Big Blue Research Articles

Evaluation of Knowledge, Attitude, and Practice (KAP) of Artificial Intelligence Among Dentists and Dental Students: A Cross-Sectional Online Survey.

Artificial intelligence (AI) is the process by which it is possible to program computers to mimic human thoughts. AI and its subsets machine learning and deep learning have been developed to analyze complicated data gathered from many sources using algorithms built into decision support systems. It has been widely used in the field of dentistry. The study aimed to evaluate the knowledge, attitude, and practice (KAP) of AI among dental students and dentists. The present study is a descriptive cross-sectional online survey that was carried out among dentists and dental students in South India. A self-structured, close-ended questionnaire that was administered that consisted of 25 questions was included. The questions were circulated through Google Forms (Google LLC,Mountain View, California, United States), and it was circulated among the study participants through online mode. The data were collected systematically, and SPSS Statistics version 22.0 (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.) was used for data analysis. One thousand (595 dental surgeons and 405 dental students) participated in the study through Google Forms. Among these, 700 (70%) were females and 300 (30%) were males. In the study group, 635 (63.5%) were aware of AI, and 365 (36.5%) were not aware (p-value 0.000). Among the 21 questions used to assess the KAP, 14 questions were significant with a p-value less than 0.05. More than 60% agreed that the dental curriculum has to be updated with AI. About 269 (26.9%) agreed that AI will replace the role of dentists in the future. There were no significant results in comparing dental surgeons and dental students. The present study showed that the KAP among dental surgeons and dental students was the same. They believe that the dental curriculum has to be updated with AI. This study shows that there is a lack of knowledge about deep learning models and websites used for AI among dentists. Thus, it is necessary to include evidence-based teaching and training about the application of AI in dental practice to improve the future of dentistry.

Skeletal and dento-alveolar changes obtained with customised and preformed eruption guidance appliances after 1-year treatment in early mixed dentition.

The aim of this study was to assess the skeletal and dento-alveolar changes produced by a customised eruption guidance appliance (EGA) and a preformed EGA in subjects presenting a skeletal class II pattern during early mixed dentition and to evaluate the differences between the two devices. All subjects included in the study were randomly selected from the record's archive according to the following inclusion criteria: (1) patients presenting upper central incisor and first permanent molars fully erupted; (2) early mixed dentition with age between 7 to 9 years old; (3) Angle class I or class II malocclusion; (4) increased overjet > 4 mm;(5) deep bite with at least 2/3 overlapping of the incisors; (6) no previous orthodontic treatment apart from maxillary expansion treatment. All children belonging to the case group received treatment with a 3D printed EGA whereas the other patients belonging to the control group were treated with preformed EGA. Records consisted in digital dental models and lateral cephalogram at the beginning (T0) and after 1 year of treatment (T1). Data collected on the digital models included the dentoalveolar changes in overbite, overjet, sagittal molar relationship, and dental crowding. Cephalometric tracings were computed by a single blinded observer using Dolphin Imaging software. Statistical analysis was performed with SPSS (version 25.00; IBM Corp, Armonk, NY). Comparison regarding the cephalometric changes between T1-T2 was carried out with paired t-test. Difference in distribution regarding sagittal molar and canine relationship and anterior crowding between groups at T1 and T2 has been computed with chi-square test. The independent sample t-test was used to perform the between group comparison. In the short time, both the appliances showed to be effective in correcting class II malocclusion, anterior crowding, overjet and overbite. Custom-made appliance demonstrated to be significantly more effective in correcting anterior crowding, the dento-skeletal vertical relation and position of permanent incisor compared to the preformed appliance. Adopting a customised device, effects due to an average prescription appliance used to a specific patient can be reduced, resulting in more predictable results.

Analysis of Registered Cases of Acute Flaccid Paralysis in Stara Zagora District as a Part of Polio Eradication Strategy

Abstract Poliomyelitis is the infection that, after smallpox, is a “serious candidate” for eradication worldwide. In accordance with the WHO strategy for 2022-2026, epidemiological surveillance of acute flaccid paralysis (AFP) is carried out with the aim of poliomyelitis eradication. The aim of the study is to determine the risk factors for the occurrence of AFP in children up to 15 years of age and to analyze the effectiveness of the established system for epidemiological surveillance of AFP, in Bulgaria. Materials and methods. All cases of AFP for the monitoring period 2012-2021, in Stara Zagora district, were studied. A questionnaire (34 questions) for sociodemographic and lifestyle possible risk factors for developing of AFP was also completed. Retrospective, descriptive and analytic cross-sectional epidemiological methods were applied. The data were analyzed using SPSS Statistics, Version 25.0 (IBM Corp. Armonk, NY, USA) (with Fisher’s exact test). Results. There were 81 cases of Facial paralysis only, registered in the Web based system for surveillance of AFP, for Stara Zagora region, and 11 – AFP (without facial paralysis), for the period 2012-2021, in Stara Zagora district (92 in total). The protective factors for developing of AFP from our study were significantly associated to: having no history of paresis or paralysis in the past; absence of trauma; presence of central sewage near the home; absence of contact with animals; absence of consumption of unwashed fruits and vegetables. Conclusion. It is very important to carry out systematic surveillance of AFP, in children up to 15 years, with the aim of investigating all cases as part of the Global strategy for the eradication of poliomyelitis; monitoring of the immunization coverage with polio vaccine to maintain a high level; surveillance of the waste and sewage waters, twice during the year in 6 months.

Ventriculoperitoneal Shunt Surgery in Brunei Darussalam: A Population-Based Perspective.

Objective Ventriculoperitoneal shunt surgery is commonly performed to treat hydrocephalus. We aimed to characterize the demographics, complications, and outcomes of patients who underwent ventriculoperitoneal shunt surgery in Brunei Darussalam. Materials and Methods We conducted a retrospective study on patients who underwent ventriculoperitoneal shunt surgery at the Neurosurgery Department of the Raja Isteri Pengiran Anak Saleha Hospital and Brunei Neuroscience Stroke and Rehabilitation Centre between January 2015 and June 2020. Statistical Analysis All statistical analyses were performed using the Statistical Package for the Social Sciences version 20 (IBM Corporation, Armonk, New York, United States). The χ 2 test, Student's t -test, and Mann-Whitney U test were performed for nominal, normally, and non-normally distributed variables, respectively. Multivariate logistic regression was used to assess the predictors of complications and shunt failure. Results Fifty-three patients with a median age of 33 (interquartile range, 4-49) years were included. A total of 53 shunt operations were performed: 18 in the pediatric population and 35 in adults. The overall complication rate was 22.6%. Infection was the most common (9.4%) complication, with coagulase-negative staphylococci being the common organism causing the infection. The shunt failure rate (defined as removal or revision) was 20.8%. Univariate and multivariate analyses did not identify factors associated with complications or shunt failure. Conclusion Ventriculoperitoneal shunt surgery, a common and technically non-demanding neurosurgical procedure, is associated with significant complications. We highlighted that shunt infection remains a concern and advocate practices to negate this risk.

The Impact of Negative Emotions on Binge Eating and BMI Among Medical Students.

Background Binge eating disorder (BED) is a condition characterized by episodes of consuming large amounts of food and feeling a lack of control over eating behavior. Stress, anxiety, and depression are risk factors for developing BED, which may be particularly relevant for medical students who experience high levels of academic pressure and stress. This study aims to investigate the prevalence of binge eating behaviors among medical students, as well as the types of negative emotions that are most strongly associated with binge eating. Methodology This cross-sectional study employed convenience sampling and included 332 medical students from Almaarefa University in Riyadh, Saudi Arabia. All medical students of all academic levels were eligible to participate in this study. Students from other colleges such as pharmacy students or students from other universities were excluded from this study. The researchquestionnaire collected information about negative emotions, BMI, number of meals, consumption of fast food, overeating behavior, and relevant demographic data. Descriptive and inferential statistics were used to analyze the data using SPSS Statistics version 26 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.). Results The descriptive analysis showed that the majority of students reported consuming two meals per day and having snacks twice a day. Fast food consumption was reported by 58.1% of students. The study found that negative emotions such as stress, depression, and loneliness were significantly associated with binge eating behavior and had an impact on weight and BMI. The findings suggest the need for interventions to address negative emotions and promote healthy eating habits among medical students. Conclusion The study concludes that negative emotions such as stress, aggression, and boredom are significantly associated with binge eating behaviors among medical students. Depression, disappointment, and thoughts about difficult tasks were linked to detrimental effects on BMI and weight loss.

Use of ivermectin and factors associated with the prevention and/or treatment of COVID-19: a cross-sectional online survey in the province of Chincha, Peru.

Peru has reported one of the highest mortality rates from COVID-19 worldwide. The Chincha province has been one of the most affected regions in Peru and the leading promoter of the use of ivermectin for the treatment of COVID-19. Therefore, our study aimed to evaluate the frequency of use and factors associated with the use of ivermectin for COVID-19 in Chincha. A cross-sectional study was conducted during the second wave of COVID-19 in Peru. For statistical analyses, frequencies and percentages were reported. Prevalence ratios (PR) with a 95% confidence interval (CI), and a p-value of 0.05 were used to determine statistical significance. SPSS version 22 (IBM Corp) program was used for the analyses. A total of 432 participants were included in the study. A total of 67.6% (n = 292) of the participants used ivermectin during the COVID-19 pandemic. Of these, 20.20% (n=59) of the people used ivermectin for prophylactic purposes only, while 41.79% (n=122) used it as treatment for COVID-19 only, and 38.01% (n=111) used it for both reasons. The consumption of ivermectin was associated with being 50 years or older (PR:1.27, 95% CI:1.04-1.54), having a technical education level (PR:1.16, 95% CI:1.01-1.34), having had symptoms of COVID-19 with negative/no diagnosis (PR: 1.28, 95% CI: 1.07-1.53) or positive diagnosis (PR:1.38, 95% CI:1.18-1.61), or having had contact with infected people (PR:1.45, 95% CI:1.06-1.98). Most people in Chincha used ivermectin during the second wave of the COVID-19 pandemic. The main factors associated with the use of ivermectin for the prevention/treatment of COVID-19 were age ≥50 years, having a technical education level, having had symptoms with negative/no diagnosis or positive diagnosis, and contact with people infected with SARS-CoV-2.

A Comparison of the Awareness, Attitude, and Uptake of COVID-19, Hepatitis B Virus, and Yellow Fever Vaccines Between Rural and Urban Respondents in Edo State, Nigeria.

Despite the target set by WHO, Africa still falls short when it comes to individuals' use of COVID-19 vaccines. There is a similar pattern of low vaccine usage for the hepatitis B virus (HBV) and yellow fever (YF). The objective of our study is to compare the awareness, attitude, and uptake of vaccine-preventable diseases (VPD), COVID-19, HBV, and YF, between a rural and an urban community in Nigeria. The study was a descriptive cross-sectional study carried out between January 2022 and December 2022 in a rural community, Okada, and an urban community, Benin, in Edo State, Nigeria. A total of 283 rural participants and 483 urban participants were interviewed. SPSS Statistics version 26 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.) was used for data collection and analysis. The significant value was set at P<0.05. A major percentage of both populations, 98.3% urban and 90.1% rural, reported being aware of COVID-19 vaccines (indicated by P<0.001). There was a similar pattern with HBV vaccine awareness. However, awareness of YF vaccines was more common in the rural (63.3%) community than in the urban (55.0%) community. A complete dose uptake of COVID-19 vaccines was reported by 7.7% of the rural and 2.2% of the urban respondents. The major reason for the refusal of vaccine uptake was the fear of possible side effects. The study showed that vaccine uptake for COVID-19, HBV, and YF is low despite seemingly good awareness of these vaccines. The number one reason for any vaccine refusal is the possibility of experiencing side effects.

Postpartum Screening for Type 2 Diabetes Mellitus Among Women With Gestational Diabetes Mellitus at King Abdulaziz University Hospital: A Cross-Sectional Study.

Background Diabetes is characterized by elevated blood glucose levels due to inadequate insulin production or abnormalities in cellular activity. Gestational diabetes mellitus (GDM) is one of the most prominent indicators of type 2 diabetes mellitus (T2DM), which develops in pregnant women whose pancreatic function is insufficient to control the insulin resistance associated with pregnancy. Moreover, it is the most common metabolic disorder, with the majority of cases beginning in the second or third trimester of pregnancy and affecting up to 25% of pregnant women. Objectives The objective of this study was to identify factors associated with postpartum T2DM screening in women with GDM at King Abdulaziz University Hospital (KAUH) between 2010 and 2022. The secondary objective was to assess the factors associated with providing information to the patients about the risks of increased blood glucose and postpartum lifestyle modification. Methods We conducted a retrospective cross-sectional study at KAUH to investigate potential factors associated with postpartum screening for T2DM. Out of 564 patients diagnosed with GDM between 2020 and 2022, we included 200 women aged over 18 years with a history of GDM, as they met the inclusion criteria for our study. Patients younger than 18 years with missing or incomplete baseline characteristics were excluded. Data were analyzed using SPSS Statistics version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.), and p-value <0.05 was considered significant. Results A total of 200 postpartum women with GDM were included in this study. Their mean age was 35.02±5.2 years. Many of them had a family history of diabetes (83.0%) and a previous diagnosis of GDM (60.5%). The patients who performed glucose testing six weeks after birth were previously diagnosed with GDM (37.0%) or with a family history of diabetes (45.5%). The significant variables in this analysis were mothers having frequent postpartum hospital follow-up visits (P<0.001), mothers with gestationalweight gain (P=0.018), those who were informed about the risks of increased blood glucose (P=0.011), and those who were informed about plans for postpartum glucose screening (P=0.002). The motherswith a previous history of GDM were the highest to be informed of the risks of elevated blood glucose. Conclusion Frequent postpartum hospital follow-up visits, gestationalweight gain, knowledge of the risks of elevated blood sugar, and postpartum glucose screening plans were all associated withpostpartum glucose testing rates among women with GDM in Saudi Arabia.

Assessment of Acute Side Effects Among 3D-Concurrent Radiotherapy With Cisplatin-Treated Head and Neck Cancer Patients.

Three-dimensional conformal radiation therapy has become one of the basic components of multidisciplinary treatment for head and neck cancer. Generally, patients with squamous-cell carcinoma of the head and neck receive cisplatin-based chemoradiation. In the current project, the goal was to assess 3D-CRT with cisplatin-induced acute side effects (dermatitis plus xerostomia) among head and neck cancer patients. This descriptive case series was held at the Institute of Nuclear Medicine and Oncology, Lahore, Pakistan, with an enrollment of 106 head and neck cancer patients following the hospital's ethical approval. All patients received 3D-CRT with concurrent cisplatin chemotherapy according to the oncology treatment protocol at the Institute of Nuclear Medicine and Oncology. The evaluation of enrolled patients was done during treatment at a weekly interval and at one-month post-radiation. Stage 3 patients (17.9%) received chemo-radiation therapy with 40 mg/m2 cisplatin once weekly for seven weeks. All patients received 70 grays in 35 fractions with two grays per fraction over the course of seven weeks following a standard protocol. All enrolled cases had biopsy-proven squamous cell carcinoma of the head and neck. IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. analyzed the data. Chi-square and Fisher's exact tests were applied, while a p-value ≤ 0.05 was taken as statistically significant. All patients developed acute skin changes (dermatitis plus xerostomia) as a side effect of radiation therapy, with cisplatin having different grades during treatment until seven weeks. However, these changes improved and became less severe in terms of grade after one month of post-treatment among all patients. It was concluded that 3D-CRT was associated with dermatitis and xerostomia during and immediately after follow-up, even though the treatment response was good. However, clinical signs and symptoms improved, indicating that radiation therapy is a relatively safe treatment modality among cancer patients. Moreover, 40 mg/m2 cisplatin once weekly for seven weeks resulted in better loco-regional control and survival among advanced-stage head and neck cancer patients as a part of treatment. Although, higher doses of cisplatin (100 mg/m2 ) every three weeks have more harmful acute side effects and delay treatment for patients due to poor compliance.

A Study on the Assessment of Anxiety and Its Effects on Students Taking the National Eligibility cum Entrance Test for Undergraduates (NEET-UG) 2020.

Background Test anxiety is a major, often overlooked, mental health concern among students. We live in a society that decides a person's future by their performance in an examination. In our country, issues about test anxiety, academic-related depression, and stress are less discussed. Most of the institutions don't guide students with stress management. The present study was conducted to measure the anxiety levels and their effect on the mental health of students takingthe National Eligibility cum Entrance Test for Undergraduates (NEET-UG) 2020. Methods A cross-sectional study was done among 200 students of a private junior college taking the NEET-UG 2020 exam using the Westside Test Anxiety Scale questionnaire. The results obtained were analyzed by appropriate statistical tests using SPSS Statistics version 25 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). Results Out of 200 students, the results showed that, overall, 151 (75.5%) were stressed out before the exam, and 49 (24.5%) were not stressed out. This study revealed that the majority of the students didn't receive any professional help to combat their mental health problems or any professional counseling to improve their morale. Conclusion It is evident from the results of the study that the majority of the students faced difficulties in their academic performance due to test anxiety, and the effects were prominent irrespective of the age and gender of the students. Professional psychological counselors, guidance, and the availability of healthcare professionals in institutions to address the mental health needs of students will yield better outcomes.

Gender Disparities in Ankylosing Spondylitis: An Algerian Retrospective Analytical Cohort Study

Background: Ankylosing spondylitis (AS) is an inflammatory disease that can impair function and lower quality of life, which causes spinal bone fusion and new bone production. Several studies have been done on the differences in damage between women and men. Objectives: This study aimed to assess the differences between men and women with AS regarding clinical characteristics, structural damage, and treatment used by Algerian patients. Methods: In this study, 292 patients diagnosed with AS at the Hassani Abdelkader Hospital Rehabilitation Department of Sidi Bel Abbes Region between 2018 and 2021 were enrolled. The studied parameters were age, disease duration, age at disease onset, morning stiffness, joint involvements, laboratory data, disease activity, and treatments. All data were processed and analyzed via Excel and SPSS 20.0 (Statistical Package for the Social Sciences, IBM Corporation, Chicago, IL, August 2011). Results: We assessed 166 females and 126 males. The mean age at disease onset was 31.69 ± 10.675 vs. 30.38 ± 10.250 years, and morning stiffness duration was 26.08 ± 26.977 vs. 23.80 ± 26.529 minutes in females and males, respectively. Positive HLA-B27 was noted more in 71.9% of women and 69.6% of men. Also, the female group suffered more from their lumbar (100%) and high inflammation (83.8% elevated erythrocyte sedimentation rate (ESR) and 59.9% positive C-reactive protein (CRP)) rather than females who suffered from a long disease duration (7.28 ± 4.867 vs. 6.74 ± 3.584). Peripheral joints were primarily affected in males than females (knees involvement: 26.4% vs. 3.6% and hips involvement: 69.6% vs. 3%, respectively). In addition, high disease activity was more noted in men (52.8% vs. 41.9%, respectively). The most noted comorbidities, including uveitis, psoriasis, and diabetes, affected more females than males (40% vs. 29.9%, 4.8% vs. 2.4%, and 2.4% vs. 1.2%, respectively). Concerning the treatment, men used more sulfasalazine than women, 86.4% vs. 76%, while women used more Humira than men (88.6% vs. 74.4%, respectively). Conclusions: According to our findings, women had a higher inflammation rate and more damage in their lumbar, requiring more sulfasalazine and Humira treatment than men who suffered from their peripheral joints and higher disease activity.

Risk Factors of Gestational Diabetes Mellitus Among Women Attending an Antenatal Care Clinic in Prince Sultan Military Medical City (PSMMC), Riyadh, Kingdom of Saudi Arabia: A Case-Control Study.

Gestational diabetes mellitus (GDM) is a serious health issue for both mother and child. As GDM is common worldwide, healthcare providers pay attention while screening and managing pregnant women to ensure good outcomes for both mother and child. This study aims to identify the risk factors associated with developing GDM in pregnant women attending antenatal care clinics in Prince Sultan Military Medical City (PSMMC) in Riyadh, Saudi Arabia. This is a case-control study that utilized patients' medical records for data collection. The study included 317 pregnant Saudi women who attended antenatal care clinics and antenatal diabetic clinics in PSMMC from May 2022 to May 2023. Cases were defined as women who met the inclusion and exclusion criteria and had a positive oral glucose tolerance test (OGTT) result, while controls were defined as women in the same age group and gravidity who had negative OGTT. Analysis was conducted using SPSS Statistics version 29.0 (IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 29.0. Armonk, NY: IBM Corp.) Results: The total number of cases was 132 out of 313 total samples, representing 42.2% of the total sample. Three factors were associated with an increased risk of developing GDM, including a family history of diabetes (p-value <0.001), a history of GDM (p-value <0.001), and macrosomia (p-value = 0.020). The study also found higher BMI and advanced maternal age were risk factors for GDM (p-value = 0.004, 0.007), respectively. However, the study did not find a significant association between GDM and other factors, such as chronic disease prevalence, history of miscarriage, or history of fetal death. The study identified several risk factors associated with an increased risk of GDM including family history of diabetes, history of GDM, macrosomia, overweight/obesity, and advanced maternal age. It is recommended that antenatal care providers screen for GDM risk factors and closely monitor overweight, obese, or older women. Education and counseling on healthy lifestyle habits, such as maintaining a healthy weight and engaging in physical activity, may also be beneficial for preventing GDM. Further research is needed to confirm and identify additional risk factors for GDM.

The Use of Social Media by Clinical Nurse Specialists at a Tertiary Hospital: Mixed Methods Study.

Recently, many health care professionals, who use social media to communicate with patients and colleagues, share information about medical research and promote public health campaigns. This study aimed to examine the motives, barriers, and implementation of social media use among clinical nurse specialists in Oman. A mixed methods study was conducted among 47 clinical nurse specialists at Sultan Qaboos University Hospital between November and December 2020. Qualitative data were collected using an open-ended questionnaire and analyzed using thematic analysis, and quantitative data were collected with a questionnaire and analyzed using SPSS (version 21.0; IBM Corp). Of the 47 clinical nurse specialists surveyed, 43 (91.5%) responded. All respondents reported using social media applications, with WhatsApp being the most commonly used platform. Most respondents (n=18, 41.9%) spent 1-2 hours per day on social media. The main motives for using social media were increasing knowledge, communication, reaching patients easily, and reducing the number of hospital visits. The main barriers to social media use were privacy concerns, time constraints, and a lack of awareness of legal guidelines for social media use in the workplace. All participants requested clear rules and regulations regarding the use of social media among health care providers in the future. Social media has the option to be a powerful institutional communication and health education tool for clinical nurse specialists in Oman. However, several obstacles must be addressed, including privacy concerns and the need for clear guidelines on social media use in the workplace. Our findings suggest that health care institutions and clinical nurse specialists must work together to overcome these impediments and leverage the benefits of social media for health care.Bottom of Form.

Serum levels of interleukin-6 and tumor necrosis factor-alpha in diagnosis and prognosis of gallbladder cancer: a pilot study

Objectives: Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) are proin- flammatory cytokines that play a major role in tumorigenesis. These biomarkers are relatively unexplored in gallbladder cancer (GBC) for their diagnostic and prognostic utility. Materials and Methods: A total of 40 healthy controls and 40 GBC patients were recruited. Serum IL-6 and TNF-α levels were measured, and their diagnostic utility was analyzed using the receiver operating characteristics (ROC) curve. The relationship between clinicopathological variables and serum tumor markers (CEA, CA125, and CA19-9) in identifying GBC patients was also assessed. Statistical Analysis: Statistical analysis was performed using IBM SPSS version 25.0 (IBM Corporation, Armonk, New York, United States). Results: Serum IL-6 and TNF-α expression were significantly higher in the GBC group (for both IL-6 and TNF-α, p = 0.0001) than in healthy controls. ROC analysis revealed that the areas under the curve for serum IL-6 and TNF-α were 0.89 and 0.71, respectively. The sensitivity and specificity for serum IL-6 were 82.5 and 97.5%, respectively, at an optimal cutoff value of 10.34 pg/mL; for TNF-α, they were 40.0 and 100%, respectively, at a cutoff value of 0.24 pg/mL. There was also a significant difference in serum IL-6 levels between the resectable and nonresectable GBC groups. Serum IL-6 showed a positive correlation with CA125 (r = 0.34, p &lt; 0.05), while no correlation was observed between serum TNF-α and serum tumor markers (CEA, CA125, and CA19-9). Conclusion: Serum IL-6 may serve as a diagnostic marker and a predictor of resect- ability, and it can be used in conjunction with other serum tumor markers in GBC.

Entanglement Parallelization via Quantum Fourier Transform

AbstractIn this study, a technique based on the quantum Fourier transform (QFT) that allows the generation of disjoint sets of entangled particles is presented, in such a way that particles of the same set are entangled with each other, while particles of different sets are completely independent. Several applications of this technique are implemented on three physical platforms, of 5 (Belem), 7 (Oslo), and 14 (Melbourne) qubits, of the international business machine (IBM Q) quantum experience program, where all these applications are specially selected due to their particular commitment to the future Quantum Internet.

Assessment of Therapeutic Bio-Activity of Cinnamoyl Sulfonamide Hydroxamate in Squamous Cell Carcinoma.

Background Cancer isthe second most common cause of death. Oral squamous cell carcinoma (OSCC) represents the most frequent of all oral neoplasms. Many treatment modalities such as chemotherapy, radiotherapy, surgery, and immunotherapy are emerging but still, the patients' quality of life is questionable. Despite the advances in therapeutic approaches, the percentages of morbidity and mortality of OSCC have not improved significantly during the last 30 years. Treatment using natural products can act as a potent anti-cancer agent with reduced adverse effects. Cinnamic acid derivatives exhibit anti-cancer potential through histone deacetylase inhibitor (HDAC) enzyme inhibition. Methodology In an experimental study design, cinnamoyl hydroxamate derivatives were prepared. The structure was confirmed using ultraviolet-visible spectroscopy (UV-Vis), nuclear magnetic resonance (NMR), infrared spectroscopy, and mass spectrophotometry. An in-vitro antioxidant assay using nitric oxide scavenging and reducing power assay was done and an in-vitro cytotoxic (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) (MTT) assay and viability assay were carried out using tryphan blue dye. Results Statistical analysis was performed using SPSS (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp). Cinnamoyl hydroxamate derivatives were obtained and named as compounds3a (E)-N-Hydroxy-3-(4-(N-(phenyl bromo) sulfamoyl) phenyl) acrylamide-)and 3b ((E)-N-Hydroxy-3-(4-(N-(phenyl nitro) sulfamoyl) phenyl) acrylamide). In the nitric oxide scavenging assay, compound 3a showed good antioxidant activity than 3b. Reducing power assay was higher in 3a compared to 3b. Cell viability using tryphan blue exhibited a concentration decrease in % cell viability with an increase in the concentration of human oral cavity squamous cell carcinoma cell line (OECM 1), a unique head and neck squamous carcinoma cellline (UM SCC 6) & human oral squamous cell carcinoma forming metastatic foci (HSC 3) cell lines. Conclusion The results of the present study revealed that the study compounds play a vital role in the up-regulation of apoptotic pathways and regulation of terminal differentiation pathways. The compounds showed good anti-oxidant and anti-cancer activities in lesser concentrations, hence they can be used as a therapeutic agent for oral squamous cell carcinoma.

Teledermatology in India During the Peri–COVID-19 Outbreak Period: Advantages, Shortcomings, and Challenges

Background Telemedicine is defined as the use of electronic information and communication technologies for health care professionals to provide care to patients. Although available since the pre–COVID-19 era, a huge surge in teledermatology consultations occurred during the COVID-19 outbreak. As access to health care became limited and difficult due to repeated lockdowns, teledermatology helped us provide health care to our patients. Moreover, as dermatology is a visual field, it was even more suitable for teleconsultations. Objective The objectives of this study were to investigate the advantages, shortcomings, and challenges of teledermatology in India during the peri–COVID-19 outbreak period. Methods This was a single-center, retrospective, observational study conducted at a tertiary care hospital in India. Teledermatology consultation data from April 1, 2020, till September 2021 (18 months) were included. All modes, including real-time (RT) video, asynchronous store and forward (SAF), and hybrid, were used to conduct teledermatology consultations. Statistical analyses were performed using SPSS software (IBM Corp). Results During these 18 months, a total of 4280 patients took teledermatology consultations at our center. The mean age of the patients was 34.19 years, with most of them (36.4%) in the age group of 31-40 years. The patient population comprised a mix of urban (55%) and rural (45%) individuals. Overall, 70% of consultations were conducted in the SAF mode; hybrid mode, 16%; and RT video consultations, 14%. Diagnosis was established in 89.1% of the cases, and the most common diagnosis was superficial fungal infection (28%), followed by eczema (16%) and acne (8.6%). Hospital visits were required in the remaining 10.9% of cases for the following reasons: lack of clear pictures and technical errors (5.57%). Additional diagnostic tests were required in 1.3% of cases, physical examination in 1.05% of cases, and 0.39% of patients had life-threatening conditions requiring hospitalization. The advantages of teledermatology include decreased need for hospital visits among 89.1% of patients, which played a very important role in decreasing overcrowding. Also, this helped us provide expert health care to the rural population of India. Owing to shortcomings including the lack of good-quality pictures (4.2%; more so in SAF teleconsultations) and technical errors (1.37%), teledermatology cannot be used to manage life-threatening conditions (0.39%), and, in particular, RT video consultations are more time-consuming (14%). Challenges faced by dermatologists during teledermatology consultations were mainly operational, such as the lack of good internet access leading to interrupted consultations (1.37%), poor quality of pictures (4.2%), and difficulty in extracting history in cases of SAF consultations. Conclusions Teledermatology serves as a triage platform and helps reduce hospital visits. It helps to cater to the rural population, which otherwise has limited access to health care. Some technical challenges are the dependence of teledermatology on pictures and information sent by the patient for establishing the diagnosis. Also, sometimes patients faced difficulty in conveying problems clearly to the doctors. Because of the ease and advantages, several dermatologists have continued to use teledermatology along with the physical consultations in the post–COVID-19 era. With a few advancements, teledermatology will certainly remain a successful and useful model for consultations, more so for catering to the population with the lack of access to specialist services. Conflicts of Interest None declared.

Determinants of respectful maternity care at a tertiary care teaching institute in South India: A mixed-methods study.

To determine the proportion of women who experienced disrespect and abuse (D&A) and the type of D&A during labor and postpartum, and to determine the factors significantly associated with D&A. A cross-sectional mixed-methods study undertaken in tertiary care teaching institute South India. After ethical approval, 380 postpartum women within 72 h of delivery were recruited for the study. The determinants of respectful maternity care (RMC) were assessed quantitatively and qualitatively. For quantitative assessment, they were interviewed using questionnaires adopted from the United States Agency for International Development- Maternal and Child Health Integrated Program (USAID-MCHIP) protocol, which has verification criteria for RMC. As a second method for quantitative assessment, they were asked to rate the care from their perspective on a 10-point score. For the qualitative component, they were asked to identify the healthcare workers associated with D&A by their designation and to answer three open-ended questions. IBM SPSS Statistics 25 (IBM Corporation, Statistical Package for Social Sciences, version 25) was used for analysis. D&A as per RMC standards I-VII and its severity were expressed as frequencies and percentages with 95% confidence interval. Univariate analysis was used to determine the associated factors, and severity was determined by χ2 test. The prevalence of D&A was high (85%) according to the RMC standards of the USAID-MCHIP questionnaire, whereas it was only 33% according to women's perspective. The most common type of D&A was non-dignified care. The factors significantly associated with D&A were women over 25 years, those admitted as an emergency referral, having a recommendation letter, and relatives working at the same healthcare facility. The prevalence of D&A was high as measured by the USAID-MCHIP questionnaire, and the most common type was non-dignified care followed by physical abuse.

Identification of Radiomic Signatures in Brain MRI Sequences T1 and T2 That Differentiate Tumor Regions of Midline Gliomas with H3.3K27M Mutation.

Radiomics refers to the acquisition of traces of quantitative features that are usually non-perceptible to human vision and are obtained from different imaging techniques and subsequently transformed into high-dimensional data. Diffuse midline gliomas (DMG) represent approximately 20% of pediatric CNS tumors, with a median survival of less than one year after diagnosis. We aimed to identify which radiomics can discriminate DMG tumor regions (viable tumor and peritumoral edema) from equivalent midline normal tissue (EMNT) in patients with the positive H3.F3K27M mutation, which is associated with a worse prognosis. This was a retrospective study. From a database of 126 DMG patients (children, adolescents, and young adults), only 12 had H3.3K27M mutation and available brain magnetic resonance DICOM file. The MRI T1 post-gadolinium and T2 sequences were uploaded to LIFEx software to post-process and extract radiomic features. Statistical analysis included normal distribution tests and the Mann-Whitney U test performed using IBM SPSS® (Version 27.0.0.1, International Business Machines Corp., Armonk, NY, USA), considering a significant statistical p-value ≤ 0.05. EMNT vs. Tumor: From the T1 sequence 10 radiomics were identified, and 14 radiomics from the T2 sequence, but only one radiomic identified viable tumors in both sequences (p < 0.05) (DISCRETIZED_Q1). Peritumoral edema vs. EMNT: From the T1 sequence, five radiomics were identified, and four radiomics from the T2 sequence. However, four radiomics could discriminate peritumoral edema in both sequences (p < 0.05) (CONVENTIONAL_Kurtosis, CONVENTIONAL_ExcessKurtosis, DISCRETIZED_Kurtosis, and DISCRETIZED_ExcessKurtosis). There were no radiomics useful for distinguishing tumor tissue from peritumoral edema in both sequences. Less than 5% of the radiomic characteristics identified tumor regions of medical-clinical interest in T1 and T2 sequences of conventional magnetic resonance imaging. The first-order and second-order radiomic features suggest support to investigators and clinicians for careful evaluation for diagnosis, patient classification, and multimodality cancer treatment planning.

Oxidative Stress in Wistar Rats Under Acute Restraint Stress and Its Modulation by Antioxidants and Nitric Oxide Modulators.

Several pathogenic conditions leading to morbidity, including cancer, aging, diabetes, reperfusion injury, cardiovascular disease, and neurological disorders, are known to be exacerbated by oxidative stress. Antioxidant therapy is effective in the treatment of such disorders and appears to be a potential therapeutic technique to reduce oxidative stress. The aim of our study is to investigate the antioxidant effects of L-ascorbic acid and nitric oxide (NO) modulators on rats suffering from oxidative stress induced by acute restraint stress (RSx1). In this in vivo study, Wistar rats were subjected to one hour of restraint stress on day 21 to induce oxidative stress. Superoxide dismutase (SOD), total antioxidant capacity (TAC), catalase, glutathione (GSH), and malondialdehyde (MDA) were used to assess the antioxidant effects. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. was used for data analysis. Compared to vehicle groups, acute restraint stress (RSx1) dramatically increased MDA levels while decreasing GSH, SOD, total antioxidant capacity, and catalase. L-NAME, 7-NI, AG (50 mg/kg each), and L-ascorbic acid (200 mg/kg) reversed the changes in SOD, MDA, GSH, total antioxidant capacity, and catalase levels. The NO precursor L-arginine (1000 mg/kg) and NO synthase inhibitors followed the same trend. Our study findings highlight the complex role of antioxidants and NO modulators in the pathogenesis of diseases, as evidenced by the reversal of oxidative stress indicators. Antioxidant therapy, with its potential to mitigate oxidative stress, emerges as a viable treatment option for a range of pathological conditions associated with oxidative stress.