Lack Of Awareness Research Articles

Guidelines for setting up low-vision and rehabilitation services in India.

Low vision and blindness are increasing public health issues impacting individuals' quality of life. During clinical low-vision services, vision rehabilitation is crucial for enhancing daily living skills and improving life quality. Low-vision and rehabilitation (LVR) services encompass comprehensive measures that aid visually disabled individuals in restoring function, autonomy, and social participation. Such holistic management requires a multidisciplinary approach, facilitating adaptation to environmental and sociocultural changes. However, the lack of awareness about the principles and practices of LVR services poses a major hindrance to setting up such a special clinic in the eye hospital. This article is about a consensus statement on the guidelines for establishing LVR services focusing on basic requirements, especially in low-resource countries. The present recommendation to set up an LVR clinic was made after group discussions and debates among various experts and stakeholders during the National Workshop on Strengthening Low-Vision and Rehabilitation Services organized at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. The event was participated by many ophthalmologists and optometrists coming from across the country. The recommendations required at the tertiary level are outlined under the four headings: Human resources and training: two ophthalmologists, that is, a low vision specialist or a well-experienced in low vision and one who has received one-week orientation and training, one optometrist, one rehabilitation supervisor, and two rehabilitation assistants; Assessment equipment: basic screening and diagnostic; Assistive devices for low vision, including, digital and non-digital; Assistive devices for rehabilitation, and methods for records maintenance. The institution may not follow strictly the present guidelines but will provide an idea on LVR services initiation.

HDAC inhibitors as a potential therapy for chemotherapy-induced neuropathic pain.

Cancer, a chronic disease characterized by uncontrolled cell development, kills millions of people globally. The WHO reported over 10 million cancer deaths in 2020. Anticancer medications destroy healthy and malignant cells. Cancer treatment induces neuropathy. Anticancer drugs cause harm to spinal cord, brain, and peripheral nerve somatosensory neurons, causing chemotherapy-induced neuropathic pain. The chemotherapy-induced mechanisms underlying neuropathic pain are not fully understood. However, neuroinflammation has been identified as one of the various pathways associated with the onset of chemotherapy-induced neuropathic pain. The neuroinflammatory processes may exhibit varying characteristics based on the specific type of anticancer treatment delivered. Neuroinflammatory characteristics have been observed in the spinal cord, where microglia and astrocytes have a significant impact on the development of chemotherapy-induced peripheral neuropathy. The patient's quality of life might be affected by sensory deprivation, loss of consciousness, paralysis, and severe disability. High cancer rates and ineffective treatments are associated with this disease. Recently, histone deacetylases have become a novel treatment target for chemotherapy-induced neuropathic pain. Chemotherapy-induced neuropathic pain may be treated with histone deacetylase inhibitors. Histone deacetylase inhibitors may be a promising therapeutic treatment for chemotherapy-induced neuropathic pain. Common chemotherapeutic drugs, mechanisms, therapeutic treatments for neuropathic pain, and histone deacetylase and its inhibitors in chemotherapy-induced neuropathic pain are covered in this paper. We propose that histone deacetylase inhibitors may treat several aspects of chemotherapy-induced neuropathic pain, and identifying these inhibitors as potentially unique treatments is crucial to the development of various chemotherapeutic combination treatments.

Robot-assisted treatment of secondary epilepsy caused by parasitic infection: a case report

BackgroundCerebral sparganosis represents the most severe manifestation of sparganosis, with a relatively low global incidence. For cases of secondary epileptic seizures caused by sparganosis infection in the functional areas of the brain, what advanced neurosurgical techniques should be employed to precisely identify and excise the epileptic lesions in the deep functional areas of the brain, aiming to achieve maximal removal while minimising the risk of neurological deficits? This remains a current challenge for epilepsy surgeons.Case presentationA 24-year-old Chinese male was admitted to our hospital, presenting with a history of left limb twitching persisting for over a year. His main clinical symptoms presented twitching and numbness of his left limb without loss of consciousness. Under the premise of inappropriate anti-seizure treatment, recurrent epilepsy attacked persist. The patient's diagnosis was considered as “space-occupying lesions in the several lobes of brain, secondary epilepsy” after comprehensive assessment and discussion. And experts considered that the patient's space-occupying lesions in the right frontal and parietal lobes were highly suspected to be infected by parasites. This report delved into the application of neurosurgery robot-assisted frameless stereotaxic technology and intraoperative stereotactic electroencephalography (SEEG) monitoring technology to accurately locate and optimize removal of parasite-related epileptic lesions situated in functional areas of the brain. As a result, the patient had achieved seizure freedom, leaving no symptoms of neurological deficit.ConclusionsWith the highly integrated development of imaging technology, mechanical technology, computer control technology, and artificial intelligence, surgical robots are poised to play a larger role across various neurosurgical specialties in the future. Considering benefits for patients and the promising application of this technology, its utilization holds significant value.

Civic Education and National Development: A Comprehensive Analysis of Zambia

Overview: Civic education plays a crucial role in the development of nations by fostering informed and responsible citizenship, promoting democratic values, and strengthening social cohesion. Hence, this study presented a thorough examination of the relationship between civic education and national development. The study was conducted in Lusaka district, the capital city of Zambia from which the participants were selected for the study from 5 different organizations. Body of Knowledge: The study comprehended various aspects, including the definition and objectives of civic education, its importance in fostering democratic values, and its impact on social cohesion and economic growth. It dwelt into the crucial role civic education plays in shaping informed and responsible citizens who actively contribute to the progress of their nations. This study was guided by the social learning theory. The social learning theory has been widely applied in the study of human behavior, including in the context of civic education and national development. Methods: The total target population was 1000. The sample size involved a total of 100 respondents, which was 10% of the target population. A mixed method approach was used in this study in combination with the descriptive survey design. Interviews and questionnaires were used to collect data. Tables, graphs and pie-charts were used to analyze the quantitative and qualitative data obtained. Data was then analyzed manually in some cases and also, a combination of software MS Access, MS Excel, and SPSS. Results: The following key findings were established on the effect of civic education on national development; increased awareness, enhanced civic engagement, strengthened community bonds, improved governance understanding, empowered citizenry while regarding the factors that hinder citizen participation in national development, the study found; lack of awareness, limited access to information, distrust in institutions, socioeconomic challenges and ineffective communication channels. Recommendation: The Ministry of Education need to integrating civic education into educational curricula and policymaking initiatives to facilitate sustainable development and democratic governance.

Mitigating Challenges to Effective Management of Post-Intensive Care Syndrome (PICS)

Introduction: Post-Intensive Care Syndrome (PICS) refers to the collective effects of prolonged physical and cognitive impairments and mental health problems during or after the stay in intensive care unit (ICU). PICS significantly affect patients’ quality of life and ability to return to their normal routines. The challenges of PICS have become more pervasive since the Covid-19 pandemic. The aim of this study is to examine the challenges to effective management of PICS and suggest tangible ways of addressing them so as to reduce the prevalence of PICS, and improve on patients’ wellbeing, quality of life and satisfaction with care services. Methods: The descriptive survey is employed to make a brief systematic review of selected 2019—2024 literatures on PICS, the challenges, and the measures for managing the challenges effectively. Results: There is a consensus on lack of awareness and inability to recognize the condition among healthcare professionals; the difficulty of predicting and managing the long-term effects of PICS; the significant emotional toll of PICS on patients and their families; and the fragmentation of healthcare systems, which together constrain effective management of PICS. Conclusion: To attain effective management of PICS, a comprehensive multidisciplinary approach, which can address cognitive, physical, and psychological aspects of the condition, has to be adopted. Resorting to a meaningful interdisciplinary collaboration among healthcare professionals, widespread awareness about PICS, the symptoms, and the need for early interventions would guarantee patients’ attainment of maximal outcomes and improved quality of life.

A comparative study on knowledge, awareness and perception of contraception among rural and urban population in Punjab

In developing countries like India, a lack of awareness about contraceptive methods often leads to misconceptions, limited choices, and improper family planning. This knowledge gap not only disrupts maternal and child health complications but also disrupts the economy of society and the nation. Therefore, the purpose of this study was to investigate the knowledge, awareness and perception of contraception among the rural and urban population in Punjab.This observational study conducted in the Department of Obstetrics and Gynecology at a tertiary health care centre, in Punjab, India. A total of 500 women were evaluated with the help of a pre-designed questionnaire to address knowledge, awareness, and perception of contraception among the rural and urban population in Punjab. The statistical analysis was performed by using SPSS Windows, version 28. In the present study, a total of 492 participants were included, of whom 387 were from rural areas and 105 were from urban areas. This study revealed, 100% of participants were aware of contraception. In terms of the source of information, social circles were identified as the primary channel (46.34%), followed by the media (33.94%), health workers (16.87%), and educational institutes (2.85%).This study highlights contraceptive methods, including condoms, oral contraceptives, and intrauterine devices (IUDs), as primary choices. Therefore, it's important to bridge the gap between awareness and action. Hence, this study, advocate the awareness program on interventions to ensure everyone can access effective family planning resources without barriers.

Posterior Reversible Leukoencephalopathy Syndrome (PRES) in a patient with post eclampsia with status epilepticus

Despite the limited number of instances and relatively low knowledge of Posterior Reversible Leukoencephalopathy Syndrome (PRES) among the population of Bangladesh, it is imperative to recognize the gravity of this health issue. The crucial aspect in achieving favorable results is the early detection of the condition, as it allows for the prompt elimination of the precipitating cause and the effective management of blood pressure. The present case study elucidates the significant discoveries pertaining to a patient with posterior reversible encephalopathy syndrome (PRES), as well as the diagnostic and therapeutic strategies used. A female individual who had just undergone a surgical operation known as a cesarean section exhibited symptoms including headache, recurrent convulsions, and loss of consciousness. Subsequent medical evaluation led to the diagnosis of posterior reversible encephalopathy syndrome (PRES). This section presents an examination of the diagnostic process using clinical and radiological characteristics, as well as an overview of the therapy plan. The fast diagnosis and timely beginning of therapy procedures have been identified as crucial factors for achieving early recovery and favorable functional outcomes. J Shaheed Suhrawardy Med Coll 2022; 14(2): 63-65

Exploring the significant problems confronting secondary schools history education: a baseline study

The purpose of this baseline study is to determine the significant problems confronting history education in secondary school. The researchers employed qualitative research methods and case study design. The techniques that were employed to acquire credible data were document analysis, interviews, and classroom observation. Six experienced history education teachers and eight top-ten students from Sebeta town public secondary school were interviewed, and academic achievement statistics of 174 students in history education were analyzed. In addition eight lesson observations were carried out to validate the information gleaned from the interviews and document analysis. The study's findings show that the primary challenges influencing history education in Sebeta town public secondary schools were teaching strategy, a lack of awareness about implementing participatory teaching methods, a lack of comprehensiveness of the contents of history education teaching materials, and the issue of the bulkiness and scope of history education texts being covered on time. The findings also indicate the significance of training history education teachers to use participatory teaching tactics, as well as the need for curriculum experts to better coordinate the range of history education content and teaching strategies. The findings of this study will help teachers, practitioners, scholars, policymakers, and educational professionals find solutions to significant problems in secondary school history education, as well as develop effective techniques for teaching history education in secondary schools that involve twenty-first century skills and abilities.

Feasibility of Urban-Based Climate Change Adaptation Strategies in Urban Centers of Southwest Ethiopia: From Local Climate Action Perspective

This study identified the practices of adaptation strategies to climate change in Jimma, Bedelle, Bonga, and Sokorru urban centers using a survey of 384 households, 55 key informant interviews, 4 focus group discussions, and field observations. A cross-sectional study design was employed from 2019 to 2021. The adaptive capacity of municipalities to reduce climate extreme events was rated as poor by the majority (51%), mostly reactive measures (76%). The climate hazards identified in four urban centers were riverine and flash floods, urban heat waves, landslides, and windstorms. The urban households practiced lifestyle modification, reduce paved surfaces, the use of air conditioner, planting trees, and multiple windows. The adaptation strategies practiced by municipalities include the relocation of prone areas, the support of basic amenities, the construction of protection walls, diversion ditches, the clearance of waterways and rivers, greenery, and park development. The adaptation actions were constrained by a lack of awareness, commitment, cooperation and coordination, adaptive capacity, and participation. Gray/physical infrastructures (costly but important) as adaptation actions were hampered by the low municipal capacity. We recommend that urban authorities should incorporate climate change adaptation strategies into urban planning and development proactively to ensure future resilient climate smart urban centers of southwest Ethiopia.

Syncope and Brugada-like ECG pattern in a patient with syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Syncope is a brief loss of consciousness caused by reduced blood flow to the brain, characterised by sudden onset, short duration and full recovery without intervention. Anamnesis, physical examination and other diagnostic tests such as laboratory analysis and electrocardiogram (ECG) can be conducted to identify the underlying cause of syncope. A Brugada pattern on an ECG in individuals with syndrome of inappropriate antidiuretic hormone secretion (SIADH) who have syncope symptoms may indicate cardiac issues. A 69-year-old man with hypertension and a history of smoking presented with syncope. His vital signs were within normal limits, with no signs of a neurological deficit. The patient met the diagnostic criteria for SIADH, as evidenced by the presence of hyponatraemia (Na 118 mmol/l), a hyperosmolar condition and euvolemia. Upon arrival, a twelve-lead ECG showed ST-segment anomalies that reflected a Brugada ECG pattern. No ventricular arrhythmias were detected during the 24-hour Holter monitoring. Coronary angiography revealed no abnormalities in the coronary arteries. The ECG demonstrated the normalisation of ST elevations and the disappearance of the Brugada ECG pattern after the correction of hyponatraemia. After three months of follow-up the patient, with a normal sodium level, had no episodes of syncope.

Characteristics of Adult Brain Tumors in Neurology Emergency Unit in Prof. Dr. I.G.N.G. Ngoerah Hospital Bali 2020-2022

Introduction: Brain tumors have a low incidence, with only 77,000 new cases reported annually in the United States, there is limited published data on brain tumor epidemiology in Indonesia, particularly in Bali. Therefore, we conducted this study to provide data that can explain the burden of care for adult brain tumors, particularly in Bali. Methods: The study collected secondary data from medical records at Prof. Dr. I.G.N.G. Ngoerah, a tertiary hospital in Bali Province. The sample consisted of adult patients aged 18 years or older who were treated in the neurology emergency department for brain tumors between 2020 and 2022, diagnosed through imaging or histopathological examination. The sample was further divided into primary and metastatic brain tumors. Primary brain tumors were categorized based on the major classification according to the type of cell precursor, while metastatic brain tumors were grouped based on the primary source of the tumor. The collected data were presented descriptively as proportions. Results: A total of 535 subjects were included in the study, out of which 298 (55.7%) had primary brain tumors and the remaining 237 (44.29%) cases were brain metastases. The incidence rate was found to be higher among males (278 cases, 51.96%) than among females (257 cases, 48.03%). The highest incidence rate (31.77%) was observed in the age group of 51 to 60 years. Majority of primary brain tumors were classified as glioma, especially high-grade glioma, accounting for 123 cases (41.27%), followed by meningioma with 94 cases (31.54%) and low-grade glioma with 44 cases (14.76%). The majority of primary brain tumors were located in the supratentorial area, accounting for 259 cases (86.91%). Although rare, the study found a sample of 6 cases (1.76%) with primary brain tumors in both the supratentorial and infratentorial areas, consisting of meningioma, Mesenchymal, non-meningothelial tumors, and hematolymphoid tumors. The majority of patients showed clinical features of headache (68.78%), hemiparesis (51.96%), and cranial nerve palsy (51.96%). Other clinical features noted were seizure (26.72%), loss of consciousness (32.33%), vomiting (11.77%), and visual impairment (8.59%). The study revealed that lung cancer was responsible for 43.88% of brain metastasis cases, making it the most common cancer to metastasize to the brain. Conclusions: Discovering the most common type of brain tumor in emergency departments can be a vital step in understanding the characteristics of brain tumor patients. This study has revealed that primary brain tumors, particularly high-grade gliomas, are the most frequently occurring type of brain tumor in emergency departments. Not only this, but the study also found that metastatic brain tumors most often resulted from lung cancer. These findings are unique to the Indonesian context and thus provide valuable insights into the epidemiology of brain tumors in emergency settings. It is hoped that this study will encourage further research in this area, and ultimately lead to improved care for brain tumor patients in emergency departments Keywords: Brain Tumor, Primary Brain Tumor, Metastatic Brain Tumor.

Investigating the trend of demographic changes, mortality, clinical and paraclinical findings of patients hospitalized in the Corona ward, before and after the start of general vaccination of COVID-19

BackgroundPrioritizing prevention over treatment has been a longstanding principle in the world health system. This study aims to compare the demographic changes, mortality, clinical, and paraclinical findings of patients hospitalized in the Corona ward before and after the start of general vaccination.MethodsThis cross-sectional study utilized the simple random sampling method in 2022, analyzing 300 medical records of patients admitted to the Corona ward at 22 Bahman Khaf Hospital. Data were collected using a checklist with the help of the Medical Care Monitoring System and analyzed using SPSS-22 statistical software and Chi-square statistical test at a significance level of p < 0.05.ResultsBefore the start of general vaccination for COVID-19, the majority of patients were hospitalized in the Corona Intensive Care Unit (59.3%), aged between 51 and 65 years (47.3%), hospitalized for more than 3 days (54%), required intubation (49.3%), had SPO2 < 93% (60.7%), and exhibited common symptoms such as cough, shortness of breath, and loss of consciousness. Paraclinical findings included positive CRP, decreased lymphocytes, and ground glass opacity (GGO). After the start of general vaccination for COVID-19, most patients were hospitalized in the general care department of Corona (68%), aged between 36 and 50 years (47.3%), hospitalized for less than three days (66%), required intubation (20%), had SPO2 ≥ 93% (77.3%), and exhibited common symptoms such as weakness, headache, and body pain. Paraclinical findings were within the normal range.ConclusionsGeneral vaccination for COVID-19 has significantly reduced patient mortality and morbidity. Health policymakers should prioritize general vaccination to achieve herd immunity and improve public health.

Variations Between Physical Banking and Internet Banking Usage amid COVID-19 Pandemic

The usage of banking functions through Internet is comfortable and time saving process, since the usage rates of different banking functions through Internet banking mechanism are very low. The present study aims to evaluate the variations between physical banking and internet banking and explores the problems faced by banking customers in using internet banking amid the COVID-19 pandemic. The primary data for the present study were collected from banking customers, who were identified on a random basis from three different areas of the Union Territory of Jammu and Kashmir. The total sample size was 1,200, comprising a breakup of 400 for each of the sampling areas of central Kashmir, south Kashmir and north Kashmir. Internet banking adoption is changing the physical usage of non-financial products and financial products worldwide. Today, a click of the mouse and mobile banking offer a lot of transactions regarding electronic non-financial products and electronic financial products. Still, the adoption rates of these products are very low. The present study has examined the situation of electronic banking adoption amid the COVID-19 pandemic, and hence, it is found that maximum number of customers are non-users of electronic non-financial products and electronic financial products. Amid the pandemic, the reason for non-usage of technology banking by a majority of customers was lack of awareness, technological barriers and security concerns. They also used physical banking activities and did not follow social distancing as suggested by the Government of India during March 2020. Therefore, it is the basic responsibility of the banking industry to motivate their customers and address their concerns regarding the usage of electronic non-financial products and electronic financial products, as the maximum number of banking customers are non-users of electronic non-financial products and electronic financial products. If the banking industry will address the concerns of banking customers regarding the usage of technology banking, then only a country like India with a huge population can have technological banking and environment-friendly banking and can face situations like the COVID-19 pandemic in future.

Managing Dust in Academic Libraries

Abstract The study investigates dust management at the Albert Ilemobade library, The Federal University of Technology Akure. Dust deposition and accumulation poses a major challenge for the university library as all the units, sections, and divisions are affected. Dust not only adversely affects all materials, equipment, and facilities including books, audiovisual collections, and computers, but also constitutes a health hazard to library personnel and users. Major sources of dust include visitor activities and infiltration through openings like windows and doors. Dust mats, special computer enclosures, dusters, dust blowers, and respiratory masks were made available for dust protection and management in the library. The library lacked equipment like High Efficiency Particulate Arresting (HEPA) filters and dust collection, and suppressions systems. Lack of awareness and training, inadequate funding, and lack of equipment were identified as the challenges to dust management in the library.

Effectiveness of Gerontechnology Empowerment Program on Awareness and Use of Mobile Apps Among Older Adults for Instrumental Activities of Daily Living: Protocol for a Cluster Randomized Controlled Trial.

Instrumental activities of daily living (iADLs) are crucial for older adults to live independently. Health care and technological advancements will increase the older adult population and life expectancy globally. Difficulties with iADLs impact older adults' quality of life. Mobile apps can assist older adults, but many require help due to limited awareness. Lack of awareness is a barrier to app use. Existing literature mainly covers health care and app design, needing more focus on iADL apps for older adults. The study objectives encompass 2 main aspects: first, to evaluate the awareness, use, and factors influencing the use of apps among older adults for iADLs; and second, to create and assess the effectiveness of a gerontechnology empowerment program (GEP) for older adults on the awareness and use of apps for iADLs. This research uses a quantitative approach divided into 2 distinct phases. In phase 1, we conduct a descriptive survey to assess the level of awareness and use of mobile apps for iADLs and identify the factors that influence the use of such apps among older adults. To ensure clarity and comprehension among participants, we provide them with a subject information sheet in both Kannada and English. The data collected during this phase enable us to gain insights into awareness levels, use patterns, and factors that shape older adults' use of apps for iADLs. The results serve as the foundation for designing the GEP. In phase 2, a cluster randomization method will be used to select older adults aged 60 to 75 years in Udupi district, Karnataka, India, who are active smartphone users. These participants will be divided into 2 groups: the experimental and the control groups. The experimental group will join the GEP. The sample size for phase 1 is 554, and phase 2 is 50. To assess the effectiveness of this program, we will measure the outcomes before and after its implementation using the same assessment tools used in phase 1. This study is funded by the Indian Council of Medical Research (Adhoc/193/2022/SBHSR on November 18, 2022). Phase 1 data collection is expected to be completed by November 2023, and phase 2 is scheduled to commence in the upcoming months. Phase 1 and 2 findings will be analyzed and discussed in the main paper, which we intend to submit to a high-quality peer-reviewed journal for publication. The research protocol, informed consent forms, and associated documentation received approval from institutional ethics committees (214/2020). Upon the successful testing of the GEP, it can be recommended that welfare departments encourage older adults to use mobile apps for iADLs and establish training programs to provide support to older adults in using these apps. Clinical Trials Registry - India CTRI/2020/09/027977; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NDUxMzM=&Enc=&userName=027977. DERR1-10.2196/53587.

The Effect of Applying Business Incubators on Enhancing the Innovative Performance of Investment and Privatization Projects in Saudi Sports Clubs

The importance of the new business systems that work on developing the concept of institutional support for the new projects has emerged. Within this context, business incubators are considered one of the most effective and successful systems in implementing development programs and supporting creativity and innovation. Therefore, business incubators have become on the list of development priorities and the formation of new projects. The purpose of the study was to identify the effect of applying business incubators on enhancing the innovative performance of investment and privatization projects in Saudi sports clubs, to achieve the objective of the study, the descriptive approach (survey study method) was used. Some officials of the Ministry of Sports, chairmen and members of sports club councils, executive directors, activity managers, financial managers, and members of various committees participated in the study. The study population categories were used to select the study sample intentionally. Two questionnaires were used to obtain data from (430) participants in the study. The results showed that there is an effect of applying business incubators on enhancing the innovative performance of investment and privatization projects in Saudi sports clubs. Business incubators can be applied to support the innovative performance of investment and privatization projects in sports clubs. However, the study also highlighted challenges and barriers faced by business incubators in the Saudi sports sector, such as a lack of awareness, insufficient logistical support, limited resources, and a shortage of skilled individuals. The absence of regulations governing incubator operations further hampers their progress. The study also provides insight into the implications of the application of business incubators to enhance innovative performance and future directions.

Effects of mTBI with loss of consciousness on neurobehavioral symptoms, depression, and insomnia in former collegiate and NFL football athletes

ABSTRACT Objective Considering that diagnostic decisions about mTBI are often predicated on clinical symptom criteria, it is imperative to determine which initial presentation features of mTBI have prognostic significance for identifying those at high risk for long-term functional impairment. Setting Zoom interview Participants: Male, former NCAA Division I, and professional-level National Football League (NFL) athletes (n = 177) between the ages of 27 and 85 (M = 54.1, SD = 14.7). Design Cross-sectional case-control. Main Measures: History of mild TBI, history of loss of consciousness (LOC), depression symptoms, insomnia, neurobehavioral symptoms. Results Number of mTBI exposures did not predict neurobehavioral symptoms (B = 0.21, SE = 0.18, p = 0.23), but number of mTBI + LOC events did (B = 2.27, SE = 0.64, p = <.001). Further analysis revealed that the number of mTBI + LOC events predicted neurobehavioral symptoms indirectly through both depression (B = 0.85, 95% CI = [0.27, 1.52) and insomnia (B = 0.81, 95% CI = [0.3, 1.4]). Further, the direct effect of mTBI + LOC events on neurobehavioral symptoms became non-significant when depression and insomnia were added to the model (B = 0.78, SE = 0.45, p = 0.08). Conclusions Findings support LOC at time of injury as an important predictor of long-term outcomes. Additionally, results suggest depression and insomnia as potential mediators in the association between mTBI + LOC and neurobehavioral symptoms. These findings provide justification for early depression and insomnia symptom monitoring following mTBI + LOC.

Carbon monoxide poisoning with hippocampi lesions on MRI: cases report and literature review

BackgroundCarbon monoxide (CO) poisoning is now one of the leading causes of poisoning-related mortality worldwide. The central nervous system is the most vulnerable structure in acute CO poisoning. MRI is of great significance in the diagnosis and prognosis of CO toxic encephalopathy. The imaging features of CO poisoning are diverse. We report atypical hippocampal lesions observed on MRI in four patients after acute CO exposure.Case presentationsWe report four patients who presented to the emergency department with loss of consciousness. The diagnosis of CO poisoning was confirmed on the basis of their detailed history, physical examination and laboratory tests. Brain MRI in all of these patients revealed abnormal signal intensity in hippocampi bilaterally. They all received hyperbaric oxygen therapy. The prognosis of all four patients was poor.ConclusionHippocampi, as a relatively rare lesion on MRI of CO poisoning, is of important significance both in the early and delayed stages of acute CO poisoning. In this article, we summarize the case reports of hippocampal lesions on MRI in patients with CO poisoning in recent years, in order to provide reference for the diagnosis and prognosis of CO poisoning.

Pulmonary Thromboembolism following Russell’s Viper Bites

Snakebite envenoming and its resulting complications are serious threats to the health of vulnerable people living in rural areas of developing countries. The knowledge of the heterogeneity of symptoms associated with snakebite envenoming and their management strategies is vital to treat such life-threatening complications to save lives. Russell’s viper envenomation induces a diverse range of clinical manifestations from commonly recognised haemotoxic and local effects to several rare conditions that are often not reported. The lack of awareness about these unusual manifestations can affect prompt diagnosis, appropriate therapeutic approaches, and positive outcomes for patients. Here, we report pulmonary thromboembolism that developed in three patients following Russell’s viper envenomation and demonstrate their common clinical features and diagnostic and therapeutic approaches used. All patients showed clinical signs of local (oedema) and systemic (blood coagulation disturbances) envenomation, which were treated using polyvalent antivenom. They exhibited elevated heart rates, breathlessness, and reduced oxygen saturation, which are non-specific but core parameters in the diagnosis of pulmonary embolism. The recognition of pulmonary embolism was also achieved by an electrocardiogram, which showed sinus tachycardia and computed tomography and echocardiogram scans further confirmed this condition. Anti-coagulant treatment using low-molecular-weight heparin offered clinical benefits in these patients. In summary, this report reinforces the broad spectrum of previously unreported consequences of Russell’s viper envenomation. The constant updating of healthcare professionals and the dissemination of major lessons learned in the clinical management of snakebite envenoming through scientific documentation and educational programs are necessary to mitigate the adverse impacts of venomous snakebites in vulnerable communities.

Deformable motion compensation in interventional cone-beam CT with a context-aware learned autofocus metric.

Interventional Cone-Beam CT (CBCT) offers 3D visualization of soft-tissue and vascular anatomy, enabling 3D guidance of abdominal interventions. However, its long acquisition time makes CBCT susceptible to patient motion. Image-based autofocus offers a suitable platform for compensation of deformable motion in CBCT, but it relies on handcrafted motion metrics based on first-order image properties and that lack awareness of the underlying anatomy. This work proposes a data-driven approach to motion quantification via a learned, context-aware, deformable metric, , that quantifies the amount of motion degradation as well as the realism of the structural anatomical content in the image. The proposed was modeled as a deep convolutional neural network (CNN) trained to recreate a reference-based structural similarity metric-visual information fidelity (VIF). The deep CNN acted on motion-corrupted images, providing an estimation of the spatial VIF map that would be obtained against a motion-free reference, capturing motion distortion, and anatomic plausibility. The deep CNN featured a multi-branch architecture with a high-resolution branch for estimation of voxel-wise VIF on a small volume of interest. A second contextual, low-resolution branch provided features associated to anatomical context for disentanglement of motion effects and anatomical appearance. The deep CNN was trained on paired motion-free and motion-corrupted data obtained with a high-fidelity forward projection model for a protocol involving 120kV and 9.90mGy. The performance of was evaluated via metrics of correlation with ground truth and with the underlying deformable motion field in simulated data with deformable motion fields with amplitude ranging from 5 to 20mm and frequency from 2.4 up to 4 cycles/scan. Robustness to variation in tissue contrast and noise levels was assessed in simulation studies with varying beam energy (90-120kV) and dose (1.19-39.59mGy). Further validation was obtained on experimental studies with a deformable phantom. Final validation was obtained via integration of on an autofocus compensation framework, applied to motion compensation on experimental datasets and evaluated via metric of spatial resolution on soft-tissue boundaries and sharpness of contrast-enhanced vascularity. The magnitude and spatial map of showed consistent and high correlation levels with the ground truth in both simulation and real data, yielding average normalized cross correlation (NCC) values of 0.95 and 0.88, respectively. Similarly, achieved good correlation values with the underlying motion field, with average NCC of 0.90. In experimental phantom studies, properly reflects the change in motion amplitudes and frequencies: voxel-wise averaging of the local across the full reconstructed volume yielded an average value of 0.69 for the case with mild motion (2mm, 12 cycles/scan) and 0.29 for the case with severe motion (12mm, 6 cycles/scan). Autofocus motion compensation using resulted in noticeable mitigation of motion artifacts and improved spatial resolution of soft tissue and high-contrast structures, resulting in reduction of edge spread function width of 8.78% and 9.20%, respectively. Motion compensation also increased the conspicuity of contrast-enhanced vascularity, reflected in an increase of 9.64% in vessel sharpness. The proposed , featuring a novel context-aware architecture, demonstrated its capacity as a reference-free surrogate of structural similarity to quantify motion-induced degradation of image quality and anatomical plausibility of image content. The validation studies showed robust performance across motion patterns, x-ray techniques, and anatomical instances. The proposed anatomy- and context-aware metric poses a powerful alternative to conventional motion estimation metrics, and a step forward for application of deep autofocus motion compensation for guidance in clinical interventional procedures.