bluuebunny/crossref_metadata_2025 huggingface dataset:
Blockchain-Based Data Storage for Internet of Things Networks
Authors: Jerbi Wassim , Cheikhrouhou Omar , Guermazi Abderrahmen , Trabelsi Hafedh
Published: March 2024

Consensus mechanisms are fundamental to blockchain technology, ensuring network integrity and the orderly progression of transactions. However, the predominant proof of work method, while widely adopted, has raised concerns regarding its energy-intensive nature and lack of scalability. In response, this research explores alternative consensus methods tailored to participants' engagement in blockchain storage activities. We conducted a comprehensive review of existing approaches, examining their reusability and efficacy. Concurrently, we observed a growing demand for distributed storage solutions driven by escalating data volumes. Our investigation identified areas for improvement in existing storage blockchains, motivating the development of our own system, BlockStock. This protocol, meticulously designed, aims to enhance intelligent data storage management reliably and robustly. Through rigorous performance evaluations, including assessments of power consumption, throughput, and data transfer times, BlockStock demonstrates superior efficacy and cost-effectiveness. These findings underscore its significance as a notable advancement in blockchain-based storage solutions, offering a promising avenue for future research and application.
Optimization of Piano Performance Teaching Mode Using Network Big Data Analysis Technology
Authors: Wei Xiang , Sun Shuping
Published: March 2024

To effectively avoid subjective bias in manual evaluation. This article proposes a MIDI piano teaching performance evaluation method based on bidirectional LSTM. This method utilizes a three-layer bidirectional LSTM neural network mechanism to make it easier for the model to capture useful information. In addition, the Spark clustering training model is constructed using the deeplearning4j deep learning framework, and the model parameters are adjusted through the UI dependency relationships provided by deeplearning4j to improve work efficiency. The experimental results verified the superiority of the bidirectional LSTM model. The methods provided in this article can improve students' independent practical abilities and reduce the pressure on teachers during the teaching process. These measures can promote the development of music education, improve students' music literacy and learning skills, and make positive contributions to the music education industry.
Zanthoxylum infructescence detection based on adaptive density clustering
Authors: Wu Diwei , Zeng Shaohua , Wang Shuai , Chen Yanan , Xu Yidan
Published: March 2024

Infructescence detection during the early fruiting stage is a necessary preliminary work to estimate the yield of Zanthoxylum. The purpose of this research is to detect and quantify the infructescences on the images of early fruit-bearing branches of Zanthoxylum which are collected in the natural environment. Thus, a machine vision-based algorithm for detecting Zanthoxylum infructescences is proposed, which contains of two phases. The first is to segment fruit-like and non-fruit region from Zanthoxylum branch image by extracting the Histogram of Oriented Gradient (HOG) feature map and Excess Green minus Excess Red (ExGR) index to obtain the fruits of Zanthoxylum infructescences. The second is to identify fruits adaptively and roughly in accordance with the density of their position distribution, then an optimization model is established to merge rough clusters and the optimal clustering result is obtained. Experiments with normal samples demonstrate that the proposed approach receives a Precision of 96.67%, a Recall of 91.07%, and an F1-score of 0.93. Compared with ADPC-kNN, DBSCAN and OPTICS, the results reveal that the proposed algorithm has an improved robustness and achieves higher Recall and F1-score. Meanwhile, its competitiveness is displayed in the experiments with deep learning-based methods. It can adaptively detect the infructescences of Zanthoxylum branch images, and the experiments prove that it is effective.
La rilevazione del fabbisogno formativo degli infermieri di area critica: una revisione sistematica della letteratura
Authors: Tafi Veronica , Marucci Anna Rita , Pucci Antonello , Torretta Claudia , Marti Flavio
Published: March 2024

Introduzione: gli infermieri che lavorano in area critica devono essere dotati di competenze che garantiscano un processo assistenziale efficiente e di qualità. Obiettivo di questa revisione è individuare le tecniche di rilevazione del fabbisogno formativo degli infermieri di area critica, individuando le principali competenze richieste e sottolineando l’importanza dell’istituzione di programmi formativi specifici e standardizzati.
Materiali e Metodi: è stata condotta una revisione sistematica della letteratura fra gennaio e aprile 2023, includendo gli studi pubblicati tra il 2013 e il 2023, provenienti da quattro banche dati, escludendo quelli inerenti la formazione sul COVID-19 o l’ambito pediatrico/ostetrico-ginecologico.
Risultati: dopo selezione in base ai criteri d’inclusione ed esclusione e valutazione qualitativa, sono stati inclusi 23 studi che rispondevano opportunamente al quesito di ricerca.
Discussione e Conclusioni: lo studio ha individuato le tecniche maggiormente utilizzate per la rilevazione del fabbisogno formativo fra gli infermieri di area critica e le principali competenze ritenute necessarie, sottolineando l’importanza dell’istituzione di programmi formativi specifici, permanenti e standardizzati a livello internazionale che vengano elaborati a partire dalla rilevazione del fabbisogno formativo degli infermieri stessi.
National Athletic Trainers’ Association Bridge Statement: Management of Sport-Related Concussion
Authors: Broglio Steven P. , Register-Mihalik Johna K. , Guskiewicz Kevin M. , Leddy John J. , Merriman Alejandra , Valovich McLeod Tamara C.
Published: March 2024

Objective

To provide athletic trainers and team physicians with updated recommendations to the 2014 National Athletic Trainers’ Association (NATA) concussion position statement regarding concussion management, specifically in the areas of education, assessment, prognostic factors, mental health, return to academics, physical activity, rest, treatment, and return to sport.

Background

Athletic trainers have benefited from the 2 previous NATA position statements on concussion management, and although the most recent NATA position statement is a decade old, knowledge gains in the medical literature warrant updating several (but not all) recommendations. Furthermore, in various areas of the body of literature, current evidence now exists to address items not adequately addressed in the 2014 statement, necessitating the new recommendations. This document therefore serves as a bridge from the 2014 position statement to the current state of concussion evidence, recommendations from other organizations, and discrepancies between policy and practice.

Recommendations

These recommendations are intended to update the state of the evidence concerning the management of patients with sport-related concussion, specifically in the areas of education; assessment advances; prognostic recovery indicators; mental health considerations; academic considerations; and exercise, activity, and rehabilitation management strategies.
Computational design, docking, and molecular dynamics simulation study of RNA helicase inhibitors of dengue virus
Authors: Satpathy Raghunath , Acharya Sonali , Behera Rashmiranjan
Published: March 2024

Background & objectives:

RNA viruses are complex pathogens in terms of their genetic makeup, mutation frequency, and transmission modes. They contain the RNA helicase enzyme, which plays a crucial role in the viral genome replication process. This work aims to develop and screen a potential molecule that could function as a dengue virus (DENV) RNA helicase inhibitor.

Methods:

The present study was performed by taking 26 potential derivatives of gedunin phytochemicals from the PubChem database as ligands. The binding of the compounds was analyzed by in silico docking considering DENV RNA helicase enzyme as the receptor.

Results:

After a thorough analysis of the docking scores, toxicity, and physicochemical properties, the compound tetrahydrogedunin was obtained as the best. Based on tetrahydrogedunin molecular structure, 100 drug-like molecules were designed using the Data Warrior tool. After screening for drug-likeness and ADMET properties, derivative number 42 was considered as promising. Further comparative docking of derivative 42 and a standard inhibitor molecule ST-610 with DENV RNA helicase enzyme showed binding affinity of 10.0 kcal/mol and -9.6 kcal/mol, respectively. The favorable interaction between DENV RNA helicase and derivative 42 was further validated by 50 nanoseconds molecular dynamics simulation and MM-GBSA analysis.

Interpretation & conclusion:

Since the antiviral activity of derivative 42 has not been reported till date, the compound was predicted as a novel therapeutic molecule that can act against the dengue virus (DENV) RNA helicase enzyme.
Asymmetrical reproductive interference between Aedes aegypti and Aedes albopictus: Implications for coexistence
Authors: Hasan Tanvir , Afrin Sadia , Sultana Afroza , Islam Ashekul
Published: March 2024

Background & objectives:

Aedes aegypti and Ae. albopictus are two sympatric mosquito species that compete with each other for resources when their breeding habitats overlap. This study examines what happens when sympatric Ae. aegypti and Ae. albopictus mosquitoes’ mate with each other and other species by looking at insemination rates, fecundity, and hatchability rate.

Methods:

We performed controlled mating experiments in laboratory settings, assessing both conspecific and interspecific crosses. We measured insemination rates, egg numbers, and hatching success to examine the reproductive interference dynamics between these two distinct mosquito species.

Results:

In the context of conspecific mating, it was observed that both female Ae. aegypti and Ae. albopictus exhibited high insemination rates, with percentages 98% and 94%, respectively. However, interspecific mating exhibited interesting asymmetries as Ae. albopictus males achieved a notable insemination success rate of 28% when mating with Ae. aegypti females, while Ae. aegypti males achieved only an 8% insemination success with Ae. albopictus females. Additionally, females that mated with interspecific males had reduced production of viable eggs compared to conspecific mating. Most notably, interspecific mating resulted in the production of infertile eggs, while conspecific mating led to successful hatching.

Interpretation & conclusion:

The study reveals that Ae. aegypti and Ae. albopictus can asymmetrically interfere with each other’s reproduction, causing a ‘satyr’ effect. This understanding of interspecific competition and reproductive interference in these mosquito species could impact their coexistence in shared breeding habitats.
Outcome assessment of the implementation of Mass Drug Administration against lymphatic filariasis in Kalaburagi (Gulbarga) Karnataka, India: A cross-sectional survey
Authors: Babu Puttamaligaiah Subhas , Goud Bhoompuram Nagaraja , Kambale Shambhulinga B
Published: March 2024

Background & objectives:

Mass Drug Administration (MDA) of Di-Ethyl Carbamazine and Albendazole is an effective strategy recommended by the World Health Organization to prevent transmission and eliminate lymphatic filariasis. Under the National Vector Borne Disease Control Programme (NVBDCP) in India, MDA is carried out as a yearly activity in endemic areas to accelerate the progress towards elimination of lymphatic filariasis. The study was carried with the objective to determine the coverage of MDA against lymphatic filariasis among the eligible population in Kalaburagi district, Karnataka and delineate the common reasons for non-acceptance of MDA.

Methods:

Field-based cross-sectional survey was carried out. Cluster sampling of 4 clusters (3 rural and 1 urban) from four different taluks (one cluster from each taluk) of the district reporting high, medium and low coverage of MDA (as reported by District Malaria Office) Members from selected households in all clusters were interviewed regarding MDA administration, directly observed treatment, side effects and any co morbidities which ruled out MDA administration. Responses documented as tally marks in assessment sheets shared by NVBDCP office. Proportions, frequencies, and mean were calculated and inferential statistics were used.

Results:

A total of 1263 individuals were assessed for MDA from a total 240 households (60 households in each cluster). The coverage of MDA varied from 90.33% in Heerapur in Kalaburagi Urban to 97.87% in Mogala thanda (Chittapur Taluk).

Interpretation & conclusion:

MDA Coverage against lymphatic filariasis has improved when compared to previous studies and it has also exceeded the coverage threshold as determined by programme for elimination of lymphatic filariasis.
“Preendodontic build up” an important aspect of endodontic treatment: Conspectus and proposal of classification
Authors: Khanvilkar Unmesh Deepak , Pawar Ajinkya M. , Pawar Sanika Diwakar , Patil Hitesh Gajendra , Dhok Vaishnavi , Mustafa Mohammed
Published: March 2024

Present-day endodontic treatments make an effort to eliminate up microorganisms from the cavity while also removing bacteria, infected tissue, and dentin. Endodontists think about preendodontic restoration for the most effective rubber dam isolation and increased irrigation space before commencing root canal treatments. This procedure makes postendodontic restoration easier by preventing fractures in poor tooth structure. In addition, it facilitates effective interappointment execution, minimizing medication seepage, gingival ingrowth, and bacterial microleakage. The article evaluates and suggests an innovative preendodontic buildup categorization system that can help with treatment planning for teeth with numerous walls that are structurally damaged.
Comparing the antimicrobial properties of graphene oxide silver nanoparticles as a root canal irrigant: A randomized controlled trial
Authors: Sevagaperumal Annapoorani , Lakshmi M. K. Gayathri , Piriyanga R. S. Rathna , Priyadharshini S. Swathi , Abirami A. Azhagu , Sherwood I. Anand
Published: March 2024

Aim:

The current study aimed to compare and evaluate the antimicrobial efficacy of graphene oxide (GO) silver nanoparticle (AgNp) as root canal irrigant (RCI) with other RCIs in maxillary anterior teeth with necrotic pulp.

Methods:

The GO AgNp RCI was synthesized following modified Turkevich method and subsequent physicochemical characterization was carried out. Sample size was calculated to be 44 and divided into four groups. Following initiation of root canal treatment, preirrigation aerobic and anaerobic samples were collected in suitable medium and the same was done after completion of irrigation adapting the proposed protocol. Further, culture of aerobic and anaerobic samples was done accompanied by determination of bacterial viability count. From the obtained results, statistical analysis was performed and analysis of variance with post hoc was used to compare the antibacterial efficacy between the four irrigants.

Results:

The statistical analysis ended up with a significant difference in antibacterial properties between GO AgNps and normal saline, 2% chlorhexidine (P < 0.01) against both aerobic and anaerobic organisms. 2.5% sodium hypochlorite and GO AgNp irrigant showed a similar result against aerobic organisms (P = 1.00) while 2.5% sodium hypochlorite was slightly effective against anaerobic organisms (P = 0.83). The bacterial viability counts also showed results in accordance with culture results.

Conclusion:

From the above results, it can be concluded that the GO AgNp irrigant is an effective biocompatible antimicrobial agent, comparable to that of 2.5% sodium hypochlorite and superior to 2% chlorhexidine and normal saline.
Present and Future Use of Exosomes in Dermatology
Authors: De Abhishek , Chakraborty Disha , Agarwal Ishad , Sarda Aarti
Published: March 2024

Exposure to external environmental stimuli can lead to skin aging, pigmentation, hair loss, and various immune-mediated as well as connective tissue diseases. Although conventional treatments are routinely used and favoured, they fail to achieve an adequate balance between clinical and cosmetic outcomes. Exosomes are vesicles with a lipid bilayer released by several cell types. These bioactive vesicles play a crucial role in intercellular communication and in several other physiological and pathological processes. They serve as vehicles for bioactive substances including lipids, nucleic acids, and proteins, making them appealing as cell-free treatments. According to studies, exosomes play a vital role in preventing scarring, and senescence, and promoting wound healing. Moreover, research on the biology of exosomes is growing, which has enabled the creation of specific guidelines and quality control methodologies to support their potential implementation in the future. In this review, we have mainly focused on the role of exosomes in various dermatological diseases, their clinical applications, and the potential for further research pertaining to this.
The Role of Malassezia in Nonscarring Scalp Folliculitis, The Disease Course, and the Treatment Responses: A Retrospective Case Series
Authors: Altunel Cemile T. , Öztürk Meryem Ö.
Published: March 2024

Nonscarring scalp folliculitis (NSSF) has been poorly addressed in the literature. Previous studies have focused more on bacterial aetiology. Recent evidence has suggested an inflammatory hypothesis. Data on the role of Malassezia in NSSF are scarce. We retrospectively reviewed the hospital records of 26 NSSF patients diagnosed between September 2021 and October 2022. Malassezia spores were detected cytologically (May-Grünwald-Giemsa stain) in 96% of the patients. Fourteen patients underwent bacterial culture (no growth (4), coagulase-negative staphylococcus (9), and Staphylococcus aureus (1)). In total, 35% of patients had immunosuppression. Antifungal treatment reduced symptoms in 79% of the patients. Four patients received systemic isotretinoin. Recurrence was observed in 35% of patients. This case series suggests Malassezia should be recognized in the pathogenesis of NSSF, which should be confirmed by large-scale studies. Immunosuppression may serve as a predisposing factor in a subset of patients. Although antifungal treatment is efficient in most patients, frequent recurrences necessitate maintenance therapy.
Comparison of body image and peer relations among girls with normal, early, and late menarche
Authors: Irannezhad Elham , Fooladvand Maryam , Soltanizadeh Mohammad
Published: March 2024

BACKGROUND:

The onset of menstruation is a turning point in women’s sexual maturity that, unlike other stages of growth, occurs abruptly and is a critical stage in girls’ lives. The present study investigated body image and peer relations among girls with early, late, and normal menarche.

MATERIALS AND METHODS:

This casual-comparative descriptive study included female students aged 9–17 in Isfahan. The participants were selected using multistage cluster random sampling. Out of 5,984 students, 56, 37, and 43 were selected for the normal, early, and late menarche groups. The Body Image Concern Inventory and Index of Peer Relations were the two tools used in this study. Moreover, the data were analyzed using a covariance statistical test.

RESULTS:

Girls with early menarche had better peer relations than those with late menarche (P = 0.01). In addition, there was a significant difference between adolescents with normal and late menarche in terms of body image (P = 0.01). Girls who experienced late menarche were more concerned about their body image and appearance; however, girls with early menarche experienced more impaired performance (P = 0.05).

CONCLUSION:

The first menstrual cycle, or menarche, affects psychological variables such as body image and peer relations. The later the menarche, the fewer problems in regard to body image and peer relations.
Iranian medical students’ E-learning continuance intention after end of COVID-19 pandemic
Authors: Ghalavand Hossein , Momtazan Mahboobeh , Jelvay Saeed , Khatamifar Seyed Hojjat , Heydarvand Zahra
Published: March 2024

BACKGROUND:

Coronavirus disease (COVID-19) pandemic caused the closure of many face-to-face classes in Iran’s universities of medical sciences, so e-learning was adopted as the alternative method. This study aims to examine the medical students’ perspectives on e-learning continuance intention.

MATERIALS AND METHODS:

In this quantitative study, the population included 1,453 students and the statistical sample size was determined to be 305 students using the Cochran formula. The participants were selected using stratified sampling method based on the field of study and the data were collected by e-learning evaluation questionnaire. The data were analyzed using SPSS 26.0 in addition to descriptive statistics.

RESULTS:

The results showed the mean perceived autonomy, perceived competence, and communication in e-learning, intrinsic motivation, information quality, e-learning applicability and students’ satisfaction with e-learning courses were 2.61, 2.81, 2.91, 3.03, 2.98, 2.92, and 3.31, respectively. There was no significant correlation between the competence and applicability, user satisfaction and e-learning continuance intention. Moreover, e-learning continuance intention had the highest correlation with students’ satisfaction (0.787) and information applicability (0.784), respectively.

CONCLUSION:

Medical students had a tendency to continue e-learning, even after controlling the COVID-19 outbreak, and health education policymakers can be of use in this opportunity to developing educational services.
Joint modeling of longitudinal and competing risks for assessing blood oxygen saturation and its association with survival outcomes in COVID-19 patients
Authors: Geraili Zahra , HajianTilaki Karimollah , Bayani Masomeh , Hosseini Seyed R. , Khafri Soraya , Ebrahimpour Soheil , Javanian Mostafa , Babazadeh Arefeh , Shokri Mehran
Published: March 2024

BACKGROUND:

The objective of the present study is to evaluate the association between longitudinal and survival outcomes in the presence of competing risk events. To illustrate the application of joint modeling in clinical research, we assessed the blood oxygen saturation (SPO2) and its association with survival outcomes in coronavirus disease (COVID-19).

MATERIALS AND METHODS:

In this prospective cohort study, we followed 300 COVID-19 patients, who were diagnosed with severe COVID-19 in the Rohani Hospital in Babol, the north of Iran from October 22, 2020 to March 5, 2021, where death was the event of interest, surviving was the competing risk event and SPO2 was the longitudinal outcome. Joint modeling analyses were compared to separate analyses for these data.

RESULT:

The estimation of the association parameter in the joint modeling verified the association between longitudinal outcome SPO2 with survival outcome of death (Hazard Ratio (HR) = 0.33, P = 0.001) and the competing risk outcome of surviving (HR = 4.18, P < 0.001). Based on the joint modeling, longitudinal outcome (SPO2) decreased in hypertension patients (β = -0.28, P = 0.581) and increased in those with a high level of SPO2 on admission (β = 0.75, P = 0.03). Also, in the survival submodel in the joint model, the risk of death survival outcome increased in patients with diabetes comorbidity (HR = 4.38, P = 0.026).

CONCLUSION:

The association between longitudinal measurements of SPO2 and survival outcomes of COVID-19 confirms that SPO2 is an important indicator in this disease. Thus, the application of this joint model can provide useful clinical evidence in the different areas of medical sciences.
Nursing institutions’ professors’ perception and distant education experience during COVID-19 pandemic lockdown
Authors: Sfendla Anis , Merabti Abdelilah , Lahjou Salwa , El Mlili Nisrin , Bahri Hind , Himmi Banacer , Lalami Abdelhakim El Ouali
Published: March 2024

Background:

The nursing profession represents a demanding and challenging profession with a purpose to keep up with the evolving health-care demands of the population.

Aims:

The purpose of this study is to assess nursing institutions’ professors’ previous experience about information and communication technologies (ICTs) and their perception of distant education during the pandemic lockdown.

Materials and Methods:

This present is a cross-sectional study among participants n = 249 recruited from all academic staff (N = 694) of 23 higher institutes of nursing professions and health techniques in Morocco. The Chi-square test for independence (χ
2) and adjusted Z scores were used as a data analysis method to assess the association between the professors’ education levels and ICT experience.

Results:

A significant association [χ
2 (1, n = 249) = 19.510, P < 0.001] was revealed between professors’ education level and taken training related to ICT in education; significant few professors (16; 9.3%) reported that taken training session [χ
2 (1, n = 249) = 8.940, P = 0.003] belonged to the bachelor degree group. In matters of perception, a few proportion (10%) reported that using technology effectively belonged to the bachelor and low education background group.

Conclusions:

The findings showed that having previous experience in teaching remotely and training related to the ICT was significantly associated with a higher education background. Moreover, professors with higher degrees agreed that distant education could be an alternative to face-to-face course during quarantine.
Bibliometric study of the scientific productivity of the COVID-19 impact on constructs affecting happiness in university students
Authors: Bedoya-Gonzales María , Yucra-Mamani Yudi , Aragón-Cruz Walker , Barrientos-Paredes Katia , Gómez-Bailón Percy , Laura-Chauca Sonia , Fuentes-López José , Flores-Gutiérrez Claudia , Cossio-Bolaños Marco , Gomez-Campos Rossana
Published: March 2024

COVID-19 has caused a wide range of psychological problems, such as panic disorders, anxiety, and depression. Knowing what others have researched on, what constructs they have focused on, will (a) summarize published information, (b) help identify research gaps, and (c) encourage future research that addresses these gaps. The aim of the study was to analyze the bibliometric indicators of scientific productivity of the impact of COVID-19 on constructs affecting undergraduate happiness. A bibliometric study was conducted. The PubMed database was used. Data summarized were: authors, year of publication, journal name, country, language of publication, and subtopic addressed. A total of 16 English-language studies were identified between April 2022 and December 2022. There were 12 countries that have published on the impact of COVID-19 on constructs affecting college students’ happiness. Most of the studies were developed in the United States (n = 4, 25%) and China (n = 2, 12.5%). Thirteen journals publishing these topics were detected. The subtopics considered were organized into nine categories (e.g., a: Psychological impact, b: Adverse childhood experiences, c: Stress, d: Personality traits, e: Perception of the educational environment, f: Spiritual health, g: Distress, h: Uncertainty and socioemotional learning, i: Satisfaction with life). This study suggests that the number of countries and scientific journals that have published on the impact of COVID-19 on constructs affecting college students’ happiness is small. In addition, the most discussed subtopics during the pandemic were related to constructs such as psychological impact and stress affecting college students’ happiness.
Hand Injuries Onboard an Aircraft Carrier – A Case Series
Authors: Kalathil Akil Anand , Surse Yogeshwar Balasaheb
Published: March 2024

Hand injuries comprise a large part of all the injuries coming to the emergency department of the hospitals. Being the most important asset to man after the brain, any injury to the hands can cause lasting consequences. The importance of gross and fine motor skills of hands can hardly be stressed upon. The cases although common in a general scenario are not easily managed onboard a mobile platform with limited resources in terms of expertise, equipment, and manpower. In this case series, we describe the management of five injuries which took place onboard an aircraft carrier during sailing over a period of 9 months.
Artificial Intelligence in Health Care – A Study on Perceptions of and Readiness for Artificial Intelligence in Health-care Professionals
Authors: Tezpal Manvinder , Ghosh Subhodeep , Lalwani Radhika , Yadav Jyoti , Yadav Arun Kumar
Published: March 2024

Background:

With a call to action from the health-care industry and the Indian government, there are significant gaps in health-care professionals’ uptake and utilization of artificial intelligence (AI)-based tools. This study attempts to explore the current perceptions and readiness for AI among health-care workers.

Methods:

A web-based questionnaire comprising seven sections on descriptive educational and occupational data, AI familiarity level, role-specific training benefits, training advantages, implementation issues, driving factors, and perceived risks was designed from a literature search. Two additional domains of perception on professional impact and preparedness for AI in health care were estimated using a prevalidated Shinners AI Perception tool.

Results:

Of the 402 study participants, 192 (47.9%) were doctors from diverse specializations, and the remaining 209 (52.1%) were undergraduate medical and nursing students and affiliated health professionals. Although 79.8% of participants had never attended a course on AI, 82% agreed on the need for training in AI to explore new opportunities in their respective fields. 72.1% of participants agreed that data privacy and confidentiality posed the most significant challenge to AI implementation among the studied factors.

Conclusion:

This survey reveals awareness regarding AI, which is attributable to a lack of formal training received by health-care professionals. Most participants believed that AI could improve population health outcomes, and collective efforts are needed to make this belief a reality.
Cultural Competency Training in Medical Education: Adopting a Multipronged Approach to Overcome Challenges
Authors: Shrivastava Saurabh RamBihariLal , Bobhate Prateek Sudhakar , Mendhe Harshal Gajanan , Tiwade Yugeshwari R
Published: March 2024

The domain of cultural competency in medical education deals with the varied cultural backgrounds and specific needs of different patients who are accessing health-care delivery services. The training in cultural competency imparted to medical students augments their knowledge and makes them aware of the presence and role of cultural, ethnic, and socioeconomic diversity in heterogeneous population groups. It is quite essential that training of medical students to become culturally competent must be conducted across all professional years of training in a longitudinal manner. Even though there are multiple benefits of training medical students in the domain of cultural competency, once we plan and implement such training, there can be multiple challenges. In conclusion, as medical education continues to evolve to meet the health-related needs of diverse population groups, cultural competency has to be acknowledged as one of the foundational pillars in empowering future cohorts of health-care professionals to deliver inclusive and culturally sensitive patient-centered medical care. The need of the hour is to identify the potential challenges in its successful implementation and then adopt a multipronged approach to effectively respond to them.
Invasive fungal disease in children with viral pneumonia in pediatric intensive care unit in a tertiary care center from Eastern India
Authors: Saha Sayantika , Chowdhury Pooja , Meur Saumen , Dutta Monideepa
Published: March 2024

Background:

Invasive fungal disease is common in immunocompromised children, although rare in children suffering from viral pneumonia. Recently, it was our observation that a large number of children who were otherwise normal were suffering from invasive fungal disease along with viral pneumonia. The aim of our study is to determine the epidemiological and clinical profile of fungal infection in children suffering from viral pneumonia.

Subjects and Methods:

It was a retrospective study of medical records of children between January 2023 and March 2023 from pediatric intensive care unit (PICU) tertiary care hospital from Eastern India. Children with suspected fungal disease as per inclusion criteria were included in the study. A total of 27 patients were enrolled in this study. The serum galactomannan and beta-D-glucan (BDG) were measured. Clinical profile and outcome were compared between children with and without invasive fungal disease.

Results:

Out of 27 subjects, 16 (59%) had invasive fungal disease. All had adenovirus pneumonia. Seven (4.44%) had acute respiratory distress syndrome while four (25%) had shock and multiple organ dysfunction syndrome each. The duration of mechanical ventilation (P = 0.01), duration of PICU stay (P = 0.02), and duration of hospital stay (P = 0.004) were significantly higher in children with invasive fungal disease. These children had significantly higher rates of complications (P = 0.001) and higher mortality (P = 0.04).

Conclusions:

The serum galactomannan and BDG can diagnose invasive fungal disease in patients of viral pneumonia with persistent symptoms for more than 2 weeks. The invasive fungal disease is associated with higher morbidity and mortality in these children.
Challenges of physiotherapy service on a patient with cystic fibrosis and severe pulmonary exacerbation and put on extracorporeal membrane oxygenation: A case report
Authors: Chan Mei Yee Raphael , Hui Wai Wai , Lam Joanna , Leung Karen K. Y.
Published: March 2024

A 14-year-old male with cystic fibrosis (CF) and severe pulmonary exacerbation was put on venovenous extracorporeal membrane oxygenation (VV-ECMO) and mechanical ventilator. This case report is to share the challenges and vigilant care on service delivery of physiotherapy services faced and gone through at a pediatric intensive care unit of a quaternary care children’s hospital. Sputum clearance technique was provided in the coexistence of VV-ECMO and mechanical ventilator. Inspiratory muscle training and physical rehabilitation commenced at the phase of progressive weaning from noninvasive ventilation. The total intervention duration was 40 days; the lung sound and chest X-ray were cleared up, and the physical tolerance was improved to walking with light assistance. Airway clearance and physical rehabilitation in CF on VV-ECMO are achievable with alertness and alternatives with careful observance. Although ECMO may hinder the efficacy of sputum clearance, cautious and safe-guarded physiotherapy techniques can influence outcomes.
Artificial Intelligence in Early Diagnosis of Preeclampsia
Authors: Bülez A , Hansu K , Çağan ES , Şahin AR , Dokumacı HÖ
Published: March 2024

Background:

Every day, 810 women die of preventable causes related to pregnancy and childbirth worldwide, and preeclampsia is among the top three causes of maternal deaths.

Aim:

To develop a diagnostic system with artificial intelligence for the early diagnosis of preeclampsia.

Methods:

This retrospective study included pregnant women who were screened for the inclusion criteria on the hospital’s database, and the sample consisted of the data of 1158 pregnant women diagnosed with preeclampsia and 9194 pregnant women who were not diagnosed with preeclampsia at Kahramanmaras Necip Fazıl City Hospital Gynecology and Pediatrics Additional Service Building, Kahramanmaras/Turkey. The statistical analysis was performed using the Statistical Package for social sciences (SPSS) version 22 for windows. Artificial intelligence models were created using Python, scikit-learn, and TensorFlow.

Results:

The model achieved 73.7% sensitivity (95% confidence interval (CI): 70.2%–77.1%) and 92.7% specificity (95% CI: 91.7%–93.6%) on the test set. Furthermore, the model had 90.6% accuracy (95% CI: 90.1% - 91.1%) and an area under the curve (AUC) value of 0.832 (95% CI: 0.818-0.846). The significant parameters in predicting preeclampsia in the model were hemoglobin (HGB), age, aspartate transaminase level (AST), alanine transferase level (ALT), and the blood group.

Conclusion:

Artificial intelligence is effective in the prediction and diagnosis of preeclampsia.
Nonalcoholic Fatty Liver Disease and Associated Risk Factors in Obese Nigerians: A Cross-Sectional Study
Authors: Onyia CP , Asogwa P , Adiri W , Obienu O , Ijoma UN , Nwokediuko SC , Okeke EN
Published: March 2024

Background:

Nonalcoholic fatty liver disease (NAFLD) is now adjudged the most common liver disease in the world, contributing to the rising incidence of hepatocellular carcinoma worldwide. However, the true prevalence of nonalcoholic fatty liver disease among obese individuals and its contribution to the burden of liver disease in Nigeria is unknown.

Aim:

To determine the prevalence of nonalcoholic fatty liver disease and associated risk factors in obese subjects.

Methods:

This was a cross-sectional analytical study of 280 obese subjects and 280 nonobese age and sex-matched controls seen at our health facility. Data collection was done using an interviewer-administered questionnaire and anthropometric parameters were obtained. Fasting blood samples were collected for blood glucose, lipid profile, and liver biochemistry. Abdominal ultrasound was used to screen for NAFLD. The results were subjected to relevant statistical analysis using SPSS version 20.

Results:

A higher prevalence of NAFLD was found in obese subjects, compared with nonobese controls (36.4% versus 0.4% P < 0.001). The degree of obesity, transaminases, total cholesterol, diastolic hypertension, fasting blood glucose, and waist circumference was significantly associated with a higher prevalence of NAFLD. However, using multivariate logistic regression analysis, diabetes mellitus and hypertension were significant associations for NAFLD. Individuals with NAFLD had a significantly higher prevalence of metabolic syndrome 65.9%, compared with 34.1% in obese individuals without NAFLD (P < 0.001).

Conclusion:

The prevalence of NAFLD in obese subjects was significant. NAFLD in obese subjects was associated with degree of obesity, hyperlipidemia, hypertension, and diabetes mellitus.
Are the GLIM Criteria Guiding in the Course of Hematological Malignancies?
Authors: Yilmaz F , Aras MR , Ozturk HBA , Sahin HN , Gunes AK , Albayrak M
Published: March 2024

Background:

Different degrees of malnutrition are seen in patients with hematological malignancies. None of the approaches used to determine malnutrition risk have general acceptance. The use of the GLIM criteria developed by the Global Leadership Initiative on Malnutrition has promising results.

Materials and Methods:

A total of 67 patients with leukemia, lymphoma, and multiple myeloma were included in the study. NRS-2002 (Nutritional Risk Screening—2002) was used to screen the nutritional status of the patients, and malnutrition was diagnosed and graded using the GLIM criteria in patients who were found to be at risk of malnutrition in this test. The parameters followed in the groups with and without malnutrition were compared. The Kolmogorov–Smirnov, Mann–Whitney U, and Chi-square test were used for statistical analysis.

Results:

Patients were analyzed by dividing them into two groups as those with and without malnutrition. The presence of infection, duration of fever, antibiotic, and antifungal use were significantly higher in malnourished than in nonmalnourished patients. Platelet counts and sodium levels were significantly lower in the malnourished arm.

Conclusion:

Early nutritional support can increase the immunological status of patients with malignant disorders as well as their tolerability to treatment. Minimizing the risk of malnutrition and providing timely calorie and vitamin support are factors that may directly affect febrile neutropenia, duration of fever, and antifungal use, which will consequently lead to a decrease in the length of hospitalization.
Diagnostic and Prognostic Value of Pentraxin 3, Interleukin-6, CRP, and Procalcitonin Levels in Patients with Sepsis and Septic Shock
Authors: Palalıoğlu B , Erdoğan S , Atay G , Tugrul HC , Özer ÖF
Published: March 2024

Introduction and Purpose:

In this prospective study, we aim to evaluate the effects of antibiotherapy on pentraxin-3 (PTX3), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in patients with sepsis and septic shock.

Materials and Methods:

In our study, CRP, procalcitonin, IL-6, and PTX3 levels at initial and 48 hours of the antibiotherapy of patients who were admitted to the pediatric intensive care unit (PICU) with the diagnosis of sepsis and septic shock between June 2020 and March 2021 were compared. Patients were compared with the age-appropriate case-control group formed from the patients who received pre-operative routines to investigate the diagnostic value.

Results:

CRP, IL-6, and PTX3 levels of the patients were significantly higher compared to controls (P < 0.05). After the 48th hour of treatment compared to initial CRP, lactate and PCT levels were significantly lower (P < 0.05). The IL-6 and PCT levels were significantly higher in patients with mortality than in surviving patients. Surviving patients showed a significant decrease in CRP level at the 48th hour. IL-6 levels of patients with septic shock were significantly higher than those with sepsis (P = 0.010; P < 0.05). In the diagnosis of septic shock, the area under curve was 0.785 for IL-6 and the standard deviation was 0.09 (P = 0.002, cut-off value, >32 pg/mL, 88.9% sensitivity, 65.6% specifity).

Conclusion:

The results of this study indicated that IL-6 level is an appropriate biomarker with high specificity in the diagnosis of sepsis and septic shock and in evaluating the response to treatment and determining the prognosis.
Vitamin D Attenuates Cardiac Hypertrophy in Rats through mRNA Regulation of Interleukin-6 and Its Receptor
Authors: Nikkholgh Ahad , Tavakoli Fatemeh , Alborzi Nasrin , Araste Fatemeh
Published: March 2024

Context:

Interleukin-6 (IL-6), a pro-inflammatory cytokine, plays an important role in the pathogenesis of myocardial hypertrophy. By integrating its membrane receptor complex (gp80), IL-6 activates the signal guidance components (gp130) and activates the hypertrophic signaling pathways. There is some evidence that 1,25 dihydroxyvitamin D exerts antihypertrophic effects, but the cellular and molecular mechanisms are not fully understood. The aim of this study was to evaluate the effect of calcitriol on the level of IL-6 and its receptor components in hypertrophied rat heart.

Subjects and Methods:

Male rats were divided into control, hypertrophy, Vitamin D + hypertrophy, and propylene glycol + hypertrophy groups. The groups receiving Vitamin D and propylene glycol were treated 2 weeks before induction of hypertrophy and 2 weeks after hypertrophy. Myocardial hypertrophy was induced by abdominal aortic stenosis. Mean arterial blood pressure was measured by cannulation of the left carotid artery, and expression of genes was determined by reverse transcription-polymerase chain reaction.

Results:

Blood pressure and heart-to-body weight ratio increased in hypertrophic groups compared to the control group (P < 0.01), but Vitamin D administration decreased these parameters (P < 0.05). Abdominal aortic stenosis increased IL-6 expression levels (P < 0.001) and Vitamin-D decreased IL-6 mRNA levels (P < 0.01). The expression of gp80 in the hypertrophic group increased compared to the control group (P < 0.05), but Vitamin D did not affect the expression of receptor subunits genes.

Conclusions:

The data from this study suggest a possible mechanism for the antihypertrophic effects of Vitamin D through the regulation of inflammatory responses during hypertrophy. Thus, Vitamin D can reduce IL-6 expression levels, thereby reducing hypertrophy.
Chronic Pain Management in a CYP2D6 Poor Metabolizer: A Case Report for Oxycodone
Authors: Pednekar Deepa , Russell Joshua , Bardolia Chandni , Thacker David , Amin Nishita Shah
Published: March 2024

The objective of this case report is to illustrate pharmacogenomics (PGx)-guided oxycodone treatment, given the conflicting data on the analgesic response from oxycodone in Cytochrome P450 (CYP)2D6 poor metabolizers (PMs). PGx-guided therapy can help improve treatment outcomes. This
case report describes a 58-year-old patient who was prescribed oxycodone for chronic pain management. The patient presented with a history of inadequate pain control despite analgesic treatment with oxycodone (morphine milliequivalent [MME] = 22.5). Pharmacogenetic testing revealed that the
patient was a CYP2D6 Poor Metabolizer (PM), which may shed light on the observed lack of analgesic response to oxycodone. The clinical pharmacist recommended switching to an alternative opioid not metabolized via the CYP2D6 pathway. The patient was subsequently switched to hydromorphone (MME
= 16), resulting in improved pain control and fewer side effects. The newer hydromorphone dose accounted for a 30% MME dose reduction. The patient’s initial average and worst pain score were 7 and 9 out of 10, respectively, per the numeric rating scale (NRS). Upon follow-up with the
patient in two weeks, her average and worst pain scores improved to 3 and 3.5 out of 10, respectively, per the NRS. Further PGx testing results led to an overall positive outcome, such as her willingness to participate in physical therapy as a result of improved pain scores. This case highlights
the importance of considering individual variability in drug metabolism when prescribing medications, particularly opioids such as oxycodone, to ensure optimal therapeutic outcomes and minimize the risk of adverse events in CYP2D6 PMs.
Nodal quintic surfaces and lines on cubic fourfolds (with an appendix by John Christian Ottem)
Authors: Huybrechts Daniel
Published: March 2024

We study nodal quintic surfaces with an even set of

16

nodes as analogues of singular Kummer surfaces. The interpretation of the natural double cover of an even

16

-nodal quintic as a certain Fano variety of lines could be viewed as a replacement for the additive structure of the cover of a singular Kummer surface by its associated abelian surface. Most of the results in this article can be seen as refinements of known facts and our arguments rely heavily on techniques developed by Beauville (1979), Murre (1972), and Voisin (1986), Results due to Shen (2012, 2014) are particularly close to some of the statements. In this sense, the text is mostly expository (but with complete proofs), although our arguments often differ substantially from the original sources.
Taste loss in COVID-19 – psychophysical evidence supporting a low prevalence
Authors: Hintschich C A , Le Bon S , Trecca E , Saussez S , Hummel T
Published: March 2024

Much – possibly even too much – has been published about chemosensory dysfunction as a consequence of COVID-19. Studies have reported prevalence of taste loss in up to 89.9% (1), which is in a similar range as COVID-19 related smell loss. However, most of these publications rely solely on patients’ self-reports. Only few studies used validated psychophysical tests to specifically address olfaction and gustation. Especially for gustation, it is evident that subjective reporting does not correlate well with more objective psychophysical findings, often leading to an overestimation of subjectively impaired taste.