Quick Administration Research Articles

Ten-words recall test: an effective tool to differentiate mild cognitive impairment from subjective cognitive decline.

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are stages 2 and 3, respectively, of the Alzheimer's continuum. The Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog's) ten-words recall test is a validated method for the early detection of cognitive impairment in Alzheimer's disease. However, limited studies have investigated its ability to differentiate between SCD and MCI. 203 participants with SCD and 62 participants with MCI underwent multiple neuropsychological assessments. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment-Basic (MOCA-B) served as brief global cognition tests. A binary logistic regression model was used to analyze the potential factors affecting MCI. The accuracy of the ten-words recall test was assessed using the area under the receiver operating characteristic (ROC) and the area under the curve (AUC). The neuropsychological assessment revealed significant differences in the ten-words recall test scores between the SCD (median age 61 years; 70.44% female) and MCI (median age 64 years; 61.29% female) groups (p < 0.001), with the MCI group scoring the highest. Using a cut-off value of 3.15 for the ten-words recall test, sensitivity for distinguishing MCI from SCD reached 87%, while specificity stood at 61% (AUC 0.777, p < 0.001). DeLong's test indicated no statistically significant difference in the ten-words recall test's ability to distinguish between SCD and MCI compared to the total score of ADAS-Cog (AUC 0.833, p) and MMSE (AUC 0.784, p > 0.05). However, a significant difference was observed when compared to MoCA-B (AUC 0.973, p < 0.001). In the population with an education level of ≤ 9 years, the optimal cut-off value for the ten-words recall test was 3.15, yielding a sensitivity of 91% and a specificity of 45% (AUC = 0.674, p = 0.030). In the population with an education level > 9 years, the optimal cut-off value was 3.63, resulting in a sensitivity of 79% and a specificity of 71% (AUC = 0.785, p < 0.001). The ten-words recall test from the ADAS-cog may detect MCI early owing to its simplicity and quick administration. It is an effective and convenient tool for rapidly identifying mild cognitive impairment.

Emergency physicians’ preferences in bronchodilator delivery for asthma exacerbations: a cross-sectional study

Objective Asthma is a chronic respiratory disorder characterized by airway inflammation and narrowing often leading to acute exacerbations that necessitate a visit to the emergency department (ED). While life threatening cases usually require bronchodilator delivery by nebulizers, mild to moderate acute asthma exacerbations can be treated by bronchodilators delivered either by metered dose inhalers (MDI). Numerous studies have attempted to compare between the two modalities and have drawn similar conclusions in that both are comparable in efficacy with minimal differences. What is evident, however, is that physicians remain inclined to favor nebulizers in the majority of acute asthma exacerbations. Methods In this questionnaire-based study, a survey was distributed to physicians who treat asthma exacerbations to examine demographics, knowledge, beliefs, and current practice in regard to bronchodilator therapy. Results The majority (90.8%) of physicians prefer short-acting beta agonists via nebulizer, with 9.2% favoring MDI + spacer. Participants include consultants, residents, and specialists across various emergency disciplines. While 90.1% find MDI + spacer equally effective as nebulizers, advantages cited include cost-effectiveness (49.6%), shorter ED stays (63.4%), quicker administration (67.9%), and ease of use (58.8%). Challenges include availability (66.4%) and ineffectiveness in younger patients (45%). Despite this, 65.6% are willing to switch to MDI for initial asthma management in the ED, while 34.4% are resistant. Conclusion Concerns about availability and effectiveness in younger patients remain barriers. However, a significant number are willing to adopt MDIs with spacers, indicating potential for broader use with better availability and training.

Online Exam Portal

An online test is one that is conducted via the internet or an intranet utilizing a computer system. It is a web-based exam system. It works well as a mass education evaluation solution. Our system for online exams is built on a Browser/Server architecture. The multiple choice questions that are fed into the system are examined and automatically graded by the system. Even while it is comfortable, the classic pen and paper exam format has drawbacks in the current digital learning environment. IT students find these limits even more noticeable because they are used to using internet resources and platforms. In response, this proposal suggests creating an efficient, user-friendly, and safe online assessment system especially for IT students. This project goes beyond practicality. It increases assessment quality with interesting formats, empowers students with freedom, and promotes efficiency with quicker administration and grading. Teachers receive insightful data-driven information for bettering their curricula. In the end, it welcomes the digital age and uses cutting-edge evaluation techniques to get IT students ready for success

Primary immunodeficiency disorders imitating inflammatory bowel diseases: clinical aspects and problems of the differential diagnosis

From the beginning of 2000s, there has been a significant increase in the incidence of inflammatory bowel diseases (IBD) and primary immunodeficiency disorders (PIDs) in adults and children in many countries around the world. The aim of the review is to summarize the state-of-the-art on diverse clinical types of PIDs with gastrointestinal manifestations and their differential diagnostic algorithms.&#x0D; Atypical PIDs with “blunted” clinical manifestations are challenging for the timely diagnosis. Some types of PIDs with gastrointestinal involvement are also difficult to differentiate with classical IBDs. Molecular genetic studies have allowed for selection of a specific group of monogenic IBD-like diseases, represented mainly by PIDs. The authors discuss current classification of PIDs and their main clinical types imitating IBD, with important clinical and laboratory aspects. High level of information and awareness of practicing specialists working with IBD patients would be helpful in the selection of a patient cohort with possible PIDs and in the performance of extended laboratory assessment or referring for genetic tests. Timely diagnosis of PIDs would ensure quick administration of target therapy or hematopoietic stem cell transplantation, which in most cases would allow for the achievement of the disease remission, improvement of quality and duration of life.

Validation of an ultra-short global quality of life scale in a large population-based health survey.

Quality of life (QoL) assessment is essential in health-related research and clinical settings, offering insights into individuals' well-being and functioning. This study validated the Essential QoL-3 (EQoL-3), an ultra-short scale assessing essential dimensions of QoL, for use in epidemiological research and clinical settings. Data from a 2021 national survey in Norway (N = 17,487) were used. Three items on the EQoL-3 assess life satisfaction, happiness, and meaningfulness on a 0-10 scale. Discriminant validity was assessed by comparing the EQoL-3 with the Satisfaction with Life Scale (SWLS) and by examining latent mean differences between individuals with adverse life experiences (ALE+) and those without such experiences (ALE-). Convergent validity was evaluated through latent regression analyses comparing the EQoL-3 with a perceived mastery scale and a mental distress scale. The discriminant validity of the EQoL-3 was less than optimal when compared with the SWLS. Nonetheless, a multigroup confirmatory factor analysis revealed that the EQoL-3 score was 1.42 (95% CI = 1.33-1.50, p < 0.001) lower in the ALE+ group compared to the ALE- group, providing support for discriminant validity. Convergent validity was established with a positive association between EQoL-3 and mastery (β = 1.75, 95% CI = 1.70-1.80, p < 0.001) and a negative association between the EQoL-3 and mental distress (β = -2.64, 95% CI = -2.71/-2.59, p < 0.001). The EQoL-3 is a reliable measure of QoL. Its streamlined nature facilitates quick administration, making it a valuable tool for clinicians and researchers in diverse settings. Its inclusion of the eudaimonic dimension, as well as its exclusion of health items in the measure itself, distinguishes it from traditional HQoL measures, making it suitable for mental health and substance use disorder research.

THU071 Key Device Attributes For Injectable SRL Therapy In Acromegaly And NETs To Aid Clinical Decision Making

Abstract Disclosure: W.W. de Herder: Research Investigator; Self; Novartis Pharmaceuticals. Speaker; Self; Novartis Pharmaceuticals, Ipsen. S. Melmed: Consulting Fee; Self; Ionis Pharmaceuticals Inc., Ipsen, Novo Nordisk. Grant Recipient; Self; Pfizer Global R&amp;D. C. Follin: None. W. Geilvoet: None. J.O. Jorgensen: Consulting Fee; Self; Novo Nordisk, Pfizer Global R&amp;D. T. Kolarova: Grant Recipient; Self; Ipsen, ITM, AAA, Novartis Pharmaceuticals. M. Marks: None. W. Martin: Speaker; Self; Ipsen, AAA. K. Geerlings-Grootscholten: None. Background: Adherence, effectiveness and safety of SRL injections are similar for self- vs healthcare setting administration but patient preferences and device satisfaction vary. Device ease of use is associated with more favourable outcomes for other injectable hormones. Aim: To define key injectable SRL device attributes associated with optimal injection experience by people living with NETs/acromegaly and HCPs, identifying differences at 95% confidence. Methods: The survey (Jun-Nov ‘22) included active current users (≥6 months) of an SRL device for NETs/acromegaly, and for HCPs currently treating patients with NETs/acromegaly. There were 263 respondents from Australia, Canada, Chile, Denmark, Ireland, Mexico, Norway, Spain, UK, and USA: 201 patients (P), 10 caregivers (C) and 52 HCPs. In the P/C group (n=211), 157 people lived with NET and 54 with acromegaly; 74% were female. The HCP group (n=52) comprised 29 physicians, 20 nurses and 3 others (research nurse, clinical manager, patient leader) treating acromegaly (n=22), NET (n=15), or both (n=15). Results: P/C treatment duration ranged from 0.5-&amp;gt;15y (≥3y in 61%); 49% had experience with &amp;gt;1 SRL device type. Most HCPs (62%) were prescribers, 48% administered SRL injections, 83% had experience with &amp;gt;1 SRL device type. In the P/C group, NET patients were significantly more likely to have injections administered by an HCP in a hospital setting (54% vs 26% with acromegaly, p=0.05). Home administration was more common among acromegaly P/C (57%; 26% self-injected, 22% by caregiver, 9% by HCP) vs NET P/C (30%; 10%, 9% and 11%, respectively). Top 3 key device attributes preferred by the P/C group were: 1) confidence that the correct amount of drug is delivered (76%); 2) quick administration with minimal pain/discomfort (68%); 3) device safety (needle-safety system, low risk of contamination; 53%).The top 3 in the HCP group was: 1) quick administration with minimal pain/discomfort (69%); 2) correct use is easy to learn, confidence in handling the device (63%); 3) confidence that the correct amount of drug is delivered (62%). Ease of learning and confidence on correct use was significantly more likely to be selected as important by HCPs than P/C (63% vs 44%, p=0.05); ‘shorter/finer needles’ was significantly more likely to be selected by P/C than HCPs (48% vs 25%; p=0.05). ‘Easy to store and transport’ was significantly more likely to be selected by people living with acromegaly vs NET (59% vs 35%, p=0.05). Conclusions: Patient opinions are important to define key device attributes impacting the injection experience. Home administration is more common in acromegaly vs NET, as reflected in P/C device attribute preferences. Identified differences in key device attributes preferred by patients and HCPs inform the decision on which SRL device best fits individual patient needs. Developed with COR2ED, supported by an independent educational grant from Ipsen. Presentation: Thursday, June 15, 2023

Key Device Attributes for Injectable Somatostatin Receptor Ligand Therapy in Acromegaly and Neuroendocrine Tumours.

People living with acromegaly and neuroendocrine tumours (NETs) may be treated with injectable somatostatin receptor ligands (SRLs), administered by either a caregiver or as self-injection via a proprietary or generic device. Injection device attributes that contribute to ease of use and storage, minimise preparation requirements, and reduce injection pain are associated with improved adherence and more favourable therapeutic outcomes. The aim of this study was to assess current opinion surrounding favourable SRL device attributes for people living with acromegaly and NETs as well as that of their caregivers. Participants (healthcare professionals [HCPs] and patients/non-HCP caregivers) from 11 countries were invited to answer survey questions related to their demographic, experience, and preferences as they relate to the real-world use of injectable SRL devices. Questions were developed based on review of available literature and meetings with a Scientific Committee. Device attributes preferred by the patient/non-HCP caregiver group (n = 211) included confidence that the correct drug amount is delivered (76%), quick administration with minimal pain/discomfort (68%), and device safety (needle-safety and low risk of contamination; 53%). Device attributes preferred by HCPs (n = 52) were quick administration with minimal pain/discomfort (69%), correct use is easy to learn, confidence in handling the device (63%), and confidence that the correct drug amount is delivered (62%). The results identified key features of injection devices for SRL therapy which merit consideration for optimal management and underscore the importance of patient partnership in treatment decisions.

Safety Profile of High-Dose Intravenous Push Lacosamide.

Lacosamide (LCM) is an antiseizure medication used to manage status epilepticus (SE). Previous retrospective analyses have demonstrated safety and efficiency in intravenous push (IVP) administration at 80mg per minute. Quick administration can be achieved in a high-acuity setting without the additional time required for compounding. However, previous literature only partially represents high doses of IVP LCM, which limits the understanding of the safety profile of these doses. Our study was a single-center, retrospective, single-arm analysis of patients who received IVP LCM 300mg or 400mg during admission. The primary outcome was the incidence of infusion site reactions, hypotension, and bradycardia within 2hours of IVP administration. Secondary outcomes included the incidence of PR prolongation. A total of 113 patients were evaluated for infusion site reactions. Of these, 108 patients had vital signs assessed within 2hours of IVP LCM and could be evaluated for hypotension and bradycardia. The sample primarily consisted of LCM 400mg IVP (85.8%). The primary outcome consisted of 7 (6.2%) infusion reactions, 12 (11.1%) hypotensive events, and no reports of bradycardia. Each adverse event was assessed using the Naranjo Adverse Drug Probability Scale. All events scored less than two, suggesting the possibility was likely related to factors other than the medication. In conclusion, LCM 300mg and 400mg IVP administration have the potential to facilitate more rapid treatment of seizures without additional risk of infusion site reactions, hypotension, and bradycardia.

Detection of Pulmonary Embolism: Workflow Architecture and Comparative Analysis of the CNN Models

Machine learning has proven to be a practical medical image processing technique for pattern discovery in low-quality labelled and unlabeled datasets. Deep vein thrombosis and pulmonary embolism are both examples of venous thromboembolism, which is a key factor in patient mortality and necessitates prompt diagnosis by experts. An immediate diagnosis and course of treatment are necessary for the life-threatening cardiovascular condition known as pulmonary embolism (PE). In the study of medical imaging, especially the identification of PE, machine learning (ML) algorithms have produced encouraging results. This study's objective is to assess how well machine learning (ML) algorithms perform in identifying PE in computed tomography (CT) scans. A range of ML approaches were used to the dataset, including deep learning algorithms such as convolutional neural networks. The effectiveness of PE detection systems can be greatly enhanced by the use of cutting-edge methodologies like deep learning, which lowers the possibility of incorrect diagnoses and enables the quick administration of therapy to individuals who require it. This work contributes to the growing body of evidence that supports the use of ML in medical imaging and diagnosis. Future research should examine how these algorithms might be included into clinical workflows, resolving any potential implementation challenges, and making sure their adoption is done so in a secure and efficient way. In this study, we provide a thorough evaluation of three different models: the streamlined architecture MobileNetV2 with an accuracy of 96%, compared to other models like the Xception model with an accuracy of 91%, and the Efficientnet B5 model with an accuracy of 97%, after observation and process following.

A Prediction Model Created by Comparing Tree-Based Methods To Assess Coronary Artery Disease

Aim: As people's quality of life and habits have changed, Coronary Artery Disease (CAD) has become the leading cause of death globally. It is a complicated cardiac disease with various risk factors and a wide range of symptoms. An early and accurate diagnosis of CAD allows for the quick administration of appropriate treatment, which contributes to a decreased mortality rate. Machine learning (ML) algorithms for CAD prediction and treatment decisions are quickly being developed and implemented in clinical practice. Predictive models based on machine learning algorithms may aid health personnel in the early diagnosis of CAD, lowering mortality. Thus, this study goal is to forecast the elements that may be connected with CAD using tree-based approaches, which are one of the machine learning methods, and to discover which factor is more effective on CAD. Material and Methods: The open-access heart disease dataset was used within the scope of the study to investigate the risk factors related with CAD. The data set used contains the values of 333 patients, as well as 20 input and 1 target variables. The 10-fold cross validation approach was employed in the modeling, and the data set was divided as 80%: 20% as training and test datasets. For model assessment, the measures of accuracy (ACC), balanced accuracy (b-ACC), sensitivity (SE), specificity (SP), positive predictive value (ppv), negative predictive value (npv), and F1-score were utilized. Results: The values of ACC, b-ACC, SE, SP, ppv, npv, and F1-score performance metrics were 9 98.5%, 98.8%, 97.7%, 100%, 100%, 95.8% and 98.8%, respectively, as a consequence of the estimate model results created with the XGBoost approach, which has the best performance among tree-based models. When the groups with or without CAD were compared, a statistically significant difference was found in terms of the age variable. There is also a significant relationship between the active, lifestyle, ihd, dm, ecgpatt, qwave variables and the presence/absence of the CAD variable. When the variable significance values obtained as a result of modeling with the highest performing XGBoost are examined, it is seen that the variables that most associated with CAD are ekgpatt: normal, ekgpatt: ST-depression, ekgpatt: T-inversion, qwave: yes, age, bpdias, height, LDL, HR, IVSD: with LVH, bpsyDM. Conclusion: According to the performance criteria of the forecasting models used, CAD gave distinctively successful results in forecasting. By identifying risk factors associated with CAD, the proposed machine learning models can provide clinicians with practical, cost-effective and beneficial assistance in making accurate predictive decisions.

Prevalence of the Novel COVD-19 in Nangarhar Province Corona Center Hospital during June 2020 to August 2021

Background: In 2019, a novel coronavirus appeared, quickly circling the world from its Chinese source. The illness brought on by this virus is known as coronavirus disease 2019 (COVID-19), and the virus was given the designation SARS-CoV-2 by the Centers for Disease Control and Prevention. On March 11, 2020, the World Health Organization proclaimed COVID-19 to be a pandemic. During 2020, the virus spread to Afghanistan and infected thousands of individuals. This study's aim is to describe the incidence of COVID-19 in the Nangarhar Corona Center Hospital in Afghanistan between June 2020 and August 2021. Thus, quick administration of the necessary therapy can stop future complications. Additionally, the management of upcoming pandemic virus illnesses will benefit from this study's findings. Materials and Methods: A descriptive retrospective investigation using interview approach and an accidental sampling technique was used to collect data for this study from the inpatient medical records of patients who were identified as having SARS-CoV-2 infection following admission to the Corona Center Hospital in Nangarhar province, Afghanistan, between June 2020 and August 2021. Additionally, information on the laboratory tests was taken from the hospital file. In addition, 140 patients were questioned about their ischemic heart disease, diabetes, hypertension, and other COVID-19 risk factors. Additionally, 100 patients were given a questionnaire about the socioeconomic effects of COVID-19 on their daily lives and behavior. Findings: In this study, patients who met the inclusion criteria provided 11000 samples. 3380 female patients and 7620 male patients in all have been reported. There were 9267 negative cases and 1733 positive cases out of them. 1133 (10.1%) of the positive instances were found in male patients, whereas 600 (5.5%) were found in female patients. The 140 patients who were examined for COVID-19 risk factors identified four, including hypertension, diabetes, chronic liver disorders, and ischemic heart disease. Additionally, 75% of participants believed that COVID-19 would be controlled in Afghanistan, compared to 70% who believed that COVID-19 would be managed globally. Conclusion: The findings of this study indicated that the majority of COVID-19 patients were of productive age. Additionally, our study found that there was a negative overall influence of COVID-19 on Afghan population social life. Immediate action is required on the part of the general public in the shape of focused mass psychological support initiatives in order to improve the mental health of those impacted by the COVID-19 problems.

Clinical Profile of Patients with Mitral Stenosis in Nangarhar University Teaching Hospital

Background: Mitral valve stenosis is strongly associated with rheumatic heart disease. Patients with mitral stenosis may have better prognoses if they receive the right care. Thus, the purpose of this study was to characterize the characteristics of patients with mitral stenosis in the Nangarhar University Teaching Hospital's respiratory and valvular heart disease ward. An earlier detection of mitral stenosis can be expected. This enables the quick administration of the proper medicine and the avoidance of subsequent complications. Materials and Methods: The inpatient medical records of patients diagnosed with mitral stenosis from echocardiography in the respiratory and valvular heart disease ward of the Nangarhar University Teaching Hospital between June 2021 and March 2022 were used for this descriptive retrospective study, which used a cross-sectional approach and accidental sampling method. The variables included the patients' age, gender, degree of illness, and place of residence. SPSS version 16 and Microsoft Excel were used to process the data. Findings: According to the inclusion criteria, sixty-two patients were included in this study. Next, the patients were divided into groups based on their age, gender, disease severity, and location. According to the study's findings, the majority of participants were between the ages of 50 and 59 (51.6%), females predominated (67%), the majority of patients had serious illnesses (51.6%), and the majority of patients were from the province of Nangarhar (46.3%). Conclusion: The bulk of patients with severe mitral stenosis were female, in their productive years. Medication is not available to treat mitral valve stenosis. As a result, the physicians might recommend medicine to treat your problems. If a cardiologist concludes that a mitral valve replacement or repair is necessary, both surgical and nonsurgical alternatives may be taken into consideration.

The Test of Mastication and Swallowing Solids and the Timed Water Swallow Test: Reliability, associations, age and gender effects, and normative data.

Quantitative measures can increase precision in describing swallowing function, improve interrater and test-retest reliability, and advance clinical decision-making. The Test of Mastication and Swallowing Solids (TOMASS) and the Timed Water Swallow Test (TWST) are functional tests for swallowing that provide quantitative results. To explore the relationship between TOMASS and TWST; evaluate test-retest and interrater reliability; explore age and gender effects; and gather normative data. Healthy community dwelling participants (n = 298, ≥ 20 years old) were recruited. Of those, 126 were included in the reliability study. Participants completed the TWST and TOMASS. Associations between TWST and TOMASS measures were found using Pearson's correlation coefficient. Age was positively associated with an increase in the number of bites (n = 292, r = 0.15, p = 0.009), masticatory cycles (n = 291, r = 0.33, p < 0.0001) and duration (n = 292, r = 0.32, p < 0.0001) for the TOMASS. For the TWST, age was positively associated with an increase in duration (n = 296, r = 0.23, p < 0.0001), and negatively associated with volume (n = 296, r = -0.205, p < 0.0001), and swallowing capacity (n = 296, r = -0.24, p < 0.0001). Females required more bites, masticatory cycles, swallows and longer time than males in TOMASS. In TWST, females required more swallows, longer time, and had lower volume per swallow and reduced swallowing capacity than males. Intraclass correlation coefficient (ICC) revealed good test-retest reliability and moderate to excellent interrater reliability. This study provides support for the validity of the TOMASS and TWST. Reduced efficiency in one of the tests might indicate a need to evaluate performance in the other. Extended chewing time and increased number of masticatory cycles might be compensatory behaviours for reduced oral processing abilities that are motor, sensory and/or mechanical. The TOMASS and TWST are functional tests of swallowing that provide quantitative results. They are easy to incorporate as part of the clinical evaluation of swallowing due to low cost and quick administration. Age and gender effects were found for the TWST and TOMASS, but they were only tested on relative measures rather than absolute measures. Different types of crackers used for TOMASS led to differences in performance and in normative values. What is already known on the subject Associations between performance during TWST and TOMASS were found: time, number of swallows and time per swallow were correlated, meaning that need for more time and more swallows is reflected in both drinking and chewing. The study provides further support for age and gender effects in TWST and TOMASS, on both relative and also on absolute measures, which were not investigated previously. Longer durations in TOMASS and TWST with an increase in age, are likely to be the result of compensatory behaviours to allow safe swallowing. Normative data for a country-specific cracker are presented (Israel). What are the potential or actual clinical implications of this work? Reduced efficiency in one of the tests might indicate a need to evaluate performance in the other. Establishing country specific norms for commonly available crackers is necessary, since crackers size and ingredients, such as fat content and moisture, influence chewing and swallowing. There is a balancing act between safety and efficiency in older adults' swallowing behaviour. Reducing pace in eating and drinking probably supports safer swallowing.

P06-01 Development of a French paper-and-pencil association test to measure athletes’ implicit doping attitudes

BackgroundThe continued prevalence of positive samples to banned performance-enhancing drugs confirms the importance to maintain the anti-doping efforts. Though the role of socio-cognitive variables in doping attitudes is well identified (e.g., Ntoumanis et al., 2014), the role of implicit processes remains sparsely studied in sports’ doping, especially in high level cyclists. While the potential of traditional computer-IAT has been developed to capture individuals’ implicit attitudes toward doping (Brand et al., 2014ab; Schindler et al., 2015), paper-and-pen IAT offers unquestionably ease-of-administration prospects (Chan and al., 2017). The aim of this study was thus to test and provide a preliminary validation of a French paper-and-pen IAT as an alternative method to measure implicit attitudes toward doping: the IAT-Dop.MethodThis work was based on the testing procedure of the paper-and-pen Personalized Single-Category IAT test (i.e., p&p SC-IAT-P) of Bardin et al. (2016), which we enriched with the procedure of Boateng et al. (2018). This paper was built around four studies: (a) the first study consisted in the development of a preliminary version of the IAT-Dop, (b) the second study measured the dimensionality and criterion validity of the IAT-Dop to confirm the structure of the p&p version, (c) the third study verified its test-retest reliability, and (d) the fourth study explored the relations between the p&p and computerized versions of the IAT-Dop as a first approach to construct validity.ResultsStudy 1 developed a preliminary French version of the IAT-Dop based on Chan et al.’s IAT proposal (2017). Study 2 provided preliminary support to the dimensionality and criterion validity of the tool. Study 3 demonstrated the test-retest reliability of the instrument. Finally, Study 4 suggested the construct validity of the IAT-Dop through a significant correlation between the computerized and p&p versions.ConclusionThe IAT-Dop is a preliminary tested French-language version of a tool for measuring athletes’ implicit attitudes toward doping, with the advantages of simplicity, low cost, and quick administration. This tool should contribute to the better assessment and understanding of the mechanisms related to doping and may be a useful new indicator in the evaluation of prevention programs.

One-Pot and Green Preparation of Phyllanthus emblica Extract/Silver Nanoparticles/Polyvinylpyrrolidone Spray-On Dressing.

A spray-on wound dressing has many benefits, including easy and quick administration to broad and uneven wounds, better interface with the wound site, adhesion without additional dressing, and multiple applications in a portable package. By limiting direct contact with the wound site, such a design can prevent wound damage during treatment. This study revealed a simple, one-pot synthesis of spray-on wound dressing relying on polyvinylpyrrolidone solution incorporating silver nanoparticles as a broad-spectrum antibacterial agent and wound-healing antioxidant Phyllanthus emblica extract. Silver nanoparticles were synthesized in situ using Phyllanthus emblica extract as a biogenic reducing agent. Polyvinylpyrrolidone was employed as a film-forming agent to create an adhesive hydrogel-based dressing matrix to provide moisture and establish a shielding barrier for the wound bed as well as to regulate the release of fruit extract. In vitro tests revealed that the produced dressing film had a controlled release of the fruit extract, high antioxidant activity, and a good antibacterial action against S. aureus, P. aeruginosa, E. coli, and MRSA. Additionally, a biocompatibility study has shown that both human fibroblasts and keratinocytes are unaffected by the dressing film. Based on established findings, the current spray-on solution might be a potential option for antibacterial wound dressing.

Automated Dispensing Cabinet Overrides—An Evaluation of Necessity in a Pediatric Emergency Department

ObjectiveAutomated dispensing cabinets, or ADCs, are often used at health care facilities to aid in the medication-use process. Although ADCs minimize certain medication errors, they introduce a new type of error involving overrides. Although helpful when used appropriately in emergencies, overrides bypass pharmacist verification and increase potential for patient harm through drug-drug interactions, medication allergies, inappropriate dosing, and more. The purpose of this study was to evaluate automated dispensing cabinets override pulls in a pediatric hospital’s emergency department. The authors sought to discover whether overridden medications were being administered before verification (indicating it was needed emergently, thus justifying override) or after verification (indicating the override did not result in quicker administration and/or the medication was not emergent). MethodsThis was a retrospective, observational study. Data were collected from electronic health record reports from a 343-bed pediatric hospital’s emergency department from October 13, 2019, to December 22, 2019. ResultsA total of 445 override pulls were identified during this time, and after data analysis, 99 override pulls remained in the data set. Overall, time from input of prescription into the electronic medical record to medication override was approximately 4 minutes. Pharmacist verification also took a median of four minutes after prescription input. However, administration took twice as long, at 8 minutes. On average, pharmacist verification occurred 4 minutes before medication administration. ConclusionThis research from a pediatric emergency department suggests that most situations did not require an immediate administration, and perhaps an override was unnecessary and could have been avoided.

Promoting Accountability and Transparency in the Customary Courts in Nigeria: Some New Approaches

The Nigerian justice system currently faces significant administration and efficiency problems. It is well-established that the justice system is slow, not accountable, not so transparent and unfriendly to its users and stakeholders. The use of legal terminologies and technicalities are rife and bogged down the wheel of justice. This study aims to determine how the implementation of the customary Law of Lagos State can facilitate quick and efficient administration of justice at the customary courts. Specifically, it investigates whether the implementation of the new customary law of Lagos state and the application and enforcement of the judicial code of conduct can impact the administration of justice, particularly at the customary court level. To test the hypothesis that these legal instruments can positively impact the legal system the research adopts the doctrinal and comparative legal research methodologies. The results showed that the implementation of the new customary laws of Lagos state and the application of the judicial code of conduct at the customary court have the potential to improve the dispensation of justice at this level. Further, the judges must do substantial justice and avoid technical justice to achieve the desired end. These results suggest that in addition, new approaches to the dispensation of justice is required.

A Seer Evaluation on Pravala Garbha Pottali with its Characterization

Pottali kalpanas are the distinctive preparations among Rasayogas, used to treat various disease conditions. It stands in the highest place among the Murchita Parada yogas because of its bonding nature as well as its efficacy. These preparations are famous for its unique method of preparation, quick administration and easy mode of transport. Usage of Pottali kalpas dates back 12th century A.D and about 87 different Pottali preparations are available in Rasagranthas. Putapaka, Gandhaka dravapaka, Kaparda/Shankha purana and Bhavana are the different methods of Pottali kalpana preparations. Gandhakadrava paka is the special method came into existence in 13th century for Soushthava sampadna (to allure patients by its colour). Garbha Pottalis come under Gandhaka Drava paka method where dhatu paka is done in garbha (midst) of Gandhaka Drava. Pravala garbha Pottali is one such rare formulation from Pottali rahasya of Rasayogasagara, which contains Sudhavarga dravyas along with Parada. Here, this study was taken to know the importance of Gandhakadrava paka and Paka parinama with respect to Pravalagarbha Pottali and studied pharmaceutically and analytically (XRD).

Pediatric infection and sepsis in five age subgroups: single-center registry

SummaryBackgroundSepsis is, worldwide, one of the leading causes of death among infants and children. Over the past two decades, mortality rates have declined due to advanced treatment options; however, the incidence of sepsis and septic shock is still on the rise in many hospital settings. The objective of this study was to evaluate the course of this disease in pediatric intensive care patients.MethodsAn evaluation of pediatric patients in the intensive care unit diagnosed with infections or sepsis between 2005 and 2015 was performed via a retrospective exploratory data analysis.ResultsDuring the observational period, 201 patients were diagnosed with infection or sepsis. The study population was divided into five age subgroups. The majority of patients were newborns, infants, and toddlers. Forty percent had sepsis; 6% had septic shock. Viral infection was the most prevalent (59%). The overall survival rate was 83%; newborns and adolescents had the lowest survival rates.ConclusionWith this registry, children divided into five age subgroups with infection or sepsis were evaluated and treatment strategies were examined. We have shown that our findings on children treated in our pediatric intensive care unit conform with current literature about pediatric sepsis. In addition to maintaining strict hygiene standards, optimal aspects of sepsis care should be stringently observed, such as the quick administration of empirical broad-spectrum antibiotics, initial adequate fluid resuscitation, and a reliable and frequent routine of source control.

Triage Standing Orders Decrease Time to Antibiotics in Neonates in Pediatric Emergency Department

IntroductionInfants aged 0 days to 28 days are at high risk for serious bacterial infection and require an extensive evaluation, including blood, urine, and cerebrospinal fluid cultures, and admission for empiric antibiotics. Although there are no guidelines that recommend a specific time to antibiotics for these infants, quicker administration is presumed to improve care and outcomes. At baseline, 19% of these infants in our emergency department received antibiotics within 120 minutes of arrival, with an average time to antibiotics of 192 minutes. A quality improvement team convened to increase our percentage of infants who receive antibiotics within 120 minutes of arrival. MethodsThe team evaluated all infants aged 0 days to 28 days who received a diagnostic evaluation for a serious bacterial infection and empiric antibiotics in our emergency department. A nurse-driven team implemented multiple Plan-Do-Study-Act cycles to improve use of triage standing orders and improve time to antibiotics. Data were analyzed using statistical process control charts. ResultsThrough use of triage standing orders and multiple educational interventions, the team surpassed initial goals, and 84% of the infants undergoing a serious bacterial infection evaluation received antibiotics within 120 minutes of ED arrival. The average time to antibiotics improved to 74 minutes. DiscussionThe use of triage standing orders improves time to antibiotics for infants undergoing a serious bacterial infection evaluation. Increased use, associated with nurse empowerment to drive the flow of these patients, leads to a joint-responsibility model within the emergency department. The cultural shift to allow nurse-initiated work-ups leads to sustained improvement in time to antibiotics.