bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Agreement Among Nurse Educators on Infection Prevention and Control Practices to Ensure Safe Clinical Training Post-COVID-19
Authors: Al Hadid Lourance , Al Barmawi Marwa , Al-Rawajfah Omar , Al-Sagarat Ahmad 
Published: September 2024

Abstract

Background:
Infection Prevention and Control (IPC) practices during nursing students’ clinical training are based on standardized precautions. However, the spread of COVID-19 raised the need to revise these practices. We aimed in this study to assess nurse educators’ agreement on items that represent precautionary guidelines, which enhance safety during clinical training of students. It aimed to reach an agreement among nurse educators on IPC practices to ensure safe clinical training.

Materials and Methods:
This descriptive explorative, cross-sectional study included 243 Jordanian and Omani educators. The study questionnaire was based mainly on evidence reported in the literature. The study questionnaire comprised items for trainers to practice and items to supervise students. It was developed based on available evidence and recommended training practices during COVID-19 suggested by the WHO and the literature. Both the face and content validity processes were adopted to validate the study questionnaire. The final version was composed of 26 items for trainers and 20 items for students subsumed in the following themes: protecting self, protecting others, and essential training needs.

Results:
All questionnaire items were rated above the midpoint indicating agreement among participants on including the new IPC practices. All suggested practices (26 items for the trainers and 20 items for the students) were supported by the study participants.

Conclusions:
Clinical training is an important component of nursing students’ preparation. Findings suggest the importance of adding new IPC practices to improve student IPC practices, protect themselves and others, minimize cross-infections, and enhance students’ training within a safe clinical environment.
Effect of Carob and Ginseng Supplements on Semen Analysis Parameters, Sexual Function, and Sex Hormones in Infertile Men: Double-Blind, Randomized Controlled Trial Study
Authors: Pilehvari Shamim , Masoumi Seyedeh Zahra , Bahar Tayebeh G. , Kazemi Farideh , Moradkhani Shirin , Maleki Parvin 
Published: September 2024

Abstract

Background:
Infertility is one of the most common problems in the world; there is a growing demand for herbal medicines to treat infertility-related problems.

Materials and Methods:
A randomized controlled trial with three groups was conducted, each with 30 participants. The first group was administered 1.5 grams of Carob daily, the second group was administered 1.5 grams of Ginseng daily, and the third group received a placebo. The treatment was administered for 12 weeks, and before and after the intervention, semen parameters, testosterone, prolactin, luteinizing hormone, follicle-stimulating hormone, thyroid hormones, and sexual function were evaluated. Sexual function was assessed using the International Index of Erectile Function Questionnaire.

Results:
The mean (SD) age of participants was 34.83 (6.22), 34.60 (5.78), and 33.67 (5.82) years in Carob, Ginseng, and Placebo groups, respectively. The results showed that in the Carob group, the normal volume of semen (Z 133 = 3.05, p = 0.02) and the normal shape of sperm (Z 134 = 2.97, p = 0.01) increased significantly compared to the control group. In the Ginseng group, the normal volume (Z 133 = 3.90, p = 0.001) and the normal viscosity of semen (Z 133 = 2.36, p = 0.01) increased significantly compared to the control group.The Carob group showed a significant increase in normal sperm counts and testosterone hormone levels (Z 131 = 2.81, p = 0.05). The Ginseng group demonstrated a significant improvement in orgasm function (H2 = 6.14, p = 0.04) and the total score of the International Index of Erectile Function (IIEF) (H2 = 5.8, p = 0.05).

Conclusions:
Carob supplements are suggested to enhance some semen parameters and male sex hormones. For infertile men, Ginseng can be beneficial in improving sexual function.
Mental Health System in the Most Populated State of India: Bounce from the Base of National Mental Health Survey 2015–2016
Authors: Kar Sujita Kumar , Sharma Eesha , Singh Amit , Agarwal Vivek , Singh Shivendra Kumar , Dalal Pronob Kumar 
Published: September 2024

Abstract

Background:
Uttar Pradesh, India’s most populous state, was part of The National Mental Health Survey 2015–2016. The survey evaluated mental health resources and treatment gaps while estimating the prevalence of mental health problems. This article assesses changes in mental health resources in the state over 7 years postsurvey.

Methods:
Surveyed in 2015–2016 in 12 Indian states, including Uttar Pradesh, the State Mental Health System Assessment used WHO instruments to evaluate the state’s mental health system across 10 domains on a Likert scale.

Results:
In 2015, there were only 0.15 psychiatrists available per 100,000 people in Uttar Pradesh. However, this increased to 0.46 by 2023. Medical colleges offering MBBS and postgraduate courses in Psychiatry have doubled and tripled, respectively. The coverage of districts under mental health programs has increased from 19% to 100% in Uttar Pradesh, though psychiatrists were not present in all the districts under these programs.

Conclusion:
The development of the resources for mental health in the past 7 years is substantial in Uttar Pradesh, though it still falls short of the recommended standards. Another assessment of the mental health treatment gap will give better insight into strategizing mental healthcare in Uttar Pradesh.
Effect of Yoga and Mindfulness Meditation on Quality of Life in Computer Users with Chronic Low Back Pain
Authors: Singphow Chametcha , Purohit Satya Prakash , Tekur Padmini , Bista Suman , Panigrahy Surya Narayan , Pradhan Balaram , Raghuram Nagarathna 
Published: September 2024

Background:
Computer professionals are more prone to chronic low back pain (CLBP) as compared to the normal population. It has been reported that the 1-year prevalence of low back pain (LBP) was 23%38% in the normally active population, while it was 31%54% in computer users.

Objective:
To investigate the effect of yoga and mindfulness meditation on the quality of life (QOL) of computer users with CLBP.

Materials and Methods:
Eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP since 5.20 ± 3.01 years; 51 males and 29 females) were recruited from Bengaluru, India. Participants were randomized into two groups: Yoga and mindfulness meditation/YM group (n = 40) and physical exercise/PE group (n = 40). The YM group practiced an integrated module comprising yoga postures and mindfulness meditation, and the PE group practiced PE designed for LBP. Both groups practiced 1 hour daily, 3 days a week for 16 weeks. WHO QOL-BREF and spinal flexibility (Straight Leg Raising [SLR]) were assessed at baseline and after 8 and 16 weeks.

Results:
Results of repeated measures-analysis of variance test showed that the scores on QOL physical health (diff = 12.43%, P < 0.001), psychological health (diff = 11.9%, P < 0.001), social relationships (diff = 15.66% P < 0.001), and environment (diff = 17.37% P < 0.001) were significantly higher in YM group as compared to PE group at the end of 16 weeks. Similarly, the scores on the SLR right leg (diff = 12.97%, P < 0.001) and SLR left leg score (diff = 11.71%, P < 0.001) were significantly higher in the YM group as compared to the PE group at the end of 16 weeks.

Conclusion:
Yoga with mindfulness meditation is significantly more effective in improving QOL and spinal flexibility in computer users with CLBP as compared to PE designed for LBP.
Effect of Prana vidya Practices on Cognitive Abilities of Adolescents
Authors: Prabhu Prem , Gowda Paran , Chandra Girish 
Published: September 2024

Context:

Prana vidya practices (PVPs) have been found to be effective in improving intelligence quotient and performance quotient previously. This article is the sequel to previous research and investigates the effect of PVPs on the selected cognitive abilities of adolescents.

Aim:
To study the effect of the PVPs (Prana Vidya Practices for Consciousness Enrichment [PVPCE]), a prana visualization-based technique, on the cognitive abilities associated with (i) Six-letter cancellation task (SLCT) and (ii) Corsi block-tapping task (CBTT).

Subjects and Methods:
The present study was a randomized control trial carried out to examine the effect of a 5-week Prana vidya intervention on the cognitive abilities of adolescents. As an intervention, the practices of the PVPCE technique were given every day for 35 min. A sample size of 36 adolescent participants (14 boys and 22 girls) was obtained for this study.

Statistical Analysis:
The descriptive statistics (average value, standard deviation, and standard error of the mean) were obtained. The paired t-test for performance comparison along with Cohen's d test and repeated-measure analysis of variance between pre- and post-situations were also performed.

Results:
The results of the study show that in the experimental group, total attempts (TA) and net attempts (NA) of SLCT were significantly increased (P < 0.05); however, there was no significant change in the wrong attempts. In the CBTT, total scores and Corsi span also significantly increased (P < 0.05) in both the forward and backward directions. The PVPCE practices are most effective for SLCT-TA, SLCT-NA, and forward total score.

Conclusion:
The results suggest that PVPs (PVPCE technique) improve cognitive abilities associated with letter cancelation and block tapping tasks.
Role of Optimal Features Selection with Machine Learning Algorithms for Chest X-ray Image Analysis
Authors: Manav Mohini , Goyal Monika , Kumar Anuj 
Published: September 2024

Introduction:
The objective of the present study is to classify chest X-ray (CXR) images into COVID-positive and normal categories with the optimal number of features extracted from the images. The successful optimal feature selection algorithm that can represent images and the classification algorithm with good classification ability has been determined as the result of experiments.

Materials and Methods:
This study presented a framework for the automatic detection of COVID-19 from the CXR images. To enhance small details, textures, and contrast of the images, contrast limited adaptive histogram equalization was used. Features were extracted from the first-order statistics, Gray-Level Co-occurrence Matrix, Gray-Level Run Length Matrix, local binary pattern, Law’s Texture Energy Measures, Discrete Wavelet Transform, and Zernikes’ Moments using an image feature extraction tool “pyFeats. For the feature selection, three nature-inspired optimization algorithms, Grey Wolf Optimization, Particle Swarm Optimization (PSO), and Genetic Algorithm, were used. For classification, Random Forest classifier, K-Nearest Neighbour classifier, support vector machine (SVM) classifier, and light gradient boosting model classifier were used.

Results and Discussion:
For all the feature selection methods, the SVM classifier gives the most accurate and precise result compared to other classification models. Furthermore, in feature selection methods, PSO gives the best result as compared to other methods for feature selection. Using the combination of the SVM classifier with the PSO method, it was observed that the accuracy, precision, recall, and F1-score were 100%.

Conclusion:
The result of the study indicates that with optimal features with the best choice of the classifier algorithm, the most accurate computer-aided diagnosis of CXR can be achieved. The approach presented in this study with optimal features may be utilized as a complementary tool to assist the radiologist in the early diagnosis of disease and making a more accurate decision.
Evaluation of In-room Volumetric Imaging Doses for Image-guided Radiotherapy: A Multi-institutional Study
Authors: Sakai Yusuke , Monzen Hajime , Takei Yoshiki , Kosaka Hiroyuki , Nakamura Kenji , Yanagi Yuya , Wakabayashi Kazuki , Hosono Makoto , Nishimura Yasumasa 
Published: September 2024

Aims:
We investigated imaging dose and noise under clinical scan conditions at multiple institutions using a simple and unified method, and demonstrated the need for diagnostic reference levels in image-guided radiotherapy (IGRT).

Materials and Methods:
Nine cone-beam and helical computed tomography (CT) scanners (Varian, Elekta, Accuray Inc., and BrainLAB) from seven institutions were investigated in this study. The weighted cone-beam dose index (CBDIw) was calculated for head and pelvic protocols using a 100 mm pencil chamber under the conditions used in actual clinical practice at each institution. Cone-beam CT image noise was evaluated using polymethylmethacrylate head and body phantoms with diameters of 16 and 32 cm, respectively.

Results:
For head and pelvic protocols, CBDIw values ranged from 0.94–6.59 and 1.47–20.9 mGy, respectively. Similarly, standard deviation (SD) values ranged from 9.3–34.0 and 26.9–97.4 HU, respectively. The SD values tended to increase with decreasing imaging dose (r = −0.33 and −0.61 for the head and pelvic protocols, respectively).

Conclusions:
Among the nine machines, the imaging dose for high imaging dose institutions was approximately 20 mGy to the pelvic phantom, and there was a 14-fold difference in dose compared with the other institutions. These results suggest the need to establish DRLs for IGRT to guide clinical decision-making.
Dosimetric Comparison of Different Dose Calculation Algorithms in Postmastectomy Breast Cancer Patients Using Conformal Planning Techniques
Authors: Gaur Garima , Dangwal Vinod Kumar , Banipal Raja Paramjeet Singh , Singh Ranjit , Kaur Gurpreet , Grover Romikant , Sachdeva Sheetal , Kang Manraj Singh , Singh Simrandeep , Garg Pardeep , Singh Baltej 
Published: September 2024

Background:
The aim of the current study was to compare three different dose-calculating algorithms, i.e., superposition (SP), fast SP (FSP), and convolution (CV), for breast cancer patients treated with intensity-modulated radiotherapy (IMRT) and field-in-Field forward plan IMRT (FiF-FP-IMRT).

Materials and Methods:
The current retrospective study involved 100 postmastectomy breast cancer patients who were given radiotherapy using IMRT and FiF-FP-IMRT planning techniques. All the initially SP-calculated plans were recalculated with the same monitor units for FSP and CV algorithm without change in any of the other planning parameters. The isodose distribution and various plan evaluating parameters, for example, conformity index (CI), homogeneity index, and uniformity index target volume and normal structure doses were compared and analyzed for all the different algorithm calculated plans.

Results:
In the IMRT plans, all the target and normal structure dose-volume parameters showed a significant difference between all the three different algorithms with P < 0.05. In the FiF-FP-IMRT plans, CV algorithm showed a significant difference in most of the target and normal structure dose-volume parameters. Among quality indexes, only CI showed a significant difference between all the algorithms in both the planning techniques. R50 showed a significant difference with the CV algorithm in both the planning techniques.

Conclusion:
The change in the dose calculation algorithm resulted in dosimetric changes which must be evaluated by the medical physicists and oncologists while evaluating treatment plans. In the current study with breast patients, the results obtained for target and normal structure doses using the CV algorithm are overestimated as compared to SP and FSP algorithms, producing variable results in air and bony normal structures. However, the ipsilateral lung V5 parameter and the ipsilateral humeral head mean dose were found to be underestimated by the CV algorithm as compared to the SP and FSP algorithm in both the planning techniques.
Assessment of Optimizers and their Performance in Autosegmenting Lung Tumors
Authors: Ramachandran Prabhakar , Eswarlal Tamma , Lehman Margot , Colbert Zachery 
Published: September 2024

Purpose:
Optimizers are widely utilized across various domains to enhance desired outcomes by either maximizing or minimizing objective functions. In the context of deep learning, they help to minimize the loss function and improve model’s performance. This study aims to evaluate the accuracy of different optimizers employed for autosegmentation of non-small cell lung cancer (NSCLC) target volumes on thoracic computed tomography images utilized in oncology.

Materials and Methods:
The study utilized 112 patients, comprising 92 patients from “The Cancer Imaging Archive” (TCIA) and 20 of our local clinical patients, to evaluate the efficacy of various optimizers. The gross tumor volume was selected as the foreground mask for training and testing the models. Of the 92 TCIA patients, 57 were used for training and validation, and the remaining 35 for testing using nnU-Net. The performance of the final model was further evaluated on the 20 local clinical patient datasets. Six different optimizers, namely AdaDelta, AdaGrad, Adam, NAdam, RMSprop, and stochastic gradient descent (SGD), were investigated. To assess the agreement between the predicted volume and the ground truth, several metrics including Dice similarity coefficient (DSC), Jaccard index, sensitivity, precision, Hausdorff distance (HD), 95th percentile Hausdorff distance (HD95), and average symmetric surface distance (ASSD) were utilized.

Results:
The DSC values for AdaDelta, AdaGrad, Adam, NAdam, RMSprop, and SGD were 0.75, 0.84, 0.85, 0.84, 0.83, and 0.81, respectively, for the TCIA test data. However, when the model trained on TCIA datasets was applied to the clinical datasets, the DSC, HD, HD95, and ASSD metrics showed a statistically significant decrease in performance compared to the TCIA test datasets, indicating the presence of image and/or mask heterogeneity between the data sources.

Conclusion:
The choice of optimizer in deep learning is a critical factor that can significantly impact the performance of autosegmentation models. However, it is worth noting that the behavior of optimizers may vary when applied to new clinical datasets, which can lead to changes in models’ performance. Therefore, selecting the appropriate optimizer for a specific task is essential to ensure optimal performance and generalizability of the model to different datasets.
Multiple Brain Metastases Radiosurgery with CyberKnife Device: Dosimetric Comparison between Fixed/Iris and Multileaf Collimator Plans
Authors: Ianiro Anna , Infusino Erminia , D’Andrea Marco , Marucci Laura , Farneti Alessia , Sperati Francesca , Cassano Bartolomeo , Ungania Sara , Soriani Antonella 
Published: September 2024

Purpose:
In our institution, stereotactic radiosurgery of multiple brain metastases is performed with the CyberKnife® (CK) device, using fixed/Iris collimators. In this study, nineteen fixed/Iris plans were recalculated with the multileaf collimator (MLC), to assess if it is possible to produce plans with comparable dosimetric overall quality.

Materials and Methods:
For consistent comparisons, MLC plans were re-optimized and re-normalized in order to achieve the same minimum dose for the total planning target volume (PTVtot). Conformation number (CN), homogeneity index (HI) and dose gradient index (DGI) metrics were evaluated. The dose to the brain was evaluated as the volume receiving 12 Gy (V12) and as the integral dose (ID). The normal tissue complication probability (NTCP) for brain radionecrosis was calculated as a function of V12.

Results:
The reoptimized plans were reviewed by the radiation oncologist and were found clinically acceptable according to the The American Association of Physicists in Medicine (AAPM) Task Group-101 protocol. However, fixed/Iris plans provided significantly higher CN (+8.6%), HI (+2.2%), and DGI (+44.0%) values, and significantly lower ID values (−35.9%). For PTVtot less than the median value of 2.58cc, fixed/Iris plans provided significantly lower NTCP values. On the other side, MLC plans provided significantly lower treatment times (−18.4%), number of monitor units (−33.3%), beams (−46.0%) and nodes (−21.3%).

Conclusions:
CK-MLC plans for the stereotactic treatment of brain multi metastases could provide an important advantage in terms of treatment duration. However, to contain the increased risk for brain radionecrosis, it could be useful to calculate MLC plans only for patients with large PTVtot.
Benchmarking a New Circular Cone-based Radiosurgery System against Clinically Tested Radiosurgery System on the same Novel Digital Linear Accelerator Platform
Authors: Sharma Dayananda Shamurailatpam , Shaju P , Sawant Mayur B , Kaushik Suryakant 
Published: September 2024

Objective:
To examine the dosimetric characteristics of circular cones, the accuracy of dose modeling and overall treatment delivery of two radiosurgery systems integrated on a linear accelerator (Linac).

Materials and Methods:
The dosimetric characteristics of circular cones (4-17.5 mm) from Varian (VC) and BrainLAB (BLC) were measured for 6 MV flattening filter free beam from Edge linac using stereotactic field diode and 0.65 cc ionization chamber following established protocols. The Eclipse and iPlan modeled dose distribution for VCs and BLCs were validated with EBT3-film measurement. End-to-end tests were performed using stereotactic phantom having PTW 60008 diode connected to a Dose-1 electrometer.

Results:
The depth at dose maximum,

JOURNAL/jomp/04.03/00660230-202348020-00001/111FF07/v/2023-07-11T195429Z/r/image-tiff

and dose at 10cm depth of the same size VC and BLC agree within ± 0.7 mm, ± 0.71% and ± 0.81% respectively. Full width at half maximum (FWHM) of any cone beyond 15 mm depth increases at 1% of nominal cone size per 10 mm depth. The penumbra of 4mm and 17.5mm VC at 15 mm depth was 1.1 mm and 1.50 mm. At 300 mm depth, penumbra increased by around 0.4 mm for 4 mm cone and up to 1 mm for cone size ≥12.5 mm. The VCs penumbra values were within ±1mm of the corresponding BLCs. Scatter factors for VCs varies from 0.609 to 0.841 and were within ± 1.0% of corresponding values of BLCs. Agreement between the Eclipse and iPlan computed dose fluence and the EBT3-film measured dose fluence was >98% (γ: 1%@1 mm), and the absolute dose difference was ≤ 2.2%, except for the 4 mm cone in which it was >96% and ≤4.83%. Target localization using cone-beam computed tomography was accurate within ± 0.8 mm and ± 0.3° in translation and rotation. The end-to-end dose delivery accuracy for both radiosurgery systems was within ± 3.62%.

Conclusion:
The dosimetric characteristics of Varian and BLC cones of same diameter was comparable. Both Eclipse and iPlan cone planning system modeled dose fluences agree well with the EBT3 film measurement. The end-to-end tests revealed an excellent target localization accuracy of Edge linac with satisfactory and comparable absolute dose agreement between Varian and BLC radiosurgery systems and hence these can be interchanged on edge linac.