bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing reading and writing skills of students with learning disabilities through assistive technology: A literature review (2013-2023)
Authors:   Faculty of Science and Arts, Northern Border University, Arar, Saudi Arabia, Alanazi Fahad Enad , Abdulkader Waleed Fathi Abdulkarim ,   Faculty of Science and Arts, Northern Border University, Arar, Saudi Arabia
Published: March 2024

This study explores how assistive technology can help students with learning difficulties improve their reading and writing. It reviews research on the use of assistive technology in primary schools, focusing on reading and writing achievements. We searched six databases with specific criteria and chose studies that matched for further examination. Our findings indicate that students using assistive technology showed notable improvements in reading and writing. Nonetheless, the extent of these improvements varied greatly among the studies. This variation indicates that multiple factors, like the kind of technology used, the amount of support given, and how long the technology is used, can affect how helpful assistive technology is. More research is needed to understand these factors fully and to create and test technologies that are suited to various environments. Despite these variations, the results of our review point towards assistive technology being a beneficial tool for enhancing the reading and writing abilities of students with learning disabilities.
Academic Detailing as a Health Information Technology Implementation Method: Supporting the Design and Implementation of an Emergency Department–Based Clinical Decision Support Tool to Prevent Future Falls
Authors: Barton Hanna J , Maru Apoorva , Leaf Margaret A , Hekman Daniel J , Wiegmann Douglas A , Shah Manish N , Patterson Brian W
Published: March 2024

Background

Clinical decision support (CDS) tools that incorporate machine learning–derived content have the potential to transform clinical care by augmenting clinicians’ expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing—personal visits to clinicians by an expert in a specific health IT tool—as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool’s implementation.

Objective

This study aimed to assess academic detailing as a method for simultaneously ensuring the correct understanding of an emergency department–based CDS tool to prevent future falls and identifying factors impacting clinicians’ use of the tool through an analysis of the resultant qualitative data.

Methods

Previously, our team designed a CDS tool to identify patients aged 65 years and older who are at the highest risk of future falls and prompt an interruptive alert to clinicians, suggesting the patient be referred to a mobility and falls clinic for an evidence-based preventative intervention. We conducted 10-minute academic detailing interviews (n=16) with resident emergency medicine physicians and advanced practice providers who had encountered our CDS tool in practice. We conducted an inductive, team-based content analysis to identify factors that influenced clinicians’ use of the CDS tool.

Results

The following categories of factors that impacted clinicians’ use of the CDS were identified: (1) aspects of the CDS tool’s design (2) clinicians’ understanding (or misunderstanding) of the CDS or referral process, (3) the busy nature of the emergency department environment, (4) clinicians’ perceptions of the patient and their associated fall risk, and (5) the opacity of the referral process. Additionally, clinician education was done to address any misconceptions about the CDS tool or referral process, for example, demonstrating how simple it is to place a referral via the CDS and clarifying which clinic the referral goes to.

Conclusions

Our study demonstrates the use of academic detailing for supporting the implementation of health information technologies, allowing us to identify factors that impacted clinicians’ use of the CDS while concurrently educating clinicians to ensure the correct understanding of the CDS tool and intervention. Thus, academic detailing can inform both real-time adjustments of a tool’s implementation, for example, refinement of the language used to introduce the tool, and larger scale redesign of the CDS tool to better fit the dynamic work environment of clinicians.
Clinical Decision Support Requirements for Ventricular Tachycardia Diagnosis Within the Frameworks of Knowledge and Practice: Survey Study
Authors: Hu Zhao , Wang Min , Zheng Si , Xu Xiaowei , Zhang Zhuxin , Ge Qiaoyue , Li Jiao , Yao Yan
Published: March 2024

Background

Ventricular tachycardia (VT) diagnosis is challenging due to the similarity between VT and some forms of supraventricular tachycardia, complexity of clinical manifestations, heterogeneity of underlying diseases, and potential for life-threatening hemodynamic instability. Clinical decision support systems (CDSSs) have emerged as promising tools to augment the diagnostic capabilities of cardiologists. However, a requirements analysis is acknowledged to be vital for the success of a CDSS, especially for complex clinical tasks such as VT diagnosis.

Objective

The aims of this study were to analyze the requirements for a VT diagnosis CDSS within the frameworks of knowledge and practice and to determine the clinical decision support (CDS) needs.

Methods

Our multidisciplinary team first conducted semistructured interviews with seven cardiologists related to the clinical challenges of VT and expected decision support. A questionnaire was designed by the multidisciplinary team based on the results of interviews. The questionnaire was divided into four sections: demographic information, knowledge assessment, practice assessment, and CDS needs. The practice section consisted of two simulated cases for a total score of 10 marks. Online questionnaires were disseminated to registered cardiologists across China from December 2022 to February 2023. The scores for the practice section were summarized as continuous variables, using the mean, median, and range. The knowledge and CDS needs sections were assessed using a 4-point Likert scale without a neutral option. Kruskal-Wallis tests were performed to investigate the relationship between scores and practice years or specialty.

Results

Of the 687 cardiologists who completed the questionnaire, 567 responses were eligible for further analysis. The results of the knowledge assessment showed that 383 cardiologists (68%) lacked knowledge in diagnostic evaluation. The overall average score of the practice assessment was 6.11 (SD 0.55); the etiological diagnosis section had the highest overall scores (mean 6.74, SD 1.75), whereas the diagnostic evaluation section had the lowest scores (mean 5.78, SD 1.19). A majority of cardiologists (344/567, 60.7%) reported the need for a CDSS. There was a significant difference in practice competency scores between general cardiologists and arrhythmia specialists (P=.02).

Conclusions

There was a notable deficiency in the knowledge and practice of VT among Chinese cardiologists. Specific knowledge and practice support requirements were identified, which provide a foundation for further development and optimization of a CDSS. Moreover, it is important to consider clinicians’ specialization levels and years of practice for effective and personalized support.
Collecting accelerometry data among adolescents: Lessons learns from the field (Preprint)
Authors: grimes amanda , Todd Reagan , Sours Olivia , Valleroy Ella , Akagi-Bustin Zakry , Hillard Natasha , Lightner Joseph S.
Published: March 2024

BACKGROUND

While physical inactivity remains a pervasive public health problem, issues surrounding measuring physical activity plague researchers. Accelerometers are the gold-standard tool to assess physical activity behavior. However, accelerometer wear compliance varies by population and is influenced by factors, such as comfort and product features, among others. While compliance and acceptability of wrist-worn accelerometers is superior to hip-worn accelerometers, issues with compliance remain and likely vary by demographics and subpopulations.

OBJECTIVE

The purpose of this study is to compare the effects of three consumer-grade accelerometer protocols on wear compliance among adolescents.

METHODS

Move More, Get More (MMGM) is a an after-school sports sampling program to increase physical activity and physical literacy urban middle schoolers. Study participants were provided a Garmin VivoFit4 accelerometer watch; participant steps and physical activity were measured during the study period. Three methods of data collection were used to assess physical activity: 1) Continuous wear, self-sync, 2) Continuous wear, researcher-sync, and 3) Intermittent wear, researcher-sync. A one-way analysis of variance was conducted to assess between-group differences.

RESULTS

Mean valid days were significantly higher at baseline (F=27.52, p<0.001) and 6 months (F=9.98, p<0.001) of the intermittent wear, researcher-synced condition than for both the continuous wear conditions, and significantly higher at 3 months (F=4.05, p<0.05) for the continuous wear, research-synced condition.

CONCLUSIONS

Study findings suggest that intermittent wear, researcher-synced protocol significantly improve wear-time compliance and meets recommendations needed for reliable estimates of physical activity compared to continuous wear protocols as measured by mean valid days. To our knowledge, there are no studies comparing accelerometer protocols specifically for consumer-grade, wrist-worn accelerometers among adolescence, a population that has lower compliance rates compared to other age groups.

INTERNATIONAL REGISTERED REPORT

RR2-10.2196/37126
The Use of Large Language Models Tuned with Socratic Methods on the Impact of Medical Students' Learning: A Randomised Controlled Trial (Preprint)
Authors: Yong Cai Ling , Furqan Mohammad Shaheryar , Lee James Wai Kit , Makmur Andrew , Mariappan Ragunathan , Ngoh Clara Lee Ying , Ngiam Kee Yuan
Published: March 2024

BACKGROUND

Large Language Models (LLM) are AI models that can generate conversational content based on a trained specified source of information (corpus).

OBJECTIVE

The aim is to use these corpus-trained LLMs to limit the content offered by LLM, then using prompt engineering to teach using Socratic methods.

METHODS

Two chatbots were created and deployed, powered by OpenAI’s GPT-3.5 model, with a medical-school textbook corpus. The first chatbot generates a brief summary and open-ended question. The second chatbot generates a case vignette from its pre-trained clinical cases, prompting users for a diagnosis. Both chatbots reply to the user’s response, commenting on the accuracy and asks further questions to encourage critical thinking. A randomised controlled trial was conducted on two groups comprising third year medical students. One group used both chatbots for 10 minutes while the other read the medical textbook. A 15-question test was administered to both groups before and after the intervention.

RESULTS

Forty students participated in the study. The average of the group before and after reading the textbook (n=20) are 3.9 +/- 1.0 and 7.6 +/- 1.5 respectively (p<0.001). The average of the group before and after using the bot (n=20) are 3.9 +/- 0.9 and 12.8 +/- 1.6 respectively (p<0.001). The respective increase in results was 3.7 and 8.9.

CONCLUSIONS

Medical students’ learning showed a better performance using a LLM based chatbot compared to self-reading of medical information assessed using a standardised test. More studies are required to determine if LLM-based pedagogical methods are superior to standard education.
Correction of endothelial dysfunction in patients with type 2 diabetes mellitus, diabetic kidney disease and non-alcoholic steatohepatitis
Authors: Kotsiubiichuk Z.Ya. , Antoniv A.A. , Kanovska L.V. , Mandryk O.Ye.
Published: March 2024

Background. Non-alcoholic fatty liver disease and chronic kidney disease are public health concerns worldwide due to their increasing prevalence, adverse prognosis, and health care burden. The purpose of the study was to determine the probable effect of a combination of metformin, rosuvastatin, essential phospholipids and quercetin on the blood lipids, endothelial function, fibrinolysis system and platelet hemostasis, which are factors for the progression of nonalcoholic steatohepatitis. Materials and methods. Studies were performed on the dynamics of treatment in 60 patients with non-alcoholic fatty liver disease, type 2 diabetes mellitus and diabetic kidney disease (stage I–III). Depending on the prescribed treatment at random, the examined patients were divided into 2 groups. Twenty-eight persons of the first group received a low-calorie diet with dietary restrictions, essential phospholipids, metformin hydrochloride, rosuvastatin. Thirty-two patients from the second group received quercetin in addition to similar dietary recommendations, essential phospholipids, hypoglycemic and hypolipidemic therapy. The mean age of patients was 53.80 ± 3.52 years. The comparison group consisted of 30 healthy individuals of the corresponding age. Results. To evaluate the degree of endothelial-protective effect of quercetin on the background of the recommended protocol therapy, markers of endothelial dysfunction, fibrinolysis and platelet hemostasis were studied. NO content significantly reduced (1.7 times) in patients of group 2 before treatment, increased by 1.5 times (p < 0.05). This can be explained by the effect of quercetin, as well as the use of metformin, which reduces the degree of insulin resistance and the level of hyperlipidemia. Conclusions. The effectiveness of a combination therapy for non-alcoholic steatohepatitis and type 2 diabetes mellitus with diabetic kidney disease using essential phospholi­pids, statins and metformin with the addition of quercetin is higher than that of traditional therapy, as it significantly restores the functional state of the endothelium, eliminates the phenomena of hypercoagulation syndrome without the additional prescription of antiplatelet agents.
Radioiodine ablation after thyroidectomy could be safely abandoned or postponed in selected stage I papillary thyroid carcinoma patients of low-risk group: an observational prospective study
Authors: Cherenko S.M. , Glagolieva A.Yu. , Makhmudov D.E.
Published: March 2024

Background. The European Thyroid Association consensus for the management of differentiated thyroid cancer (2006) suggested to avoid radioactive iodine (RAI) after thyroidectomy in patients with unifocal microcarcinoma (≤ 1 cm) with no extension beyond the thyroid capsule and without lymph node metastases. As the new data was collected and the risk stratification was revised, in 2022 the same recommendation was expanded to the patients with microcarcinoma and central neck lymph node involvement. The American Thyroid Association guidelines (2015) advocated no RAI ablation after hemi- or total thyroidectomy for thyroid cancer less than 1 cm with 5 and less micrometastases up to 2 mm in central neck lymph nodes as this strategy has no negative impact on the disease prognosis. In low-risk patients, no sufficient evidence of the obligatory postsurgical radioiodine ablation has been yet demonstrated. The aim of our study was to reveal whether RAI after thyroidectomy can be abandoned or postponed until the disease progression is confirmed in low-risk patients. Materials and methods. Two groups of patients (30 per group, 60 in total) with papillary microcarcinoma Т1N1a (5 and less level VI micrometastases up to 2 mm) were observed during a 5-year follow-up. In the first group, patients received 100 mCi (3.75 GBq) I131 shortly after total thyroidectomy while in the second group, postponed RAI was applied when progression signs were observed (elevated serum thyroglobulin level and US/CT suspected findings) after thyroid surgery. Results. After 5 years, no significant difference between groups was observed regarding post-RAI local recurrences (one in the first group and two in the second group) and/or distant metastases (t-test, p = 0.58). All cases of neck recurrences were treated with subsequent surgical excision, with no new data of progression within the specified follow-up. Conclusions. RAI adjuvant therapy for papillary thyroid carcinoma Т1N1a may not be necessary for patients with small number of level VI micrometastases. Local and distant metastases revealed during the careful follow-up by thyroglobulin level elevation and when using visualization techniques can be effectively treated with postponed RAI therapy and/or surgery.
Features of type 2 diabetes combined with metabolic dysfunction-associated fatty liver disease under conditions of chronic stress
Authors: Tkach S.M. , Pankiv V.I. , Krushinska Z.H.
Published: March 2024

Background. Metabolic-associated fatty liver disease (MAFLD) is the most common chronic liver disease in which the main pathogenic processes originate from metabolic dysfunction. In recent years, MAFLD has acquired the nature of an epidemic, which is closely related to the epidemic of obesity, type diabetes mellitus (T2DM) and a significant increase in the risk of cardiovascular diseases. Along with the known pathogenetic factors outlined in the “multiple parallel hits” hypothesis, in the context of the COVID-19 pandemic and the russian military aggression in Ukraine, an additional powerful pathogenetic factor that can affect the course of many diseases, including MAFLD, is chronic stress. The aim of the study is to identify the clinical and biochemical features of MAFLD against the background of T2DM under the conditions of military stress in Ukraine. Materials and methods. We conducted a comparative study on the features of the course of MAFLD in 64 participants with T2DM: the first group — 44 individuals who were constantly under martial law in Ukraine, and controls — 20 patients who returned to Ukraine after a long (over 12 months) stay abroad. Results. The research shows that patients with MAFLD, who were affected by the negative consequences of military actions, had a statistically significant increase in the level of fasting glucose and markers of insulin resistance, an increase in the activity of liver transaminases and the level of markers of systemic inflammation compared to the pre-war period. The negative impact of wartime stress factors causes diabetic distress and a more severe course of MAFLD, which can subsequently lead to rapid progression of the disease. Most patients of the first group reported significant changes in the psycho-emotional state. The most common were low mood (81.8 %), feeling of anxiety/fear (79.5 %), sleep disturbances (81.8 %), general weakness and quick fatigue (63.3 %), which occurred much more often and were more pronounced than in the control group. Conclusions. During active military operations, epigenetic factors such as changes in the regime and quality of nutrition, psycho-emotional disorders in the form of astheno-neurotic and anxiety-depressive disorders, post-traumatic stress disorders, war-related unemployment and other negative factors become of great importance. Therefore, in these patients, control of optimal levels of glycemia, indicators of liver tests and lipid spectrum, as well as the state of mental health, are very significant.
Post-COVID syndrome: status of carbohydrate metabolism in patients with hypertension and stable ischemic heart disease
Authors: Kuryata O.V. , Mytrokhina O.S. , Kushnir Yu.S. , Stadnyk O.I.
Published: March 2024

Background. Post-COVID syndrome is associated with a wide range of chronic symptoms or conditions. Coronavirus di­sease 2019 (COVID-19) causes metabolic disorders such as hyperglycemia, insulin resistance. Insulin-like growth factor 1 (IGF-1) is associated with an impaired glucose tolerance and a higher risk of developing type 2 diabetes. Currently, the study of molecules regulating carbohydrate metabolism as potential biomarkers of post-COVID syndrome and targets for therapeutic influence is relevant. The purpose of the study was to assess the level of IGF-1 and its relationship with regulation of carbohydrate metabolism, as well as the dynamics of the evaluated indicators under the influence of drug treatment in patients with hypertension and stable coronary heart disease who suffered from COVID-19. Materials and methods. Fifty-five patients who had a mild and moderate COVID-19 were included in the study; their average age was 55.87 [40; 75] years. The results of routine laboratory tests were registered and analyzed. The content of insulin and IGF-1 was assessed by enzyme immunoassay. The HOMA-IR was calculated. Results. In patients with a mode­rate COVID-19 compared to those with a mild one, a significant decrease in the level of IGF-1 (р = 0.008) was found against the background of increased reference values of glucose, insulin, and HOMA-IR (р < 0.01). The influence of the degree of hypertension on the IGF-1 level was revealed (р = 0.004). An inverse relationship between IGF-1 and glucose level was noted (r = –0.28, p = 0.034). The use of meldonium contributed to a significant decrease in glucose and insulin content (p < 0.001), and an increase in IGF-1. Against the background of taking meldonium, the dynamics of the shift towards a decrease in the HOMA-IR was more significant. Conclusions. An inverse relationship was found between IGF-1 and blood glucose, regardless of the level of insulin and HOMA-IR, in patients with hypertension and stable ischemic heart disease in the post-COVID period. Meldonium has been shown to improve carbohydrate metabolism by normalizing insulin levels and redu­cing the phenomena of insulin resistance as a potential drug target. Meldonium improved the clinical course of ischemic heart disease and demonstrated good tolerability and safety.
Growth indices and vitamin D content in children with idiopathic short stature depending on the variants of the Taql polymorphism genotype of the VDR gene
Authors: Ryznychuk M.O. , Bolshova O.V.
Published: March 2024

Background. The vitamin D receptor (VDR) gene is a key regulator of biological processes, including tissue and cell growth and differentiation, bone metabolism, and modulation of immune responses. Several studies have shown that 1,25(OH)2D increases circulating insulin-like growth factor-1 (IGF-1) levels in vivo and in bone cell cultures. It also increases the expression of IGF-1 receptors in growth plate chondrocytes and several IGF-binding proteins in osteoblasts and bone marrow stromal cell cultures. A vitamin D receptor gene polymorphism is associated with adult height and may affect the growth indicators in children with idiopathic short stature. The purpose was to study the growth indicators and vitamin D levels in children with idiopathic short stature depending on the variants of the Taql polymorphism genotype of the VDR gene. Materials and methods. Determination of the Taql polymorphism of the VDR gene (rs731236) was performed using polymerase chain reaction followed by an analysis of the length of the restriction fragments when detected by agarose gel electrophoresis in 35 children with idiopathic short stature. Results. Most children (68.57 %) were heterozygotes, 17.14 % were homozygotes for T/T alleles, and 14.29 % were homozygotes for C/C alleles. The highest growth retardation has been observed in homozygous T/T carriers. Children carrying homozygotes for C/C alleles had the least growth retardation. Growth hormone levels after clonidine stimulation test and IGF-1 levels in blood were within normal limits in all patients. Vitamin D deficiency was found in T/T homozygotes and vitamin D insufficiency in C/T heterozygotes and C/C homozygotes. Conclusions. Among children with idiopathic short stature, the prevalence of the T/C genotype was 68.57 %. The greatest growth retardation occurred in patients with homozygous T/T alleles (SDS = –2.61 ± 0.31). A decrease in serum vitamin D levels was detected in all children. Vitamin D deficiency (43.83 ± 6.47 nmol/l) was found in children homozygous for the T/T allele, and vitamin D insufficiency — in T/C heterozygotes (58.97 ± 11.78 nmol/l) and C/C homozygotes (56.93 ± 19.54 nmol/l).
Metabolic syndrome and hyperuricemia: features of patient management (clinical case)
Authors: Zhdan V.M. , Kitura Ye.M. , Babanina M.Yu. , Volchenko H.V. , Tkachenko M.V. , Kyrіan O.A. , Ivanitsky I.V. , Lebid V.G.
Published: March 2024

Metabolic syndrome (MS) is a group of interrelated metabolic disorders such as high blood pressure, central obesity, insulin resistance (IR), dyslipidemia. The main mechanisms that indicate a metabolic disorder and contribute to its development are IR and a large amount of circulating free fatty acids. In turn, tissue IR is often combined with other abnormalities including disorders of uric acid metabolism, changes in the hemostasis system, endothelial dysfunction, increased levels of C-reactive protein. At the same time, metabo­lic disorders are a risk factor for hyperuricemia. MS occurs in 25–60 to 90 % of all gout patients. About 50 % of patients with hyperuricemia have symptoms of MS. Hyperuricemia as a component of MS is a predictor of cardiovascular mortality, development of diabetes mellitus, hypertension and nephrolithiasis. Hyperuricemia is closely related to diabetes, obesity, coronary heart disease, hypertension. On the example of a clinical case, the main components of MS are considered, as well as the issue of the relationship between hyperuricemia, gout and the components of MS. The main idea behind the creation of the MS concept is to select a population of patients at a high cardiovascular risk in whom preventive measures such as lifestyle modification and the use of adequate drugs can significantly affect the main health indicators. The goal of managing patients with MS is to minimize cardiovascular risk and mortality as much as possible. Accordingly, the therapeutic strategy should include optimal ways to modify the lifestyle; lowering blood pressure to the target level and treating comorbid conditions; reducing low-density lipoprotein cholesterol according to the risk profile: > 50 %, and < 70 mg/dL (1.4 mmol/L) in patients at a very high cardiovascular risk; > 50 %, and < 100 mg/dL (1.8 mmol/l) in high-risk patients; reducing fasting serum glucose < 126 mg/dl (7 mmol/l) or glycated hemoglobin < 7 % (53 mmol/mol); maintaining uric acid level < 6.5 mg/dL (0.387 mmol/L), in patients with gout — below 6 mg/dL (0.357 mmol/L). Thus, according to the results of the research, a causal relationship was found between insulin resistance and serum uric acid levels in patients with metabolic syndrome. The strategy for managing patients with metabolic syndrome should include screening and correction of hypertension, carbohydrate purine metabolism, dyslipidemia, and prevention of cardiovascular events.
On Violence Writing in Ian McEwan’s Saturday
Authors: He Jingyi
Published: March 2024

Ian McEwan is one of the most preeminent contemporary British writers. His masterpiece Saturday is longlisted for the 2005 Booker Prize. Revolving around the protagonist Perowne’s one-day life, the novel portrays a realistic picture of British society after the “9·11” terrorist attack. So far, scholars have interpreted Saturday from the perspective of space, trauma, intertextuality, culture, and ethics, while few studies have touched upon the violence writing in this novel. Therefore, this paper will explore the manifestations and roots of direct, structural and cultural violence in Saturday based on Johan Galtung’s violence triangle theory. The study of violence writing in the novel can reveal not only hidden violence problems in British society but also McEwan’s appeal for a harmonious society. Meanwhile, the solution to violence issues McEwan provides in the novel is also instructive for modern people to cope with violence dilemmas.
English Publicity of Chinese Folk Songs—With the Tea Picking Dance as an Example
Authors: Zhang Dezhi , Liao Huihui , Zhu Xiaowen , Li De , Zhu Min
Published: March 2024

Chinese folk songs have unique inheritance and dissemination value. While actively developing the local dissemination of folk songs, we should constantly expand the transmission of Chinese folk songs overseas and enhance the international influence of Chinese folk song culture. Utilizing folk song micro-lesson to popularize the knowledge of Chinese folk songs, conducting surveys and analyzing the attitudes of international students from different countries towards four folk song micro-lesson videos, we have obtained over 30 valid survey data. The survey found that 96.77% of respondents believe that this series of micro-lesson plays a certain role in spreading Chinese folk songs, and the majority of the audience is interested in folk song micro-lesson and willing to share them. Micro-lessons of folk songs is one of the media for disseminating Chinese folk songs and folk song culture in the new era, providing a reference for the new approach to the external dissemination of Chinese culture.
Antimicrobial Resistance: Techniques to Fight AMR in Bacteria – A Review
Authors: Mahizhchi Ernessto , Sivakumar Diveyaa , Jayaraman Megala
Published: March 2024

Antimicrobials or antibiotics were the important revelations of the last century, however, it came along with a silent curse that people care less to talk about. Antimicrobial resistance (AMR) which emerged alongside antibiotics in the last century has been a significant concern for scientists and policymakers. Since their discovery, it has been noted that the widespread use of antibiotics is the primary cause of bacteria developing antimicrobial drug resistance. Despite the recognition of this issue, it is challenging to curtail the widespread use of antibiotics because they are essential for treating various infections. Paradoxically, the necessity of using these drugs becomes an inadvertent advantage for bacteria to evolve resistance mechanisms. This dilemma creates a seeming stalemate in our battle against these tiny microorganisms. Delaying action could have dire consequences, potentially leading to the emergence of stronger superbugs that pose a serious threat to the entire human population. The recent COVID-19 pandemic serves as a stark reminder of the devastating impact a small microbe can have on global health. This paper delves into the mechanisms of antimicrobial resistance in bacteria, the evolution of superbugs and the innovative techniques employed by scientists to combat these challenges. Taking proactive steps is crucial to avoid a future where we are at the mercy of increasingly resilient microbes.
Psychological Impact of COVID-19 Pandemic among Healthcare Personnel in United Arab Emirates
Authors: Srivastava Ananya , Menezes Godfred A. , Kenneth Jewel Mary , John Jennifer , Saif Sahina , Bambani Taniqsha , Fayaz Zyna Ayesha , Mathias Carol Avil , Patni Mohamedanas Mohamedfaruk , Adam Shukri , Hakim Tarig , Al Nuaimi Mariam , Alayyan Muna Obaid
Published: March 2024

Given the magnitude of the COVID-19 pandemic, adverse psychological outcomes are expected to occur among healthcare personnel (HCPs). However, little is known about these outcomes within Ras al Khaimah, UAE. This study aims to assess the psychological impact of COVID-19 on healthcare personnel from different hospitals and clinics in Ras Al Khaimah (RAK), UAE. An online questionnaire was distributed to healthcare personnel within Ras al Khaimah, UAE, through an institutional email that enabled them to enroll in the study after giving informed consent. Likert scale was used to calculate the relation between demographic factors and 13 variables of psychological distress. An unpaired t-test was applied. This study shows that 31.7% of HCPs in RAK report moderate to high levels of anxiety due to concerns of potential workplace exposure, 41.6% are afraid of infecting their families and 13.1% find themselves feeling isolated from their families. Those who were younger than 45 years old, unmarried people and having more than two children were more likely to experience psychological distress than their counterparts. While the adverse psychological impact within this population is not as severe as what was noted in different populations in other countries, they must be addressed. It is important to ensure that HCPs have the appropriate physical and mental resources to persevere through similar stressful periods in the future.
Case Series of Melioidosis in a Tertiary Health Care Centre in Puducherry, India
Authors: Easow Joshy M. , Bhosale Namrata K. , Pramodhini S. , Priyadarshini Ramya
Published: March 2024

Melioidosis, a potentially fatal disease caused by the bacterium Burkholderia pseudomallei continues to be neglected in the Indian Subcontinent despite bearing about 44% of the global burden. Diagnosis poses a significant challenge since the disease presents a wide range of symptoms and closely mimics tuberculosis and pneumonia both of which are endemic in India. Sophisticated diagnosis and treatment often become unaffordable for patients from rural or low-income backgrounds. We present five cases of melioidosis from a tertiary care hospital (Mahatma Gandhi Medical College and Research Institute ) in Pondicherry that exhibited predominantly high-grade fever, abdominal pain, and vomiting. Radiological imaging revealed abnormalities in the brain (1/5, 20%), lung (3/5, 60%), liver (2/5, 40%), spleen (2/5, 40%), kidney (2/5, 40%), and prostate gland (1/5, 20%). Burkholderia pseudomallei infection was confirmed through blood culture. Treatment with meropenem or ceftazidime was initiated immediately. Neuromelioidosis was confirmed in one patient. The clinical diagnoses for the remaining cases were as follows: septic shock, melioidosis with urosepsis, and refractory shock. Three patients required intensive care and of the five, one patient was discharged, one died, and three discontinued treatments against medical advice. In the case of the deceased patient, the clinical diagnosis encompassed refractory shock accompanied by lactic acidosis, melioidosis, and community-acquired pneumonia, which subsequently progressed to acute respiratory distress syndrome (ARDS). Notably, this patient presented with co-morbidities, notably type 2 diabetes mellitus. This exemplifies the difficulty faced by patients from low-income backgrounds which forces them to discontinue expensive treatment. The true burden of melioidosis in the Indian Subcontinent is uncertain as many cases remain undiagnosed. Unawareness of the disease, low index of suspicion among medical professionals, incorrect treatment, and discontinuation contribute to the disease burden. It is therefore imperative that melioidosis is brought to the attention of healthcare policymakers to determine the true burden of the disease by prioritizing nationwide surveillance and diagnosis.
Biochar: A Comprehensive Review on a Natural Approach to Plant Disease Management
Authors: Dorjee Lham , Nishmitha K. , Pattanayak Sudeepta , Wangmu Tsedar , Meshram Shweta , Chongtham Sushma , Gogoi Robin
Published: March 2024

Since time immemorial organic amendments have been an important strategy for improving soil fertility and suppressing a wide range of soil-borne pathogens. Biochar, a charcoal-like amendment has true potential in managing phytopathogens with an eco-friendly approach. It is produced by subjecting plant materials and agricultural waste to high temperatures of around 900°C in limited oxygen conditions. Biochar is considered to be an excellent carbon sequester and has an undeniably imperative role in improving soil properties. Biochar has innumerable applications in the remediation of environmental pollutants by immobilizing heavy metals such as Cadmium and Arsenic and degradation of dyes and pesticides. One of the most significant advantages of biochar in addition to mitigating environmental pollution is effectively managing plant pathogens by altering soil physical and chemical properties and promoting antagonistic microorganisms. Biochar directly suppresses plant pathogens by priming plant defense mechanisms. For instance, sugarcane bagasse biochar remediates Cd from contaminated soil, and citrus wood biochar induces systemic resistance against Botrytis cinerea in host-Lycopersicon esculentum, Capsicum annuum L. cv. Maccabi and Fragaria ananassa. Nevertheless, it is essential to acknowledge its limitations, such as the potential to absorb and enhance the residual activity of harmful chemicals. Further research is needed to develop a deeper understanding of biochar’s properties and mechanisms for more effective results. Advanced techniques like meta-transcriptomics and metaproteomics hold the potential to provide invaluable insights into this field. The review provides a comprehensive overview of current information regarding biochar, covering its production techniques and highlighting its agricultural benefits, with a particular focus on its role in plant disease management. Furthermore, the associated risks and concerns are also discussed.
Molecular Identification of Carbapenem Resistance Acinetobacter baumannii causing Ventilator-Associated Pneumonia Isolated from Intensive Care Unit of Tertiary Care Hospital
Authors: Sharma Vijeta , Sharma Rajni , Vyas Aruna
Published: March 2024

Ventilator-associated pneumonia (VAP) is a serious complication in critically ill patients, significantly increasing morbidity and mortality. One concerning organism behind VAP is Acinetobacter baumannii, a multidrug-resistant bacterium has ability to evade treatment, particularly with carbapenems, the last-line antibiotics. This is especially worrisome within the confines of Intensive Care Units (ICUs) of tertiary care hospitals, hubs for high-risk patients and potential reservoirs of antimicrobial resistance. This study focused on identifying carbapenem-resistant Acinetobacter baumannii using both phenotypic and genotypic methods. In 132 isolates of Acinetobacter baumannii, we observed 96% resistance to the cephalosporins while least resistance found to colistin and tigecycline. However, a concerning 51.5% of isolates exhibited carbapenem resistance. Phenotypically confirmation of carbapenem resistance detected in 47% isolates by Combined Disc Test and 51.5% isolates by Modified Hodge Test and E-test. Genotypic analysis with RT-PCR revealed a diverse array of resistance genes: blaIMP (33.82%), blaVIM (25%), blaOXA-Group (20.58%), and blaNDM (8.82%). These findings highlight the alarming prevalence of carbapenem-resistant Acinetobacter baumannii in healthcare settings.
The Attitude Regarding the Uptake of Influenza Vaccine in the COVID-19 Era in Jeddah City, Saudi Arabia
Authors: Alaa Mujallad , Yasin Hala Mohammed , Alharbi Hotaf Abdullah , Barry Mazin , Qashqary Mohammed
Published: March 2024

The onset of COVID-19 has had a profound impact on the world, leading to significant adjustments in human behavior. A plethora of behavioral modifications have been embraced by individuals. As COVID-19 symptoms are similar to influenza symptoms, this study aimed to measure attitudes regarding the uptake of influenza vaccination in the COVID-19 era. This cross-sectional study used a self-administered questionnaire. A total of 311 participants were conveniently selected from two of the most popular shopping malls in Jeddah City, Saudi Arabia, during a three-day influenza awareness campaign conducted between 11 November 2020 to 14 November 2020. Demographic items and all scales (summed and examined for internal reliability using Cronbach’s alpha) were analyzed using univariate analysis, including measures of central tendencies and frequencies. This study indicates that the COVID-19 pandemic has not significantly affected vaccination adoption rates. Only 9.3% of the individuals who received the vaccine expressed fear or a desire for protection against COVID-19.
Effectiveness of Medicinal Plant Extract against Pathogenic Bacteria in the Prevention and Treatment of Urinary Tract Infections
Authors: Al-Hilu Suad Abdulhadi , Al-Shujairi Wisam Hamzah
Published: March 2024

A urinary tract infection (UTI) is an infectious disease that infects humans in the presence of microorganisms, often not treated with broad-spectrum antibiotics because they contribute to developing resistant microorganisms. Therefore, this study aimed to investigate the antibacterial efficacy of medicinal plants used to treat infection in the urinary tract. One hundred samples were collected from patients with UTIs, ranging in age from 10–60 years. Outpatients and inpatients with UTIs live in Al-Najaf Center and attend treatment at Al-Hakeem Hospital and Al-Sader Teaching Hospital. Ten microliters of urine samples were inoculated on selective media to isolate and identify pathogenic bacteria, presumptive identification was performed using the Viteck-2 system. Eight antibiotics were used for showed antibiotic susceptibility: cefixime (5 μg), streptomycin (25 μg), amoxicillin (30 μg), erythromycin (10 μg), ciprofloxacin (10 μg), azithromycin (15 μg), gentamicin (10 μg), and nitrofurantoin (50 μg). Two species of plants were used to determine antibacterial activity: Castanea crenata and Saussurea costus. Of 100 urine samples, 80 tested positive for bacteriuria. Escherichia coli was the most prevalent bacterium in the urine 50 (62.5%), followed by Klebsiella pneumonia 10 (12.5%), Proteus vulgaris seven (8.75%), Pseudomonas aeruginosa six (7.5), Staphylococcus aureus four (5%), and Streptococcus pyogenes three (3.75%). Some bacteria with Gram staining comprising E. coli, Klebsiella spp., Pseudomonas spp., and Proteus spp. are resistant to many antibiotics. C. crenata and S. costus inhibited the growth of pathogenic bacteria isolated from the urine samples. Testing and determining the antimicrobial activities of medicinal plants will help pharmaceutical companies develop modifiers or precursors for synthesizing new therapeutic alternative drugs to treat infectious diseases caused by pathogens.
Deep Learning Techniques Used in Agriculture: A Review
Authors: Sherkhane Pranita D. , Ratnaparkhi Nayana S.
Published: March 2024

Abstract: Deep learning (DL) is a kind of sophisticated data analysis and image processing technology, with good results and great potential. DL has been applied to many different fields, and it is also being applied to the agricultural field. Deep learning algorithms have revolutionized various industries, including agriculture, by enabling advanced image processing and accurate predictions. This paper explores a wide-ranging review of research papers and articles on deep learning algorithms for image processing and predictions in the field of agriculture. It analyzed works on an overview of convolutional neural networks (CNNs), recurrent neural networks (RNNs), and their variants, highlighting their applications in crop yield estimation, disease detection; weed identification, and irrigation management. Additionally, the paper discusses the challenges and potential future directions of deep learning algorithms in agriculture.
Stress Detection System Using Machine Learning
Authors: Solanke Prof. S. A. , Tidke Shreyash S. , Malokar Tejas G. , Udapurkar Sarvesh S. , Sheikh Faiz Mohammad , Gaikwad Prajakta G.
Published: March 2024

Abstract: Stress is a pervasive aspect of modern life, posing significant health risks if left unmanaged. Early detection of stress is crucial for preventing adverse health outcomes and promoting well-being. This paper presents a novel approach to stress monitoring and management using machine learning (ML) techniques and wearable physiological sensors. By analyzing multimodal datasets, including electrocardiogram (ECG) signals and other physiological parameters, our proposed model aims to accurately detect stress levels in individuals. Leveraging low-cost wearable sensors and IoT technology, our system provides real-time feedback and alerts individuals to their stress levels, enabling proactive intervention to mitigate health risks. Through a comprehensive review of existing stress detection approaches and integration of ML algorithms, our study contributes to the development of more efficient and effective stress monitoring systems. This research holds promise for improving health outcomes and enhancing quality of life in individuals facing stress-related challenges.
Review on Android Application Based Peltier Cooling System for Medicine Safety
Authors: Udade Prachi , Mahawadiwar Prof. V. N. , Thak Avantika , Ladekar Ananta
Published: March 2024

Abstract: As the demand for heat-sensitive chemicals continues, ensuring their storage and transportation becomes increasingly important to maintain their effectiveness and safety. This article describes the Peltier cooling system as an Android application designed to improve the safety and reliability of drug storage during transportation. The proposed system combines the Peltier cooling module with a purpose-built Android application to monitor and control the temperature in the storage chamber. Peltier cooling components actively control the internal temperature based on instantaneous feedback from the temperature sensor. The Android app gives users an easy way to set the temperature, monitor the current temperature, and get instant notifications when there is a difference. The basic features of the system include fever measurement, temperature control and instant notifications. The Android app communicates with the Peltier cooling system using Bluetooth or Wi-Fi connection, allowing users to easily access and control the system from their smartphones. This allows doctors and staff supervising the delivery of temperaturesensitive medications to constantly monitor and control storage conditions.
Comparative Analysis of Annular Raft and Solid Raft
Authors: Kumar Rohit , Rai Anubhav
Published: March 2024

Abstract: The goal of the study is annular mat foundation in various modern structures: Circular tower-shaped structures, like, microwave towers,TV tower, cooling towers, overhead water tanks, etc For this purpose, three raft cases are considered, which are mentioned below. (1) Intze overhead tank Annular raft with net SBC 24Kn/m2 (2)Intze overhead tank Circular Solid raft This study aims to evaluate these foundation systems' structural behavior and performance aft's outer radius is also taken as a variable for obtaining different results in our thesis work. An F.E.M.-based analysis is done to determine critical moments and deflections in both annular and circular rafts. Comparison of this base pressure critical moments, shear force, bending stress, and deflections are made based on the above-mentioned case, including the cost comparison foundation. The concrete grade is M-30, and HYSD FE 500 steel reinforcement is used in design calculation. The load combination is followed as IS 1893-2016 and IS 456-2000—seismic zone 3. The software package staad pro v8i and connect edition is used. To provide relevant calculations, Microsoft Excel is used.