Search

Aims. Baccalaureate nursing students often enter nursing programs with varying degrees of writing skills. The use of formative assessment can provide students and faculty with information to act upon during a course and improve learning. This study aimed to test the use of a program-level written communication rubric as a formative assessment to be able to provide targeted interventions for improvement as part of curricular evaluation. Methods. A written communication rubric (14 criteria with scores ranging from 1–4) was applied twice during the semester to assess the writing assignments of 33 undergraduate nursing students enrolled in a nursing research course. A targeted intervention was designed and implemented based on deficient aggregate assessment results from the first student assignment. Results. Paired t-test analysis demonstrated a significant upward change in student performance in the second student assignment for all seven of the targeted competency scores (all p < 0.05). Conclusions. The use of a program-level rubric as a formative assessment paired with a targeted intervention improved the writing skills of nursing students during a single semester. By harnessing the tools of online learning management systems, faculty can quickly identify specific challenges for students in academic writing. There is potential for formative assessment to be used by faculty and students to direct the ongoing development of writing skills both during a course and throughout the program of study. [ABSTRACT FROM AUTHOR]

This paper constructs and applies a university student sports health management system through the theory of integrated regional collaborative medical care and distributed computing technology. Firstly, it analyzes the current situation and problems of cross-regional medical care, the root causes, and the corresponding business scenarios, reflecting the development trend of cross-regional medical care, in the light of the current practical needs of cross-regional medical care. In response to the strong demand for cross-regional medical care, this paper gives the overall design of the distributed computing system, for the deployment and architecture of the cross-regional platform; the registration of cross-regional patients, regional platforms, and health events and documents; and data exchange, service integration, and process integration, etc. The corresponding design is given. The research was conducted on several medical institutions to refine the functional requirements for the construction of the regional collaborative medical platform, and the requirements were analyzed to present the research results of the collaborative medical project. Based on this, requirements were made for the preparation of the project construction data center and medical institutions, and the remote consultation and two-way referral modules of the distributed collaborative medical platform were designed, which are processed and analyzed through a system composed of multiple servers. The results are returned to the user, and the design results were tested for functionality, compatibility, security, and other usability tests. The necessity and feasibility of the college physical health test data platform were analyzed. Students have various needs for physical test data management, the necessity of designing the college physical health test data platform, and the feasibility of the college physical health test data platform in terms of technical means, theoretical basis, and social environment. [ABSTRACT FROM AUTHOR]

Background. The academic scientific research in the field of dentistry has rapidly increased in the last 20 years under the pressure of the multidisciplinary technological advancements and the growing demand for new predictable and cost-effective techniques and materials. The aim of the present investigation was to analyze the academic scientific production conducted by Italian Academies and Dental Schools. Methods. The list of MED/28 academic researchers, associate and full professors, and academic affiliations was collected from the national database of CINECA to evaluate the scientific output of the Italian Universities. The complete list of scientific contributions and the bibliometric parameters were recorded in the Scopus database. Results. The scientific production of 37 Italian Universities, 416 researchers, and 23689 papers was evaluated. The measurement of total academic papers, citations, h-index, and relative citation ratio (RCR) was calculated. The study data showed an increase of the academic scientific production over the last 5 years. Conclusions. The results presented show how scientific research is increasingly pursued by dental clinicians. [ABSTRACT FROM AUTHOR]

Although individual factors play a vital role in determining professional autonomy, their specific impact during the coronavirus disease 2019 (COVID-19) pandemic has not been studied. This study aimed to compare nurses' professional autonomy when caring for patients with COVID-19 and for other patients and explore factors related to autonomy when caring for these patients. A paper-based questionnaire survey was conducted from June to August 2022 among nurses working at a university hospital in Japan. The survey included demographic factors (10 items, including, age, section, years of nursing experience, position, educational background, ladder level, and having certified nurse specialists or certified nurse qualifications) and individual experience factors (4 items: number of COVID-19 patients experienced, frequency and contents of searching for the latest information about COVID-19, frequency of using scientific sources, and frequency of training/study sessions on COVID-19 attended at the hospital). Additionally, basic knowledge of COVID-19 was evaluated. The scale for nurses' professional autonomy was developed based on a previous study. A paired t-test and stepwise multiple linear regression were used for the analyses. Overall, 241 nurses participated in the survey. The average length of nursing experience was 10.3 ± 9.2 years. The total scores for nurses' professional autonomy in all 5 factors 27 items were significantly lower (t = −12.1, p < 0.001) when caring for COVID-19 patients than when caring for other patients. Specifically, Factor 1 (Cognition) exhibited the most decreased scores when caring for COVID-19 patients than when caring for other patients. Factor 4 (Abstract judgment) differed the least between caring for COVID-19 and for other patients, but the average score was the lowest. More years of nursing experience (β = 0.208, p = 0.001) and a higher number of patients with COVID-19 cared for (β = 0.140, p = 0.026) were associated with higher autonomy scores. In conclusion, to enhance professional autonomy during an unprecedented pandemic, nurses must enhance cognition and abstract judgment. In the event of a future pandemic, nurses need to create an environment in which they routinely access and utilize the latest information and scientific evidence to provide high-quality nursing care based on their professional judgment and competence. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate risk factors associated with keratoconus in a monocentric cross-sectional case-control study. Methods. This observational study occurred from June 2019 to February 2021 in a university hospital (France). The case group consisted of 195 patients with keratoconus in at least one eye who were followed up by a corneal specialist. The control group consisted of 195 patients without any evidence of keratoconus on slit-lamp examination and corneal topography, who were matched 1 : 1 to controls by age and sex. Data were collected by a self-completed paper questionnaire before the consultation, and a multivariate logistic regression was performed. Results. Multivariate analysis revealed significant associations of keratoconus with family history (odds ratio [OR] = 22.2, p < 0.001), rubbing eyes (OR = 10.9, p < 0.001), allergy (any kind) (OR = 3.80, p < 0.001), smoking exposure (OR = 2.08, p = 0.017), and dry eyes (OR = 1.77, p = 0.045 f). The worst eye was associated with the more rubbed eye (p < 0.001) and the more pressed eye during the night according to sleeping position (p < 0.041). Conclusion. This study confirmed the association between keratoconus and eye rubbing, family history, and allergy. It highlighted the role of pressure on the eyes during sleep. Other less known risk factors such as dry eyes and smoking exposure should be explored in future studies. [ABSTRACT FROM AUTHOR]

Objective. Internet of Things (IoT) integrates several technologies where devices learn from the experience of each other thereby reducing human-intervened likely errors. Modern technologies like IoT and machine learning enable the conventional to patient-specific approach transition in healthcare. In conventional approach, the biggest challenge faced by healthcare professionals is to predict a disease by observing the symptoms, monitoring the remote area patient, and also attending to the patient all the time after being hospitalised. IoT provides real-time data, makes decision-making smarter, and provides far superior analytics, and all these to help improve the quality of healthcare. The main objective of the work was to create an IoT-based automated system using machine learning models for symptom-based COVID-19 prognosis. Methods. Comparative analysis of predictive microbiology of COVID-19 from case symptoms using various machine learning classifiers like logistics regression, k-nearest neighbor, support vector machine, random forest, decision trees, Naïve Bayes, and gradient booster is reported here. For the sake of the validation and verification of the models, performance of each model based on the retrieved cloud-stored data was measured for accuracy. Results. From the accuracy plot, it was concluded that k-NN was more accurate (97.97%) followed by decision tree (97.79), support vector machine (97.42), logistics regression (96.50), random forest (90.66), gradient boosting classifier (87.77), and Naïve Bayes (73.50) in COVID-19 prognosis. Conclusion. The paper presents a health monitoring IoT framework having high clinical significance in real-time and remote healthcare monitoring. The findings reported here and the lessons learnt shall enable the healthcare system worldwide to counter not only this ongoing COVID but many other such global pandemics the humanity may suffer from time to come. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this paper is to analyse the correlation between cardiac ultrasound-related indicators and cardiac function in patients with coronary heart disease and heart failure. Methods. In this experiment, a total of 160 patients with coronary heart disease and heart failure who were diagnosed and treated in our hospital from June 2019 to March 2021 were recruited as the study group. All were examined by colour Doppler ultrasound instrument, SPSS statistical software was used to analyse the data obtained, and Spearman correlation was used to analyse the correlation between cardiac ultrasound-related indicators and cardiac function in patients with coronary heart disease and heart failure. Results. In the study group, there were 68 patients with grade II cardiac function, accounting for 42.50%; 74 patients with grade III, accounting for 46.25%; and 18 patients with grade IV, accounting for 11.25%. The ultrasound parameters of the patients in the study group were profiled and calculated, and then statistically analysed with cardiac function grading. Cardiac function classification was significantly positively correlated with LVMI, LAD, and LVEDd (r = 0.689/0.915/0.928, P = 0.001) and significantly negatively correlated with CI, LVFS, and LVEF (r = −0.689/−0.878/−0.912), P = 0.001). Conclusion. Cardiac ultrasound-related indicators are associated with patients with coronary heart disease and heart failure. With the decline of cardiac function in patients with coronary heart disease and heart failure, the patient's condition is aggravated. Therefore, cardiac ultrasound-related indicators play a major role in the diagnosis of clinical disease progression. [ABSTRACT FROM AUTHOR]

Nosocomial infections, in lay term known as hospital acquired infections, are caused mainly by airborne pathogens found in healthcare facilities and their surroundings. The aim of this study was to quantify and identify bacteria and fungi in a hospital, which is an understudied area of air quality in Sri Lanka. Air samples were collected in agar medium and petri plates containing sterile filter papers. The number of culturable and total airborne microorganisms was estimated by manual counting and fluorescent microscopy, respectively. The morphologically distant bacteria and fungi were identified by DNA sequencing. The statistical analysis revealed significant variances between studied sites (p < 0.05) where Outpatients Department and Respiratory Unit showed higher levels of airborne microbial load. Culturable microbial count was higher at noon (hospital visiting hours) compared to other sampling periods (after hospital visiting hours) within the hospital. Total count of airborne microbes was found to be the highest during the afternoon. The most sensitive zones such as Operating Theatre and Intensive Care Unit showed considerably higher counts of airborne microbes. Identification by molecular means revealed the presence of human pathogens in the hospital air including Bacillus sp, Micrococcus sp, Pseudomonas sp, Staphylococcu ssp, Exiguobacterium sp, Enterobacter sp, Escherichia sp, Sphingomonas sp, Massilia sp, Kocuria sp, Fusarium sp, and Aspergillus sp. In conclusion, the results from this study indicate that the hospital air was generally contaminated. Therefore, the implementation of proactive policies and strategies are needed to monitor hospital air quality in sensitive zones as well as other areas of the hospitals. [ABSTRACT FROM AUTHOR]

Expansion of a primary spontaneous intracranial hemorrhage (PSICH) has become lately of increasing interest, especially after the emergence of its early predictors. However, these signs lacked sensitivity and specificity. The flood phenomenon, defined as a drastic increase in the size of a PSICH during the same magnetic resonance study, was first described in this paper based on the data of a university medical center in Lebanon. Moreover, further review of this data resulted in 205 studies with presumed diagnosis of primary spontaneous intracranial hemorrhage within the last 10 years, of which 29 exams showed typical predictors of hematoma expansion on computed tomography. The intended benefit of this observation is to draw the radiologists' attention towards minimal variations in the volume of the hematoma between the two extreme sequences of the same MRI study, in order to detect inconspicuous flood phenomena—a direct sign of hematoma expansion. [ABSTRACT FROM AUTHOR]

Background. Systemic sclerosis (SSc) is an autoimmune disease characterized by inflammation, progressive vasculopathy, and fibrosis of skin and internal organs. The aim of the study was to evaluate extended inflammatory parameters (EIP) in patients with SSc in comparison to the control group of healthy subjects. Methods. A total of 28 patients with SSc and 29 healthy controls (HCs) were included in the study. The following EIP parameters were analyzed: neutrophil reactive intensity (NEUT‐RI), neutrophil granularity intensity (NEUT‐GI), antibody‐synthesizing lymphocytes (AS‐LYMP), and reactive lymphocytes (RE‐LYMP). Results. Patients with SSc showed significantly higher values of parameters determining neutrophil reactivity and neutrophil granularity when compared to HCs (respectively, 49.16 FI vs. 44.33 FI, p < 0.001, and 152.01 SI vs. 147.51 SI, p < 0.001). Moreover, patients with SSc had higher absolute numbers of RE‐LYMP than HCs (0.69 × 103/µl vs. 0.04 × 103/µl, p < 0.001). Importantly, significant correlations between the RE‐LYMP and either IL‐6 (R = 0.447, p < 0.001) or ESR (R = 0.532, p < 0.001) were found among patients with SSc. Conclusions. Changes in NEUT‐RI, NEUT‐GI, and RE‐LYMP levels positively correlate with inflammation in SSc and, thus, could potentially be used as an additional reliable inflammatory biomarker to assess inflammation in this disease. [ABSTRACT FROM AUTHOR]

Background. Novel educational strategies are essential to cultivate a cadre of nurses with the requisite skills, critical thinking abilities, and adaptability demanded by contemporary healthcare contexts. The shift towards various learning modalities in nursing education, including online, hybrid, and in‐person formats, raises questions about their impact on student engagement and academic self‐concept. Objectives. This study aimed to assess and compare the levels of student engagement and academic self‐concept among nursing students engaged in different study modalities (online, hybrid, and in‐person). Methods. In this descriptive comparative study, 203 nursing students were evaluated using the university student engagement inventory (USEI) and academic self‐concept questionnaire (ASCQ). Participants were divided into groups based on their involvement in online, hybrid, or in‐person study modes. Differences and correlational analysis within variables were performed to evaluate the comparison between groups. Results. Significant differences were observed in the USEI scores among the study modalities: online (mean = 45.7, SD = 5.6), hybrid (mean = 48.8, SD = 6.1), and in‐person (mean = 50.4, SD = 6.2), with in‐person students displaying the highest levels of engagement (F = 10.663, P < 0.001). Academic self‐concept scores also varied notably (F = 9.422, P < 0.001) between modalities, particularly between online (mean = 54.8, SD = 5.3) and in‐person students (mean = 58.8, SD = 7.7). Correlational analysis within each modality revealed significant relationships among the subdomains of USEI and ASCQ. Conclusion. The study demonstrates that the mode of study substantially influences nursing students' engagement and academic self‐concept, with in‐person learners showing higher scores in both domains. These results are vital for educators and policymakers in nursing education to optimize learning experiences across different modalities. [ABSTRACT FROM AUTHOR]

The increased funding provided for Community Health Worker (CHW) hiring and training as part of the COVID‐19 pandemic response was to increase their impact in alleviating the effects of negative social determinants of health in the lives of the most vulnerable individuals and communities. This enhanced use of CHW in vulnerable populations can also be used to improve access to such populations for applied research to study ways to improve health outcomes for low‐income minority populations. We carried out a feasibility study using the State CHW association as partners to reach CHWs working with low‐income minority population. Three hundred and three (303) clients of CHWs were interviewed on various demographic, health access, and employment information and both univariate and multivariate analyses was used to determine factors associated with being unvaccinated against COVID‐19 and chi‐squared used to determine if employment was associated with having health insurance. About half of the clients self‐identified as Black/African American and half as Hispanic. Two‐thirds were women and 52.1% were unemployed and 55.1% had no health insurance. There was no association between employment status and having health insurance. Majority (71.6%) had received one dose of a type of COVID‐19 vaccine and being younger and being African American were associated with not getting a dose of COVID‐19 vaccine, as well as being unemployed and not having health insurance. Most of the clients came to see the CHW about a Health/Healthcare issue of the five social determinants of health (SDOH). There were 38 different job titles provided by the clients and the job titles were mainly blue collar jobs and jobs in health and personal care. Our results indicate that CHWs reach the most vulnerable population who have limited health access and high unemployment and that CHWs can effectively be used for linkage to low‐income minority population for applied research. Our analyses found that in this low‐income population, being younger, being African American, being unemployed, and not having health insurance are each associated with not getting vaccinated against COVID‐19, and employment is not associated with having health insurance. We have shown that partnership with CHWs to access their clients as research subjects leads to elucidating new information on the population that can be used in addressing public health programming. [ABSTRACT FROM AUTHOR]

Objectives. This study aimed to report clinical outcomes of patients with vaginal melanoma (VaM) or vulvar melanoma (VuM) who were treated with immune checkpoint inhibitors (ICI) and discuss the development of immune‐related adverse events (irAE). Materials and Methods. This is a retrospective case series of patients diagnosed with VaM or VuM between July 2011 and September 2022 at the University of Virginia, Emily Couric Clinical Cancer Center. Patient demographics, disease characteristics, treatment outcomes, and adverse events were abstracted. The primary outcome was incidence of irAE. Results. Eight patients were included in this study, four with VaM and four with VuM. Most (n = 6) had local or regional disease at first presentation, and 25% (n = 2) presented with distant metastasis. All patients received a CTLA‐4 inhibitor and 75% (n = 6) received PD‐1 inhibitor alone or in combination with a CTLA‐4 inhibitor. Most (75%, n = 6) patients experienced irAE. Of those who had irAE, 83% (n = 5) required therapy interruption or discontinuation. Most (66%, n = 4) underwent ICI rechallenge of which 75% (n = 3) experienced subsequent irAE. Of all patients in the series, 75% of patients (n = 6) had partial or complete response to ICI. Conclusion. This series is the first to detail incidence of irAEs and ICI rechallenges in vulvovaginal melanoma. Our findings indicate that while ICIs are effective, their use is associated with significant irAE development. Rechallenge of ICI after irAE is feasible but associated with risk of recurrent/new irAE. Further studies are needed to better quantify this risk. [ABSTRACT FROM AUTHOR]

The low cost, simple, noninvasive, and continuous measurement of cerebral blood flow velocity (CBFV) by transcranial Doppler is becoming a common clinical tool for the assessment of cerebral hemodynamics. CBFV monitoring can also help with noninvasive estimation of intracranial pressure and evaluation of mild traumatic brain injury. Reliable CBFV waveform analysis depends heavily on its accurate beat-to-beat delineation. However, CBFV is inherently contaminated with various types of noise/artifacts and has a wide range of possible pathological waveform morphologies. Thus, pulse onset detection is in general a challenging task for CBFV signal. In this paper, we conducted a comprehensive comparative analysis of three popular pulse onset detection methods using a large annotated dataset of 92,794 CBFV pulses—collected from 108 subarachnoid hemorrhage patients admitted to UCLA Medical Center. We compared these methods not only in terms of their accuracy and computational complexity, but also for their sensitivity to the selection of their parameters' values. The results of this comprehensive study revealed that using optimal values of the parameters obtained from sensitivity analysis, one method can achieve the highest accuracy for CBFV pulse onset detection with true positive rate (TPR) of 97.06% and positive predictivity value (PPV) of 96.48%, when error threshold is set to just less than 10 ms. We conclude that the high accuracy and low computational complexity of this method (average running time of 4ms/pulse) makes it a reliable algorithm for CBFV pulse onset detection. [ABSTRACT FROM AUTHOR]

As global populations age, a looming nursing shortage is anticipated to become a critical issue. Charge nurses have the responsibility of optimally allocating nursing resources to ensure the quality of patient care during a shift. Therefore, an accurate estimate of nursing demand is crucial. However, the ability to forecast future nursing demand remains underdeveloped, mainly because the nature of nursing demand is highly individualized and does not follow a definitive pattern. In practice, the nursing demand is often perceived as unpredictable, leading to an ad hoc approach to staffing. The primary objective of our study is to demonstrate that longitudinal data analysis can reveal strong statistical regularities in the temporal dynamics of nursing demand. This approach not only provides new possibilities for efficient resource allocation but also paves the way for data‐driven prediction of nursing demand. Our study uses Sankey diagrams to visualize the temporal dynamics of nursing demand within each ward for each fiscal year, representing these dynamics as an overlay of trajectories from multiple individual patients. Consequently, our study reveals ward‐specific statistical regularities in the temporal dynamics of nursing demand. In one ward, approximately 25% of patients experienced an increase in nursing demand from 1 to between 6 and 9 points from the second to the third day of hospitalization, while in another, only 0.1% showed such an increase. These findings suggest that patients admitted to the wards tend to exhibit a certain probabilistic change in nursing demand. This study can predict probabilistically the temporal variation of nursing demand among patients in the coming years by analyzing data on the temporal changes in nursing demand over the past years. Our findings are expected to significantly influence the forecasting of nursing demand and the estimation of nursing resources, leading to data‐driven and more efficient nursing management. [ABSTRACT FROM AUTHOR]

Background: Patients with inflammatory bowel disease (IBD) often experience worries related to travel due to frequent bowel movements. However, there is currently limited research focusing on the travel worries of patients with IBD. The aim of this study was to assess the level of worry regarding out‐of‐home activities in patients with IBD and identify factors associated with worry. Methods: This study included patients with IBD who visited the outpatient clinics between September 2020 and March 2022, during the COVID‐19 pandemic. Participants completed a self‐designed questionnaire, providing general clinical data and indicating their level of worry for out‐of‐home activities. Results: A total of 529 patients with IBD completed the questionnaire. Patients with Crohn's disease (CD) had a higher proportion of individuals under 40 years old and males compared to patients with ulcerative colitis (UC). Regarding out‐of‐home activities, patients with UC expressed greater worry about going out and taking buses than patients with CD. However, there were no significant differences observed between the two groups in terms of travel worries and worries about finding public washrooms. A significant majority (85.4%) of patients with clinically active IBD expressed worries about not finding public washrooms when going out, while 46.7% of patients in clinical remission had similar worries. Moreover, the worry about finding public washrooms was higher in patients with UC compared to those with CD, both during the clinical activity and remission. Conclusion: This survey conducted during the COVID‐19 pandemic reported worries among patients with IBD about out‐of‐home activities. The patients with clinically active IBD, especially UC, expressed worries about not finding public washrooms when going out. We highlight the actual psychological and quality of life challenges faced by patients with IBD. [ABSTRACT FROM AUTHOR]

Background. Granulomatous dermatoses, particularly on facial skin, pose a diagnostic challenge, as similar histologic patterns can be produced by different causes. Aim. To evaluate the correlation between clinical suspicion and histopathological findings in various facial granulomatous dermatoses. Materials and Methods. This retrospective, cross-sectional study included all patients with the histopathological diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 in an academic hospital. Demographic, clinical, and histopathologic features were reviewed and analyzed. Results. In this study, 150 histopathological records with the diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 were reviewed. The most common clinical diagnosis was rosacea 34 (23.6%), followed by sarcoidosis 27 (18.8%), leishmaniasis 15 (10.4%), and granulomatous rosacea 10 (6.9%). The frequency of clinical diagnosis of rosacea (70.6), sarcoidosis (66.7), foreign body G (62.5), TB (75), pseudolymphoma (75), acne agminata (66.7), and granulomatous rosacea (70) in female patients was higher than that in males (P value = 0.03). The effect of age on the type of both clinical and histopathological diagnosis was statistically significant (P value = 0.0001 and 0.004, respectively). Conclusion. Our study contributed significantly to the understanding of the clinicopathological aspects of facial granulomatous dermatoses and advocated for a multidisciplinary approach to the diagnosis and management of these complex skin conditions. [ABSTRACT FROM AUTHOR]

Background. Atrial fibrillation (AF) is associated with significant mortality and morbidity from stroke and thromboembolism. Despite the availability of effective oral anticoagulation medication, AF patients remain at a high risk of stroke if not treated properly. The purpose of this study was to evaluate antithrombotic therapy practices in patients with AF in the adult cardiac clinic at Hawassa University Comprehensive Specialized Hospital (HUCSH). Methods. It was a retrospective document review study. Total charts of 119 patients who had follow‐up at the adult cardiac clinic with a history of documented AF from January 1 to December 30, 2018, were included. Indicators for antithrombotic therapy based on the congestive heart failure, hypertension, age ≥75 (doubled), diabetes, stroke (doubled), vascular disease, age 65 to 74, and sex category (female) (CHA2DS2‐VASc) score were recorded. A p value of 0.05 was considered statistically significant. Data analysis was done using SPSS 23 software. Results. In this study, about 55% of patients with AF were receiving the appropriate antithrombotic treatment. The patients were 48 ± 18.2 years old. Of these, 70% were women. The most frequent underlying cardiac etiology was chronic rheumatic valvular heart disease (50%), followed by cardiomyopathy (14%). In nonvalvular AF, the mean CHA2DS2VASc score was 4.0 ± 1.07. In valvular AF compared to nonvalvular AF, the need for appropriate antithrombotic therapy was substantially greater (p 0.0001). Only 8 (13.6%) of the warfarin‐using patients had adequate anticoagulation. Conclusion. The study's findings in regard to antithrombotic usage and maintenance of appropriate antithrombotics for stroke prevention in our patients revealed a discrepancy between recommendations and practice. Therefore, we demand that patients with AF who meet the criteria utilize antithrombotics properly to prevent stroke. Warfarin‐taking patients' subpar optimum anticoagulation has to be addressed. Lastly, we advocate proper CHA2DS2‐VASc score utilization for nonvalvular heart disease. A regular INR follow‐up is also advised for patients who have started taking warfarin. [ABSTRACT FROM AUTHOR]

Purpose. Breast cancer is considered a huge health problem among women all over the world due to its increased mortality rate. Breast cancer deaths are decreased by 28–34% due to improvement in treatment and early detection. In order to detect breast cancer early and provide the best possible therapy, knowledge and awareness are essential. So, this study aimed to assess risk of breast cancer among nurses, the knowledge and practices of breast self-examination (BSE) and determine its barriers, and implement an educational program for them. Design. A quasiexperimental research design was used. Methods. This study was conducted at two university hospitals (main university hospital and woman's health hospital). A purposive sample of 280 nurses with age more than thirty-five years were included in the study using three tools, namely, structure interview questionnaire, breast cancer risk assessment tool, and a structured breast cancer knowledge and practice questionnaire. Nurses' knowledge and practices regarding breast cancer and BSE were first assessed and then they were provided with two educational courses covering theoretical and practical information. One month after the program ended, the nurses' knowledge and practices were assessed again. Results. About 3.2% of the participants have five years high risk of developing breast cancer according the risk assessment tool, the main barriers of do not do BSE did not find any symptoms and scared from finding any abnormality. There was a significant increase in knowledge and practice of breast self-examination posteducation compared to pre-education (73.2 and 98.2%, respectively). Also, there was a statistically significant difference between pre- and postprogram with a p value of 0.0001. Conclusion. This study concluded that 3.2% of the nurses with high risk of developing breast cancer needed a follow-up; more than half of them do not perform breast self-examination because they think that do not have any symptoms in the breast and the educational program with a significant effect on knowledge and practices of nurses. So, the researchers recommend the nurses need for an empowerment program and support by providing assistance in places of work as done free clinical examination and mammography by female specialist for privacy. [ABSTRACT FROM AUTHOR]

Dyskinetic disorders are characterized by excess of motor activity that may interfere with normal movement control. In patients with Parkinson's disease, the chronic levodopa treatment induces dyskinetic movements known as levodopa-induced dyskinesias (LID). This paper analyzed the pathophysiology, clinical manifestations, pharmacological treatments, and surgical procedures to treat hyperkinetic disorders. Surgery is currently the only treatment available for Parkinson's disease that may improve both parkinsonian motor syndrome and LID. However, this paper shows the different mechanisms involved are not well understood. [ABSTRACT FROM AUTHOR]

Introduction. Little is known about how shifting hospital visitor restrictions issued by national health authorities were communicated, managed, and adapted by hospital charge nurses during the COVID-19 pandemic. Aims. To describe the shifting visitor restrictions and the passing on of restrictions from the national authority level to charge nurses and secondly describe charge nurses' management of the restrictions and their challenges when enforcing them. Methods. The study consisted of a document analysis and a cross-sectional survey including open-ended questions. Descriptive statistics and qualitative content analysis were used. The survey was distributed online to 88 charge nurses in somatic units in a Danish university hospital from March 2020 to April 2021. Results. Restrictions were communicated from national authority level in an effective administrative cascade. The charge nurses led their enforcement in each unit. In total, 71 charge nurses (81%) responded to the survey. For 70%, the wording of the restrictions was clear, while 31% found them challenging to handle. On a weekly or daily basis, 68% of the charge nurses deviated from the restrictions. They identified both upsides and downsides to the absence of relatives. Communication, collaboration, and leadership were experienced as key tools in the ongoing processes of adapting to shifting restrictions. Conclusion. During this severe health crisis, essential information was passed on through well-defined management levels in an effective communication pathway. Charge nurses and their professional values were challenged when balancing shifting national restrictions against individual needs of patients and relatives. Implications for Nursing Management. Charge nurses serve as vital intermediaries between national authorities and frontline nursing practice in managing shifting visitor restrictions during a pandemic. Their experiences can contribute to further qualifying nurse managers' considerations when designing family-centred hospital visitor policies for the future. Also, they may strengthen the handling of future sudden major organizational changes. [ABSTRACT FROM AUTHOR]

Background. The mnemonic learning method is a systematic approach that helps nursing students memorize new information more effectively, productively, and easily by connecting new information with existing information and exploring unfamiliar information through visual images or combinations of letters and words. While mnemonics can help students remember specific information, it is essential to examine how well they facilitate the transfer of learning to real-world nursing practice. Aim. To investigate the effect of the mnemonic learning strategy on critical care nursing students' tracheal suction skill acquisition and learning satisfaction. Methods. A quasi-experimental research design was used. A total of 280 second-year nursing students enrolled in critical care and emergency nursing courses were recruited. These students were assigned to study and control groups. The study group used a mnemonic learning strategy to recall the steps involved in the tracheal suction procedure, while the control group used the traditional learning strategy. Two tools were used for data collection: the tracheal suction procedure checklist and learning satisfaction scale. Comparisons between both groups regarding their performance and satisfaction scores were done. Results. Performance scores regarding the tracheal suction procedure were significantly higher in the study group than in the control group in the 5th, 6th, and 10th weeks (P < 0.001 , <0.001, and <0.001). A total of 70.6% of the participants in the study group reported high satisfaction using the mnemonic learning experience. Conclusion. Using a mnemonic learning strategy with critical care nursing students was effective. Participants in the study group exhibited improvement in their tracheal suction procedure scores over time. Critical care nursing students reported higher levels of learning satisfaction with the mnemonic learning method than with the traditional method. [ABSTRACT FROM AUTHOR]

Background. As nursing interns enter challenging clinical settings, evaluating their preparation and readiness is vital for adaptation success. Sufficient real-world experience and patient care are crucial preparation components that enable effective practice and higher competencies. Aim. This study aimed to assess nurse interns' perception of clinical preparation and readiness for clinical internship experiences. Methods. A self-administered questionnaire was distributed, comprising three sections on demographics, clinical preparation requirements, and the Casey–Fink Readiness for Practice Survey. Descriptive statistics as the mean and standard deviation, numbers and percentages, linear regression model, and Pearson correlation coefficient were used for reporting normal distribution, categorical variables, and relationship between a scalar response and one or more explanatory variables and to calculate statistics between two continuous variables. Results. The participants were 130 nurse interns who were involved in an internship between 2016 and 2020, 50% of the nurse interns. They had a moderate level of clinical preparation, and 28.5% of them exhibited a low level. In addition, 53.8% were found to be moderately ready for practice, while 22.3% had a low level of readiness Conclusion. The observed significant positive correlation between perceived preparation and readiness underscores the pivotal role of clinical preparation in influencing practice readiness. Implications. These findings emphasize the importance of targeted interventions aimed at enhancing clinical preparation to directly bolster overall readiness for professional practice among nurse interns. [ABSTRACT FROM AUTHOR]

The aim was to explore why registered nurses (RNs) in Sweden choose to quit their jobs in hospitals, also in relation to experienced patient safety. Previous research has shown that nurse turnover, especially in hospital settings, is a serious challenge for society and health care globally. Insufficient staffing of RNs is linked to poorer patient outcomes and a general patient safety at risk. It is, therefore, important to continually explore how nurses describe their reasons for quitting their jobs. The study was conducted using a qualitative descriptive design, based on 11 semistructured interviews with RNs. The analysis generated four categories describing the results: Feeling that the profession is not valued; Psychological and physical symptoms related to work; An insufficient and unsupportive organization; and Unsatisfying leadership and teamwork. Specifically, the RNs participating in this study described a range of reasons for quitting, where the feeling of not being valued and treated as a respected and autonomous profession was a common thread throughout the results. RNs experienced that, overall, the insufficient work conditions, also resulting in lower patient safety, ultimately led to their decision to quit. The findings highlight the crucial need for employers to develop working conditions for RNs, to make sure that the profession is valued according to professional standards and provide the potential for autonomous nursing practice. To reduce nurse turnover, and instead attract and retain nurses, leadership and management in nursing need to be adjusted to meet the demands of a modern academic profession. [ABSTRACT FROM AUTHOR]

Nowadays, several screening strategies are available to prevent cervical cancer, but inadequate resources, sociocultural barriers, and sampling issues impede their success in low-income countries. To overcome these issues, this study aimed to evaluate the performance of human papillomavirus (HPV) testing from dried urine spots (DUS). Eighty-eight urine samples (including 56 HPV DNA positive specimens) were spotted on filter paper, dried, and stored in paper-bags. HPV DNA was detected from the DUS after 1 week and 4 weeks of storage using a polymerase chain reaction (PCR) assay. The sensitivity, specificity, and concordance of the DUS-based HPV test were evaluated by comparing the results with those of HPV testing on fresh urine samples as the gold standard. The sensitivity of the test was 98.21% (95% CI: 90.56–99.68) for DUS stored for 1 week and 96.42% (95% CI: 87.88–99.01) for DUS stored for 4 weeks. The specificity was 100% (95% CI: 89.28–100) at both time points. The concordance between DUS and fresh urine HPV testing was “almost perfect” using the κ statistic. These preliminary data suggest that a DUS-based assay could bypass sociocultural barriers and sampling issues and therefore could be a suitable, effective tool for epidemiological surveillance and screening programs, especially in low-income countries. [ABSTRACT FROM AUTHOR]

Objective. Refractive surgery volume has not rebounded despite economic recovery and literature describing safety, efficacy, and high patient satisfaction. We sought to examine characteristics of consultation seekers and status after consultation. Methods. Charts of patients seeking refractive surgery at Johns Hopkins University from 2013 through 2016 were retrospectively reviewed for age, gender, refractive characteristics, and outcome: surgery (photorefractive keratectomy, laser in-situ keratomileusis, implantable collamer lens, or refractive lens exchange); no surgery—"lost candidate" (good candidates who were lost after consultation); noncandidates based on technological limitations or contraindications; or no surgery—possessing expectations that surgery would not meet. Associations between characteristics and status after consultation were examined. Results. Twenty percent (142/712) of all patients were "lost candidates"; 57% (408/712) completed surgery. More women (56% or 401/712) sought consultation, but a greater percentage (63% or 195/311) of men completed surgery than women did (53% or 213/401) p = 0.02 . Of consultation seekers, 60% were low myopes, 29% were high myopes (>6 diopters of myopic spherical equivalent), and 11% were hyperopes. Surgical patients' mean age was 34.2 ± 10.2 (standard deviation) years; for each additional year of age, patients were less likely to have surgery p < 0.001 . Hyperopes were ≥3 times more likely than myopes to have expectations not met by surgery or to be noncandidates than to have surgery p < 0.005 . Conclusions. Most patients seeking refractive surgery had 6 diopters or less of myopia. About 20% of patients were lost after consultation; better counseling and follow-up of candidates may be warranted. Expectations and technology limit eligibility for many, especially hyperopes. Low surgery volume may affect training of future refractive surgeons. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify factors affecting the noise management performance of adult intensive care unit (ICU) nurses in Korea. The ICU environment is exposed to various types of noises due to the use of medical devices for the treatment of critically ill patients. The noise has an adverse effect on nurses' health and their nursing performance, which might potentially threaten patient safety. A cross-sectional study was conducted with a total of 148 nurses working in adult ICUs from two university hospitals in Korea. Data were collected using self-administered questionnaires, which included various aspects such as noise knowledge, response to noise, patient safety culture, and noise management performance. Multiple regression analysis revealed that teamwork (β = 0.33, p = 0.004), patient safety policy, and procedure (β = 0.25, p = 0.037), which were subscales of patient safety culture, as well as frequency of noise experience (β = 0.16, p = 0.030) were significant factors affecting adult ICU nurses' performance of noise management. This study provides a significant basis for promoting adult ICU nurses' performance in noise management. A structured policy and procedure for noise management should be established for reducing noise in adult ICUs. In terms of nursing education, it is necessary to consider and develop team-based training programs to promote noise management performance in the ICU. Nurse managers and nursing organizations should consider how to create conditions in which nurses can recognize the importance of noise reduction and perform well in noise management. [ABSTRACT FROM AUTHOR]

Rationale. Contribute to the understanding of DNR decision-making and conducting end-of-life conversations, about which there is a paucity of data available in the current literature. Aims and Objectives. Assess how the decision-making process to determine a DNR code is implemented in the day-to-day clinical practice in a tertiary teaching hospital. Familiarity with the use of different scores as a possible objective support for DNR decisions and the influence of various elements on a DNR decision was explored. Method. A cross-sectional survey study was conducted between February 2021 and April 2021 for all doctors and doctors in training, working in the Antwerp University Hospital during the COVID-19 pandemic. Results. 127 doctors participated in this study. The familiarity with the different scores used in the triage during the COVID-10 pandemic was 51% for the Clinical Frailty Scale (CFS) and 20% for the Charlson Comorbidity Index (CCI). Participants indicated that their DNR decision is based on various aspects such as clinical assessment, comorbidities, patient's wishes, age, prognosis, and functional state. Conclusion. The familiarity with the different scores used during triage assessments is low. The total clinical picture of the patient is needed to make a considered decision, and this total picture of the patient seems to be well encompassed by frailty measurement (CFS). Although many participants indicated that the different scores do not offer much added value compared to their clinical assessment, it can help guide DNR decisions, especially for doctors in training. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) is a monomer found in commonly used consumer plastic goods. Although much attention in recent years has been placed on BPA's impact as an endocrine disruptor, it also appears to activate many immune pathways involved in both autoimmune disease development and autoimmune reactivity provocation. The current scientific literature is void of research papers linking BPA directly to human or animal onset of autoimmunity. This paper explores the impact of BPA on immune reactivity and the potential roles these mechanisms may have on the development or provocation of autoimmune diseases. Potentialmechanisms by which BPA may be a contributing risk factor to autoimmune disease development and progression include its impact on hyperprolactinemia, estrogenic immune signaling, cytochrome P450 enzyme disruption, immune signal transduction pathway alteration, cytokine polarization, aryl hydrocarbon activation of Th-17 receptors, molecular mimicry, macrophage activation, lipopolysaccharide activation, and immunoglobulin pathophysiology. In this paper a review of these known autoimmune triggering mechanisms will be correlated with BPA exposure, thereby suggesting that BPA has a role in the pathogenesis of autoimmunity. [ABSTRACT FROM AUTHOR]

De-qi refers to the participant's subjective sensations and objective body responses as well as the acupuncturist's perceptions while the acupuncturist needles certain acupoints in the participant's body. In recent years, De-qi is getting increasing attention of the researchers and many efforts have been made to understand its mechanism. By the broad literature survey, this paper explores the subjective De-qi sensation of the patients, its influencing factors, and the resulting physiological responses. The purpose of this paper is expected to find out a possible mechanism of De-qi and to provide certain scientific evidence for acupuncture fundamental research and clinical practice. [ABSTRACT FROM AUTHOR]

The hexapeptide angiotensin IV (Ang IV) is a metabolite of angiotensin II (Ang II) and plays a central role in the brain. It was reported more than two decades ago that intracerebroventricular injection of Ang IV improved memory and learning in the rat. Several hypotheses have been put forward to explain the positive effects of Ang IV and related analogues on cognition. It has been proposed that the insulin-regulated aminopeptidase (IRAP) is the main target of Ang IV. This paper discusses progress in the discovery of inhibitors of IRAP as potential enhancers of cognitive functions. Very potent inhibitors of the protease have been synthesised, but pharmacokinetic issues (including problems associated with crossing the blood-brain barrier) remain to be solved. The paper also briefly presents an overview of the status in the discovery of inhibitors of ACE and renin, and of AT1R antagonists and AT2R agonists, in order to enable other discovery processes within the RAS system to be compared. The paper focuses on the relationship between binding affinities/inhibition capacity and the structures of the ligands that interact with the target proteins. [ABSTRACT FROM AUTHOR]

Senear-Usher syndrome or pemphigus erythematosus is a pathology that overlaps clinically and serologically with pemphigus foliaceus and lupus erythematosus. Skin biopsies of patients with pemphigus erythematosus reveal acantholysis and deposits of immunoglobulins in desmosomes, and they are positive in the lupus band test. In the present paper, we determined whether the autoantibodies associated with pemphigus erythematosus targeted a single antigen or multiple antigens as a result of the stimulation of independent B cell clones. Our present paper demonstrates that patients with pemphigus erythematosus produce both antiepithelial antibodies specific for desmoglein 1 and 3 and antinuclear antibodies specific for Ro, La, Sm, and double-stranded DNA antigens. After eluting specific anti-epithelial or anti-nuclear antibodies, which were recovered and tested using double-fluorescence assays, a lack of cross-reactivity was demonstrated between desmosomes and nuclear and cytoplasmic lupus antigens. This result suggests that autoantibodies in pemphigus erythematosus are directed against different antigens and that these autoantibodies are produced by independent clones. Given these clinical and serological data, we suggest that pemphigus erythematosus behaves as a multiple autoimmune disease. [ABSTRACT FROM AUTHOR]

L-DOPA, the most effective drug to treat motor symptoms of Parkinson's disease, causes abnormal involuntary movements, limiting its use in advanced stages of the disease. An increasing body of evidence points to the serotonin system as a key player in the appearance of L-DOPA-induced dyskinesia (LID). In fact, exogenously administered L-DOPA can be taken up by serotonin neurons, converted to dopamine and released as a false transmitter, contributing to pulsatile stimulation of striatal dopamine receptors. Accordingly, destruction of serotonin fibers or silencing serotonin neurons by serotonin agonists could counteract LID in animal models. Recent clinical work has also shown that serotonin neurons are present in the caudate/putamen of patients grafted with embryonic ventral mesencephalic cells, producing intense serotonin hyperinnervation. These patients experience graftinduced dyskinesia (GID), a type of dyskinesia phenotypically similar to the one induced by L-DOPA but independent from its administration. Interestingly, the 5-HT1A receptor agonist buspirone has been shown to suppress GID in these patients, suggesting that serotonin neurons might be involved in the etiology of GID as for LID. In this paper we will discuss the experimental and clinical evidence supporting the involvement of the serotonin system in both LID and GID. [ABSTRACT FROM AUTHOR]

Restoration of form and function after burn injury remains challenging, but emerging laser and pulsed light technologies now offer hope for patients with hypertrophic scars, which may be associated with persistent hyperemia, chronic folliculitis, intense pruritis, and neuropathic pain. In addition to impairing body image, these scars may limit functional recovery, compromise activities of daily living, and prevent return to work. Three different platforms are now poised to alter our reconstructive algorithm: (1) vascular-specific pulsed dye laser (PDL) to reduce hyperemia, (2) ablative fractional CO2 laser to improve texture and pliability of the burn scar, and (3) intense pulsed light (IPL) to correct burn scar dyschromia and alleviate chronic folliculitis. In this paper, we will provide an overview of our work in this area, which includes a systematic review, a retrospective analysis of our preliminary experience, and interim data from our on-going, prospective, before-after cohort trial. We will demonstrate that laser- and light-based therapies can be combined with each other safely to yield superior results, often at lower cost, by reducing the need for reconstructive surgery. Modulating the burn scar, through minimally invasive modalities, may replace conventional methods of burn scar excision and yield outcomes not previously possible or conceivable. [ABSTRACT FROM AUTHOR]

There are some important prognostic factors for papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). In this paper, clinicopathological features significantly affecting patient prognosis are described based on our data as well as others. Distant metastasis at diagnosis is the most important prognostic factor for both PTC and FTC. Other than that, preoperative and intraoperative findings are important to evaluate the biological behavior of PTC. Extrathyroid extension, large lymph-node metastasis, and extranodal tumor extension that can be evaluated preoperatively or intraoperatively are significant prognostic factors for PTC patients. In contrast, pathological findings are important not only for diagnosis of FTC, but also for the evaluation of its biological character. Grade of invasiveness (minimally or widely invasive) and degree of differentiation (well differentiated or including a poorly differentiated component) greatly affect the prognosis of FTC patients. [ABSTRACT FROM AUTHOR]

The U.S. population is undergoing a dramatic shift in demographics, with a rise in the proportion of elderly Americans. Given an increased prevalence of thyroid disease and malignancy with age, understanding the safety of thyroid surgery in this age group is increasingly pertinent. There remains disagreement regarding the clinical outcomes of elderly patients after thyroidectomy and the applicability of single-institution cohorts to the population at large. This paper reviews the epidemiology of thyroid disease in the elderly, current surgical indications and practice patterns, and the clinical and economic outcomes of elderly patients with thyroid disease after surgical intervention. [ABSTRACT FROM AUTHOR]

Autoimmune pancreatitis is part of the spectrum of IgG4-associated diseases. Its diagnostic criteria and histological subtypes have been formally proposed recently and although based on current data it has been suggested that there are differences in clinical presentation among populations,more research is needed to properly establish if this heterogeneity exists. In this paper, we describe 15 cases of autoimmune pancreatitis diagnosed at a Mexican centre of reference, all of them associated to the lymphoplasmocytic sclerosing pancreatitis variant. The mean age at the onset of symptoms was 47.5 ± 14.4 years, and 53% of patients were male. The main manifestations were weight loss (87%), obstructive jaundice (53%), and acute (27%) and chronic (27%) pancreatitis. Only 20% of patients had high IgG4 serum levels at the time of diagnosis. All patients receiving prednisone responded favourably, both in their pancreatic and extrapancreatic manifestations. Clinical manifestations of Mexican patients showed certain differences with respect to those usually reported. [ABSTRACT FROM AUTHOR]

The polypeptide hormone stanniocalcin-1 (STC-1) is widely expressed in mammals and signals both locally and systemically. In many tissues STC-1 ligand is sequestered by target cell organelles (mitochondria, nuclei, and cholesterol lipid droplets) to exert diverse biological effects. Most notably, STC-1 serves as an uncoupler of oxidative phosphorylation in liver, muscle, and kidney mitochondria. The present paper describes the identification of STC-1 receptors in mouse pancreatic ß cells and the discovery that the ligand co-localizes with insulin in pancreatic ß cells. In situ hybridization (ISH) analysis subsequently revealed that pancreatic ß cells were the source of the ligand. Intriguingly however, all ISH signal was localized over putative islet cell nuclei as opposed to the cell cytoplasm. Real-time qPCR and agarose gel electrophoresis revealed that the STC-1 amplicon generated from islet cell total RNA was the same size as that from kidney. However, relative levels of STC-1 gene expression were >100-fold lower in islets than those in kidney tissue. Collectively, these findings are indicative of a local STC-1 signalling pathway in pancreatic ß cells. The role of STC-1 in this context remains to be established, but it could very well entail the regulation of ß cell mitochondria membrane potential which is an integral aspect of regulated insulin release. Interestingly, STC-1 immunoreactivity was not evident in embryonic pancreatic islets, suggesting that ligand synthesis may only commence postnatally. [ABSTRACT FROM AUTHOR]

Microwave imaging of the breast is of interest for monitoring breast health, and approaches to active microwave imaging include tomography and radar-based methods.While the literature contains a growing body of work related to microwave breast imaging, there are only a few prototype systems that have been used to collect data from humans. In this paper, a prototype system for monostatic radar-based imaging that has been used in an initial study measuring reflections from volunteers is discussed. The performance of the system is explored by examining the mechanical positioning of sensor, as well as microwave measurement sensitivity. To gain insight into the measurement of reflected signals, simulations and measurements of a simple phantom are compared and discussed in relation to system sensitivity. Finally, a successful scan of a volunteer is described. [ABSTRACT FROM AUTHOR]

A wide range of studies show the capacity of multivariate statistical methods for fMRI to improve mapping of brain activations in a noisy environment. An advanced method uses local canonical correlation analysis (CCA) to encompass a group of neighboring voxels instead of looking at the single voxel time course. The value of a suitable test statistic is used as a measure of activation. It is customary to assign the value to the center voxel; however, this is a choice of convenience and without constraints introduces artifacts, especially in regions of strong localized activation. To compensate for these deficiencies, different spatial constraints in CCA have been introduced to enforce dominance of the center voxel. However, even if the dominance condition for the center voxel is satisfied, constrained CCA can still lead to a smoothing artifact, often called the "bleeding artifact of CCA", in fMRI activation patterns. In this paper a new method is introduced to measure and correct for the smoothing artifact for constrained CCA methods. It is shown that constrained CCA methods corrected for the smoothing artifact lead to more plausible activation patterns in fMRI as shown using data from a motor task and a memory task. [ABSTRACT FROM AUTHOR]

The optic disc (OD) is an important anatomical feature in retinal images, and its detection is vital for developing automated screening programs. Currently, there is no algorithm designed to automatically detect the OD in fundus images captured from Asians which are larger and have thicker vessels compared to Caucasians. In this paper, we propose such a method to complement current algorithms using two steps: OD vessel candidate detection and OD vessel candidate matching. The first step is achieved with multiscale Gaussian filtering, scale production, and double thresholding to initially extract the vessels' directional map of various thicknesses. The map is then thinned before another threshold is applied to remove pixels with low intensities. This result forms the OD vessel candidates. In the second step, a Vessels' Directional Matched Filter (VDMF) of various dimensions is applied to the candidates to be matched, and the pixel with the smallest difference designated the OD center. We tested the proposed method on a new database consisting of 402 images from a diabetic retinopathy (DR) screening programme consisting of Asians. The OD center was successfully detected with an accuracy of 99.25% (399/402). [ABSTRACT FROM AUTHOR]

Intravascular ultrasound (IVUS) imaging is a catheter-based medical methodology establishing itself as a useful modality for studying atherosclerosis. The detection of lumen and media-adventitia boundaries in IVUS images constitutes an essential step towards the reliable quantitative diagnosis of atherosclerosis. In this paper, a novel scheme is proposed to automatically detect lumen and media-adventitia borders. This segmentation method is based on the level-setmodel and the contourletmultiresolution analysis. The contourlet transform decomposes the original image into low-pass components and band-pass directional bands. The circular hough transform (CHT) is adopted in low-pass bands to yield the initial lumen and media-adventitia contours. The anisotropic diffusion filtering is then used in band-pass subbands to suppress noise and preserve arterial edges. Finally, the curve evolution in the level-set functions is used to obtain final contours. The proposed method is experimentally evaluated via 20 simulated images and 30 real images from human coronary arteries. It is demonstrated that the mean distance error and the relative mean distance error have increased by 5.30 pixels and 7.45%, respectively, as compared with those of a recently traditional level-set model. These results reveal that the proposed method can automatically and accurately extract two vascular boundaries. [ABSTRACT FROM AUTHOR]

Lung radiotherapy is greatly benefitted when the tumor motion caused by breathing can be modeled. The aim of this paper is to present the importance of using anisotropic and subject-specific tissue elasticity for simulating the airflow inside the lungs. A computational-fluid-dynamics (CFD) based approach is presented to simulate airflow inside a subject-specific deformable lung for modeling lung tumor motion and the motion of the surrounding tissues during radiotherapy. A flow-structure interaction technique is employed that simultaneously models airflow and lung deformation. The lung is modeled as a poroelastic medium with subject-specific anisotropic poroelastic properties on a geometry, which was reconstructed from four-dimensional computed tomography (4DCT) scan datasets of humans with lung cancer. The results include the 3D anisotropic lung deformation for known airflow pattern inside the lungs. The effects of anisotropy are also presented on both the spatiotemporal volumetric lung displacement and the regional lung hysteresis. [ABSTRACT FROM AUTHOR]

Fracture detection in pelvic bones is vital for patient diagnostic decisions and treatment planning in traumatic pelvic injuries. Manual detection of bone fracture from computed tomography (CT) images is very challenging due to low resolution of the images and the complex pelvic structures. Automated fracture detection from segmented bones can significantly help physicians analyze pelvic CT images and detect the severity of injuries in a very short period. This paper presents an automated hierarchical algorithm for bone fracture detection in pelvic CT scans using adaptive windowing, boundary tracing, and wavelet transform while incorporating anatomical information. Fracture detection is performed on the basis of the results of prior pelvic bone segmentation via our registered active shape model (RASM). The results are promising and show that the method is capable of detecting fractures accurately. [ABSTRACT FROM AUTHOR]

This paper reports the progress toward a fast and reliable microwave imaging setup for tissue imaging exploiting near-field holographic reconstruction. The setup consists of two wideband TEM horn antennas aligned along each other's boresight and performing a rectangular aperture raster scan. The tissue sensing is performed without coupling liquids. At each scanning position, wideband data is acquired. Then, novel holographic imaging algorithms are implemented to provide three-dimensional images of the inspected domain. In these new algorithms, the required incident field and Green's function are obtained from numerical simulations. They replace the plane (or spherical) wave assumption in the previous holographic methods and enable accurate nearfield imaging results. Here, we prove that both the incident field and Green's function can be obtained from a single numerical simulation. This eliminates the need for optimization-based deblurring which was previously employed to remove the effect of realistic non-point-wise antennas. [ABSTRACT FROM AUTHOR]

Multisection magnetic resonance spectroscopic imaging is a widely used pulse sequence that has distinct advantages over other spectroscopic imaging sequences, such as dynamic shimming, large region-of-interest coverage within slices, and rapid data acquisition. It has limitations, however, in the number of slices that can be acquired in realistic scan times and information loss from spacing between slices. In this paper, we synergize the multi-section spectroscopic imaging pulse sequence with multichannel coil technology to overcome these limitations. These combined techniques now permit elimination of the gaps between slices and acquisition of a larger number of slices to realize the whole brain metabolite mapping without incurring the penalties of longer repetition times (and therefore longer acquisition times) or lower signal-to-noise ratios. [ABSTRACT FROM AUTHOR]

Current clinical breast imaging modalities include ultrasound, magnetic resonance (MR) imaging, and the ubiquitous X-ray mammography. Microwave imaging, which takes advantage of differing electromagnetic properties to obtain image contrast, shows potential as a complementary imaging technique. As an emerging modality, interpretation of 3D microwave images poses a significant challenge.MR images are often used to assist in this task, and X-ray mammograms are readily available. However, X-ray mammograms provide 2D images of a breast under compression, resulting in significant geometric distortion. This paper presents a method to estimate the 3D shape of the breast and locations of regions of interest from standard clinical mammograms. The technique was developed using MR images as the reference 3D shape with the future intention of using microwave images. Twelve breast shapes were estimated and compared to ground truth MR images, resulting in a skin surface estimation accurate to within an average Euclidean distance of 10 mm. The 3D locations of regions of interest were estimated to be within the same clinical area of the breast as corresponding regions seen on MR imaging. These results encourage investigation into the use of mammography as a source of information to assist with microwave image interpretation as well as validation of microwave imaging techniques. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the authors discusses various research articles within the issue of the periodical on topics including neuropsychiatric syndromes, rehabilitation programs in patients of Parkinson's disease (PD) and association of apathy and anxiety in PD patients.

Objective. In Ethiopia, there is no national-level cancer registry except capital Addis Ababa, and little research was performed on ovarian tumors. This study is aimed at assessing different histopathologic patterns of ovarian tumors and their distribution based on age, biological behavior, and gross findings at a tertiary-level hospital in Ethiopia. Methods. In this study, 187 biopsy-confirmed ovarian tumors from September 2017 to August 2021 were included. All data were collected from the pathology department report format, classified according to the latest World Health Organization (WHO) classification system, and analyzed using SPSS 20.0 and Microsoft Excel 2010 at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia. Results. A total of 187 women with ovarian tumors were included in this study. Of these, 143 (76.5%) were benign, 35 (18.7%) were malignant, and 9 (4.8%) were borderline tumors. Both benign and borderline tumors mostly occur at the age of 20–39 years. Surface epithelial tumors were the most common histopathologic pattern at 57.8% followed by germ cell tumors at 29.4% and sex cord-stromal tumors at 11.7%. Mature cystic teratomas were the most common benign ovarian tumors accounting for 37.8% of them, while serous cystadenocarcinomas were the most common malignant ovarian tumors accounting for 31.4% of malignant neoplasms. Conclusion. In the current study, surface epithelial tumors were the most common ovarian tumors followed by germ cell tumors. Younger age at presentation was observed for malignant ovarian tumors. [ABSTRACT FROM AUTHOR]

Objective. To determine if increasing variability of blood pressure influences determination of cerebral autoregulation. Methods. A prospective observational study was performed at the ICU of a university hospital in the Netherlands. 13 comatose patients after cardiac arrest underwent baseline and intervention (tilting of bed) measurements. Mean flow velocity (MFV) in the middle cerebral artery and mean arterial pressure (MAP) were measured. Coefficient of variation (CV) was used as a standardized measure of dispersion in the time domain. In the frequency domain, coherence, gain, and phase were calculated in the very low and low frequency bands. Results. The CV of MAP was significantly higher during intervention compared to baseline. On individual level, coherence in the VLF band changed in 5 of 21 measurements from unreliable to reliable and in 6 of 21 measurements from reliable to unreliable. In the LF band 1 of 21 measurements changed from unreliable to reliable and 3 of 21 measurements from reliable to unreliable. Gain in the VLF and LF band was lower during intervention compared to baseline. Conclusions. For the ICU setting, more attention should be paid to the exact experimental protocol, since changes in experimental settings strongly influence results of estimation of cerebral autoregulation. [ABSTRACT FROM AUTHOR]