This paper proposes a lychee classification method using an improved ResNet-34 residual network for six common varieties. We enhance the CBAM attention mechanism by replacing the large receptive field in the SAM module with a smaller one. Attention mechanisms are added at key network stages, focusing on crucial image information. Transfer learning is employed to apply ImageNet-trained model weights to this task. Test set evaluations demonstrate that our improved ResNet-34 network surpasses the original, achieving a recognition accuracy of 95.8442%, a 5.58 percentage point improvement.
The Canadian Database of Geochemical Surveys: Historical Overview and Current Challenges
Authors: Adcock S. W. , Spirito W. A.
Published: July 2024

La Banque de données de levés géochimiques du Canada est une banque de données rela¬tionnelle sophistiquée qui constitue un répertoire exhaustif des levés géochimiques à l’échelle régionale effectués au Canada depuis les années 1950. Le contenu peut être consulté au moyen d’un site Web public du gouvernement du Canada. Le répertoire fournit des métadonnées détaillées pour chaque levé, y com¬pris des liens vers des publications et des données numériques, dans la mesure du possible. En plus des métadonnées de haut niveau, les résultats d’analyses chimiques pour les levés individuels sont ajoutés pro¬gressivement. Nous avons répertorié plus de 1 600 levés à ce jour et avons intégré les données analytiques de 300 levés, pour un total de 13 millions de mesures analytiques individuelles. L’article commence par une discussion sur la philosophie générale de la gestion de l’information qui sous-tend la banque de données, puis donne quelques exemples pratiques sur la façon d’utiliser le système, et conclut en soulignant certains des défis actuels liés à la création et à l’entretien du système.
Antioxidant and Apoptotic Effect of Edaravone on Cisplatin-Induced Brain Injury in Rats
Authors: Kara Ozlem , Kilitci Asuman
Published: July 2024

Purpose:

This study aims to investigate the effect of edaravone in preventing cisplatin-induced brain damage.

Methods:

Forty female Wistar albino rats were included in the study. 4 groups were created. In group 1 (control group) (n=10), neither any drugs were given nor anything was performed. Group 2 (cisplatin group) (n=10), single dose 7.5 mg/kg cisplatin was given. In group 3 (edaravone group) (n=10), single dose 1 mg/kg edaravone was administered. Group 4 (cisplatin+ edaravone group) (n=10), single dose 7.5 mg/kg cisplatin and 1 mg/kg edaravone were given. Brain tissue was removed in all rats after 3 days. Blood samples taken from heart tissue were examined for malondialdehyde (MDA) and nitric oxide (NO) levels. Brain tissue was evaluated for damage with p53, GFAP and Ki 67.

Results:

Edaravone reduced cisplatin-induced brain damage. MDA and NO levels in the cisplatin group were significantly higher than the other groups (p< 0.05). Likewise, tissue damage in the cisplatin group was significantly higher than in the other groups (p< 0.05). The immunohistochemical staining which was done by using p53, GFAP and Ki 67 was shown that tissue damage was higher in cisplatin group than cisplatin+ edaravone group and this difference was found to be statistically significant (p< 0.05).

Conclusion:

The findings of our study suggest that edaravone therapy may be effective in the prevention and treatment of cisplatin-induced brain injury.
Isolated Bilateral Triceps Weakness in Myasthenia Gravis
Authors: Özenç Betül , Işık Kübra , Odabaşı Zeki
Published: July 2024

Purpose:

Myasthenia gravis (MG) is the most common autoimmune disease that affects the neuromuscular junction and can cause weakness in various muscle groups. The most commonly affected muscles are the eye, facial, and neck flexors. Focal or dominant weakness of the triceps muscle is rare. In this case, we aimed to describe a rare form of MG consisting of selective or dominant triceps muscle weakness.

Case report:

We present a 45-year-old male patient whose initial complaints were diplopia and ptosis. Acetylcholine receptor antibody was positive. After 10 years of well-being following thymectomy, bilateral triceps weakness was added to his ocular symptoms despite regular medication (pyridostigmine and prednisone). Repetitive nerve stimulation (RNS) showed decremental responses in the right triceps muscles.

Conclusion:

It is important to recognize this type of myasthenia gravis to facilitate diagnosis and appropriate treatment and to avoid unnecessary investigations and treatments.
Secondary Trigeminal Neuralgia Caused by Cerebellopontine Angle Arachnoid Cyst in A 27-Year-Old Female: A Case Report
Authors: Niryana I Wayan , Tombeng Marthinson Andrew , Lauren Christopher , Maliawan Sri , Golden Nyoman , Mahadewa Tjokorda Gde Bagus , Maliawan Made Gemma Daniswara
Published: July 2024

Purpose:

Secondary (TN) caused by an arachnoid cyst in the (CPA) region is a rare finding. Based on the reported literature, there are only 5 cases of secondary trigeminal neuralgia caused by an arachnoid cyst in the cerebellopontine angle region.

Case report:

A 27-year-old female presented to our neurosurgery clinic with a 2-year history of brief episodes of paroxysm pain in the left cheek. The pain was described as an electric shock-like pain triggered by simple stimuli. The magnetic resonance imaging (MRI) showed a well-confined cystic lesion in the left CPA, which compresses the left pons and the cisternal segment of the left trigeminal nerve. The patient was managed operatively to fenestrate the cyst and decompress the trigeminal nerve. The histopathological result of the cyst wall was consistent with an arachnoid cyst. Six months after surgery, the patient is in good health condition and symptom-free without medication.

Conclusion:

Arachnoid cyst in the CPA region is one of the rare causes of secondary TN. Preoperative imaging with MRI is important to provide better results to differentiate the pathology. Surgical treatment to fenestrate the arachnoid cyst and decompress the trigeminal nerve have a good result and can improve the patient’s quality of life.
Effects of Crocin on Brain Neurotrophins, Cognition, Balance and Pain in Toxic-Induced Demyelination Model
Authors: Fatemi Rouholah , Moghaddam Hadi Fathi , Farbod Yaghoub , Bigtashkhani Roya
Published: July 2024

Objective:

The purpose of this study was to investigate the effects of Crocin on brain neuroterophins, cognition, sensory and motor dysfunction and compare to fingolimod effects in toxic-induced demyelination with Ethidium Bromide (EB) in female Wistar rats.

Methods:

Animals were assigned in to 8 groups; Sham, Sham operated (ShOp), Experimental Autoimmune Encephalomyelitis (EAE), crocin treated (Cr5,10,20 mg/kg), Vehicle, Fingolompd (Fing) and fingolimod + crocin (Cr+Fing). Demyelination was induced by single dose injection of 10 μl of EB 0.1% into the fourth ventricle of the brain. Crocin and fingolimod were administered for 21 days, daily, oral gavage. BDNF, NGF1, tail flake latency, balance and behavioral variables were sampled and analyzed by paired t-test and ANOVA test with repeated post hoc measurements.

Results:

The results showed that crocin improves all studied factors, but remarkable improvements were observed in dosage of 10 mg/kg. Crocin (10mg/kg) and fingolimod (1mg/kg) significantly improved cognition variables in open field test, sensory and motor nerve conduction velocity, tail flick latency and clinical scores (p<005). In addition, applying of crocin co-administered with fingolimod led to significant increases in all assessed factors, greater than crocin or fingolimod intervention alone (α≤0.001).

Conclusion:

Based on the current findings, crocin can improve the level of brain neurotrophins, exploratory behavior, balance and pain after toxin-demyelination as close as fingolimod results.
Application of Perfusion Imaging in the Telehealth Setting for Acute Ischemic Stroke
Authors: Valente Michael , Phan Thanh , Parsons Mark , Ma Henry
Published: July 2024

In the remote telehealth setting, computed tomography perfusion (CTP) provides important information in assessing the suitability of reperfusion therapy for patients with stroke syndromes. This review will discuss key concepts surrounding the use of CTP, including basic science, clinical applications, pitfalls, recent trials, and technical considerations. CTP can enhance decision-making for patients who are in the extended window from stroke onset, and this review will address key concepts relevant to its use.
Etiological Patterns and Clinical manifestations of Severe Anemia in Hospitalized Patients
Authors: Gara Himavathy Kodandarao , Vanamali Dharma Rao
Published: July 2024

Abstract

Background:

Severe anemia is a significant global health issue, particularly among hospitalized patients, with diverse etiologies and complex clinical presentations. This retrospective hospital-based study aimed to explore the prevalence, clinical manifestations, and etiological factors of severe anemia in hospitalized patients.

Materials and Methods:

Medical records of 103 patients admitted with severe anemia from February 2023 to January 2024 were analyzed. After exclusions, data from 85 patients were included in the final analysis.

Results:

The mean age of participants was 45.82 years, with a predominance of middle-aged and older individuals. Dyspnea was the most prevalent symptom, followed by giddiness and weight loss. Approximately one-fifth of patients had congestive heart failure, which was more common in older age groups. Hemoglobin levels ranged from 6.5 to 7.9 g/dL in 63% of patients, with microcytic hypochromic anemia being the most common peripheral blood smear finding. Nutritional deficiencies were the leading cause of severe anemia, followed by anemia of chronic disease (ACD), with iron deficiency anemia being the most prevalent subtype. ACD was predominantly seen in older age groups, while nutritional deficiencies were more common in younger patients and significantly higher in females. Gender disparities were evident, with males exhibiting a higher prevalence of ACD and females showing a higher prevalence of nutritional deficiency anemia.

Conclusion:

This study underscores the need for targeted interventions addressing nutritional inadequacies, disease-specific treatments, and gender-sensitive healthcare strategies to optimize patient outcomes. A comprehensive understanding and management of severe anemia are essential to mitigate its impact on morbidity and mortality, particularly among hospitalized patients.
Vinegar Activity against Clinically Isolated Escherichia Coli
Authors: Hussein Hassan Mahdi , Al-Khikani Falah Hasan Obayes , Mohammed Jamal Bahaa , Hassan Baneen Haider , Hamza Tabarek Maytham , Ali Bainat Hassan , Shaalan Ban Abdulkarim , Mohammed Hassanein Jasim , Ali Hussein Jawad , Mohammed Hassan Faris
Published: July 2024

Abstract

Background:

Antibiotic resistance in Escherichia coli (E. coli) has become a worrying issue been increasingly observed worldwide in recent decades. E. coli intrinsically has a great capacity to accumulate resistance, making them difficult to treat with standard therapies. So, using alternative strategies to treat it is urgent.

Material and Methods:

The bacteria were isolated from urinary tracts and wounds, and then cultured in three media (blood agar, MacConkey agar, and eosin methylene blue agar). They were incubated for 24 h at a temperature of 37oC to grow. The well diffusion method was used to evaluate the activity of vinegar, and the disk diffusion method was used for antibiotic sensitivity test of gentamicin as a control agent after overnight incubation. Statistical analysis was done by using SPSS 26 software.

Results:

Out of the 24 participants in the study, 66.6% were women, while 33.4% were men with significant differences (P < 0.05). Isolated E. coli (75%) were sensitive to vinegar, while 70.80% of isolates were sensitive to gentamycin. The mean inhibition zone for vinegar was 13 ± 6.04 mm compared to 15 ± 6.43 mm for gentamicin with no significant differences (P = 0.27).

Conclusions:

Vinegar shows 75% sensitivity to clinically isolated E. coli, and thus it can be a promising treatment option. Gentamicin with high rate of sensitivity can be used as an empirical treatment for E. coli infections. Vinegar has similar activity to gentamicin (P > 0.05).
COVID-19 and Ethnic Disparities: An Analysis of the Impact of COVID-19 on Different Ethnic Groups of Assam State in Indian Sub-Continent
Authors: Sarma Pratham B. , Baruah Manash Pratim , Bhattacharya Bhaskar
Published: July 2024

Abstract

Background:

The coronavirus disease 2019 (COVID-19) pandemic spread throughout the world and nearly collapsed the healthcare system worldwide. During this period, major disparities around the healthcare system were observed among the different nations. The pandemic revealed glaring disparities to COVID-19 and different outcomes across different racial and ethnic groups.

Objectives:

This research study aims to investigate the impact of COVID-19 on various ethnic groups within Assam, exploring the socioeconomic, healthcare access, and cultural factors contributing to disparities in infection rates, severity, and mortality; since the people of the Assam are an intermixture of various racial stocks such as Mongoloid, Indo-Burmese, Indo-Iranian, Austroasiatic and Aryan.

Materials and Methods:

This study employed a survey-based research approach to investigate the impact of Covid-19 on Assam's different racial and ethnic groups, exploring disparities in infection rates, severity, and mortality, along with the underlying factors contributing to these disparities. The study involved 310 participants aged 15 years and above from rural suburban and urban areas. The data was collected in the month of September’2023 and using Google Form, an easily navigable online survey platform. The survey comprised a series of multiple-choice questions; covering topics related to demographic information, experience during pandemic, observations.

Results:

321 persons responded to the questionnaire, and out of which 11 submissions were rejected because of invalid response. People from 18 ethnic groups and 5 sub-groups responded. One of the worst effected ethnic tribe appears to be the Boro tribe, where 57% of respondents were infected, 70% showed severe symptoms & 60% were hospitalized. In fact, the Boro tribe also showed the second highest percentage of infected persons who showed post-Covid complications (43%). Another ethnic tribe showing similar results was the Rabha tribe. 52% of respondents were infected, 60% showed severe symptoms & 70% were hospitalized. However, only 20% of the infected showed post-Covid complications.

Conclusions:

Assam with such a diverse and abundant ethnic pool, the disparities that was seen amongst these ethnic tribes and groups could not be completely attributed to disparity in socio-economic condition or access to primary health care. Further research is essential to look beyond socio-economic disparities and look deeper into the genetic or other factors that safeguarded many of these ethnic tribes and will be helpful in finding a right direction in minimizing the impact of future pandemics.
Steroid-responsive Multifocal Motor Neuropathy with Cranial Manifestations
Authors: Chen Yi-Hsiang , Wei Yi-Chia , Weng Wei-Chieh , Chien Yu-Yi , Wu Chia-Lun
Published: July 2024

The typical presentation of multifocal motor neuropathy (MMN) is progressive asymmetric limb weakness. Cranial neuropathy is rare. We report a 28-year-old woman with cranial and bulbar palsies but with typical electrophysiological features of MMN by multifocal motor conduction blocks and serological markers of anti-ganglioside GM1 antibodies. The previous consensus on the treatment of MMN is intravenous immunoglobulins, but our patient responded to oral steroids and had clinical and electrophysiological improvement under continuous low-dose prednisolone treatment. In summary, MMN is a treatable chronic inflammatory disease of peripheral nerves. Cranial neuropathies can be its initial presentation. Electromyography studies are crucial for MMN diagnosis and helpful in monitoring disease activity and treatment responses. Although the previous guideline did not suggest using steroids for MMN, with careful patient selection, low-dose oral steroids can be an effective treatment in patients with relatively minor symptoms.
Advancing Our Knowledge of Cognition in Disorders of Consciousness: A Critical Revisit
Authors: Lin Po-Tso , Yu Hsiang-Yu
Published: July 2024

This narrative review aims to elucidate an emerging state of consciousness termed “cognitive-motor dissociation (CMD),” characterized by brain activity patterns closely resembling those observed in healthy individuals. This distinctive phenomenon is notably evident in patients diagnosed with comatose states, unresponsive wakefulness states, or minimally conscious states. Employing functional magnetic resonance imaging or electroencephalography holds promise for identifying CMD. The emergence of CMD not only introduces a fresh conceptual framework but also provides valuable predictive insights into outcomes and prognoses for individuals with disorders of consciousness. However, the recognition of CMD raises ethical considerations, particularly in evaluating the decision-making capacity regarding life-or-death choices for individuals in this state. Therefore, it is crucial to advocate for further scientific and comprehensive research to enhance our understanding of CMD and navigate its nuanced complexities.
Guidance to Improve Prehospital Trauma Triage Decisions for Geriatric Patients: A Review of the Literature
Authors: Alshibani Abdullah , Banerjee Jay , Williams Christopher , Conroy Simon
Published: July 2024

Major trauma has become a major issue in older people. Prehospital assessment of older trauma patients is not clearly defined, with reported high rates of undertriage. There are several factors that potentially impact upon appropriate prehospital assessment and decision-making for older trauma patients: (a) the presentation of trauma in this population including mechanism, location, and pattern of injury; (b) unique factors with older adults including age-related anatomical and physiological changes, comorbidities, and medication use; (c) distance to trauma centers; and (d) paramedics’ subjective judgments. These factors may have contributed to suboptimal assessment and triage decisions and, hence, increased undertriage rates for this population in prehospital care. This paper aims to provide guidance for paramedics to appropriately assess and accurately triage these patients through applying adjusted physiological criteria specifically for older trauma patients and considering the assessment of mechanism of injury, age cutoffs, comorbidities, and anticoagulants as a method of triage. It also highlights and provides recommendations about other important aspects to optimize prehospital trauma triage decisions for older patients including the integration of frailty assessment in prehospital care and shared decision-making.
Impact of COVID-19 Pandemic on Emergency Medical Services
Authors: Alruwaili Abdullah
Published: July 2024

Emergency medical services (EMSs) are crucial to national health-care systems, facilitating the transfer of disaster, accident, and illness victims to hospitals or providing treatment in ambulances. During the COVID-19 pandemic, symptoms such as cough, fever, and throat discomfort significantly increased EMS calls in Israel, indicative of the virus’s impact. Concurrently, there was a notable rise in mental health-related calls and nonhospitalization incidents. As countries implemented social distancing and “stay-at-home” orders to reduce virus transmission and health-care system strain, several changes occurred in social behaviors and emergency response systems. This led to a reduction in emergency department (ED) visits, possibly due to fears of contracting COVID-19, suggesting that serious medical cases may have avoided seeking necessary care. Furthermore, in some regions, the high demand on EMS services resulted in prolonged response times. For instance, in Tijuana, Mexico, ambulance arrival times increased from 16.4 min in 2019 to 20.5 min during the pandemic’s peak. Similar delays were observed in New York City, including Manhattan and the Bronx. The global impact was also evident as ambulance response times, case volumes, and hospital wait times worsened even after lockdowns were lifted. In Italy, ambulance journeys that typically took 8 min extended to several hours. In addition, some trauma centers were unable to accept trauma patients due to a shortage of inpatient beds, further strained by the heightened demand for EMS amid the pandemic.
Strategic Integration of Artificial Intelligence in Health-care Systems: Assessing Costs, Technological Upgrades, and Training Timelines
Authors: Azharuddin Ahmed , Chandran Suriyakala Perumal
Published: July 2024

BACKGROUND:

In recent years, the evaluation of artificial intelligence (AI) in health-care sector has undergone significant growth and is substantially helpful in supporting clinical decision-making based on evidence. The primary aim of the study is to investigate the strategic integration of AI in health-care systems, specifically focusing on assessing costs, technological upgrades, and training timelines.

MATERIALS AND METHODS:

This study followed quantitative techniques to explore the AI integration’s importance in the systems of health care highlighting training timelines, upgradation of technology, and associated costs. Using descriptive statistics, data were evaluated and a survey was performed on the professionals of emergency medical care. The study employed a combination of descriptive statistics analysis, such as mean and median calculations, to analyze the data. To select participants, this study applied purposive sampling. The selected sample size of the study was 242 from the Indian health-care context.

RESULT:

The results of this study indicated that clear training timelines establishment, technological upgradation, and cost assessments are important for successfully integrating AI technologies. In addition, the discussion explored the acceptance of the significance of stakeholders’ collaboration, cost-effective strategies for training, and information technology infrastructure enhancements. The training costs for AI implementation in health care, with 66.12%–69.83% of respondents selecting “strongly agree” and 25.21%–29.75% selecting “agree.” Strong consensus on the necessity of providing specific timelines for AI implementation in emergency departments, with “strongly agree” responses ranging from 66.12% to 68.60%, and “agree” responses from 26.45% to 29.75%. Issues including timeline adherence and funding constraints were discovered, focusing on the necessity for proactive management.

CONCLUSION:

This research highlighted comprehensive planning’s major role in the integration of AI. Health-care organizations by addressing training timelines, technological upgradation, and cost optimize the incorporation of AI. However, engagement with different financial experts and collaboration with stakeholders are necessary for successfully achieving organizational goals.
Evaluating Practices, Overcoming Pitfalls, and Integrating Artificial Intelligence for Enhanced Quality in Advancing Ambulatory Care
Authors: Shariff Ehtesham Ahmed , Chandran Suriyakala Perumal
Published: July 2024

BACKGROUND:

For delivering health-care services in addressing preventive care, medical requirements of nonemergency, and the management of chronic diseases, ambulatory care is characterized outside of the hospital setting. The interest in artificial intelligence (AI) integration into ambulatory care settings has increased with the rise of technological advancements. However, by prompting the requirements for systemic assessment across different health-care systems, the AI implementation in ambulatory care is varied.

OBJECTIVE:

The aim of conducting this study is to investigate the current status of AI in the services of ambulatory care across five Asian countries such as Myanmar, Malaysia, China, Indonesia, and the Philippines. The implications for health-care delivery are discussed and the common challenges are identified during this study.

MATERIALS AND METHODS:

The descriptive research strategy was employed during this study, and within ambulatory care, the surveys targeting administrators, nurses, and doctors were utilized. For assessing the impact of AI implementation, statistical analysis including quantitative techniques and Likert scale ratings was conducted. The sample size can be validated and the respondents can be selected using the pilot study and purposive sampling.

RESULTS:

The significant variations in treatment protocols and health-care delivery models across surveyed countries were revealed by the obtained findings. The compromised health-care quality and accessibility issues were identified as a few of the challenges in ambulatory care services that are identified during the findings. For enhancing patient engagement, data management, and decision support, the AI integration into electronic health records was evaluated.

DISCUSSION:

For enhancing patient outcomes and health-care delivery, the understanding of variation significance in ambulatory care practices is emphasized by the respondents. As an essential aspect of different countries, collaboration among health-care professionals is highlighted. The challenges in ambulatory care services are addressed by system-level interventions. The implications of AI integration are discussed during this study along with its roles in enhancing cost reduction in ambulatory care settings.

CONCLUSION:

The significance of AI integration in enhancing patient outcomes across diverse health-care systems is underscored. The collaboration among stakeholders is fostered and the complex challenges are addressed by the successful implementation of AI.
Rehabilitation needs of critically Ill patient’s at General Hospital -Kafr- ELsheikh Governorate
Authors: Youssef Shimaa H. M. , Morsy Warda Y. M. , Elreheim Fatma S. A. A. , Ghoniem Basma M.
Published: July 2024

Background

Assessing rehabilitation needs is an essential part of the care provided to critically ill patients and is used to identify areas of need to develop an individualized care plan for each patient.

Aim

To explore rehabilitation needs of critically ill patients during the acute stage of illness.

Research question

What are the different rehabilitation needs of critically ill patients at a general hospital- Kafr- El sheikh Governorate over a period of 6 months?

Design

descriptive exploratory research design was used.

Sample

Purposive sample consist of 100 conscious adult male and female patients, aged from 18- 60 years within period of 6 months was included.

Setting

Four intensive care units affiliated to General Hospital- Kafr Elsheikh Governorate.

Tools

Two tools were utilized (A) Rehabilitation needs of critically ill patient assessment tool, (B) Patient Categorization Assessment Tool (PCAT).

Result

More than half (52%) of patients were the age group 51-60 years old, more than half (54%) of them were females. More than half (55%) of patients stayed 4-6 days at the hospital, all of them were fully conscious. More than one quarters (37%) of the studied patients had a cardiac disease. There were statistical significant difference (χ2=25.28,P=0.00) with deterioration in chest sound 42% of patient (n=100)had abnormal chest sound in first day elevated to 70% of them(n=10) at the last day of their hospitalization. there were significant statistical differences (p≤0.05) in daily living activity between the hospitalization days among critically ill patients. there were significant statistical differences (p≤0.05) in mobility between the hospitalization days among critically ill patients. the cognitive aspect needs were the same at the hospitalization days. There were statistical significant difference (χ2=94.5,P=0.03) with deterioration in psychological stressors presence 71% of them had psychological stressors in first day increased to all of them at the last day of their hospitalization.

Conclusion

Critically ill patients have variable rehabilitation needs that change throughout acute stage of their illness.

Recommendation

Putting into practice the rehabilitation needs assessment for critically ill patients, which is regarded as the initial stage in creating rehabilitation programs. Replication of this study on a larger probability sample from different geographical locations in Egypt is recommended.
The pattern of female sexual function throughout pregnancy
Authors: Garadah Shimaa B. , Abdelmonem Amel S. , Abdelghani Rania M.
Published: July 2024

Background

Pregnancy is a normal physiological stressful process that cause a lot of changes in all body systems so that it can affect the female sexual function.

Aim

To assess the pattern of female sexual function throughout pregnancy.

Design

A descriptive cross-sectional design was adopted for the present study.

Setting

The study was conducted at the antenatal clinic at Alkser Alini.

Sample

A purposive sample of 90 pregnant women was recruited in the study and divided into three groups: 30 pregnant women according to pregnancy trimester.

Tool

The interviewing questionnaire was composed of the woman personal data, husband’s personal data, sexual history, and the Female Sexual Function Index (FSFI) were used.

Results

Most women suffered from deteriorated sexual function during the first and third trimesters of pregnancy (86.7 and 96.7%), respectively, while they remained sexually active in the second trimester. There was a statistical significant relation between the FSFI total scores and having back pain, dyspnea, leg pain, and heartburn (P<0.05). Also, there was a statistical significant relation between the FSFI total scores and woman’s age, number of children, residence, husband’s age, and state of circumcision.

Conclusion

Pregnancy plays a negative role in decreasing the pregnant woman’s sexual function, especially in the first and third trimesters as compared to the second trimester.

Recommendation

Replication of the study using a prospective approach of one group of women to assess the female sexual function and further studies using a qualitative approach allow collecting more detailed information about female sexual function and biopsychosocial factors affecting it are recommended.
Relationship between nursing informatics competencies and evidence-based decision-making use among nurse managers
Authors: Hussein Mostafa M. , Al-Hamid Magda A. , Hassan Shimaa
Published: July 2024

Background

In today’s changing health systems, it is imperative that nursing managers must be proficient in nursing informatics to make evidence-based decisions, which may ultimately lead to increased organizational effectiveness. The study aims to examine the relationship between nursing informatics competencies and evidence-based decision-making (EBDM) use among nursing managers.

Study design

A descriptive correlational design was used in this study.

Sample

The sample included a total of 97 nurse managers.

Setting

This study was conducted at a selected private hospital.

Tools

Three tools were used to collect the study data as follows: (a) the nurses manager’s personal and work-related data tool, (b) the Nursing Informatics Competency Assessment Tool, and (c) Evidence-Based Decision-Making Usage Questionnaire.

Results

The main findings indicated that more than one-fifth (21.6%) of the study sample were proficient in total informatics competencies. In addition, EBDM attitude and beliefs had the highest mean percentage (66.13%), EBDM skills had the lowest mean percentage (52.44%), and EBDM overall had a moderate level mean percentage (60.29%). A statistically significant strong positive correlation (r=0.628, P=0.00) between the overall informatics competencies and the overall EBDM process skills was found.

Conclusion

Nursing informatics competencies levels influence the study participants’ attitudes and abilities regarding the use of EBDM.

Recommendations

Incorporate the nursing informatics qualification in the job descriptions of all nurse management levels and provide an environment that supports and allows the use of an effective EBDM process.
Multicomponent tympanometry in ears with cochlear implant
Authors: Vanaja C. S. , Rucha V.
Published: July 2024

Introduction:

Multifrequency and multicomponent tympanometry procedures enable the evaluation of minute changes in the middle ear system and the estimation of resonant frequency. Changes in the resonant frequency beyond normative values indicate the presence of pathology or change in the natural characteristics of the middle ear. The present study aimed to investigate if there is a difference in the admittance of the middle ear on the side of cochlear implantation and the contralateral ear for different probe tones. The study also investigated if there was a difference in the type of multicomponent tympanogram obtained in ears that have undergone cochlear implantation when compared to the contralateral ear.

Methods:

Twenty children in the age range of 4–14 years with bilateral severe to profound sensorineural hearing loss, having undergone unilateral cochlear implantation, were included in the study. Tympanometry using four probe-tone frequencies (226 Hz, 678 Hz, 800 Hz, and 1000 Hz) was carried out in each ear. Total compliance (Y) and type of tympanogram were compared across the ear with cochlear implantation and the contralateral ear.

Results:

It was found that the implanted ears had lower mean admittance values as compared to the contralateral side at all four probe-tone frequencies. Wilcoxon signed-rank test indicated that the difference was statistically significant for 226 Hz, 678 Hz, and 800 Hz probe tones, suggesting increased stiffness in the ear with cochlear implantation. There was a significant difference in the type of tympanograms obtained in the two ears for 800 Hz and 1000 Hz probe-tone frequencies.

Conclusions:

These results warrant the testing of the contralateral ear for obtaining electrically evoked stapedial reflex thresholds (eSRT).