bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine Learning for Healthcare Fraud Detection
Authors: Alam Md Shoaib , Rai Pankaj , Tiwari Rajesh Kumar
Published: December 2024

The paper presents a comprehensive literature review on the application of machine learning for healthcare fraud detection. It analyzes studies published that employ various machine learning algorithms to detect different types of healthcare fraud, including billing fraud, prescription fraud, and identity theft. The review examines the datasets used in prior studies, considering their sources, size, and characteristics and how these impact the effectiveness of machine learning models. It also discusses feature selection and engineering techniques used to enhance model performance. Potential future research directions are identified including incorporating deep learning, leveraging explainable AI to improve interpretability, addressing privacy concerns, and integrating domain knowledge to improve accuracy of fraud detection. In summary, this review provides an overview of existing literature on using machine learning for healthcare fraud detection, highlights key challenges, and suggests opportunities for advancing research in this important area of healthcare fraud prevention.
Future of Blue-Green Cities Emerging Trends and Innovations in iCloud Infrastructure
Authors: Aragani Venu Madhav , Maroju Praveen Kumar
Published: December 2024

The future of urban development is increasingly focused on the integration of blue-green infrastructure, which combines natural and engineered systems to enhance urban resilience, sustainability, and livability. This paper explores emerging trends and innovations in blue-green cities, emphasizing the critical role of cloud infrastructure in supporting these initiatives. By leveraging cloud-based technologies, municipalities can improve data management, facilitate real-time monitoring, and enable collaborative decision-making processes. This study analyzes the potential of smart water management systems, green spaces, and AI-driven analytics to create adaptive urban environments. Furthermore, it discusses the challenges and opportunities associated with implementing cloud infrastructure in blue-green city projects. Ultimately, the findings aim to provide insights for urban planners, policymakers, and researchers interested in shaping sustainable urban futures.
Integrating Green Infrastructure With AI-Driven Dynamic Workload Optimization
Authors: Vemulapalli Gopichand , Pulivarthy Padmaja
Published: December 2024

The integration of green infrastructure with AI-driven dynamic workload optimization offers a transformative approach to sustainable technology design, specifically within the fields of network and chip architecture. As the demand for energy-efficient systems continues to rise, this chapter explores the potential of leveraging artificial intelligence (AI) to dynamically optimize workloads, reducing power consumption and enhancing system performance. Through a detailed analysis of network and chip design principles, we investigate how AI can autonomously manage energy flows, predict workload variations, and redistribute tasks to improve efficiency. The chapter also highlights the role of green infrastructure in reducing the environmental footprint of modern computing systems, emphasizing the need for sustainable approaches in both hardware and software development. By integrating AI-driven optimization techniques with environmentally-conscious infrastructure design, this research aims to pave the way for next-generation, low-power, high-performance systems that balance performance with sustainability.
Urban Development Challenges and the Role of Cloud AI-Powered Blue-Green Solutions
Authors: Mudunuri Lakshmi Narasimha Raju , Attaluri Vivekchowdary
Published: December 2024

Urban areas are increasingly facing challenges such as rapid population growth, environmental degradation, and climate change, necessitating innovative solutions for sustainable development. This paper explores the role of cloud-based artificial intelligence (AI) in promoting blue-green solutions that integrate natural and engineered systems to enhance urban resilience. By leveraging cloud computing, urban planners and decision-makers can analyze vast datasets, simulate environmental scenarios, and optimize resource management. The study highlights successful case studies where AI-driven blue-green interventions have improved water management, enhanced green spaces, and mitigated urban heat effects. Furthermore, it discusses the collaborative potential of cloud AI in fostering stakeholder engagement and participatory governance. The findings suggest that adopting cloud AI-powered blue-green solutions is crucial for addressing urban development challenges and promoting sustainable, livable cities.
AI (Artificial Intelligence) Integration for Integrity Ethics and Privacy in AI-Driven Organizations
Authors: Karthikeyan C.
Published: December 2024

As India rapidly advances in artificial intelligence (AI), the need for robust ethical frameworks and comprehensive data privacy measures has become increasingly critical. This paper explores the current landscape of AI ethics and privacy concerns within India, highlighting key developments such as the implementation of the Personal Data Protection Bill (PDPB) and various state-level initiatives like the Karnataka AI Policy 2023. It examines how these efforts align with global standards and address emerging challenges in the digital age. The chapter also contrasts India's approach with those of other developing nations, showcasing the unique hurdles and strategies employed. The disparateness and the importance of strengthening regulatory frameworks, promoting ethical AI practices, enhancing public awareness, and fostering international collaboration.
The Impact and Consequences of Artificial Intelligence in Copywriting
Authors: Provasi Veronica , Duarte Alexandre
Published: December 2024

The implications of artificial intelligence (AI) on content creation, especially the impact on copywriting remain little explored in Academia. This article aims to determine the ability of social media users to distinguish AI-generated content from human-crafted prose. Using a mixed methodology, this study combines qualitative insights from a focus group, with quantitative data (n=514) from an online experiment. Results indicate a discord in discernment skill based on the specific content pairs presented, with no overarching consensus on AI's detectability. This signifies how AI can be recognized if used by inexperienced hands, but it cannot if used correctly as a tool. The study revealed that participants consistently underestimated AI's capabilities, highlighting a gap between perceived and actual discernment abilities, and showing that participants with a writing background demonstrated a higher accuracy rate. This research emphasizes the need for a holistic understanding that integrates the technological prowess of AI and the intricate human factors influencing content perception
Novel Presentation of Type 1 Wolfram Syndrome as Intracranial Hemorrhage and Longitudinally Extensive Transverse Myelitis: Neuroimaging and Angiographic Findings
Authors: Singh Ravi P , Jayanth SS , Seetam KT , Holla Vikram V , Arvinda HR , Netravathi M
Published: December 2024

Wolfram syndrome (WS), a rare genetic neurodegenerative condition, is primarily characterized by diabetes mellitus, optic atrophy, diabetes insipidus, and sensorineural hearing loss, along with diverse systemic manifestations. Late-stage cases exhibit widespread brain atrophy. While bleeding tendencies are not commonly observed in Type 2 WS (WS2), there is a distinctive bleeding tendency that is exclusive to WS2, with no documented occurrences in Type 1 WS (WS1). Extensive documentation exists regarding various neurologic manifestations of this syndrome; however, as of now, there is no reported mention of intracranial hemorrhage, a rarity within this condition.
Spectrum of Pediatric Brain Tumors in a Tertiary Care Hospital in Kerala, India: A 5-Year Study
Authors: Sekar Nivetha , Bindhu M. R. , Udayakumaran Suhas
Published: December 2024

Background:

Pediatric brain tumors include a spectrum of tumors that differ from their adult counterparts in location and biological behavior. It is also one of the most common causes of solid childhood cancer, being second only to hematological cancers.

Aims and Objectives:

We aim to study the distribution of pediatric brain tumors in a tertiary care hospital and their incidences according to age, gender, anatomical location, and histological types.

Material and Methods:

This is a retrospective analysis of the spectrum of pediatric brain tumors for a period of 5 years (January 2017–December 2021) in a tertiary care hospital in Kerala, India. A total of 111 children from the age of 0–18 years with histopathologically proven brain tumor diagnosis during the 5 years were included for the analysis.

Results:

The results showed that a total of 111 children had histologically proven brain tumors during the 5 years. Males had slightly more preponderance compared with females (59 boys and 52 girls). Infratentorial lesions were more common [59 (53.1%)]. The distribution in different age groups is as follows (1) 0–5 years—29 (26.1%), (2) 6–10 years—34 (30.6%), and (3) 11–18 years—48 (43.2%). Overall astrocytoma is the most common pediatric brain tumor [29 (26.1%)].

Conclusions:

The study concluded that the pediatric brain tumors showed a slightly more male preponderance, infratentorial lesions were more common. Overall astrocytoma was the most common type of brain tumor.
Early Integration of Palliative Care into Oncology Practice: Is It Still a Mirage?
Authors: Rajashree Kattil Chittazhathu , Anupama Sasidharan
Published: December 2024

For over a decade, “early integration” has become a slogan in the palliative care (PC) community. The care of cancer patients requires improvement, and the studies on the early integration of PC reveal its deficits in the oncological practice. Unmet needs in physical, psychological, spiritual, or social care need to be addressed. A “collusion of hope” in cancer treatment delays appropriate end-of-life care and complicates bereavement. Communicating prognosis and comprehending survival and discussion on measures to enhance the quality of life frequently do not occur simultaneously. Early collaboration between an oncologist and a PC specialist for those with advanced cancer improves symptoms and reduces aggressive cancer care at the end of life without shortening survival. Within the changing care environment and increasing time limitations, the multidimensional needs of a patient on therapy for advanced cancer will increase. A holistic approach to the patient and the family hence requires a multi-professional team. Consensus around palliative quality indicators is in its infancy and is often governed by cost-effectiveness. This is a real crunch for already resource-poor settings.
Practice of Breast Self-Exam and Awareness of Breast Cancer Among Rural Women in Ernakulam District, Kerala: A Cross-Sectional Study
Authors: Saju Basil , Bhaskaran Renjitha , George Sobha
Published: December 2024

Background:

Breast cancer is the most common malignancy affecting women worldwide. In India, breast cancer is now the most common cancer among women, accounting for 28% of all cancers. Despite good health indicators, breast cancer is a public health problem in Kerala with an annual incidence of 14.9/100,000 population. This study aims to estimate the proportion of women who practice breast self-exam (BSE) in rural areas of Ernakulam district and to assess the awareness of breast cancer in the same community.

Materials and Methods:

A community-based cross-sectional study was conducted in rural areas of Ernakulam district, among 267 females aged 20 to 70 years, selected by cluster sampling. After obtaining consent from the participants, data were collected using a pretested, self-designed semi-structured questionnaire.

Results:

Among the 267 study participants, 57.7% practice BSE. Among those respondents practicing BSE, only 16.9% practice it regularly at monthly intervals, 49.1% of the respondents had good knowledge on the practice of BSE, and 57.3% of the respondents had good awareness on breast cancer. Education, Occupation, and Socioeconomic status was associated with knowledge on practices of BSE and awareness of breast cancer with P value of <0.05. There was a correlation between knowledge on practice of BSE and awareness of breast cancer.

Conclusion:

The regular practice of BSE is very low, though the knowledge of BSE scored Good in nearly half of the respondents. Educational programs stressing on the importance of regular practice of BSE are the need of the hour.
Knowledge About Breast Cancer and Screening Practices Among Women Aged 35 Years and Above in Tirupati District, Andhra Pradesh, India
Authors: Ayesha Palagiri , Ajay Aparna , Francis Paul T.
Published: December 2024

Background:

Breast cancer is one of the most prevalent cancers among women, with an increasing incidence, particularly in developing countries. Early detection is key to improving outcomes and reducing mortality.

Objective:

We aimed to assess the knowledge about breast cancer and screening practices among women aged 35 years and above in Tirupati and to identify the sociodemographic factors associated with their knowledge and screening practices.

Materials and Methods:

A cross-sectional study was conducted among women aged 35 years and above in Tirupati using cluster sampling. Data were collected using a pretested questionnaire on sociodemographics, breast cancer knowledge, and screening practices through house-to-house visits. The data were analyzed using SPSS version 21.

Results:

A total of 199 women participated in the study. About 58 (29.1%) had good knowledge about breast cancer, while only 22 (11.1%) had good knowledge regarding screening practices. Univariate analysis indicated that education was significantly associated with breast cancer knowledge (P < 0.05).

Conclusion:

The study revealed a significant lack of knowledge about breast cancer and screening practices among the participants. Education played a key role in improving knowledge levels. Efforts must be directed toward health education to improve the awareness and screening practices among women in Tirupati.
Cancer Epidemiology and Cancer Care: Transforming the Landscape
Authors: Moidu Mufeeda , Sasidharan Navami , Mohandas Sreelakshmi , Krishna Sathish Kumar , Song Yao , Kannan Ravi , Sreedevi Aswathy , Gouri Balagopal Prabhakar , George Paul
Published: December 2024

Cancer poses the highest clinical, social, and economic burden in terms of cause-specific disability-adjusted life years. Between 30% and 50% of these cancers can currently be prevented by avoiding risk factors and implementing existing evidence-based prevention strategies. The 6th Amrita International Public Health Conference centered around the theme of “Advancing Public Health Strategies for Cancer Control.” It was a holistic approach toward discussing explicit stratagems for cancer control. The objective of this study is to document the important discussions in the trends of cancer epidemiology with a special focus on molecular epidemiology and digital technologies for screening. A model for improving the accessibility and affordability of cancer care in India is also highlighted by experts.
Reasons of Hospitalization of Subjects with Type 2 Diabetes Compared to Non-diabetes General People: Experience from a Medical College Hospital of Dhaka City
Authors: Hasan Md Rakibul , Haque Parinda Tusmee , Munira Mahbuba , Bithi Tonima Islam , Karim Rezwana , Alam Mohammad Fakhrul , Kader M. A. , Mithila Maysha Ferdous
Published: December 2024

Context:

Diabetes is one of the most common comorbidities among hospitalized patients; however, reasons of hospitalization among diabetes patients are not well studied in Bangladesh.

Aims:

The aim of this study was to determine the reasons of hospitalization among subjects with type 2 diabetes.

Materials and Methods:

This cross-section study was done among the patients who got admitted in the general medicine ward from June 2022 to May 2024. Samples were collected by consecutive convenient sampling. Patients, who got admitted with epidemic diseases, e.g., dengue fever and COVID-19 infections, were excluded from the study. Finally, we used data of 504 patients for analysis using SPSS version 23.0.

Results:

Infection is the most common cause of hospitalization for both diabetic and nondiabetic patients, though it was a little bit higher in the nondiabetes group (52.6% vs. 65.7%; P = 0.003). Among the infectious causes, genitourinary tract infection (54.9% vs. 29.7%; P < 0.0001) and respiratory tract infection (RTI) (24.8% vs. 21.8%; P < 0.0001) are most common for both groups and significantly more common among diabetes patients. Among the noninfectious causes of hospitalization, diabetes and its complications along with other endocrine diseases was the most common (19.2%), whereas gastrointestinal disease was the most common (30.2%) cause for hospitalization in the nondiabetes group. We also observed a significantly high frequency of hypertension, renal dysfunction, cardiovascular disease, and hypothyroidism in the diabetes group.

Conclusion:

Infection is the major cause of hospitalization for both diabetes and nondiabetes subjects. Genitourinary tract and RTI are the major forms of infection during hospitalization in diabetes subjects.
Exploring Choroidal Masses: A Comprehensive Guide
Authors: Raj Pragati , Kumar Roshan , Rajan Aditya , Kant Dev
Published: December 2024

Choroidal osteoma is a rare benign ossifying tumor that is generally a unilateral condition in the juxtapapillary and macular area. There are multiple choroidal conditions that could remain asymptomatic and identified as an incidental finding during regular checkup, like choroidal osteoma, choroidal hemangioma, choroidal melanoma, choroidal nevus, and choroidal metastasis. We carried out a number of investigations for making a distinguished diagnosis, such as B-scan, optical coherence tomography, FFA/ICGA, and sometimes X-ray/CT-scan other than clinical examination. We hereby report a case of choroidal osteoma in a 48-year-old relatively asymptomatic female and describe an approach to differentiate similar clinical entities of the choroid.
Comparative Efficacy of Cyclosporine 0.1% and Sodium Hyaluronate 0.1% in Moderate-to-Severe Dry Eyes
Authors: Agrawal Vironika , Kumar Nishant , Shahnawaz Asif
Published: December 2024

Background:

Dry eye disease (DED) is accompanied by hyperosmolarity of the tear film and inflammation of the ocular surface, which in the long term is responsible for loss of goblet cells, instability of the tear film, and disturbed mucin expression.

Aim:

We aimed to compare the efficacy of sodium hyaluronate (HA) 0.1% and cyclosporine 0.1% in treating moderate-to-severe DED in terms of ocular surface disease index (OSDI) score, tear film breakup time, and Schirmer’s test.

Settings and Design:

Hospital-based, randomized clinical trial.

Materials and Methods:

The study consisted of 90 patients with moderate-to-severe dry eye condition allotted to two groups A and B to receive either cyclosporine 0.1% twice or HA 0.1% thrice for a 6-month duration. In the first 4 weeks, these drugs were given along with carboxymethyl cellulose (0.5%) four times. OSDI, Schirmer’s test, and tear breakup time (TBUT) were performed at baseline visit and at 6 weeks, 3 months, and 6 months of treatment.

Results:

In the primary analysis, the mean change from baseline in TBUT, Schirmer’s, and OSDI score was increased in both the groups (P < 0.05), although no significant intergroup differences were observed at weeks 6 and 12. However, all these tests in the 0.1% cyclosporine group showed a significant tendency for better improvement at 6 months compared with the other group (P < 0.05). No serious adverse events were observed.

Conclusion:

Both cyclosporine 0.1% and HA 0.1% are effective in treating moderate-to-severe dry eye conditions, but comparatively, cyclosporine is superior than HA in the long run.
Idiopathic CNVM in a Young Female: A Chronological Case Study of Ranibizumab Biosimilars Efficacy Using OCT Angiography
Authors: Kumar Nilesh , Singh Kanhaiya , Sharma Ashish
Published: December 2024

Idiopathic choroidal neovascular membranes (CNVM) represent a rare, vision-threatening condition in young individuals without identifiable predisposing factors. The pathogenesis involves disruptions in angiogenic balance, leading to abnormal blood vessel growth in the subretinal space. Diagnosis hinges on imaging techniques such as optical coherence tomography angiography (OCTA), which provides a non-invasive alternative to fluorescein angiography.

This case report highlights the successful treatment of a 21-year-old female with idiopathic CNVM using a ranibizumab biosimilar. The patient presented with sudden metamorphopsia and visual disturbances. Initial imaging confirmed CNVM with associated subretinal and intraretinal fluid. Following three intravitreal injections of the biosimilar, substantial improvement in visual acuity and lesion size was documented using OCTA. The treatment demonstrated the biosimilar's efficacy and cost-effectiveness, enhancing accessibility for long-term therapy.

The report underscores the critical role of OCTA in diagnosis and monitoring, emphasizing the utility of biosimilars in expanding therapeutic options for retinal diseases. This case validates the safety and effectiveness of biosimilars for conditions beyond their approved indications, encouraging broader adoption in clinical practice.
A retrospective record-based study to evaluate the profile of TB patients diagnosed and registered at DOTS center at the tertiary care center and to study the gaps in the implementation of the latest guidelines toward TB elimination
Authors: Arora Sachdeva Ruchi , Singh Sahil , Sen MK
Published: December 2024

Context: Tuberculosis (TB) has infected mankind since time immemorial. India has been a breeding ground for this disease due to high population density and lack of awareness and education in the population. It is thus very important to understand the profile of TB patients and to find out the various limitations in the functioning of the National Tuberculosis Elimination Programme in order to focus on strengthening the goal of TB elimination in India. Aim: To describe the demographic profile and clinical characteristics of TB patients enrolled at DOTS Centre between October 2018 and December 2022 at a tertiary care center in North India. Settings and Design: A retrospective record-based study. Materials and Methods: A retrospective record-based study was carried out involving a review of existing data in Nikshay-2, which was accessed from the DOTS center at a tertiary care center in North India. Statistical Analysis Used: The data entry was done in a Microsoft EXCEL spreadsheet and analyzed using the SPSS version 17. Results: Of the total 2689 patients, 1222 (45.4%) were diagnosed with pulmonary TB (PTB) and 1467 (54.6%) with extrapulmonary TB, with most common type of EPTB was lymph node TB in 750 (51.1%) patients. The most common comorbidity was diabetes mellitus in 154 (30.1%) patients. Diagnosis of PTB was made by sputum microscopy in 410 (33.5%), CBNAAT 712 (58.2%), chest X-ray 21 (1.7%), and CT chest in 79 (6.4%) patients. Diagnosis of extra-PTB was made by CBNAAT 145 (9.8%), CT and MRI 190 (12.9%), and by cytopathology in 1132 (77.1%) patients. Outcome of TB patients was cured in 1082 (40.2%), treatment completed 1300 (48.3%), 32 (1.2%) patients died during treatment, 190 (7.1%) lost to follow-up, 2 patient migrated, treatment failed in 5 patients, regimen changed in 6 patients and data were not updated for 41 (1.5%) patients. Conclusion: This study thrusts on intensification of strategies like to improve lab infrastructure, to provide CBNAAT and LPA facilities at all medical colleges and district level, and IEC training to doctors (Interns, Medical officers, specialists), TB health workers and laboratory staff with the latest guidelines, importance of updating Nikshay portal and sensitization of treating physicians and lab personnel to send relevant samples for CBNAAT and LPA testing so as to detect drug-resistant cases on time in order to achieve elimination of disease.
Correlation between invasive and noninvasive oxygen indices in critically ill COVID patients with ARDS: A retrospective analysis
Authors: Choudhury Arin , Singh Meena , Jaswal Amandeep , Mustafi Saurav Mitra , Kohli Santvana
Published: December 2024

Objective: This study aims to evaluate the correlation between peripheral oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) and arterial partial pressure of oxygen (PaO2)/FiO2 ratio in the diagnosis and assessment of severity in acute respiratory distress syndrome (ARDS) patients admitted to intensive care unit (ICU) during the SARS-CoV-2 outbreak. Methods: A retrospective observational study was conducted in patients admitted to COVID-ICU during a 1-year period. Time coinciding values of SpO2 and PaO2 were noted from patients’ medical records. An evaluation was made to judge the efficacy of the SpO2/FiO2 ratio (S/F ratio) for the prediction of 100, 200, 300, and >300 mmHg cutoff values of PaO2/FiO2 ratio (P/F ratio) using receiver operating characteristic (ROC) curves. Results: The medical records of 196 patients were evaluated. A strong positive correlation was identified between P/F and S/F ratios in the sample population (correlation coefficient r = 0.716, p < 0.002). The area under the ROC curve of the S/F ratio was 0.720 (95% confidence interval [CI] 0.637–0.804) for mild ARDS. The optimal S/F threshold was found to be ≤411% (sensitivity and specificity 65% and 80%, respectively). Similarly, the S/F threshold was ≤405% (area under the curve [AUC] 0.781, 95% CI 0.713–0.848, p < 0.000) for moderate ARDS (sensitivity 71.8% and specificity 70.8%), and ≤ 395% (AUC 0.762, 95% CI 0.689–0.835, p < 0.000) for severe ARDS (specificity 73.5% and sensitivity 66.7%). Conclusions: The S/F ratio can be used as a reliable, noninvasive alternative tool for the diagnosis of ARDS and assessment of severity. This can be used as an early warning score in patients admitted in low-resource settings with respiratory illness, and an escalation of care can be decided.
Primary pulmonary adenocarcinoma manifesting as multiple metastatic-like nodules: A detailed case series analysis of two patients
Authors: Trilok Chand , Remya Rajan , Sana Elkhazin
Published: December 2024

Primary pulmonary adenocarcinoma typically presents as diffuse alveolar opacities or mass-forming lesions. However, this study delineates two unique case reports in which patients with a background of persistent dry cough exhibited multiple bilateral pulmonary nodules on radiological imaging. These nodules, initially mimicking metastatic lesions, were ultimately identified as primary lung adenocarcinoma following extensive diagnostic evaluations. This series emphasizes the critical need for thorough diagnostic approaches in identifying atypical presentations of pulmonary adenocarcinoma.
Successful weaning in a patient of post-tubercular sequalae with obstructive airway disease by leak valve
Authors: Chaudhary Kamran , Singh Sahil , Sen Manas Kamal , Shailly  , Jha Mona
Published: December 2024

A leak valve is intended to provide leak ventilation during positive pressure ventilation. This is an important way for patients to experience difficult or prolonged weaning. It is designed with an anti-asphyxia valve to allow for spontaneous breathing and prevent CO2 rebreathing figure 1. It also allows continuous airflow through the vent holes. We report a case of a 22-year-old female patient diagnosed with post-tubercular obstructive airway disease with hypercapnic respiratory failure discharged with tracheostomy with home oxygen and noninvasive ventilation support with leak valve after prolonged weaning in the intensive care unit.
Pulmonary Langerhans cell histiocytosis—an unlikely diagnosis in a nonsmoker with clubbing and concomitant celiac disease: a case report
Authors: Mudda Swaroop Kumar , Bansal Dhruv , Bansal Priya , Sud Ritika , Negi Motilal
Published: December 2024

Pulmonary Langerhans cell histiocytosis (PLCH) is a disease characterized by the infiltration of Langerhans cells into the lungs, affecting young adults with a history of smoking. Spontaneous pneumothorax is a recognized complication of PLCH. We present a case of a 19-year-old male nonsmoker who presented with recurrent pneumothorax, two episodes within a period of one month. Diagnostic workup, including imaging studies and lung biopsy, confirmed the diagnosis of PLCH. This case highlights the importance of considering PLCH in cases of recurrent pneumothorax, even with no history of smoking, and emphasizes the importance of timely diagnosis and management to prevent long-term pulmonary complications.
Incidence of new-onset bronchial asthma in post-COVID patients with persistent respiratory symptoms
Authors: Singh Priyanka , Vasan Amit Singh , Ahuja Nitin Balram , Choudhary Robin , Kumar Kunal , Rana Sandeep
Published: December 2024

Background: The current coronavirus disease 2019 (COVID-19) pandemic is an ongoing global healthcare challenge that has caused morbidity and mortality at unprecedented levels. Studies have estimated that approximately 10% of all patients who have recovered from COVID-19 are suffering from persistent symptoms of cough, dyspnea, and fatigue over months after the acute infection. Many patients reported persistent airway symptoms post-COVID. Since the post-COVID pulmonary complications are evolving and challenging, a study was carried out to assess post-COVID new-onset asthma in adults. Objectives: To assess the incidence of new-onset asthma following COVID-19 in adults. Methods: A prospective observational study including all adult patients admitted or treated on an out patient department (OPD) basis for COVID-19 was carried out. All patients on follow-up who reported with airway symptoms (cough, wheezing, breathlessness, or chest tightness) with no prior diagnosed obstructive/restrictive airway disease were included in the study and followed up for a duration of 01 years. New-onset asthma was diagnosed based on symptomatology and assessed as per Global Initiative for Asthma guidelines. Results: Among 411 patients with airway symptoms post-COVID-19, 9.4% (n = 97) developed new-onset bronchial asthma on follow-up. Conclusion: Asthma in patients’ post-COVID-19 disease is not uncommon, and detailed evaluation and follow-up are instrumental in instituting timely and correct therapy and in providing symptomatic relief to patients.
Factors influencing individualized nursing care in acute medical and perioperative settings: A scoping review
Authors: Ramos Ana , Sá Eunice , Pombo Delmira , Sá Florinda , Ramos Filipe , Bernardo Fernanda , Mira Helena , Lopes Hélder , Santos Paula , Marcão Regina , Gomes Idalina
Published: December 2024

Individualized nursing care addresses the needs, experiences, behaviors, feelings, and perceptions of patients and families, but its implementation in clinical practice contexts remains challenging. This review aims to map the factors that interfere with the individualization of nursing care, in acute medical and perioperative settings. Scoping review was conducted according to the Joanna Briggs Institute guidelines. The MEDLINE, CINAHL, Cochrane, SciELO, Scientific Repository of Open Access, and LILACS databases were searched for publications from January 2017 up to March 2023. Of the 124 articles selected, 17 met the inclusion criteria. The individualization of nursing care is complex and shaped by multiple variables in the care environment, nursing, and patient characteristics. The institutional organization, the nurses’ expertise, and the patient’s attributes were identified as variables that interfere with the individualization of nursing care. Individualized nursing care is responsible for better quality of care and health outcomes. The identification of the variables that affect individualized care contributes to planning programs to improve individualization, during hospitalization and the discharge.
Understanding the concept of health literacy: A strategy to improve nursing practice
Authors: Bello Cecilia Bukola , Akinwale Oladayo Damilola , Elemile Mayowa Grace
Published: December 2024

Health literacy (HL) is an effective approach for improved health status and measures the capacity of individuals to engage in health promotion and disease prevention activities as low HL constitutes a global problem in health-care delivery. Nurses play a significant role in providing adequate information to the client and as such it becomes imperative for them to understand the concept of HL. Clinical approach of HL refers to ability to utilize literacy skills in relation to appointments, prescriptions, and instructions for self-management. Public health approach presents HL as means of empowering individuals to take control of their health and factors that influences health. HL is a hierarchy of skills that can be assessed and managed through health education and effective communication. Nurses’ understanding of the concept of HL and strategies to reduce HL demands is crucial to delivery of effective nursing practice. This review will provide a clear understanding of the concept of HL which is essential for nurses to effectively educate patients and provide holistic care. More so, nurses will be able to assess literacy level of the patients, plan and develop better educational program tailored to patients’ level of literacy. This could invariably improve patients’ comprehension and adherence to treatment plans and overall health outcomes.
Impact of educational interventions on mothers’ awareness and communication with their attention–deficit hyperactivity disorder children
Authors: Alseraty Wafaa Hassan Hassnan , Abdullhameed Sahar Mohamed , Alenezi Atallah
Published: December 2024

Objective:

The objectives of this study are to evaluate the effects of the educational intervention on mothers’ knowledge, awareness, and communication difficulties experienced with their children and mothers’ capacity to successfully interact with their affected child before and after the intervention.

Materials and Methods:

A quasi-experimental research design was used. A total of 30 mothers and their children complaining of attention-deficit hyperactivity disorder from four Dawadmi primary schools were included. Data were collected through a self-developed questionnaire from September 2023 to January 2024 after study acceptance by Shaqra University’s scientific deanship. Intervention prepared according to subjects’ needs and current scientific base and demonstrated in 10 sessions in schools.

Results:

Regarding mothers’ age, more than one-fourth of them (26.7%) ranged from 31 to 35 year old, and about a third (36.7%) had secondary education. Regarding mother’s job, about 76.7% do not work, and the majority of affected children (66.6%) were male, there were significant improvements in mothers’ knowledge pre- and postintervention also a significant improvement in mothers’ awareness about symptoms of poor attention, hyperactivity, and impulsivity pre- and postintervention was found. Significant differences were found before and after the intervention regarding the impact of the intervention in decreasing mothers’ challenges.

Conclusion:

The study hypothesis was accepted, and the intervention improved mothers; knowledge, awareness, and communication challenges. The intervention should be conducted and followed up for a long period of time to manage all mother’s and children’s daily challenges, improve children’s daily activities, and stabilize effective communication patterns between children and their family members.
Significance of Functional Status Scale in decannulation after pediatric tracheostomy: A single-center, retrospective study
Authors: Teplitzky Taylor B. , Randolph Nicholas Paul , Li Ji , Pereira Kevin D. , Gopalakrishnan Mathangi , Holloway Adrian
Published: December 2024

Background:

Metrics to successfully predict pediatric decannulation have been ineffective. The Functional Status Scale (FSS) is a validated pediatric scoring system of functional outcomes. The objective of this study was to evaluate if the FSS over time predicts pediatric tracheostomy decannulation.

Subjects and Methods:

Chart review of patients admitted to the pediatric intensive care unit (PICU) and underwent tracheostomy at a tertiary care children’s hospital from 2010 to 2019. Baseline demographics, comorbidities, tracheostomy indication, decannulation status, and FSS scores were recorded at PICU discharge and 1 and 3 years after tracheostomy. Logistic regression was performed to assess the association of FSS components with decannulation status at 3 years.

Results:

Fifty-three patients met the inclusion criteria. Forty (75.5%) patients had complete data. There were no decannulations at 1 year. Nine (22.5%) patients were decannulated at 3 years. An abnormal 3-year FSS score in the feeding domain was significantly associated with persistent tracheostomy at 3 years, with an odds ratio of 7.4 (95% confidence interval: 1.5–36.6, P = 0.01).

Conclusions:

FSS score can predict decannulation in children discharged from the PICU. This information could modify caregiver expectations and guide rehabilitative efforts.
Nutrition in neonatal and pediatric patients on extracorporeal membrane oxygenation: A survey of current practice in the US and Canada
Authors: Furlong-Dillard Jamie M. , Facciolo Michael D. , Ozment Caroline P. ,   and the Pediatric ECMO (PediECMO) Subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network and Extracorporeal Life Support Organization (ELSO)
Published: December 2024

Background:

Patients requiring extracorporeal membrane oxygenation (ECMO) are at increased risk of malnutrition due to high rates of protein catabolism, unclear metabolic needs, and safety risks with both parenteral and enteral nutrition (EN). Malnourishment is associated with increased morbidity and mortality, and improved EN and protein intake are associated with decreased 60-day mortality. A standardized practice for nutrition therapy in this population is unestablished. We aim to provide an update on current nutritional practices in pediatric and neonatal patients receiving ECMO support.

Subjects and Methods:

An online survey was distributed to ECMO medical directors in the US and Canada who had previously participated in survey-based research and those who requested participation during a pediatric ECMO presentation of this study. Each medical director was asked to forward the survey to their center’s registered dietitians (RDs).

Results:

Of 100 institutions surveyed, 36 physicians and 19 RDs responded yielding a physician response rate of 36% and an RD response rate of 19%. Physicians report “always” providing nutrition parenterally 28% and enterally 17% of the time with 11% of institutions using a protocolized approach. Nutrition therapy aids reduction of morbidity and mortality; however, there is variability in its delivery.

Conclusions:

Compared to 2015, EN is reported to be less utilized (47% vs. 55%) with less protocol use (11% vs. 38%). These data support the need for the development of a stepwise nutritional support algorithm, which is congruent with the recommendations in the Extracorporeal Life Support Organization Nutrition Guidelines.
Successful management of uncommon complication after brachiocephalic vein catheterization: A case report
Authors: Mishra Namita , Qutub Danish , Bhadani Umesh
Published: December 2024

Central venous catheterization is an inextricable requirement in intensive care units, long surgeries, postoperative care, and as a part of malignancy treatment that delivers intravenous fluids, drugs, inotropic agents, and intravenous feeding. Recently, different approaches for brachiocephalic vein cannulation gained interest in children and adults. We aimed to describe the rare complication of pleural effusion occurred after brachiocephalic catheterization and managed the case related to cannulation. We tried to emphasize that great vigilance is required at the time of transferring the patient to prevent the displacement and dislodgement of catheter.
Harmonic Measurement Algorithm of Power System Integrating Wavelet Transform and Deep Learning
Authors: Jiang Hanshu , Li Yutian , Liu Zhu , Wu Guanghao , Liu Zeyang
Published: December 2024

INTRODUCTION: The problem of low accuracy in harmonic measurement is a significant challenge in power systems. Traditional methods often exhibit higher measurement errors, leading to unreliable detection of harmonics. To address this, the author proposes a new approach that integrates wavelet transform and deep learning techniques for enhanced harmonic measurement accuracy.
OBJECTIVES: The primary goal of this study is to develop a more accurate harmonic measurement algorithm by combining full phase fast Fourier transform (FFT) and adaptive neural networks. The research aims to automatically detect power system harmonics with minimal error and improve upon the limitations of traditional methods.
METHODS: The study implemented a harmonic measurement method using full phase FFT integrated with an adaptive neural network. This approach calculates harmonic amplitudes based on the fundamental component and its amplitude, while determining the precise start and end times of harmonics. The system also incorporates mean filtering for automatic detection of harmonics. The effectiveness of the proposed method was evaluated through experiments that compared it to traditional harmonic measurement techniques.
RESULTS: Experimental results demonstrated that the proposed method achieved an average measurement error of 0.02V, with a maximum error of 0.03V, both of which are below the acceptable error limit. In contrast, traditional methods exhibited significantly higher average errors of 3.31V and a maximum error of 5.17V. The new method consistently showed higher accuracy in harmonic detection compared to conventional approaches.
CONCLUSION: The study concludes that the proposed harmonic measurement algorithm significantly improves accuracy compared to traditional methods. With its lower measurement error and effective automatic detection capabilities, the method proves to be highly suitable for harmonic measurement in power systems.
An extension of the Kantorovich inequality to Hilbert spaces
Authors: Roy Saikat , Sain Debmalya
Published: December 2024

By using the singular value decomposition, we present an extension of the famous Kantorovich inequality for a class of operators on Hilbert spaces, including the invertible ones. In particular, this extends the Kantorovich inequality for positive definite matrices due to Greub and Rheinboldt. We also obtain a refinement of the finite-dimensional version of the Kantorovich inequality for invertible operators due to Strang.
A Retrospective Analysis of Strategic Management Practices in Local Government Authorities: Trends, Challenges, and Areas for Improvement
Authors: Pandisha Haghai , Kombe Wilbard , Kayunze Kim
Published: December 2024

This study examines a retrospective analysis of the implementation processes of Strategic Management Practices (SMPs) in Local Government Authorities (LGAs) over the past decade. The study principallyidentifies trends, challenges, and areas for improvement in the implementation of SMPs in LGAs. A comprehensive review of literature and secondary data analysis of LGAs' strategic plans and performance reports were conducted. The findings revealed that LGAs have made significant progress in adopting SMPs, but challenges persist in implementing these practices effectively. The study identifies trends, including the increasing adoption of SMPs, the importance of leadership commitment, and the need for capacity building. Challenges include limited resources, inadequate infrastructure, and lack of stakeholder engagement. Areas for improvement include the need for more effective monitoring and evaluation, better stakeholder engagement, and more robust capacity building programs. The study concludes that SMPs are essential for improving the performance of LGAs, but their effective implementation requires addressing the identified challenges and areas for improvement
Effect of Gender Based-Violence on the Social Well-being of Women in Rwanda. Case Study of Ngoma Sector, Huye District
Authors: Bikorimana Gerald , Bimenyimana Pierre , Esther Niyoyavuze , BAHIZI Marcel , Safari KAMBANDA , Joseph Hahirwa
Published: December 2024

This study examines the impact of gender-based violence (GBV) on the social well-being of women in Rwanda, focusing on the Ngoma Sector in Huye District. Guided by three main objectives, it explores how GBV affects women's social well-being, identifies prevalent forms and causes of GBV, and proposes strategies to address the issue. Using a mixed-methods approach with data collected from 40 women through questionnaires and interviews, the study uncovers various forms of GBV, including intimate partner violence and discriminatory societal norms. Root causes are linked to cultural traditions, economic hardships, and systemic barriers. The research highlights strategies for combating GBV, such as community awareness programs, legal reforms, and economic empowerment initiatives. These measures aim to reduce GBV and improve women's social and economic status. The study concludes by emphasizing the critical link between GBV and women’s social well-being, providing a basis for interventions that promote gender equality, protect women’s rights, and enhance their overall welfare in Rwanda. It offers insights to guide efforts in mitigating GBV in the Ngoma Sector and beyond.
Immune-virological status in people with HIV from naïve to six months on cART at Ahmadu Bello University Teaching Hospital Zaria, Nigeria.
Authors: Aminu Yusuf , Musa Bolanle O.P. , Muktar Haruna M. , Babadoko Aliyu , Mohammed Abdullahi A. , Abdurrahman Ahmad E.
Published: December 2024

The implementation of Combine Antiretroviral Therapy (cART) to treat HIV infection has been an incredible success and has saved millions of lives by improved clinical outcomes. Antiretroviral treatment reduces viremia to undetectable levels in people living with HIV (PLWH) by suppressing viral replication and allowing immune reconstitution. However, ongoing background inflammation continues in most PLWH, despite virological suppression, in particular in those individuals who started cART in the acute phase of infection. In this study, we investigated the plasma viral load of HIV-infected treatment-naive participants at baseline and after six (6) months on treatment. We demonstrated that the plasma viral load of HIV-infected treatment-naive participants at baseline and after six (6) months on treatment were significantly suppressed. Systematic assessment for antiretroviral treatment response is a fundamental aspect in addressing the issues associated with the poor clinical consequence including immunologic failures among HIV-positive patients on cART. We employed quasi-experimental design, where non-probability sampling techniques were used in recruiting thirty-eight (38) cART naive HIV patients up to six (6) months on cART and ten (10) controls. We quantified the plasma HIV RNA using Hologic Panther Platform. The mean ± SD age of the HIV-infected cART naive participants was 36.16 (±8.5) years. Most of the participants were female constituting 68.4% (26/38) of the total number of cases studied. The median and interquartile range (IQR) of the viral load of HIV-infected cART naive participants at baseline and on treatment were 761,420 copies/ml (240794-2704986) and 30 copies/ml (30-30) respectively. The result shows a high percentage of plasma viral suppression in 6 months with viral load 82% (<30 copies/ml) and 18% (≥30 copies/ml) virological failure. This study shows the beneficial effect of immune-virological suppression following the introduction of cART. This may be the reason for the early initiation of cART (test and treat policy) and commitments of the center in terms of counselling, follow-up, and regular assessment.