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Background: Diagnosing lung diseases accurately is crucial for proper treatment. Convolutional neural networks (CNNs) have advanced medical image processing, but challenges remain in their accurate explainability and reliability. This study combines U-Net with attention and Vision Transformers (ViTs) to enhance lung disease segmentation and classification. We hypothesize that Attention U-Net will enhance segmentation accuracy and that ViTs will improve classification performance. The explainability methodologies will shed light on model decision-making processes, aiding in clinical acceptance. Methodology: A comparative approach was used to evaluate deep learning models for segmenting and classifying lung illnesses using chest X-rays. The Attention U-Net model is used for segmentation, and architectures consisting of four CNNs and four ViTs were investigated for classification. Methods like Gradient-weighted Class Activation Mapping plus plus (Grad-CAM++) and Layer-wise Relevance Propagation (LRP) provide explainability by identifying crucial areas influencing model decisions. Results: The results support the conclusion that ViTs are outstanding in identifying lung disorders. Attention U-Net obtained a Dice Coefficient of 98.54% and a Jaccard Index of 97.12%. ViTs outperformed CNNs in classification tasks by 9.26%, reaching an accuracy of 98.52% with MobileViT. An 8.3% increase in accuracy was seen while moving from raw data classification to segmented image classification. Techniques like Grad-CAM++ and LRP provided insights into the decision-making processes of the models. Conclusions: This study highlights the benefits of integrating Attention U-Net and ViTs for analyzing lung diseases, demonstrating their importance in clinical settings. Emphasizing explainability clarifies deep learning processes, enhancing confidence in AI solutions and perhaps enhancing clinical acceptance for improved healthcare results.

IntroductionErectile dysfunction (ED) has been established as a comorbidity among men living with HIV, but comparisons by HIV serostatus of ED incidence in a longitudinal follow-up cohort of men are lacking. We sought to evaluate the incidence of ED spanning a period of 12 years in a longitudinal cohort of sexual minority men (SMM) living with and without HIV.MethodsWe analyzed ED incidence data for 625 participants in the longitudinal Multicenter AIDS Cohort Study from visits spanning October 2006 to April 2019.ResultsSMM living with HIV were more likely to have incident ED compared with those living without HIV (rate ratio: 1.41; 95% CI: 1.14–1.75). Older age, current diabetes, cumulative cigarette use, and cumulative antidepressant use were associated with increased incidence of ED in the entire sample. Self-identifying as Hispanic, current diabetes, and cumulative antidepressant use were positively associated with ED incidence among SMM living with HIV. Cumulative cigarette use was positively associated with greater ED incidence only among SMM living without HIV.DiscussionIn summary, age (full sample/ with HIV), current diabetes (full sample/with HIV), cumulative cigarette use (full sample/without HIV), and cumulative antidepressant use (full sample/with HIV) were associated with increased ED incidence. Skillful management of diabetes and careful titration of antidepressants, along with smoking cessation practices, are recommended to mitigate ED in this population.

BackgroundAutopsy studies suggest that implanting stents in lipid-rich plaque (LRP) may be associated with adverse outcomes.ObjectivesThe purpose of this study was to evaluate the association between LRP detected by near-infrared spectroscopy (NIRS) and clinical outcomes in patients with coronary artery disease treated with contemporary drug-eluting stents.MethodsIn this prospective, multicenter registry, NIRS was performed in patients undergoing coronary angiography and possible percutaneous coronary intervention (PCI). Lipid core burden index (LCBI) was calculated as the fraction of pixels with the probability of LRP >0.6 within a region of interest. MaxLCBI4mm was defined as the maximum LCBI within any 4-mm-long segment. Major adverse cardiac events (MACE) included cardiac death, myocardial infarction, definite or probable stent thrombosis, or unplanned revascularization or rehospitalization for progressive angina or unstable angina. Events were subcategorized as culprit (treated) lesion-related, nonculprit (untreated) lesion-related, or indeterminate.ResultsAmong 1,999 patients who were enrolled in the COLOR (Chemometric Observations of Lipid Core Plaques of Interest in Native Coronary Arteries Registry), PCI was performed in 1,621 patients and MACE occurred in 18.0% of patients, of which 8.3% were culprit lesion-related, 10.7% were nonculprit lesion-related, and 3.1% were indeterminate during 2-year follow-up. Complications from NIRS imaging occurred in 9 patients (0.45%), which resulted in 1 peri-procedural myocardial infarction and 1 emergent coronary bypass. Pre-PCI NIRS imaging was obtained in 1,189 patients, and the 2-year rate of culprit lesion-related MACE was not significantly associated with maxLCBI4mm (hazard ratio of maxLCBI4mm per 100: 1.06; 95% confidence interval: 0.96 to 1.17; p = 0.28) after adjusting clinical and procedural factors.ConclusionsFollowing PCI with contemporary drug-eluting stents, stent implantation in NIRS-defined LRPs was not associated with increased periprocedural or late adverse outcomes compared with those without significant lipid.

During the pandemic of Corona Virus Disease 2019 (COVID-19) that hit Indonesia, all activities were very limited. Electrical Engineering Study Program of Universitas Kristen Maranatha was motivated to share knowledge especially in the field of science about "Basic Unity and Virtual Reality (VR)" to the public. This has been realized through community service activities pursued by students and lecturers. VR refers to computer simulations that create images of the world that appear in human senses, in the same way as humans perceive the real world in reality. This community service used the Participatory Action Research (PAR) approach. From the results of a survey of community service activities that have been carried out, it is concluded that the success in providing mentoring to improve the ability of the community to use Basic Unity and VR online, is shown by the results of an increase in the score from an average of 5.85 before the activity, to 7.58 (from a total score of 10) after the activity. The community service committee team's service during the activity was also considered very good and worthy of being maintained in subsequent activities. Meanwhile, the implementation of providing teaching materials, the readiness of the trainers, and the implementation of organizing activities online, still need to be re-evaluated and improved in the future for better results.

The COVID-19 pandemic has greatly affected the learning process in practice, especially for people in the engineering field. Activities stopped and learning activities become very obstructed for a long time. Tinkercad is a simulator application that could be used as a learning tool or medium in engineering. The service learning method is used as a way of teaching and learning that links positive and meaningful action in society. Service learning uses demonstrations and experiments are used to transfer knowledge to society. A workshop elaborating the use of Tinkercad based on the service learning method was carried out online through community service activities to meet community needs in the engineering field. The workshop results showed that the service learning method was sufficient to help the community to meet the learning needs of engineering practices. A thorough demonstrations by instructors and experiments done by participants guided by assistants, produced a satisfactory result for more than 90% of the workshop participants. Periodic literacy provision was a follow-up to improve the abilities of all participants who have take part in workshop activities.

Case Presentation Chondromyxoid fibroma (CMF) is a relatively rare bone tumor of cartilaginous origin and it comprises less than 1% of all primary bony tumors. Clavicle is an unusual site of involvement for any bone tumor and may produce diagnostic dilemma. Approximately only 1% of all primary bone tumors may involve the clavicle. The literature on clinical features and outcome of CMF clavicle remains sparse.

The incidences of suicides by students from marginalized communities at Indian public universities indicate that the structural reforms have been insufficient in bringing social justice at universities and the situation demands a change in cognitive structures and processes that can mobilize shift towards just relations at the universities. This article aims to reflect upon pedagogy of consciousness developed by Paulo Freire and argue for its adoption by teachers to develop student voice that has the potential to bring social justice from within the universities. Following the interpretivist paradigm, the idea of the university given by Kant is explored to locate student voice and social justice within the framework of universities. The idea though places voice at core of university teaching learning process, limits its democratic potential by assuming apolitical role of the universities. Therefore, the author elaborates upon pedagogy of consciousness by Paulo Freire, to bring out its relevance in developing voice for social justice and rethinking the idea of the university. Through the analysis of in-depth interviews conducted with teachers and students at University of Delhi, the voices of students citing incidences of structural as well as epistemic injustice in the University are highlighted to develop the link between theory and practice. These voices point towards lack of spaces for expression of dissenting voices and understanding of these voices by teachers and students from privileged backgrounds. The article concludes with illustrating, how pedagogy of consciousness can develop this consciousness enabling praxis of transformation that brings political dissenting voices to the core of the idea of the university in democracy.

Purpose: The objective of this research is to explore factors that influence interns' satisfaction (is) toward the e-internship program, an alternate adopted by management institutes in lieu of the regular summer internship amidst the global pandemic, coronavirus disease 2019 (COVID-19). Design/methodology/approach: A cross-sectional research design with a self-reported questionnaire was conducted on business school (B-school) interns to rate the factors that contribute to their e-internship satisfaction. Structural equation modeling was used to examine the responses obtained from 203 B-school interns with a diverse demographic background belonging to a government university of North India. Convenience sampling was employed to get valid responses from interested respondents. Findings: Results revealed that although all the four factors under consideration, faculty mentors' preparedness (FMP), industry mentors' preparedness (IMP), interns' readiness toward online internship and interns' Internet efficacy (IIE) are significantly related to IS, industry mentors' role was found to have a major impact on the IS. The study unravels that industry mentors' interaction has a potential role in the successful implementation of e-internships. Research limitations/implications: The study has implications for the university as well as the companies to ponder on factors that satisfy interns during the virtual internship and designing an effective internship program by having a collaborative approach. Originality/value: There is a dearth of empirical studies on internships in general and e-internship in particular, so this study fills the gap and contributes to the existing literature and provides ways to satisfy B-school interns toward e-internship by addressing the key factors.

Background: In pre-analytical phase of Clinical Biochemistry Laboratory, sample rejection is a very frequent and important source of error. It affects the overall quality of laboratory services and patient care by increasing cost and turnaround time. It leads to test abandonment and causes inconvenience to patients and staff. Aims and Objectives: The aim of the study was to implement the define, measure, analyze, improve, and control (DMAIC) method of six-sigma to decrease the rate of sample rejection in Clinical Biochemistry Laboratory. Materials and Methods: In this prospective study, sample rejection rates were analyzed in a clinical Biochemistry Laboratory before and after implementation of DMAIC method of six-sigma. Baseline rejection rates were calculated for a year and classified based on cause of rejection and patient location. Current defects per million opportunities and six sigma values were calculated. This was followed by root cause analysis and implementation of corrective and preventive measures. Reanalysis of the baseline measures was done to observe the impact of these measures. Results: After implementation of DMAIC, the overall rejection rate fell from 1.07% to 0.49% with an increase in sigma value from 3.8 to 4.1. Conclusion: Six-sigma tool like DMAIC can be successfully implemented to improve sample rejection rates ultimately improving the quality of laboratory services in resource limited setting with minimal financial implications.

Background: Temporomandibular joint (TMJ) dysfunction affects up to 28% of the population, where the main cause is the internal derangement, with a painful click and disc derangement often arising from the retro-discal tissue inflammation. Objectives: The present study aims to analyze the relationship between pain and changes in magnetic resonance (MR) signal from retro discal tissue in anterior disc displaced patients with and without reduction using 3 Tesla MR imaging (MRI). Methods: 70 TMJs were evaluated, of which 45 joints were displaced anteriorly with reduction and 25 joints without reduction. MRI features other than disc position evaluated degenerative changes and effusion too. Results: The T2 signal from the retro-discal fibers showed a statistically significant (P < 0.05) association between pain and increased T2-weighted signal. Conclusions: T2-weighted MRI images showed a substantial correlation between increased posterior disc attachment (PDA) signal intensity and TMJ pain, reflecting increased vascularization of joint tissues. Our result showed elevated MR signals from PDA, suggesting it to be a probable MRI marker for painful TMJ.

Background: Mucoceles are mucous-filled cavities. Sclerotherapy with various advantages over surgery has evolved in the dental field to treat this lesion. Objectives: To evaluate and compare the efficacy of polidocanol and sodium tetradecyl sulfate in the management of oral mucoceles. Materials and Methods: Thirty-two patients diagnosed with oral mucoceles were selected and randomly allocated into groups A and B. The 16 selected patients of group A were given sclerosant therapy with polidocanol, and the remaining 16 patients of group B were given sclerosant therapy with sodium tetradecyl sulfate at weekly intervals depending upon the regression of the lesions. The size of the lesion was measured before therapy and 1 week after first injection, second injection, third injection, and fourth injection. All the patients were recalled 6 months after completion of treatment to check for recurrence. The data analysis was done using the analysis of variance test, post hoc test, and unpaired t-test. Results: A significant size reduction was seen within group 1 and group 2 (P = 0.0000). No significant difference statistically was present when group 1 and group 2 were compared showing the effectiveness of both agents. Conclusion: Both agents are equally effective in reducing the size of oral mucoceles.

Background & objectives: Malaria is the most common parasitic infection in children and the most common cause of mortality by vector-borne disease in tropical countries. In these endemic countries there is limited published literature on the clinical profile and severity of Plasmodium vivax malaria in children. We highlight the clinical presentations and severity of malaria in children belonging to Uttar Pradesh, North India Methods: This observational study was conducted in a tertiary care hospital, in Moradabad, western Uttar Pradesh, India. Children (aged 6 months–18 years) hospitalized from June 2019 to May 2020 with a clinical picture consistent with malaria along with a positive rapid malaria antigen test (RMAT) and/or positive peripheral blood smear for malaria were enrolled. All data about the clinical profile and laboratory features were recorded. Results were analyzed for significance using appropriate statistical tests for continuous and categorical data. Results: One hundred children were enrolled in this study; 59 cases had Plasmodium vivax (PV) malaria, 33 cases had Plasmodium falciparum (PF) malaria, and 8 cases had mixed infections (both PV and PF). Among 59 children with P V malaria, 44 (74%) had severe malaria and 15 (26%) had uncomplicated malaria. Severe malarial anaemia (43.2%), followed by jaundice (36.4%), impaired renal function (21.6%), significant bleeding (18.9%), shock (18.9%), and prostration (16.2%), were the main severity parameters of malaria among these hospitalised children. Impaired renal function (P-value = 0.01) and unconsciousness (P-value = 0.02) were more frequent in Plasmodium falciparum cases. Other severity parameters were not significant between the vivax and falciparum species. Interpretation & conclusion: We conclude that a significant proportion of severe malaria was caused by Plasmodium vivax in this region, where both species coexist. Plasmodium vivax malaria is no longer the benign entity it was around ten years ago in hospitalised children. Severe malarial anaemia was the most common severity parameter found in both Plasmodium vivax and P. falciparum species. The clinical presentation and a change in the severity parameters in vivax malaria indicate a recent shift in the disease severity from benign to fatal.

The study examines the relationship between Quality of work life (QWL) and job performance among the faculty of technical institutions in the state of Punjab, India. Data collected from a sample of 445 respondents through a structured questionnaire have been put to data analysis with the help of the Statistical Package for the Social Sciences (SPSS 20). Four factors that are associated with QWL (i.e., management policies, fair pay, work environment, and job design & social space) have been identified through Exploratory Factor Analysis (EFA). Subsequently, the relationship between the identified factors of QWL and job performance is modelled through Partial Least Squares Structural Equation Modelling (PLS-SEM). The results infer that all four factors of QWL have a substantial association with job performance of the faculty. The study puts forward improvement in the level of existing institutional measures to ensure a superior QWL and improved performance of faculty in the technical education sector.

Background: Regional anesthesia is a common procedure in an adult patient undergoing ophthalmic surgery, but it cannot be done alone in the pediatric age group. General anesthesia is accompanied by complications intra- and post-operatively. Objectives: to determine whether or not using regional anesthesia in combination with general anesthesia in pediatric eye procedures improves patient outcomes. Methods: Forty children, with an age range of 6 - 12 years were included in the study that was conducted at Ghazi Al-Hariri Hospital / Department of Ophthalmology and Ibn Al-Haytham (Ophthalmology Hospital), both teaching hospitals, from December 2018 to October 2019. These children were allocated into one of two groups: GA (general anesthesia) and GA-R (general anesthesia-regional anesthesia). Heart rates, mean arterial blood pressure, oculo-cardiac reaction, and postoperative nausea and vomiting were measured. All required approvals were obtained from the scientific committee of the Iraqi Board for Medical Specializations. Statistical analysis was done using SPSS V26, with a P value of

The European corn borer (ECB) (Ostrinia nubilalis Hübner) and to a lesser extent the western corn rootworm (Diabrotica virgifera virgifera LeConte) are a threat to maize in the Po Valley (Northern Italy), and their control can require insecticide applications. The results of a study to evaluate the effects of insecticide sprays on the beneficial insect Trichogramma brassicae (Hymenoptera: Trichogrammatidae) and aphid predators are reported. A three-year research project was carried out in two Study Areas, in Lombardy. In area 1, crop rotation was a common practice, while in area 2 repeated maize crop was practiced. The natural trend of ECB egg masses attacked by T. brassicae was affected and parasitism rates were reduced as a result of insecticide exposure (chlorpyriphos methyl, cypermethrin, alphacypermethrine). Repeated maize crop and insecticides spraying increased the abundance of the aphid population and negatively affected the aphid predator community, which mainly included ladybirds, hoverflies, true bugs and lacewings. The predator community was dominated by hoverflies in sprayed fields managed according to repeated maize crop protocols, whereas ladybirds and Orius spp. dominated in maize fields managed according to crop rotation protocols. Crop rotation protocols help to prevent ECB outbreaks; when the risk of exceeding the economic threshold limit is high, and this may be the case when maize is cultivated for seeds or for horticultural crops such as sweet corn, inundative release of T. brassicae and/or microbial control (i.e., use of Bacillus thuringiensis preparations) can integrate natural biocontrol, and provide a valuable alternative to chemical insecticides.