Vital Signs Research Articles

국내 간호대학생의 핵심간호술 교육 중재의 효과: 체계적 고찰

Objectives This study systematically reviewed the effectiveness of core nursing skill training intervention programs for nursing students in Korea. Methods Literature searches were conducted using the databases RISS, KISS, DBpia, and KCI for papers published up to June 2024, with the keyword ‘core nursing skills’. A total of 130 papers were identified, and ultimately, 14 papers were selected for the literature review. Results The literature review revealed that among the research designs, 1 was randomized and 13 were nonrandomized. Core nursing skill training interventions included studies using various methods of retraining and evaluation (10 papers) and studies using various methods of self-practice and evaluation (4 papers). Retraining and evaluation methods included traditional retraining, STEPS Model retraining, senior mentoring retraining, multimedia retraining, and online learning retraining, while self-practice and evaluation methods included traditional self-practice, scenario-based self-practice, Virtual Reality-based self-practice, and self-observation methods. The most frequently applied core nursing skill was subcutaneous injection, appearing in 10 studies, followed by vital signs measurement, intramuscular injection, intermittent gastric tube feeding, and foley catheterization, each appearing in 8 studies. Outcome variables of core nursing skill training programs showed significant effects on confidence in performance (9 papers), clinical performance ability (4 papers), self-efficacy (3 papers), and knowledge (3 papers). Conclusions Korean nursing colleges have researched various intervention programs to achieve core nursing skill competency levels in accordance with the Nursing Education Evaluation Criteria. These programs have shown significant effects on performance confidence, clinical performance ability, and self-efficacy. Therefore, there is a need to develop and utilize diverse intervention programs to enhance learning motivation and satisfaction among nursing students.

Cardiorespiratory and circadian clock markers in intensive care unit patients.

Biological synchronized rhythmicity is a critical physiological process. The lack of synchronized rhythms, mainly those showing a circadian basis, like sleep, the heart rate (HR) and arterial blood pressure (BP), often leads to several organic challenges, usually associated with adverse outcomes. The aim of the study was to investigate whether the intensive care unit (ICU) environment favors clock genes and cardiorespiratory changes. A total of 22 critically ill patients (16 males; 72.73%) with a mean age of 60.82 ±20.07 years and well-established cardiovascular conditions were selected from ICU. Blood samples were obtained, and total RNA was isolated and reverse-transcribed into complementary DNA (cDNA). A quantitative polymerase chain reaction (qPCR) was performed to assess the target gene expression levels. The urinary concentration levels of melatonin (MEL) were assessed. The heart rate, BP (systolic - SBP, diastolic - DBP and mean - MBP) and the oxygen saturation (SpO2) levels were assessed as continuous variables. The urinary MEL and Brain and muscle Arnt-like protein-1 (BMAL1) levels were shown to have a non-linear relationship with HR (coefficient (coef): 2.318, p = 0.032; coef: 2.722, p = 0.006, respectively) and SBP (coef: 1.000, p = 0.008; coef: 2.000, p = 0.037, respectively), with an explanatory power of up to 50.3% and 39.7% of the HR and SBP variability, respectively. Melatonin, but not BMAL1, was also shown to have a non-linear relationship with MBP (coef: 1.000, p = 0.007), with an explanatory power of up to 31.3% regarding the MBP variability. The HR and SBP oscillatory dynamics was shown to be related to changes in the genetic expression of BMAL1 and the urinary MEL concentrations. To a lower degree, MEL also impacted the variation of MBP. Our results suggest that not only are circadian functional matrices crucial for the dynamics of vital parameters in critically ill patients, but also that routinely assessed cardiovascular parameters like HR and BP may constitute important markers for the circadian timing system function. These parameters are easy to assess and have a relevant prognostic value regarding recovery outcomes, as well as the morbidity and mortality rates in ICU.

A Cloud Infrastructure for Health Monitoring in Emergency Response Scenarios.

Wearable devices have a significant impact on society, and recent advancements in modern sensor technologies are opening up new possibilities for healthcare applications. Continuous vital sign monitoring using Internet of Things solutions can be a crucial tool for emergency management, reducing risks in rescue operations and ensuring the safety of workers. The massive amounts of data, high network traffic, and computational demands of a typical monitoring application can be challenging to manage with traditional infrastructure. Cloud computing provides a solution with its built-in resilience and elasticity capabilities. This study presents a Cloud-based monitoring architecture for remote vital sign tracking of paramedics and medical workers through the use of a mobile wearable device. The system monitors vital signs such as electrocardiograms and breathing patterns during work sessions, and it is able to manage real-time alarm events to a personnel management center. In this study, 900 paramedics and emergency workers were monitored using wearable devices over a period of 12 months. Data from these devices were collected, processed via Cloud infrastructure, and analyzed to assess the system's reliability and scalability. The results showed a significant improvement in worker safety and operational efficiency. This study demonstrates the potential of Cloud-based systems and Internet of Things devices in enhancing emergency response efforts.

Robust extraction of pneumonia-associated clinical states from electronic health records

Mining of electronic health records (EHR) promises to automate the identification of comprehensive disease phenotypes. However, the realization of this promise is hindered by the unavailability of generalizable ground-truth information, data incompleteness and heterogeneity, and the lack of generalization to multiple cohorts. We present here a data-driven approach to identify clinical states that we implement for 585 critical care patients with suspected pneumonia recruited by the SCRIPT study, which we compare to and integrate with 9,918 pneumonia patients from the MIMIC-IV dataset. We extract and curate from their structured EHRs a primary set of clinical features (53 and 59 features for SCRIPT and MIMIC-IV, respectively), including disease severity scores, vital signs, and so on, at various degrees of completeness. We aggregate irregular time series into daily frequency, resulting in 12,495 and 94,684 patient-day pairs for SCRIPT and MIMIC, respectively. We define a "common-sense" ground truth that we then use in a semisupervised pipeline to optimize choices for data preprocessing, and reduce the feature space to four principal components. We describe and validate an ensemble-based clustering method that enables us to robustly identify five clinical states, and use a Gaussian mixture model to quantify uncertainty in cluster assignment. Demonstrating the clinical relevance of the identified states, we find that three states are strongly associated with disease outcomes (dying vs. recovering), while the other two reflect disease etiology. The outcome associated clinical states provide significantly increased discrimination of mortality rates over standard approaches.

A novel digital health approach to improving global pediatric sepsis care in Bangladesh using wearable technology and machine learning.

Sepsis is the leading cause of child death globally with low- and middle-income countries (LMICs) bearing a disproportionate burden of pediatric sepsis deaths. Limited diagnostic and critical care capacity and health worker shortages contribute to delayed recognition of advanced sepsis (severe sepsis, septic shock, and/or multiple organ dysfunction) in LMICs. The aims of this study were to 1) assess the feasibility of a wearable device for physiologic monitoring of septic children in a LMIC setting and 2) develop machine learning models that utilize readily available wearable and clinical data to predict advanced sepsis in children. This was a prospective observational study of children with sepsis admitted to an intensive care unit in Dhaka, Bangladesh. A wireless, wearable device linked to a smartphone was used to collect continuous recordings of physiologic data for the duration of each patient's admission. The correlation between wearable device-collected vital signs (heart rate [HR], respiratory rate [RR], temperature [T]) and manually collected vital signs was assessed using Pearson's correlation coefficients and agreement was assessed using Bland-Altman plots. Clinical and laboratory data were used to calculate twice daily pediatric Sequential Organ Failure Assessment (pSOFA) scores. Ridge regression was used to develop three candidate models for advanced sepsis (pSOFA > 8) using combinations of clinical and wearable device data. In addition, the lead time between the models' detection of advanced sepsis and physicians' documentation was compared. 100 children were enrolled of whom 41% were female with a mean age of 15.4 (SD 29.6) months. In-hospital mortality rate was 24%. Patients were monitored for an average of 2.2 days, with > 99% data capture from the wearable device during this period. Pearson's r was 0.93 and 0.94 for HR and RR, respectively) with r = 0.72 for core T). Mean difference (limits of agreement) was 0.04 (-14.26, 14.34) for HR, 0.29 (-5.91, 6.48) for RR, and -0.0004 (-1.48, 1.47) for core T. Model B, which included two manually measured variables (mean arterial pressure and SpO2:FiO2) and wearable device data had excellent discrimination, with an area under the Receiver-Operating Curve (AUC) of 0.86. Model C, which consisted of only wearable device features, also performed well, with an AUC of 0.78. Model B was able to predict the development of advanced sepsis more than 2.5 hours earlier compared to clinical documentation. A wireless, wearable device was feasible for continuous, remote physiologic monitoring among children with sepsis in a LMIC setting. Additionally, machine-learning models using wearable device data could discriminate cases of advanced sepsis without any laboratory tests and minimal or no clinician inputs. Future research will develop this technology into a smartphone-based system which can serve as both a low-cost telemetry monitor and an early warning clinical alert system, providing the potential for high-quality critical care capacity for pediatric sepsis in resource-limited settings.

Metabolic Risk Factors and Survival in Patients with Glioblastoma.

Metabolic syndrome increases the risk of developing various systemic cancers. The prevalence of metabolic syndrome in newly diagnosed glioblastoma patients is unknown. Further, there have been contradictory reports about how metabolic syndrome affects clinical outcomes. Therefore, the purpose of this study is to test the hypothesis that metabolic syndrome is associated with an increased prevalence of glioblastoma and worsened survival outcomes. This retrospective cohort study examines seventy-three patients with isocitrate dehydrogenase (IDH)-wild-type glioblastoma as it provides a relatively homogeneous population to examine. Patient characteristics, vital signs, lab results, tumor molecular markers, and overall survival were analyzed. Patients with metabolic syndrome and individual risk factors were identified, and survival outcomes were examined. Our results demonstrate that there is a higher prevalence of metabolic syndrome in our cohort of patients with glioblastoma than in the general population (41% vs. 33%), though this effect is confounded by older age. We also demonstrate that after correction for confounding variables, metabolic syndrome is not significantly associated with overall survival (p = 0.1). When analyzing individual metabolic risk factors, we demonstrate that there is a significant association between the accumulation of metabolic risk factors and decreased survival (p = 0.03), and hyperglycemia emerges as a significant independent risk factor for decreased survival (p = 0.05). These results suggest that metabolic risk factors can affect survival in patients with glioblastoma, which can have significant implications for clinical practice. These findings need to be further explored through further clinical and mechanistic studies.

Efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy: a prospective, randomized, double-blind controlled clinical trial

BackgroundWe explored the efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy.MethodsA total of 195 patients who underwent painless colonoscopy surgery were randomly divided into three groups: the propofol deep sedation group (group DS), the sufentanil combined with propofol for conscious sedation (group CS1) and the esketamine combined with propofol for conscious sedation (group CS2). The primary outcomes of this study included the incidence of hypoxemia, hypotension, hypertension, and bradycardia and excellent and good rates of anaesthesia during colonoscopy. The secondary outcomes included perioperative changes in vital signs (MAP, HR, and SpO2), anaesthesia induction time, dischargeable time, patient and endoscopist satisfaction scores, and incidence of postoperative nausea and vomiting (PONV), drowsiness, dizziness, propofol injection pain, assisted ventilation and vasoactive medications.ResultsThe incidence of intraoperative hypoxemia in the DS group was significantly greater than that in the CS1 and CS2 groups (χ2 = 7.081, P = 0.029). The incidence of hypotension in the CS2 group was significantly lower than that in the DS and CS1 groups (χ2 = 16.278, P < 0.001). The risk of hypoxemia was 5.727 times higher in Group DS than in Group CS2 (OR 5.727; 95%CI 1.203–27.273), and the risk of hypotension was 9.864 times higher in Group DS than in Group CS2 (OR 9.864; 95%CI 2.770–35.120). The risk of hypotension in Group CS1 was 5.167 times that in Group CS2 (OR 5.167; 95%CI 1.396–19.117). The incidence of propofol injection pain, assisted ventilation, ephedrine usage and drowsiness in the DS group was significantly greater than that in the CS1 and CS2 groups (χ2 = 57.618, P < 0.001; χ2 = 9.544, P = 0.008; χ2 = 14.820, P = 0.001; χ2 = 37.257, P < 0.001). The incidence of dizziness during recovery in the CS1 group was significantly greater than that in the DS and CS2 groups (χ2 = 6.594, P = 0.037). The dischargeable time in the DS group was significantly greater than that in the CS1 and CS2 groups (F = 53.039, P < 0.001). The satisfaction scores of the endoscopist and patients in the DS group were significantly lower than those in the CS1 and CS2 groups (F = 17.390, P < 0.001; F = 19.282; P < 0.001).ConclusionsIn conclusion, esketamine combined with propofol for conscious sedation can be safely and effectively used for painless colonoscopy and has fewer complications.It is recommended for painless colonoscopy.

A Cross Sectional Study of the Prevalence of Retinopathy in Patients with Chronic Kidney Disease on Hemodialysis in a Tertiary Care Centre in Chengalpattu District, South India

Context: Many studies have reported varying proportions of retinopathy among cases with chronic kidney disease (CKD). Cases with severe grades of CKD were more likely to develop ocular complications, especially diseases which occurs due to small vessel pathology. Aim: To estimate the prevalence of various types of retinopathies in patients with CKD undergoing hemodialysis in a tertiary care centre in South India. Settings and Design: The outpatient Department of Ophthalmology and Hemodialysis unit of Nephrology, Karpaga Vinayaga Institute of Medical Sciences from January 2022 to June 2023 A cross-sectional hospital-based observational study in a low resource setting. Methods and Material: The study consists of 28 patients who were known cases of CKD on hemodialysis. Patients underwent complete ocular evaluation and findings were noted. The pre hemodialysis values of blood urea and serum creatine, hemoglobin, liver function tests and vital parameters were also noted. Data analysis was done utilising version 20 of Statistical Packages for the Social Sciences (SPSS). Results: 56 eyes of 28 patients on hemodialysis were studied. The mean age was 53 years + 10.9 with a male preponderance. 31.6% had retinopathy of which 26.3% had hypertensive retinopathy and 5.3% had diabetic retinopathy. This is contrary to the previous studies that have reported a higher incidence of diabetic retinopathy in patients with end stage CKD. Hypertension resulted in CKD earlier than diabetes. Conclusion: The results emphasize the importance of frequent eye examination in patients with CKD to identify retinopathy earlier, thus potentially averting permanent vision impairment.

The Relationship Between Chronic Energy Deficiency and Anemia in Pregnant Women at The Madandan Community Health Center Rantetayo District Tana Toraja Regency

Chronic Energy Deficiency in pregnant women negatively impacts maternal health and fetal development, leading to weight loss, fatigue, weakness, and reduced immunity. CED also increases the risk of anemia, which can decrease oxygen supply and disrupt vital organ function. Anemia in pregnant women can cause fatigue, reduced productivity, and a higher risk of pregnancy and childbirth complications. This quantitative cross-sectional study aimed to analyze the relationship between CED and anemia in 40 pregnant women out of a total population of 64 at the Madandan Community Health Center, Tana Toraja. Data collection was carried out using a questionnaire, and the analysis employed a chi-square test. The results of Fisher's Exact Test indicated a significant association (p 0.000 &lt; 0.05) between Chronic Energy Deficiency and anemia among pregnant women seeking treatment at the Madandan Community Health Center. The study recommends that community health centers enhance education on balanced nutrition for pregnant women through prenatal clinics, including up-to-date nutritional information, regular health monitoring, and provision of appropriate supplements to reduce the risk of anemia.

Management of Anesthesia in Mandibular Tumors with Difficult Airway

A 39-year-old female patient with a diagnosis of mandibular tumor underwent mandibleectomy surgery and Free Fibular Flap reconstruction. Preoperative evaluation is carried out on the patient, namely by conducting an anamnesis, physical examination, and supporting examination to determine the problem and conclusion of the patient's physical status. The physical status of the patient is ASA III. During the surgical durante, a tracheostomy is performed with local anesthesia. Next, the patient is positioned head down to undergo the surgical procedure. The operation lasted for 10 hours with stable hemodynamics. Postoperatively, patients are treated in the ICU treatment room, vital signs observation, and postoperative pain management. A closed study by the American Society of Anesthesiologists (ASA) Professional Committee revealed that the risks and severe complications of anesthesia are most often closely related to airway management problems. Success in overcoming complications depends on early detection of symptoms and corrective actions to prevent the situation from worsening. In this patient, airway management based on the Difficult Airway Algorithm other options, local anesthesia with tracheostomy and watershed algorithm was successful with plan A, namely facemask ventilation and tracheal intubation.

SPICT tool among intubated elderly patients at emergency department

BackgroundThe global rise in the aging population necessitates a proactive approach to palliative care, with a substantial gap between the demand for and access to such care. The Supportive and Palliative Care Indicators Tool (SPICT) has emerged as a valuable instrument for identifying patients at risk of deterioration and death, enhancing the timely initiation of palliative care. This study aimed to investigate the characteristics and outcomes of patients aged 60 and above who got intubated in the emergency department (ED), with and without fulfilling SPICT criteria. MethodsThis retrospective single-center study was conducted at a tertiary care teaching hospital in Thailand. The research involved 408 adults aged 60 and older who underwent ED intubation and subsequent admission. Baseline characteristics and follow-up data were collected, encompassing vital signs, comorbidities, and SPICT criteria. Mortality rates between SPICT criteria-fulfilled and non-fulfilled groups were compared. ResultsOut of 408 analyzed patients, SPICT criteria were met by 39.7 % of patients, exhibiting distinctive features such as a higher respiratory rate and lower diastolic blood pressure. Hypertension and diabetes mellitus were most prevalent comorbidities. Respiratory and neurological disorders were the leading final diagnoses. The overall in-hospital mortality rate was 28 %, significantly higher in the SPICT criteria-fulfilled group compared to the non-fulfilled group (34.0 % vs 23.6 %, P = 0.022). SPICT criteria demonstrated moderate sensitivity (48.7 %) and specificity (63.7 %) for predicting mortality. ConclusionSPICT criteria identified elderly patients at an elevated mortality risk following intubation in the emergency setting. The early implementation of SPICT as a screening tool for identifying palliative care candidates is advocated for more effective advance care planning.

ML-powered Internet of Medical Things (MLIoMT) Structure for Heart Disease Prediction

Background ML-powered Internet of Medical Things (MLIoMT) is a burgeoning framework poised to transform healthcare, particularly in the timely identification of heart disease. Objectives This article proposes an innovative MLIoMT structure aimed at leveraging machine learning (ML) algorithms for heart disease detection. Materials and Methods Through the integration of wearable sensors, mobile applications, cloud computing, and advanced ML techniques, MLIoMT enables continuous monitoring of vital signs and cardiac health indicators in real time. By analyzing this data stream, abnormalities indicative of heart disease can be detected early, facilitating timely intervention and personalized healthcare recommendations. The MLIoMT framework employs diverse ML methods, such as deep learning and ensemble techniques to enhance the accuracy and reliability of heart disease prediction models. Results The proposed structure holds promise for revolutionizing preventive healthcare, enabling proactive management of cardiac health, and ultimately reducing the burden of heart disease. Results in terms of accuracy, precision, recall and F1 score show that the proposed system has better performance and efficiency. Conclusion Overall, MLIoMT represents a significant advancement in healthcare technology, with the potential to improve patient outcomes and enhance overall quality of life.

A case of successful pediatric heat stroke treatment using normothermic targeted temperature management

This case report describes a successful use of normothermic targeted temperature management (TTM) for the treatment of a 14-year-old girl with exertional heat stroke. Upon hospitalization, she exhibited a 40.5 ℃ core temperature and multiorgan failure. We immediately applied the TTM, targeting a range of 36-37 ℃. Her condition improved rapidly, with vital signs stabilized and consciousness fully regained by day 3. She experienced a bimodal pattern of rhabdomyolysis during recovery, which was managed without further complications. No neurological sequelae were observed, and all laboratory parameters were normalized before discharge on day 10. This case suggests the potential efficacy of normothermic TTM in pediatric heat stroke.

Telehealth innovations for cardiovascular disease management

Telehealth innovations and wearable technologies are revolutionizing the management of cardiovascular diseases (CVD), providing patients with more accessible and continuous care. The integration of remote monitoring tools and mobile health applications allows for real-time tracking of vital signs, such as heart rate, blood pressure, and oxygen levels, enabling early detection of abnormalities and timely medical interventions. These technologies empower patients to actively participate in their own health management, encouraging adherence to prescribed lifestyle changes, such as increased physical activity and improved dietary habits, which are essential for preventing and controlling CVD. Wearable devices, such as smartwatches and fitness trackers, play a critical role in the continuous monitoring of cardiovascular health. Combined with telehealth platforms, they offer personalized insights and facilitate communication between patients and healthcare providers, enhancing care coordination. This leads to improved patient outcomes, particularly in managing chronic conditions like hypertension and heart failure, where early intervention is key to preventing complications. Additionally, telehealth solutions reduce the need for frequent in-person visits, cutting healthcare costs and making care more convenient and accessible for patients in remote or underserved areas. As telehealth and wearable technologies continue to advance, they hold the potential to further transform cardiovascular care, contributing to more efficient healthcare delivery and better management of cardiovascular risk factors.

Health literacy and COVID-19 pandemic impacts among adults in rural northern Arizona.

Limited health literacy - the ability to access, process, and use health information and services - contributes to persistent health inequities. Yet little is known about associations of limited health literacy with impacts from the COVID-19 pandemic, particularly for US adults in rural areas. This study sought to determine associations of limited health literacy with impacts from the COVID-19 pandemic among a diverse sample of adults in rural Northern Arizona. A cross-sectional, interviewer-administered survey was conducted with 119 adults from June 2020 to August 2021. Participants were recruited from two federally qualified health centers and by word of mouth. The Newest Vital Sign was used to measure health literacy, and the Epidemic-Pandemic Impacts Inventory was used to measure the effects of the COVID-19 pandemic on various aspects of personal and family life (eg spent more time on screens and devices, had family celebrations canceled or restricted). Descriptive, bivariate, and multivariable linear regression statistics were computed. Nineteen percent of participants had limited health literacy, and participants had an average of 22 individual impacts and 2 household impacts of the 92 COVID-19 impacts assessed. Multivariable regression model results showed that being male versus female or having public only versus any private insurance was significantly associated with fewer individual COVID-19 impacts on average. Being black, Indigenous, people of color versus White or being Hispanic, Latino, or Spanish versus not were each associated with significantly more individual COVID-19 impacts on average. Limited versus adequate health literacy was significantly associated with more household COVID-19 impacts on average. Sensitivity analysis results further showed that limited versus adequate health literacy was associated with significantly higher adjusted rates of household social, emotional, and infection COVID-19 impacts. This study's findings highlight the importance of assessing and accounting for health literacy in clinical practice and health services research addressing the impacts of the COVID-19 pandemic and future emergency events.

Dietary vitamin E (α-tocopherol acetate) modulates growth, digestive enzymes, histopathology, and vulnerability of Nile tilapia, Oreochromis niloticus to Aeromonas hydrophila infection

Vitamin E is a fat-soluble vitamin that plays a vital function in several biological processes, and fish cannot synthesize it to meet their requirement. So, 56-day research was conducted to examine the influence of vitamin E (vit-E) (α-tocopherol acetate) on the Nile tilapia's growth, digestive enzymes, hematology, histology, and susceptibility to Aeromonas hydrophila. A total of 450 mono-sex Acclimated Nile tilapia (Oreochromis niloticus) were haphazardly dispersed into 30 aquaria, each with a capacity of 100 liters (15 fish/aquarium) to exemplify five groups with six replicates. A control diet (30 % protein) was enriched with 0.0 (E0), 150 (E150), 300 (E300), 600 (E600), and 1200 (E1200) mg/kg feed. Fish (13.5 ± 0.12 g) were given the trial diets until obvious satiation thrice daily for 56 days. At the end of the feeding trial, growth performance, digestive enzymes, hematology, and histology for the mid-intestine were examined. Subsequently, twenty fish from each treatment were challenged to contagion with Aeromonas hydrophila bacteria, and fish mortality was recorded for a further 14 days. At the end of the bacterial challenge, histology for the mid-intestine, liver, and spleen tissues was examined. Growth performance, feed utilization, and digestive enzyme secretion (proteases, lipase, and α-amylase) were substantially (P < 0.5) improved with raising vit-E levels in fish feeds up to E1200. Increasing the vit-E doses improved fish gut histomorphology by increasing the count and size of intestinal folds bordered by well-arranged enterocytes. The body composition was not influenced by dietary vitamin E, except lipid content, which increased substantially as vitamin E levels increased. Fish fed with vita-E enriched diets had higher resistance to A. hydrophila infection; however, the control group exhibited the greatest fish mortality rate (80 %), while the lowest rate was observed at E1200 (30 %). Hepatic and spleen tissues in the control group (E0) showed severe congestion and degeneration, whereas vit-E-treated fish groups progressively recovered normal histomorphology depending on the vit-E doses. Finally, this research recommends feeding Nile tilapia on vit-E, particularly 1200 mg/kg feed, to enhance its performance, welfare status, and resistance to A. hydrophila contagion.

Leveraging openCV and image processing for crime identification through facial recognition

To maintain the safety and security of communities, law enforcement agencies provide vital functions such as crime prevention and identification. Identifying people with a criminal record efficiently and accurately is one of the biggest hurdles in this field. This study delves into a fresh strategy for taking on this problem by making use of state-of-the-art image processing methods and machine learning algorithms. The project's main goal is to identify convicted felons by utilizing OpenCV, a robust open-source computer vision toolkit, and different facial recognition algorithms. By giving them a tool that guarantees a faster reaction rate and improved accuracy in suspect identification, the system is aimed to boost the capacities of law enforcement organizations. This project is based on the tenet of criminal psychology, which states that criminals are prone to committing new crimes. The system's goal is to detect and track repeat criminals both before and after they commit crimes by making use of this information. The method works by taking pictures of people who are known to be criminals and putting them in a database. From there, they can be compared to either live video streams or static photographs taken by surveillance cameras. In order to analyze and identify facial characteristics effectively, algorithms like LBPH and the Haar cascade classifier are also used. The system's robustness and efficiency are guaranteed by integrating these approaches into the OpenCV framework. This research makes a valuable contribution to the field of crime prevention by offering law enforcement authorities a dependable and scalable alternative. This system provides a streamlined interface for storing, retrieving, and matching facial photos. It was built using Python 3.5 and uses SQLite to manage the database of offenders' details. Proactively monitoring persons with a criminal record is made easier and faster with the suggested method. Suspect identification is also made easier. This research showcases the possibility of integrating machine learning and image processing to enhance public safety and crime prevention initiatives. It is an early step towards more complete video surveillance systems.

The effect of virtual reality hypnosis (HypnoVR) in patients undergoing inguinal hernia repair under local anesthesia. A preliminary report.

Surgical procedures, even under local anesthesia, can induce significant stress and anxiety in patients. Innovative approaches to alleviate anxiety are crucial for improving patient outcomes. Sedatives and anxiolytics may alleviate this discomfort, but they can also subject patients to undesirable side effects, diminishing their overall effectiveness, and, finally, delaying discharge. We present the first case series of a patients underwent inguinal hernia surgical repair under local anesthesia using VRH (HypnoVR) to avoid use of sedatives and anxiolytics. 12 consecutive patients were enrolled to undergo elective monolateral inguinal hernia repair surgery via an open approach using HypnoVR, at Colorectal Surgery Unit of Fondazione Policlinico Universitario Campus Bio-Medico di Roma. Vital signs (heart rate, SpO2, blood pressure) were detected for all patients before surgery, during local anesthesia, during the whole intervention and after surgery. No intraoperative or postoperative complications have been recorded and only one postoperative complication occurred (seroma), which not required invasive treatment but only drug administration. All patient's vital parameters were recorded during all operative and perioperative phasis. No use of intraoperative analgesic, sedative or anxiolytic were needed. All patients were discharged no later than 3h after surgery. Virtual Reality Hypnosis is a promising tool for anxiety management in surgical settings. Our series highlights the positive impact of HypnoVR in reduction and management of surgical patient anxiety and discomfort, allowing to perform inguinal hernia repair using only local anesthesia, with good patients' satisfaction.

Assessment of hemodynamic parameters and caudal vena cava-to-aorta ratio pre- and post-pericardiocentesis in dogs with cardiac tamponade.

To evaluate haemodynamic parameters and ultrasonographic measurements of the caudal vena-cava-to-aorta ratio at the splenorenal view in canine cardiac tamponade before and 30 minutes after pericardiocentesis. Dogs presenting with cardiac tamponade at two veterinary hospitals were included. Triage examination, noninvasive systolic arterial blood pressure, shock index, venous lactatemia and POCUS results were recorded at admission and 30 minutes after pericardiocentesis. This prospective observational study included 22 dogs, and all had an increased caudal vena-cava-to-aorta ratio. After pericardiocentesis, there were significant changes in vital signs, including a decrease in the median heart rate by 42.1%, a decrease in the median respiratory rate by 40.1%, and an increase in the median rectal temperature from 37.8°C (range: 35.6 to 39.2) to 38.1°C ( 36.1 to 38.7). In regards of hemodynamic parameters, the median systolic arterial pressure increased significantly by 23.2%, the shock index decreased significantly by 52.8%, the median lactate level decreased significantly from 6.1 mmol/L (1.4 to 14.7) to 3.6 mmol/L (1.1 to 13.6), and the median caudal vena-cava-to-aorta ratio decreased significantly by 37.5%, from 1.76 (1.35 to 2.13) to 1.12 (0.91 to 1.51). This study demonstrated an increased caudal vena-cava-to-aorta ratio in dogs with cardiac tamponade and a rapid haemodynamic improvement in dogs with cardiac tamponade within 30 minutes of the pericardiocentesis, resulting in excellent short-term prognosis.

Efficacy of Nusinersen Treatment in Type 1, 2, and 3 Spinal Muscular Atrophy: Real-World Data from a Single-Center Study

Background: Spinal muscular atrophy (SMA) is an inherited neuromuscular disease characterized by progressive muscle weakness and atrophy due to the absence of the survival motor neuron 1 (SMN1) gene. SMA is classified into types 0 through 4 based on the age of symptom onset and the severity of motor function decline. Recent advances in SMA treatment, including nusinersen, onasemnogene abeparvovec, and risdiplam, have significantly improved the prognosis of SMA patients. This study evaluated the safety and efficacy of nusinersen in pediatric patients with SMA types 1, 2, and 3 in a real-world clinical setting. Methods: This prospective observational single-center study assessed the treatment effects of nusinersen in 23 pediatric patients with genetically confirmed SMA over a 22-month observation period. All the participants received intrathecal loading doses of 12 mg of nusinersen on days 1, 14, 28, and 63, followed by maintenance doses every four months. Functional assessments were conducted using the CHOP-INTEND scale. Data were collected during routine patient visits, including clinical laboratory tests and vital sign parameters, and adverse events were recorded. The inclusion criteria were defined by the national reimbursement program for nusinersen treatment in Poland. Results: Initially, 37 patients ranging from 1 month old to 18 years old were included, but 23 were ultimately observed due to changes in treatment regimens or assessment scales. The patients showed significantly improved CHOP-INTEND scores over the 22-month period. At 6 months, the average increase was 4.2 points, continuing to 17.8 points at 22 months. By the end of the study, 100% of patients showed either stabilization or improvement, with significant clinical improvements observed in several patients. Nusinersen was generally well-tolerated, with post-lumbar puncture headache and lower back pain being the most common adverse events. Conclusions: Nusinersen treatment significantly enhances motor function in pediatric patients with SMA types 1, 2, and 3. This study demonstrates the importance of early and sustained treatment, with most patients showing the continuous improvement or stabilization of motor function. These findings support the use of nusinersen as an effective therapy for SMA; however, further research is needed to understand the long-term outcomes and optimize treatment strategies.