Myocardial fibrosis in aortic stenosis: comparison between clinical data, laboratory, echocardiography, and cardiac magnetic resonance
Published on: 16th May, 2023
Introduction: Patients with aortic stenosis often develop hypertrophy and fibrosis, regardless of symptoms. Cardiac Magnetic Resonance (CMR) represents the gold standard for the evaluation of fibrosis despite numerous limitations: cost, availability, atrial fibrillation, claustrophobia, kidney failure or inability to apnea.Purpose: The aim is to validate the role of echocardiographic parameters, such as Global Longitudinal Strain (GLS), as early markers of fibrosis. Clinical and laboratory data, particularly B-type Natriuretic Peptide (BNP), were also analyzed.Material and methods: In our study we recruited 33 patients with severe aortic stenosis, correlating echocardiographic values of GLS with the qualitative analysis of Late Gadolinium Enhancement (LGE) and the quantitative analysis of T1 mapping of CMR.Results: 70% of patients with an alteration of GLS had LGE+. Univariate logistic regression shows that the factors associated with the presence of LGE on CMR are hypertension (p = 0.043), GLS (p = 0.032), and elevated BNP values (p = 0.021); for GLS, Odds Ratio (OR) is 5 so the chance of finding fibrosis on CMR increases 5 times in presence of an altered GLS. The multivariate analysis confirms the association with impaired GLS values (p = 0.033) and hypertension (p = 0.025), but not with elevated Pro-BNP values.Conclusion: In patients with severe aortic stenosis, the association between GLS, LGE, and T1 mapping can help identify earlier those patients with structural changes caused by the disease, who could benefit from early intervention. It remains to be established how the presence of these alterations has a role in determining the intervention time and the outcome of these patients.
COVID-19 detection and classification: key AI challenges and recommendations for the way forward
Published on: 25th May, 2023
Coronavirus disease (COVID-19) is a viral pneumonia that is found in China and has spread globally. Early diagnosis is important for effective and timely treatment. Thus, many ongoing studies attempt to solve key COVID-19 problems such as workload classification, detection, and differentiation from other pneumonia and healthy lungs using different imaging modalities. Researchers have identified some limitations in the deployment of deep learning methods to detect COVID-19, but there are still unmet challenges to be addressed. The use of binary classifiers or building classifiers based on only a few classes is some of the limitations that most of the existing research on the COVID-19 classification problem suffers from. Additionally, most prior studies have focused on model or ensemble models that depend on a flat single-feature imaging modality without using any clinical information or benefiting from the hierarchical structure of pneumonia, which leads to clinical challenges, and evaluated their systems using a small public dataset. Additionally, reliance on diagnostic processes based on CT as the main imaging modality, ignoring chest X-rays. Radiologists, computer scientists, and physicians all need to come to an understanding of these interdisciplinary issues. This article first highlights the challenges of deep learning deployment for COVID-19 detection using a literature review and document analysis. Second, it provides six key recommendations that could assist future researchers in this field in improving the diagnostic process for COVID-19. However, there is a need for a collective effort from all of them to consider the provided recommendations to effectively solve these issues.
The secondary metabolites profiling of the phytopathogenic fungus Sclerotinia Sclerotiorum
Published on: 10th June, 2023
Sclerotinia sclerotiorum is a necrotrophic plant pathogen causing more than 60 different disease symptoms in approximately 400 plants globally. Hence, due to this distinctive characteristic, S. sclerotiorum has been the subject of various research to comprehend its pathogenicity mechanism, including virulent genes, proteins, and metabolites. Likewise, the genomic annotation of S. sclerotiorum uncovered its remarkable potential for producing secondary metabolites, of which genome mining has additionally prompted the disclosure of these uncharacterized metabolic pathways, which might aid the pathogenicity process. To comprehend the secondary metabolites secreted by S. sclerotiorum that might be involved in its pathogenicity, a secondary metabolite-level investigation of this plant pathogen was performed. Profiling and characterizing these secondary metabolites produced during in vitro germination would increase the current knowledge of this pathogen. In this study, S. sclerotiorum secondary metabolites profile examination was conducted, utilizing the Ultra-High Resolution Qq-Time-Of-Flight mass spectrometer (UHR-QqTOF). Proficient data analysis and verification with the genomic pathways of S. sclerotiorum gave an unequivocal metabolome profile of this pathogen. Two hundred and thirty secondary metabolites were identified in all three biological replicates, and their bodily functions were identified.
The Impacts of Angiotensin Receptor Blockers (ARBs) or Angiotensin-Converting Enzyme Inhibitors (ACEIs) on Patients with Stereotactic Body Radiation Therapy (SBRT) for Early-Stage NSCLC
Published on: 24th June, 2023
Purpose: Stereotactic body radiation therapy (SBRT) has emerged as an alternative to surgery for patients with inoperable early-stage non-small cell lung cancer (NSCLC). The majority of inoperable NSCLC patients are elderly and frequently have comorbidities including cardiovascular diseases for which they frequently receive angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs). The interactions of these medications with SBRT are not clear. The objective of the current study is to investigate the interaction of ARBs and ACEIs with SBRT for the outcomes of early-stage NSCLC. Methods and Materials: A retrospective chart review of patients treated with SBRT for Stage I and II NSCLC (AJCC 7th edition) at a single institution between 2006 and 2017 was conducted. Information on the use of ARBs, ACEIs, demographics, and tumor-related factors was collected. Kaplan-Meier and Cox proportional hazard analyses were performed to assess the impact of ARBs and ACEIs combined with SBRT respectively on the treatment outcomes of these patients. Results: In total, 116 patients were included in the study, among whom 38/116 (32.76%) received ACEIs, and 20/116 (17.24%) received ARBs. In the multivariable analysis, the use of ARBs, but not ACEIs, with SBRT, was significantly associated with the increased risk of dissemination (Hazard Ratio (HR): 2.97; CI: 1.40-6.27; p < 0.004) compared to SBRT without ARBs. The tumor size of > = 3 cm was associated with significantly decreased time to local failure and OS compared to tumor size <3cm. Conclusion: In the current retrospective study, the use of ARBs, in combination with SBRT, was associated with a significantly increased risk of disease dissemination in early-stage NSCLC compared to SBRT alone. The findings warrant further investigations on the concurrent use of ARBs, ACEIs, and other medicines used for chronic diseases with SBRT for early-stage NSCLC.
Cost Variation Analysis of Various Brands of Anti-Depressants Agents Currently Available in Indian Markets
Published on: 21st June, 2023
Depression is a mental, psychiatric medical condition or disorder in which individuals manifest some clinical syndrome characterized by sadness, mood swings, societal withdrawal, lack of interest, family issues, and education problems which affect the daily student life in which the individual does not participate in daily activities. Sometimes individual commits suicide due to exam stress and that swings the mood upon the condition of the individual. The cost of brand-name medications prescribed in such circumstances exacerbates the disease burden and may even result in noncompliance with therapy. IDR (Indian Depository Receipt) was used to calculate the cost of various antidepressant drug brands. Using the percentage cost ratio, one can ascertain the price of each brand’s 10 tablets in INR (Indian Rupees), the cost ratio, and the percentage cost variance. The difference between the greatest and lowest prices of the same drug produced by Indian pharmaceutical industries was calculated. There is a greater price disparity between agents on the market. The greatest expense variance was found to be amitriptyline 25 mg (195%), fluoxetine 50 mg (95%), sertraline 50 mg (83%) and the lowest % cost variation was of fluvoxamine 20 mg (13.8 mg), duloxetine 20 mg (16%) and escitalopram 10 mg (38%). On the Indian market, the average price disparity between antidepressant medications of various brands is quite high. If a pricey brand is prescribed, patients will incur additional costs.
Celiac disease presenting as transient intussusception in two 3-year-olds
Published on: 21st June, 2023
Although intussusception occurs in children and adults with celiac disease, it is a relatively uncommon symptom. Even more rare is the occurrence of intussusception as the presenting symptom of the disease. In the two cases we report here, transient intussusception, occurring at three years of age, was the first and only physical sign of celiac disease, and lead to a timely diagnosis by immunoserology and histology, followed by implementation of a gluten-free diet before sequelae such as significant anemia or Failure to Thrive (FTT) developed. In both cases, neither immunoserological nor physical signs of disease were present at the follow-up examination after 6 months on a gluten-free diet. In addition, genetic screening of the patients’ families revealed HLA-DQ2 positivity in two cases, leading to the additional diagnosis of celiac disease in the pregnant mother of one of the patients.
Au26-35: A Special Geometrical Structure of Au33 (D2) Cluster with Highly Occupied - 14 Pairs of Double-State Degeneracy
Published on: 30th December, 2022
In this article, an interesting phenomenon has described the geometries and vibrational frequency of the stable AuN clusters with N = 26 to 35. We have found nine out of ten clusters are having the very same C1 symmetry, except the cluster N = 33 (D2). The finite-differentiation method has been implemented within the density-functional tight-binding (DFTB) approach. The effects of the range of interatomic forces were calculated and the desired set of system eigenfrequencies (3N-6) are obtained by diagonalization of the symmetric positive semidefinite Hessian matrix. Mainly, we have observed the vibrational spectra and the range comes in between 2.04 and 347.32 cm−1 at ground state, ∆E = 0. Most significantly, all the clusters have revealed double-state degeneracy. The vibrational spectrum is strongly dependent upon the size, shape, and structure, at the same time, the stretching and the bending mode of the atoms with respect to the bond length plays a major role. We have compared some of our results, which have an excellent agreement, with the less availability of the experimental and the theoretical predictions.
IC87201, a PSD-95/nNOS Inhibitor, Ameliorates Heart Rate Variability in the Rat Model of Middle Cerebral Artery Occlusion
Published on: 11th July, 2023
Objective: Assessment of heart rate variability (HRV) is a non-invasive and reliable method to evaluate autonomic disorders after cerebral ischemia. The present study was conducted to investigate the therapeutic potential of IC87201 in reducing post-stroke cardiac dysfunction. Materials and methods: Cerebral ischemia was induced by the middle cerebral artery occlusion (MCAO) method in 15 anesthetized adult male rats in three MCAO, MCAO+ DXM, and MCAO+ IC87201 groups, for one hour. Electrocardiogram was recorded before, and 48 hours after ischemia and drug administration, and HRV parameters were calculated from R-R intervals. In the treatment groups, IC87201 and Dextromethorphan hydrobromide monohydrate (DXM) were injected after an ischemic period. Results: After brain ischemia, the R-R interval decreased and consequently heart rate increased. The R-R intervals were used to extract the HRV frequency and time domains, including normalized low frequency (LF), high frequency (HF), LF/HF ratio, and standard deviation of R-R interval (SDRR). Normalized LF and LF/HF ratio enhanced 48 hours after ischemia, while normalized HF and SDRR significantly reduced compared to the pre-ischemic state. All HRV parameters had returned to their pre-ischemic level 48 hours after IC87201 and DXM administration, except SDRR, which recovered only in the IC87201 administered group. Conclusion: Based on our findings, it can be concluded that cerebral ischemia significantly worsens HRV parameters as a result of sympathetic overactivity. These changes were reversed by administering DXM and IC87201, but IC87201 has generally been more effective in lowering lesions. As a result, IC87201 can be introduced as an effective substance for the treatment of post-ischemic cardiac side effects.
Noninvasive Cuffless Blood Pressure Monitoring. How Mechanism-Driven and Data-Driven Models Can Help in Clinical Practice
Published on: 12th July, 2023
Continuous noninvasive cuffless blood pressure (BP) monitoring is essential for early detection and treatment of hypertension. In this paper, we provide an overview of the recent advancements in cuffless BP sensors. These include contact wearable sensors such as electrocardiography (ECG), photoplethysmography (PPG), contact non-wearable sensors such as ballistocardiography (BCG), and contactless sensors such as video plethysmography (VPG). These sensors employ different measuring mechanisms such as pulse arrival time (PAT), pulse transit time (PTT), and pulse wave analysis (PWA) to estimate BP. However, challenges exist in the effective use and interpretation of signal features to obtain clinically reliable BP measurements. The correlations between signal features and BP are obtained by mechanism-driven models which use physiological principles to identify mathematical correlations, and data-driven models which use machine learning algorithms to analyze observational data to identify multidimensional correlations. On the one hand, applying mechanism-driven models to non-linear scenarios and incomplete or noisy data is challenging On the other hand, data-driven models require a large amount of data in order to prevent physically inconsistent predictions, resulting in poor generalization. From this perspective, this paper proposes to combine the strengths of mechanism-driven and data-driven approaches to obtain a more comprehensive approach, the physiology-informed machine-learning approach, with the goal of enhancing the accuracy, interpretability, and scalability of continuous cuffless BP monitoring. This holds promise for personalized clinical applications and the advancement of hypertension management.
Internet Addiction and its Relationship with Attachment Styles Among Tunisian Medical Students
Published on: 13th July, 2023
Internet addiction is a growing addictive behavior and a major public health problem worldwide. Several psychological factors can contribute to the problematic use of the Internet. This study aimed to determine the prevalence of Internet Addiction (IA) in a sample of university students and to examine the relationship between IA, self-esteem, and attachment styles.The present study was a cross-sectional study, involving 135 students from the Faculty of Medicine of Monastir. The participants completed a questionnaire, which contained the socio-demographic data, the reasons for Internet use, the Young Cyberaddiction scale to seek IA, the Relationships-style-questionnaire-RSQ to assess attachment style, and the Rosenberg Self-Esteem Scale (RSES).The mean age of the students was 21.5 ± 1.9 years old. They were 112 (83%) females. The prevalence of Internet addiction was 23.7%. The average connection time was 3.5 ± 1.8 hours/day. The most frequent online activities were chat (online discussion, forums ...) in 94.8% of cases followed by download activities (78.5%), scientific research (75.6%), online games (23.7%), and online shopping (13.3%). IA was associated with school failure, alcohol use, online gaming, and low self-esteem. The majority of the participants (84.4%) in this study reported an insecure attachment style. Logistic regression analysis showed a strong association between IA and fearful attachment style.IA was frequent among students. Fearful attachment style was found to be a risk factor for IA. This study highlights the impact of relationships between child and their caregivers on the development of addiction.
Evaluation of the Antihyperglycaemic Activities, Safety and Phytochemical Profile of Celtis zenkeri Engl
Published on: 14th July, 2023
Objective: The study evaluated the hyperglycaemia-lowering effects, safety, and phytochemical profile of Celtis zenkeri leaf extract in order to justify its antidiabetic folkloric usage. Methods: Modified OECD test guidelines were used to assess its acute and sub-acute toxicity while its effect on blood parameters such as blood glucose, and haematological and biochemical levels were evaluated using appropriate assays. Both in vitro and in vivo antihyperglycaemic assays were used for the antidiabetic studies while histology of the pancreas, liver, and kidney of the rats was examined after treatment with the extract at 250, 500, and 1000 mg/kg for 21 days. GC-MS analysis was used to determine the chemical constituents of the extract. Results: The results obtained showed that the leaf extract of C. zenkeri was not toxic in rats at 5000 mg/kg. It elicited a significant decrease in the blood glucose levels of the animals but did not affect the haematological and biochemical components of normal rats. It significantly inhibited α-amylase and α-glucosidase actions and gave comparable activity to glibenclamide (5 mg/kg) at all time points at 200 and 400 mg/kg. The extract comparably reduced blood glucose levels with glibenclamide at 100 and 200 mg/kg on days 10 and 14 in drug-induced diabetic rats and maintained the histoarchitecture of the liver, kidney, and pancreas at 250 and 500 mg/kg.Conclusion: The study justified the ethnomedicinal use of C. zenkeri in diabetes management.
Challenges and Concerns of Parents with Children with Down Syndrome
Published on: 18th July, 2023
Down syndrome is a common chromosomal abnormality that affects individuals in their physical, cognitive, and social development. The diagnosis of this syndrome in a newborn can be challenging for parents as it may disrupt family dynamics. In this study, we describe the different aspects of the impact of Down syndrome on parents, including psychological, social, and familial impacts. 55 cases participated in this survey; the average age of parents was 34 years old, and mothers represented 96% of the participants. 70% of cases were from urban areas. The average time between diagnosis and parental evaluation was 32.7 months. In 57% of families, the diagnosis of Down syndrome was established only after the third month of pregnancy, and only 5% obtained it during the prenatal period. Depression was reported in 32% of mothers at the time of diagnosis, while one mother exhibited persistent denial of her child’s disability. 30% of families indicated that their child with Down syndrome was the source of tension within the couple and that learning difficulties were the main factor of tension, while 1% eventually divorced. 5% of parents regretted having a child with Down syndrome. All mothers expressed concerns about their child’s future and are in favor of the establishment of a national screening program for trisomy 21 and dedicated learning centers to ensure social and professional integration.
Review of the Efficiency of Ten Different Commercial Kits for Extracting DNA from Soil Mixed Biological Samples
Published on: 19th July, 2023
Soil-mixed bodily fluids are the most common kind of evidence at outdoor crime scenes. This biological evidence contains DNA, which is a key component of forensic science’s ability to prove an accused person’s guilt because it connects the victim and suspect to the crime scene and aids in identifying the offender and victim. The yield of DNA is significantly influenced by factors including temperature, humidity, storage environment, time since deposition, etc. DNA degradation is caused by a variety of microbes, bacteria, humic acid, and other substances present in soil. Nowadays for DNA extraction, a variety of commercial DNA extraction kits was used now. This paper’s objective is to compare the efficiency of ten different commercial kits used to extract mixed DNA samples. It has been observed that samples stored at a low temperature (-20 °C) are the best for soil blood mixture samples. Compared to samples paired with other types of soil (silt, clay, and marshland), sand soil had the largest production of DNA using the QIAmp investigator kit (Qiagen). Blood Miniprep kit extractions were mostly inhibited, the control that amplified confirms that this kit was the worst in terms of DNA extraction potency. The samples with fewer dirt particles had a much greater yield of DNA.
Calciphylaxis in Hemodialysis
Published on: 20th July, 2023
Calciphylaxis (CP) or uremic calcific arterial disease (CUA) is a rare, potentially fatal calcific vasculopathy characterized by calcific and thrombotic occlusion of the vessels of the subcutaneous and dermis leading to extremely painful necrotic lesions. It mainly affects patients with end-stage kidney disease (ESKD) and under long time dialysis. The only therapeutic option is represented by intravenous sodium thiosulfate. Currently, clear guidelines are lacking. We have had a good therapeutic response with doses of sodium thiosulfate in association with multidisciplinary management of the patient (vulnologist, dermatologist, nephrologist, dietitian, and cardiologist). There is limited literature on the use of DOAC therapy as a successful alternative to warfarin in patients on dialysis with calciphylaxis. The left atrial appendage closure could represent an important alternative to dicumarolics in patients with atrial fibrillation with calciphylaxis. A new perspective for the treatment of this disease is SNF472 a selective inhibitor of vascular calcification.
Impact of COVID-19 on Laboratory Health Staff in an Indian Tertiary Care Hospital
Published on: 24th July, 2023
Background: The COVID-19 pandemic has resulted in significant burdens globally. Healthcare workers (HCWs), at the heart of the unparalleled crisis of COVID-19, face challenges treating patients and doing testing for COVID-19: reducing the spread of infection; developing suitable short-term strategies; and formulating long-term plans. We aimed to assess the psychological impact of COVID-19 on Laboratory health staff. Material and methods: Between February - March 2021, 72 laboratory staff workers of a tertiary care teaching hospital were invited to fill out a questionnaire regarding concerns and worries about the novel coronavirus pandemic, along with a coping scoring system and General health questionnaire level (GHQ-12) survey. Results: Out of 72 laboratory health staff who completed the survey questionnaire, 10 were faculty members, 17 were residents (including senior residents, junior residents, and demonstrators), 39 were lab technicians, followed by 4 were attendants and 2 were data operators. Laboratory staff workers with an age group range from 30 years - 60 years had a higher level of depression symptoms than respondents with 20 years - 29 years of age. Similarly, the symptoms of anxiety were noted to be significantly higher among female respondents and respondents with age >30yrs. The most frequent concern was transmitting the infection to family than to themselves only. A considerable number of laboratory staff workers utilized online psychological resources to deal with their psychological distress.Conclusion: The findings of this survey recognize the various problems faced by laboratory health workers during the period of COVID-19 which affect their working ability. Therefore, in the future, we have to implement such strategies that enhance the performance of laboratory workers, boost their energy level, and encourage them to take care of themselves, in times of such crisis.
Factors Associated with Elevated Transcranial Doppler Ultrasound Velocities in Children With Sickle Cell Anemia in Mwanza, Tanzania
Published on: 28th July, 2023
Background: Stroke occurs in 11% of patients with SCA before 20 years of age. In Northwestern Tanzania, the prevalence of stroke among children living with SCA under the age 15 years is 16.9%, of which might be attributed to the absence of routine screening for the risk of stroke by using Transcranial Doppler Ultrasound (TCD). Screening with TCD allows preventive measures such as chronic blood transfusion to be done which has led to the reduction of stroke by 92%.Methods: This was a prospective analytical cross sectional study which enrolled 267 SCA children aged 2 to 16 years attending Bugando Medical Centre Pediatric Sickle Cell Clinic from July 2019 to June 2020. Assessment of factors associated with elevated TCD included a clinical history of stroke in sibling, death in sibling, temperature, oxygen saturation in room air, blood pressure, hemoglobin level and total white blood cell count. TCD was done by accessing transtemporal window and recording the highest time average mean of maximum velocity (TAMMV) of major vessels mainly, middle cerebral artery (MCA) and distal internal carotid artery (dICA).Results: The median age of enrolled was 6.6 (IQR: 4-9) years. The prevalence of elevated TCD (> 170 cm/s)was found to be 21% (56/267). By multivariate logistic regression, low oxygen saturation in room air, p - value = 0.037, OR 1.08 [95% CI 1.00-1.17] and low hemoglobin level, p - value = 0.001, OR 1.76 [95% CI 1.26-2.45] were statistically significantly associated with elevated TCD among children living with SCA.Conclusion: The high prevalence of elevated TCD velocity, with low hemoglobin and low oxygen saturation in room air as associated factors under multivariate logistic regression, warrants routine TCD screening for children with SCA aged 2 to 16 years.
Rare Presentation of Chromoblastomycosis Due to Multiple Simultaneous Inoculations: A Case Report
Published on: 7th August, 2023
Chronic infectious, granulomatous and suppurative dermatosis, classified among the subcutaneous mycoses, prevalent in tropical and subtropical regions and caused by the traumatic implantation of dematiaceous fungal species, where the presence of muriform bodies is an expression of the causal agent in the grafted tissue, are characteristic of chromoblastomycosis. Considered the second implantation mycosis in the world, it manifests itself with slow and progressive growth lesions of exophytic and verrucous plaques and black dots on the surface.The disease is considered a neglected and occupational disease, which occurs mainly among agricultural workers, coconut and babassu harvesters, lumberjacks, and traders of agricultural products. It is important to highlight that people at risk of contracting chromoblastomycosis work in tropical countries, where the temperature can be above 40 °C in summer, and generally refuse to wear protective equipment during the day (shoes, gloves, clothes, etc.), although they know that this type of prophylactic measure can prevent different types of diseases. These vulnerable people often live in low-income countries and sometimes live far from medical services and, once infected, do not seek medical attention. We report below an exuberant and unusual case due to multiple simultaneous inoculations on the back after the patient suffered an accidental fall while working on his farm. The diagnosis was established by direct mycological examination, histopathological examination, culture, microculture, and MALDI-TOF MS analysis that identified the agent of the Fonsecaea pedrosoi.
Physiotherapy Can Help Recover Functional Status in Community-dwelling Seniors Assessed in Emergency Departments for Minor Injuries
Published on: 1st August, 2023
Background: Around 75% of seniors seeking treatment for injuries in Emergency Departments (ED) are discharged home with minor injuries that put them at risk of functional decline in the following months. Objectives: To 1) describe seniors’ characteristics using or not physiotherapy services following ED visits for minor injuries and 2) examine their functional status according to physiotherapy use. Methods: Secondary data analyses of the Canadian Emergency Team Initiative cohort study. Participants were 65 years and older, discharged home after consulting EDs for minor injuries and assessed three times: ED, 3- and 6-months. Physiotherapy use was recorded as yes/no. Functional status was measured using the Older American Resources Scale (OARS). Multivariate linear regressions were used to examine change in OARS scores over time, accounting for confounders. Results: Among the 2169 participants, 565 (26%) received physiotherapy, and 1604 (74%) did not. Physiotherapy users were more likely females (71% vs. 64%), more educated, and less cognitively impaired. The overall change in OARS at 6 months was -0.31/28 points (95% CI: -0.55; -0.28) with no difference across groups after adjustment. Subgroup analyses among frail seniors showed that physiotherapy users maintained their function while non-users lost clinically significant function (-0.02 vs. -1.26/28 points, p = 0.03). Among the severely injured (Injury Severity Scale ≥ 5), physiotherapy users’ results were higher by almost 1/28 points (p = 0.03) compared to non-users. Conclusion: These results suggest that among seniors discharged home after consulting the ED for minor injuries, the frail and severely injured may benefit from being systematically referred to physiotherapy services.
Betty Neuman System Model: A Concept Analysis
Published on: 4th August, 2023
Introduction: Nursing theories are critical as they drive nursing education, practice, and research. Neuman Systems Model (NSM) considers a person a complete system with integrated psychological, physiological, spiritual, social, and developmental components. Nurses give their patients physical, emotional, and psychological assistance and are subjected to mental and physical pressure due to these responsibilities, impacting their health, psychological well-being, and interpersonal relationships. This paper aims to perform a concept analysis of stressors proposed in NSM about lines of defense and the level of preventive interventions that can affect a person’s well-being. Further, this paper discusses knowledge generation through NSM’s applicability to preventing exhaustion and burnout among nurses. Methodology: This theoretical attempt is carried out using the theory analysis approach suggested by Walker and Avant (2019).Discussion: Nursing is a career that requires a great deal of dedication and personal engagement. Nurses are subjected to recurrent stresses due to technological advances and rising demands. Burnout occurs when nurses get discouraged and have less compassion for the patients due to recurrent burdens. Stress and burnout are two of the most common reasons for nurses to quit hospitals. The NSM is concerned with stresses that may affect a person’s health and well-being (prediction). Nurses assist patients at the most vulnerable and challenging times, such as surgical procedures, traumas and personal and physical losses.Conclusion: The NSM enables the investigation of preventative and protective treatments. Because of the model’s flexibility, it may be used in a wide range of nursing situations. Administrative, hospitals, clinics, and other nurses can benefit from this paradigm. Evaluating the many distinct elements contributing to burnout is also feasible. The model’s client factors of physiological, sociocultural, developmental, and spiritual characteristics are used to achieve this. Viewing the individual as an open system that responds to environmental stimuli encourages the existence of stressors that might lead to burnout.
Studies of dose distribution to Lung and Stomach and Estimation of Second Cancer Risk due to Outfield Dose in Radiotherapy with 60Co Teletherapy Beam
Published on: 8th August, 2023
A critical component of the radiation regimen for treating cancer patients is the precise dose delivery to the treatment organ while minimizing the dose to the healthy tissue. This study aims to evaluate in-field organ dose and dose distribution outside the target organs to estimate the excess lifetime risk of second cancer. The study was carried out with a male Alderson Rando Phantom. 20 sets of thermoluminescence dosimeters (MTS-100) were used in this study. The in-field organs absorbed dose was measured by inserting TLDs at different geometrical depths of the left lung, right lung, and stomach, and for peripheral organs skin dose TLDs were placed at the surface of the corresponding organs. Target organs were irradiated at 100 cGy and 200 cGy by a 60Co teletherapy unit, and irradiated TLDs were read out by a RE-2000 TLD reader. For precise dose delivery to the cancerous organs by 60Co teletherapy, the depth dose correction factor for lung cancer treatment is 0.8667 ± 0.01, and for the stomach is 0.7856 ± 0.017. In the case of the treatment for the lung and stomach, the closest organs received significant doses compared to the other distant organs. Thus, the risk of second cancer due to the peripheral dose is obtained. The stomach is at the highest risk when the lung is the target and the liver is at the highest risk when the stomach is the targeted organ.
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