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Social media has transformed the communication landscape for institutions of Higher Education by providing improved teaching and learning experience. However, very little is known as to whether the use of social media by Higher Education students improves their satisfaction. Grounded in social media, risk and technology acceptance literature, this paper examines Higher Education students' perceptions of social media use (SMU) and the impact of SMU on their satisfaction. Data collected from the students were analysed using Structural Equation Modelling. The study finds that: (1) perceived usefulness of social media has positive effect on the use of social media in student learning; (2) perceived risk of using social media discourages the use of the tool, and (3) SMU has positive effect on student satisfaction. The study further discusses the theoretical and practical implications of these findings.

Background: Patients with medical imaging performed and interpreted elsewhere often come to tertiary referral centers for further management. At our tertiary cancer hospital, external imaging studies of patients with head-and-neck cancer undergo formal second opinion reporting by subspecialty oncoradiologists. Objectives: We aimed to audit the second in-house review of outside scans by specialized head-and-neck radiologists to estimate the potential impact on patient management. Our secondary objective was to determine the direct impact of the second opinion by head-and-neck specialist radiologists on the change in diagnosis, stage, and management of patients. We also aimed to determine the indirect impact on the cost–benefit ratio and the time taken for decision making. Materials and Methods: This was a retrospective review of original and second opinion reports for consecutive patients that came with films/compact discs (CDs) and reports of computed tomography (CT), magnetic resonance imaging (MRI), or positron resonance imaging - computed tomography (PET-CT), initially performed and interpreted at another institution, and later, a second opinion review of imaging was done by the in-house subspecialty radiologists in head-and-neck onco-imaging between May 2016 and December 2017. The rates of discrepancy for staging and recommended management and the report accuracy were determined and compared to the gold standard: pathological staging. Results: Following the specialist in-house radiologist's second opinion review, the cancer stage changed in 28% (139/492) cases, and the management recommendation changed in 6.7% (67/492) of the patients with head-and-neck cancer. Compared to the histopathology results that were available for 93/492 (19%) cases, the second opinion interpretation was correct 87% of the time (81/93). The average time saved by the second radiology opinion was 8.6 days. Significant monetary savings amounting to ₹11,35,590 ($13,788.3) were achieved. Conclusion: A second opinion review of outside imaging in patients with head-and-neck cancer by expert in-house onco-radiologists results in a change in the stage of cancer and the management plan in a significant number of cases, saves time by expediting the work-up, and helps to avoid expenditure on repeat imaging.

Abstract The rapid adoption of artificial intelligence methods in healthcare is coupled with the critical need for techniques to rigorously introspect models and thereby ensure that they behave reliably. This has led to the design of explainable AI techniques that uncover the relationships between discernible data signatures and model predictions. In this context, counterfactual explanations that synthesize small, interpretable changes to a given query while producing desired changes in model predictions have become popular. This under-constrained, inverse problem is vulnerable to introducing irrelevant feature manipulations, particularly when the model’s predictions are not well-calibrated. Hence, in this paper, we propose the TraCE (training calibration-based explainers) technique, which utilizes a novel uncertainty-based interval calibration strategy for reliably synthesizing counterfactuals. Given the wide-spread adoption of machine-learned solutions in radiology, our study focuses on deep models used for identifying anomalies in chest X-ray images. Using rigorous empirical studies, we demonstrate the superiority of TraCE explanations over several state-of-the-art baseline approaches, in terms of several widely adopted evaluation metrics. Our findings show that TraCE can be used to obtain a holistic understanding of deep models by enabling progressive exploration of decision boundaries, to detect shortcuts, and to infer relationships between patient attributes and disease severity.

Combined methylmalonic acidemia (MMA) and hyperhomocysteinemias are inborn errors of vitamin B12 metabolism, and mutations in the transcriptional regulators HCFC1 and RONIN (THAP11) underlie some forms of these disorders. Here the authors generated mouse models of a human syndrome due to mutations in RONIN (THAP11) and HCFC1, and show that this syndrome is both an inborn error of vitamin B12 metabolism and displays some features of ribosomopathy.

This case report aims to present clinicopathological features of an extremely rare case of multifocal pseudomyogenic hemangioendothelioma (PMHE) in the scalp. A 21-year-old male developed multiple, focally ulcerated, nodules over the root of his nose and scalp. One of the skin lesions was sampled at another dermatology clinic, where this was diagnosed as a sarcoma. A review of biopsy sections showed well-circumscribed dermal lesions, comprising plump spindle and epithelioid cells, mimicking rhabdomyoblasts. Immunohistochemically, tumor cells were positive for AE1/AE3, CD31, FLI-1 and ERG. INI-1 was retained. A diagnosis of PMHE was offered. Subsequently, the patient underwent wide excision and has been asymptomatic for 8 months, post-surgery. PMHE is rarely reported in the head and neck region, where it can constitute a diagnostic pitfall. Awareness of this tumor and appropriate immunohistochemical stains are necessary for its timely diagnosis, in order to avoid radical treatments. A review of similar, previously documented cases is presented.

Introduction: Systemic arterial hypertension is an important cause of adverse cardiovascular events with high morbidity and mortality in adults. Blood Pressure (BP) percentile chart from outside India varies significantly in comparison with Indian charts. Percentile distribution charts have already been developed for adults in various studies but its use is limited in paediatric age group. Aim: To measure blood pressure values of children aged between 1-13 years and derive percentile charts for each age group. Materials and Methods: A cross-sectional study was conducted at SRM Medical College and Research Centre in Kattankalathur, Tamil Nadu, India. Duration of the study was six months from July to December 2021. After Registration of an Institutional Review Board (IRB) approval, 1230 children were recruited and BP was measured using oscillometric method. Blood pressure values were represented as mean with standard deviations. Univariate analyses between blood pressure, age, height, and weight were done with Pearson’s correlation method, and gender differences were tested with Student’s t-test. Results: Study group included 1,230 children with a mean (SD) age of 6.1 (3.4) years. Simplified percentile charts were created using age and gender. Height and weight was not used as it was seen to explain very little variability of BP. 95th percentile values suggested levels indicating hypertension to be 110/71.5, 125/79, 131/83.5 at ages of 1,5 and 10 years respectively for female while the same for male was 105/70, 124/79, 129/82. Conclusion: Simplified reference tables and charts, and simple convenient thresholds may be useful for rapid screening of hypertension using oscillometric method.

The world's underdeveloped countries, who have been affected the worst, are experiencing an increase in climatic issues. Today more than ever, the requirement for precise measurements and predictions of pollutants with low-cost installation is essential. Low-cost air quality sensors are susceptible to inaccurate readings, frequent outages, and erratic operating circumstances. To provide an efficient and adaptable calibration method in such a setting, a cautious approach is required. There are several commercially available monitoring options; a typical system uses particle sensor and gas to keep track of the air quality. These sensor values are compared to established criteria, and alerts are then generated when those thresholds are exceeded. An IoT node with many sensors for a few pollutants, including NH3, NO2, CO, and PM 2.5 as well as air humidity & the ambient temperature, is designed for this purpose. The Internet of Things node is installed inside a research facility to gather indoor air data for research purposes and proof of concept. The suggested system may use GSM/WiFi technology to transmit real-time air quality reports to a web site and web/mobile app, and it can also produce alarms when it notices abnormalities in the air quality. The platform is appropriate for Big Information analysis applications including weather forecasts, and traffic predictions since it can capture sensor readings as fast as one sample per second. Normalized to the average CO, O3, and NO2 sensor readings and association of sensor information are optimal in range. The goal of the study is to advance the field of distributed, low-cost sensing devices for environment intelligence applications.

PURPOSEVirtual tumor board (VTB) via videoconference facility involving multiple specialists in the decision making for various tumors is well accepted, especially in high-income countries. Information on virtual tumor boards for head and neck cancers especially from low- and middle-income countries is sparse. In this study, we have audited the findings of the National Cancer Grid VTBs performed for head and neck cancers.METHODSAll patients discussed in the head and neck VTBs at our center between December 2016 and February 2022 were included in the study. Details such as the type of institute sending patients for discussion, its location, subsites within the head and neck region, histopathology, treatment setting or question for the VTB, and availability of guidelines for such patient scenarios were assessed. Also, a survey was sent to assess the usefulness of the VTBs.RESULTSA total of 208 patients were discussed in 54 VTB sessions. The most common head and neck sites discussed in the VTBs were the oral cavity (n = 64, 30.7%) followed by skull base/nose and paranasal sinuses/eyelid-orbit tumors (n = 49, 23.5%). Nonsquamous cell carcinoma was the most common histopathology discussed; recurrent cancers/residual diseases were the most common treatment settings (n = 134, 64.4%) for which there were no existing guidelines. Survey results showed that most VTB decisions were implementable, and respondents felt that VTBs were a useful educational tool as well.CONCLUSIONOur study affirms the feasibility of VTBs in low- and middle-income countries' health care systems for managing uncommon malignancies and clinical situations, which act as an important educational platform.

OBJECTIVES:. Children presenting with acute myocarditis may experience rapid clinical deterioration requiring extracorporeal membrane oxygenation (ECMO); however, our understanding of best practices and timing of ECMO initiation are lacking. We explored the relationships between pre-cannulation factors and survival in this high-acuity patient population. DESIGN:. Retrospective review of a large international registry. Primary outcome was survival to hospital discharge, stratified by incident cardiac arrest (CA) prior to ECMO and time to cannulation after intubation. SETTING AND SUBJECTS:. The Extracorporeal Life Support Organization registry was queried for patients less than or equal to 18 years old receiving ECMO support for myocarditis between 2007 and 2018. Exclusion criteria included being nonindex runs, non-venoarterial ECMO or missing data points for main variables studied. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Population characteristics and survival were compared using t test, Wilcoxon rank-sum test, or Fisher exact test. Multivariable logistic regression was used for significant factors in the unadjusted logistic regression. Among 506 index ECMO runs in pediatric patients with myocarditis, survival for the cohort was 72%, with no difference between early and late eras (2007–2012 vs 2013–2018; p = 0.69). Survivors demonstrated higher pre-ECMO pH levels as well as shorter intubation-to-cannulation (ITC) times (3 hr [interquartile range (IQR)], 1–14 hr vs 6 hr [IQR, 2–20 hr]; p = 0.021). CA occurred within 24 hours prior to ECMO cannulation, including extracorporeal cardiopulmonary resuscitation, in 54% of ECMO runs (n = 273). Accounting for the interaction between pre-ECMO CA occurrence and ITC time, longer ITC time remained associated with lower survival for patients who did not experience a CA prior to ECMO, with adjusted odds ratio of 0.09 (IQR, 0.02–0.40; p = 0.002) for ITC time greater than or equal to 18 hours. CONCLUSIONS:. The results of this multicenter analysis of ECMO utilization and outcomes for pediatric myocarditis suggest that patients approaching ECMO cannulation who have not experienced CA may have better survival outcomes if cannulated onto ECMO early after intubation.

BackgroundLife expectancy initially improves rapidly with economic development but then tails off. Yet, at any level of economic development, some countries do better, and some worse, than expected - they either punch above or below their weight. Why this is the case has been previously researched but no full explanation of the complexity of this phenomenon is available.New research networkIn order to advance understanding, the newly formed Punching Above Their Weight Research Network has developed a model to frame future research. It provides for consideration of the following influences within a country: political and institutional context and history; economic and social policies; scope for democratic participation; extent of health promoting policies affecting socio-economic inequities; gender roles and power dynamics; the extent of civil society activity and disease burdens.ConclusionFurther research using this framework has considerable potential to advance effective policies to advance health and equity.

Heusler compounds are a ripe platform for discovery and manipulation of emergent properties in topological and magnetic heterostructures. In these applications, the surfaces and interfaces are critical to performance; however, little is known about the atomic-scale structure of Heusler surfaces and interfaces or why they reconstruct. Using a combination of molecular beam epitaxy, core-level and angle-resolved photoemission, scanning tunneling microscopy, and density functional theory, we map the phase diagram and determine the atomic and electronic structures for several surface reconstructions of CoTiSb (001), a prototypical semiconducting half-Heusler. At low Sb coverage, the surface is characterized by Sb-Sb dimers and Ti vacancies, while, at high Sb coverage, an adlayer of Sb forms. The driving forces for reconstruction are charge neutrality and minimizing the number of Sb dangling bonds, which form metallic surface states within the bulk bandgap. We develop a simple electron counting model that explains the atomic and electronic structure, as benchmarked against experiments and first-principles calculations. We then apply the model to explain previous experimental observations at other half-Heusler surfaces, including the topological semimetal PtLuSb and the half-metallic ferromagnet NiMnSb. The model provides a simple framework for understanding and predicting the surface structure and properties of these novel quantum materials.