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BackgroundArtificial intelligence (AI) is reforming healthcare, particularly in respiratory medicine and critical care, by utilizing big and synthetic data to improve diagnostic accuracy and therapeutic benefits. This survey aimed to evaluate the knowledge, perceptions, and practices of respiratory therapists (RTs) regarding AI to effectively incorporate these technologies into the clinical practice.MethodsThe study approved by the institutional review board, aimed at the RTs working in the Kingdom of Saudi Arabia. The validated questionnaire collected reflective insights from 448 RTs in Saudi Arabia. Descriptive statistics, thematic analysis, Fisher’s exact test, and chi-square test were used to evaluate the significance of the data.ResultsThe survey revealed a nearly equal distribution of genders (51% female, 49% male). Most respondents were in the 20–25 age group (54%), held bachelor’s degrees (69%), and had 0–5 years of experience (73%). While 28% had some knowledge of AI, only 8.5% had practical experience. Significant gender disparities in AI knowledge were noted (p

Background: In recent years, many countries have embraced demand-driven healthcare systems, emphasizing patient choice and pre-enquiry in selecting healthcare providers. The purpose is to assess the occurrence and factors influencing beforehand enquiry of the general rural population regarding the health care practitioners and delivery places Materials and methods: The study was a cross-sectional survey conducted over 2 months among 1100 participants in Perambalur district, Tamil Nadu. The study utilized a questionnaire gathering sociodemographic data and 20 questions about healthcare enquiries, including place/person of enquiry, information source, enquiry characteristics, and reliability. Bivariate analysis identified significant predictor variables, while principal component analysis with Varimax rotation determined core factors. Results: The study found that 68.8% of participants (757 individuals) enquired about healthcare facilities and professionals before visiting. Core factors influencing these enquiries included healthcare professionals, hospitals, subjects, and cost concerns. Enquiries about healthcare places were mainly influenced by discussions with relatives, travel issues, and costs. Regarding healthcare professionals, characteristics such as communication skills, physician quality, previous patient experiences, and costs played significant roles in pre-enquiries. Conclusion: Patient enquiries are influenced by diverse factors and may not always be rational. Providing truthful information is crucial to support informed decision-making in healthcare.

Abstract Background Aspects of glutamate neurotransmission implicated in normal and pathological conditions are predominantly evaluated using in vivo recording paradigms in rats anesthetized with isoflurane or urethane. Urethane and isoflurane anesthesia influence glutamate neurotransmission through different mechanisms; however, real-time outcome measures of potassium chloride (KCl)-evoked glutamate overflow and glutamate clearance kinetics have not been compared within and between regions of the brain. In order to maintain rigor and reproducibility within the literature between the two most common methods of anesthetized in vivo recording of glutamate, we compared glutamate signaling as a function of anesthesia and brain region in the rat strain most used in neuroscience. Methods In the following experiments, in vivo amperometric recordings of KCl-evoked glutamate overflow and glutamate clearance kinetics (uptake rate and T80) in the cortex, hippocampus, and thalamus were performed using glutamate-selective microelectrode arrays (MEAs) in young adult male, Sprague-Dawley rats anesthetized with either isoflurane or urethane. Results Potassium chloride (KCl)-evoked glutamate overflow was similar under urethane and isoflurane anesthesia in all brain regions studied. Analysis of glutamate clearance determined that the uptake rate was significantly faster (53.2%, p

Background Few studies have looked at how SARS-CoV-2 affects pulmonary function, exercise capacity, and health-related quality of life over time. The purpose of this study was to evaluate these characteristics in post COVID-19 subjects 1 year after recovery. Methods The study included two groups. The case group included post COVID-19 subjects who had recovered after a year, and the control group included healthy participants who had never tested positive for COVID-19. Results The study screened 90 participants, 42 of whom met the eligibility criteria. The findings revealed that the majority of post COVID-19 subjects had relatively normal lung function 1-year post-recovery. A significant reduction in DLCO (B/P%) was observed in the case group vs. control. The exercise capacity test revealed a clinically significant difference in distance walked and a significant difference in the dyspnea post-walk test in the case group compared to the control group. The case group’s health-related quality of life domain scores were significantly affected in terms of energy/fatigue, general health, and physical function. Conclusions The post COVID-19 subjects were shown to have well-preserved lung function after 1 year. However, some degree of impairment in diffusion capacity, exercise capacity, and health-related quality of life remained.

Aluminium electrical wires scrap that are available after the demolition of buildings is generally left unused in the market. It is a lightweight material capable of exhibiting strength properties with a potential for reusability in concrete. The aluminium fibres used in this work were looped at its ends to enhance its bond strength with the concrete. This paper shows the outcomes obtained from an experimental study on the mechanical properties of aluminium fibre reinforced concrete to attain its ideal fibre volume fraction. A total of three grades of concrete and five different fibre volume fractions at (0, 0.5, 1, 1.5 and 2%) were incorporated in this study. After 28 days of curing, the compressive strength and split tensile strength of the concrete specimens were determined through laboratory tests. Also, based on the experimental outcomes a regression analysis was performed to predict strength of fibre-reinforced concrete using statistical modelling based on the experimental outcomes. This indicate the effectiveness of interaction of looped end aluminium fibres with the concrete matrix.

Drosophilae are emerging as a valuable model to study traumatic brain injury (TBI)-induced secondary injury cascades that drive persisting neuroinflammation and neurodegenerative pathology that imposes significant risk for long-term neurological deficits. As in mammals, TBI in Drosophila triggers axonal injury, metabolic crisis, oxidative stress, and a robust innate immune response. Subsequent neurodegeneration stresses quality control systems and perpetuates an environment for neuroprotection, regeneration, and delayed cell death via highly conserved cell signaling pathways. Fly injury models continue to be developed and validated for both whole-body and head-specific injury to isolate, evaluate, and modulate these parallel pathways. In conjunction with powerful genetic tools, the ability for longitudinal evaluation, and associated neurological deficits that can be tested with established behavioral tasks, Drosophilae are an attractive model to explore secondary injury cascades and therapeutic intervention after TBI. Here, we review similarities and differences between mammalian and fly pathophysiology and highlight strategies for their use in translational neurotrauma research.

Bronze metal matrix composites (MMCs) are futuristic materials that may find applications in automobile, aviation, and marine industries, specifically for propellers in submarines, bearings, and bushings for defence purposes. The present investigation studied the effect of Si3N4 (5, 10, 15 wt%) ceramic particles on the physical, metallurgical, and tribological behaviour of Cu-10Sn/Si3N4 MMCs. Cast rods of three composites and a base alloy were fabricated using the liquid metallurgy route. The microstructural characterisation for the cast samples was conducted using FESEM (Field Emission Scanning Electron Microscope), EDS (Energy Dispersive Spectroscopy), XRD (X-ray diffraction), and TEM (Transmission Electron Microscope), which revealed that the Cu-10Sn alloy reinforced with 5 wt% of Si3N4 had homogeneous distribution and perfect bonding of the Si3N4 with the bronze MMC. The dry sliding wear test was performed by varying parameters such as the applied load (10, 20, 30 N) and sliding velocity (1, 2, 3 m/s). The specific wear rate (SWR) increased against an increased load. However, the SWR and coefficient of friction decreased and then increased against an increasing sliding velocity due to tribolayer formation. The primary wear mechanism observed at low and high loads was severe delamination. In contrast, the wear mechanism was adhesion wear at high and low velocities. Amongst the researched samples, Cu-10Sn/5 wt% Si3N4 composites revealed the least SWR at a load of 10 N and sliding velocity of 2 m/s and hence can be recommended for manufacturing bearings and bushings in the automobile and defence industry.

Background: This study was targeted toward comparing volume-guaranteed (VG) ventilation with conventional pressure-controlled (PC) ventilation in preterm infants with respiratory distress syndrome (RDS) in terms of the facilitation of weaning and extubation and occurrence of complications, such as pneumothorax, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC). Methods: This single-center randomized controlled trial was conducted on neonates who were mechanically ventilated in the Neonatal Intensive Care Unit of Kasturba Hospital Manipal Udupi, Karnataka, India. Infants with the gestational age (GA) of 27-34 weeks with RDS requiring mechanical ventilation in the first week of life were randomized to receive either SIMV-PC or SIMV-VG ventilation. Infants were stratified into two GA groups of 27-30 and 31-34 weeks. Sealed opaque envelope was used to randomize the infants into two treatment modalities. Sample size was calculated as 120 and 60 in each treatment group. Results: A total of 115 neonates were enrolled. The mean GA and birth weight of the treatment groups were 31±2.3 weeks and 1230±374 g, respectively, and 70% of them received antenatal steroids. As the primary outcome variable, the total duration of ventilation was 8 h (range: 3-17) (median and IQR) in the SIMV-PC group and 6 h (range: 3-13) in the SIMV-VG group (P=0.366). Stratified analysis of neonates with the GA of > 31-34 weeks showed a significant difference between the VG and PC ventilation groups regarding the duration of ventilation. Conclusion: There was a decrease in the duration of ventilation in VG ventilation, compared to that in PC ventilation at a higher GA. The leak was the major issue with VG ventilation in the lower GA group.

Over 2.8 million traumatic brain injuries (TBIs) are reported in the United States annually, of which, over 75% are mild TBIs with diffuse axonal injury (DAI) as the primary pathology. TBI instigates a stress response that stimulates the hypothalamic-pituitary-adrenal (HPA) axis concurrently with DAI in brain regions responsible for feedback regulation. While the incidence of affective symptoms is high in both men and women, presentation is more prevalent and severe in women. Few studies have longitudinally evaluated the etiology underlying late-onset affective symptoms after mild TBI and even fewer have included females in the experimental design. In the experimental TBI model employed in this study, evidence of chronic HPA dysregulation has been reported at 2 months post-injury in male rats, with peak neuropathology in other regions of the brain at 7 days post-injury (DPI). We predicted that mechanisms leading to dysregulation of the HPA axis in male and female rats would be most evident at 7 DPI, the sub-acute time point. Young adult age-matched male and naturally cycling female Sprague Dawley rats were subjected to midline fluid percussion injury (mFPI) or sham surgery. Corticotropin releasing hormone, gliosis, and glucocorticoid receptor (GR) levels were evaluated in the hypothalamus and hippocampus, along with baseline plasma adrenocorticotropic hormone (ACTH) and adrenal gland weights. Microglial response in the paraventricular nucleus of the hypothalamus indicated mild neuroinflammation in males compared to sex-matched shams, but not females. Evidence of microglia activation in the dentate gyrus of the hippocampus was robust in both sexes compared with uninjured shams and there was evidence of a significant interaction between sex and injury regarding microglial cell count. GFAP intensity and astrocyte numbers increased as a function of injury, indicative of astrocytosis. GR protein levels were elevated 30% in the hippocampus of females in comparison to sex-matched shams. These data indicate sex-differences in sub-acute pathophysiology following DAI that precede late-onset HPA axis dysregulation. Further understanding of the etiology leading up to late-onset HPA axis dysregulation following DAI could identify targets to stabilize feedback, attenuate symptoms, and improve efficacy of rehabilitation and overall recovery.

Women approximate one-third of the annual 2.8 million people in the United States who sustain traumatic brain injury (TBI). Several clinical reports support or refute that menstrual cycle-dependent fluctuations in sex hormones are associated with severity of persisting post-TBI symptoms. Previously, we reported late-onset sensory hypersensitivity to whisker stimulation that corresponded with changes in glutamate neurotransmission at 1-month following diffuse TBI in male rats. Here, we incorporated intact age-matched naturally cycling females into the experimental design while monitoring daily estrous cycle. We hypothesized that sex would not influence late-onset sensory hypersensitivity and associated in vivo amperometric extracellular recordings of glutamate neurotransmission within the behaviorally relevant thalamocortical circuit. At 28 days following midline fluid percussion injury (FPI) or sham surgery, young adult Sprague-Dawley rats were tested for hypersensitivity to whisker stimulation using the whisker nuisance task (WNT). As predicted, both male and female rats showed significantly increased sensory hypersensitivity to whisker stimulation after FPI, with females having an overall decrease in whisker nuisance scores (sex effect), but no injury and sex interaction. In males, FPI increased potassium chloride (KCl)-evoked glutamate overflow in primary somatosensory barrel cortex (S1BF) and ventral posteromedial nucleus of the thalamus (VPM), while in females the FPI effect was discernible only within the VPM. Similar to our previous report, we found the glutamate clearance parameters were not influenced by FPI, while a sex-specific effect was evident with female rats showing a lower uptake rate constant both in S1BF and VPM and longer clearance time (in S1BF) in comparison to male rats. Fluctuations in estrous cycle were evident among brain-injured females with longer diestrus (low circulating hormone) phase of the cycle over 28 days post-TBI. Together, these findings add to growing evidence indicating both similarities and differences between sexes in a chronic response to TBI. A better understanding of the influence of gonadal hormones on behavior, neurotransmission, secondary injury and repair processes after TBI is needed both clinically and translationally, with potential impact on acute treatment, rehabilitation, and symptom management.

Mild traumatic brain injury (TBI) often results in pathophysiological damage that can manifest as both acute and chronic neurological deficits. In an attempt to repair and reconnect disrupted circuits to compensate for loss of afferent and efferent connections, maladaptive circuitry is created and contributes to neurological deficits, including post-concussive symptoms. The TBI-induced pathology physically and metabolically changes the structure and function of neurons associated with behaviorally relevant circuit function. Complex neurological processing is governed, in part, by circuitry mediated by primary and modulatory neurotransmitter systems, where signaling is disrupted acutely and chronically after injury, and therefore serves as a primary target for treatment. Monitoring of neurotransmitter signaling in experimental models with technology empowered with improved temporal and spatial resolution is capable of recording in vivo extracellular neurotransmitter signaling in behaviorally relevant circuits. Here, we review preclinical evidence in TBI literature that implicates the role of neurotransmitter changes mediating circuit function that contributes to neurological deficits in the post-acute and chronic phases and methods developed for in vivo neurochemical monitoring. Coupling TBI models demonstrating chronic behavioral deficits with in vivo technologies capable of real-time monitoring of neurotransmitters provides an innovative approach to directly quantify and characterize neurotransmitter signaling as a universal consequence of TBI and the direct influence of pharmacological approaches on both behavior and signaling.

Abstract Photocatalysis is essential for wastewater cleanup and clean energy, and in this current study, we have synthesized nanomaterials (iron oxide-based) for photocatalytic pollution degradation and hydrogen production. The performance of aluminium oxide/ferric oxide (Al2O3/Fe2O3), samarium oxide/ferric oxide (Sm2O3/Fe2O3) and yttrium oxide/ferric oxide (Y2O3/Fe2O3) were compared for the production of hydrogen (H2) and degradation of dye under natural sunlight. Various characterisation equipment was used to characterize these photocatalysts’ structure, morphology, elemental content, binding energy and band gap. The hydrogen recovery efficiency of iron oxide-based photocatalysts from sulphide-containing wastewater is assessed. Y2O3/Fe2O3 has shown the highest hydrogen production of 340 mL/h. The influence of operating factors such as sulphide ion concentration, catalyst quantity, and photocatalyst photolytic solution volume on hydrogen production is studied. The optimal values were 0.25 M, 0.2 g/L, and 1L, respectively. The developed photocatalyst passed multiple cycles of stability testing. Fe2O3 has shown the highest Rhodamine B (RhB) dye degradation efficiency of 94% under visible light.

Purpose: CDKL5 deficiency disorder (CDD) is a developmental and epileptic encephalopathy with multisystemic comorbidities. Cardiovascular involvement in CDD was shown in animal models but is yet poorly described in CDD cohorts. Methods: We identified 38 individuals with genetically confirmed CDD through the Cleveland Clinic CDD specialty clinic and matched 190 individuals with non-genetic epilepsy to them as a comparison group. Natural language processing was applied to yield Human Phenotype Ontology (HPO) terms from medical records. We conducted HPO association testing and manual chart review to explore cardiovascular comorbidities associated with CDD. Results: We extracted 243,541 HPO terms from 30,512 medical encounters. Phenome-wide analysis confirmed well-established CDD phenotypes and identified association of tachycardia with CDD (Odds ratio 4.2, 95% confidence interval (CI) 1.75-9.93, Padj < .001). We found a 99.6-fold enrichment of supraventricular tachycardia (SVT) in CDD encounter notes (Padj < .001), which led to identification of 2 cases of fetal/neonatal onset SVT previously undescribed in CDD. Tachycardia in CDD individuals was associated with the presence of other autonomic symptoms (Odds ratio 5.63, 95% CI 1.08-40.3, P = .038). Conclusion: CDD is associated with tachycardia, potentially including early-onset SVT. Alongside prospective validation studies, semiautomated genotype-phenotype analysis with matched controls is a scalable, rapid, and efficient approach for validating known and identifying novel phenotype associations.

As the demand for quality healthcare increases, healthcare systems worldwide are grappling with time constraints and excessive workloads, which can compromise the quality of patient care. Artificial intelligence (AI) has emerged as a powerful tool in clinical medicine, revolutionizing various aspects of patient care and medical research. The integration of AI in clinical medicine has not only improved diagnostic accuracy and treatment outcomes, but also contributed to more efficient healthcare delivery, reduced costs, and facilitated better patient experiences. This review article provides an extensive overview of AI applications in history taking, clinical examination, imaging, therapeutics, prognosis and research. Furthermore, it highlights the critical role AI has played in transforming healthcare in developing nations.

Resistive random access memory (RRAM) is a promising technology for energy-efficient neuromorphic accelerators. However, when a pretrained deep neural network (DNN) model is programmed to an RRAM array for inference, the model suffers from accuracy degradation due to RRAM nonidealities, such as device variations, quantization error, and stuck-at-faults. Previous solutions involving multiple read-verify-write (R-V-W) to the RRAM cells require cell-by-cell compensation and, thus, an excessive amount of processing time. In this article, we propose a joint algorithm-design solution to mitigate the accuracy degradation. We first leverage knowledge distillation (KD), where the model is trained with the RRAM nonidealities to increase the robustness of the model under device variations. Furthermore, we propose random sparse adaptation (RSA), which integrates a small on-chip memory with the main RRAM array for postmapping adaptation. Only the on-chip memory is updated to recover the inference accuracy. The joint algorithm-design solution achieves the state-of-the-art accuracy of 99.41% for MNIST (LeNet-5) and 91.86% for CIFAR-10 (VGG-16) with up to 5% parameters as overhead while providing a 15-150× speedup compared with R-V-W.

Introduction: Carbon monoxide is known as the silent killer, being colorless, odourless, and tasteless. Initially non-irritating, it is very difficult for people to detect Carbon monoxide is a product of incomplete combustion of organic matter due to insufficient oxygen supply that prevents complete oxidation of carbon to C02. During World War II, Nazis used gas vans to kill an estimated over 700,000 prisoners by carbon monoxide poisoning. This method was also used in the gas chambers ofseveral death camps. The true number of incidents of carbon monoxide poisoning is unknown, since many non-lethal exposures go undetected From the available data, carbon monoxide poisoning is the most common cause of injury and death due to poisoning worldwide. Clinical features and management: The signs of carbon monoxide poisoning vary with concentration and length of exposure. Subtle cardiovascular or neurobehavioural effects occur at low concentration. The onset of chronic poisoning is usually insidious and easily mistaken for viral prodrome, depression, or gastroenteritis in children. The classic sign of carbon monoxide poisoning which is actually more often seen in the dead than the living is appearing red-cheeked and healthy. Cherry pink colour develops in nails, skin and mucosa. In acute poisoning, common abnormalities of posture and tone are cogwheel rigidity, opisthotonus, spasticity or flaccidity and seizures. Retinal haemorrhages and the classic cherry red skin colour are seldom seen. Different people andpopulations may have different carbon monoxide tolerance levels. On average, exposures at 100ppm or greater is dangerous to human health. Treatment and prevention: The mainstay of treatment is 100% oxygen administration until the COHb level is normal When the patient is stable enough to be transported, hyperbaric oxygen (HBOT) should be considered This treatment is safe and well tolerated Public education about the danger of carbon monoxide, with emphasis on safety in the home and workplace, is the key to effective prevention. This could be achieved through a media campaign when risk is greatest, Le. during the winter. Close liaison between public health physicians and leaders of building, gas and home heating industries is a prerequisite for an effective prevention strategy.

Abstract Mesenchymal stromal cells (MSC) from adult bone marrow are the most commonly used cells in clinical trials. MSCs from single donors are the preferred starting material but suffer from a major setback of being heterogeneous that results in unpredictable and inconsistent clinical outcomes. To overcome this, we developed a method of pooling MSCs from different donors and created cell banks to cater clinical needs. Initially, the master cell banks (MCBs) were created at passage 1 (P1) from the bone marrow MSCs isolated from of nine different donors. At this stage, MCBs from three different donors were mixed in equal proportion and expanded till P3 to create working cell banks. Further, the pooled cells and individual donor MSCs were expanded till P5 and cryopreserved and extensively characterised. There was a large heterogeneity among the individual donor MSCs in terms of growth kinetics (90% Coefficient of variation (CV) for cell yield and 44% CV for population doubling time at P5), immunosuppressive ability (30% CV at 1:1 and 300% CV at 1:10 ratio), and the angiogenic factor secretion potential (20% CV for VEGF and71% CV for SDF-1). Comparatively, the pooled cells have more stable profiles (60% CV for cell yield and 7% CV for population doubling time at P5) and exhibit better immunosuppressive ability (15% CV at 1:1 and 32% CV at 1:10 ratio ) and consistent secretion of angiogenic factors (16% CV for VEGF and 51% CV for SDF-1). Further pooling does not compromise the trilineage differentiation capacity or phenotypic marker expression of the MSCs. The senescence and in vitro tumourigenicity characteristics of the pooled cells are also similar to those of individual donor MSCs. We conclude that pooling of MSCs from three different donors reduces heterogeneity among individual donors and produces MSCs with a consistent secretion and higher immunosuppressive profile.

Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by articular and extra-articular involvement. The extra-articular involvement in RA is primarily manifested in pulmonary system characterized with pleurisy, airway diseases, nodular formations, and interstitial involvement. Aim: The aim was to assess the need of pulmonary screening in RA. Patients and Methods: A cross-sectional observational study was conducted on 122 patients who presented with respiratory difficulties and suspected RA. Initial screening for pulmonary involvement was done with physical assessment and pulmonary function tests (PFTs) followed with high-resolution computerized tomography (HRCT) scan. Health-related quality of life was assessed with pre–post 6-min walk test (6MWT) followed with dyspnea assessment and pulse oximetry. Results: Of the 122 patients screened, 33 were diagnosed with RA. The mean age was 40–50 years, was more common in women, and PFT showed both restrictive and obstructive pattern. Review of HRCT pattern of all patients showed nonspecific interstitial pneumonia pattern as the most common finding. Patients had desaturation after 6MWT and worsening of dyspnea. Conclusion: The degree of pulmonary involvement in RA is related to the duration of the disease. Clinical assessment, PFT, and 6MWT used in combination are cost-effective tools in early detection. HRCT provides a better understanding of the pattern of pulmonary involvement in RA.

Background: Obstructive sleep apnea (OSA) is a sleep-associated breathing disorder, which left untreated can cause severe morbidities or even mortality. The recommended treatment strategy for moderate-to-severe OSA is continuous positive airway pressure (CPAP). The optimal pressure required for OSA can be measured by either manual CPAP titration or auto-CPAP titration study. Objective: To assess the efficacy of auto-PAP titration for OSA patients. Methodology: This was a cross-sectional study conducted on Pulmonary Medicine Sleep Lab at Amrita Institute of Medical Sciences, Kochi. Fifty patients who have undergone full-night polysomnography and followed with auto-PAP titration are included in the study. The research was approved by the institutional ethics committee. Results: In the study cohort, 50% showed optimal titration, 40% good titration, 10% adequate titration and none in unacceptable category. The results showed that auto-PAP usage has good result in moderate-to-severe OSA. Conclusion: Unattended auto-PAP titration seems to be highly effective modality which can be considered as an alternative to attended CPAP titration, thus reducing labor intensiveness and cost.