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Abstract Purpose We aimed to evaluate the ability of the peripheral perfusion index (PPI) to predict reintubation of critically ill surgical patients. Methods This prospective observational study included mechanically ventilated adults who were extubated after a successful spontaneous breathing trial (SBT). The patients were followed up for the next 48 h for the need for reintubation. The heart rate, systolic blood pressure, respiratory rate, peripheral arterial oxygen saturation (SpO2), and PPI were measured before-, at the end of SBT, 1 and 2 h postextubation. The primary outcome was the ability of PPI 1 h postextubation to predict reintubation using area under the receiver operating characteristic curve (AUC) analysis. Univariate and multivariate analyses were performed to identify predictors for reintubation. Results Data from 62 patients were analysed. Reintubation occurred in 12/62 (19%) of the patients. Reintubated patients had higher heart rate and respiratory rate; and lower SpO2 and PPI than successfully weaned patients. The AUC (95%confidence interval) for the ability of PPI at 1 h postextubation to predict reintubation was 0.82 (0.71–0.91) with a negative predictive value of 97%, at a cutoff value of ≤ 2.5. Low PPI and high respiratory rate were the independent predictors for reintubation. Conclusion PPI early after extubation is a useful tool for prediction of reintubation. Low PPI is an independent risk factor for reintubation. A PPI > 2.5, one hour after extubation can confirm successful extubation.

Medical students attending university for the first time experience a new environment, full of significant social, cultural, and intellectual challenges. Moreover, drug abuse and bullying among university students are major global concerns. The aim of the current study was to assess the impact of medicolegal issues on undergraduate and postgraduate students. It is a cross-sectional survey-based study, with each set of questions investigating cognitive functions, aggression, personality, and exposure to medicolegal issues. Males and those with a chronic disease have been significantly exposed to medicolegal issues; exposed students were significantly older than nonexposed ones. The scores of aggression were significantly higher among exposed and male students. The cognitive scores were higher for the students from rural areas than in urban areas, and females were more neurotic than males. The current study recommends conducting campaigns to educate university students on the importance of formally disclosing unethical behaviors and listening to the victims to facilitate overcoming their negative feelings. As many victims feel comfortable disclosing victimization to their friends, we recommend conducting peer educational programs to help friends support their colleagues regarding unethical misconduct.

This work describes the synthesis of novel ligand (H2L2) (4-((2-hydroxy-5-nitrophenyl)imino)methyl)-5(hydroxymethyl)-2methylpyridin-3-ol) type (NOO) donor atoms. When it coordinates with metal ions[V2+, Fe2+,Co2+ and Pt4+] with the general formula K2[M(L2)2].XH2O and K2[VO(L2)(OSO3)].H2O . This ligand can form tridentate structures. The ligand was synthesized from the reaction of pyridoxal hydrochloride with 2-amino-4-nitrophenol in ethanol (as a solvent) at a mole ratio of 1:1 and thoroughly mixed and refluxed for 6-8 hrs . The reaction was monitored using TLC (Ethylactate/hexane 1:1). The structures of the ligand and the complexes were characterised using spectroscopic techniques such as (FT-IR, 1HNMR, 13CNMR, UV-Vis, and Mass spectroscopy). In addition, molar conductance, magnetic susceptibility, elemental analysis, and thermo gravimetric, melting points were also measured for complexes. The antibacterial activities of the obtained products were tested against G- bacteria (Klebsiella pneumoniae and pseudomonas), G+ bacteria (Staphylococcus aureus and Bacillus subtilis). In addition, antifungal action was tested against (Candida albicans). The results were good in both tests.

Protecting the privacy of healthcare information is an important part of encouraging data custodians to give accurate records so that mining may proceed with confidence. The application of association rule mining in healthcare data has been widespread to this point in time. Most applications focus on positive association rules, ignoring the negative consequences of particular diagnostic techniques. When it comes to bridging divergent diseases and drugs, negative association rules may give more helpful information than positive ones. This is especially true when it comes to physicians and social organizations (e.g., a certain symptom will not arise when certain symptoms exist). Data mining in healthcare must be done in a way that protects the identity of patients, especially when dealing with sensitive information. However, revealing this information puts it at risk of attack. Healthcare data privacy protection has lately been addressed by technologies that disrupt data (data sanitization) and reconstruct aggregate distributions in the interest of doing research in data mining. In this study, metaheuristic-based data sanitization for healthcare data mining is investigated in order to keep patient privacy protected. It is hoped that by using the Tabu-genetic algorithm as an optimization tool, the suggested technique chooses item sets to be sanitized (modified) from transactions that satisfy sensitive negative criteria with the goal of minimizing changes to the original database. Experiments with benchmark healthcare datasets show that the suggested privacy preserving data mining (PPDM) method outperforms existing algorithms in terms of Hiding Failure (HF), Artificial Rule Generation (AR), and Lost Rules (LR).

Abstract Aim The study aimed to assess the incidence of needlestick and sharps injuries among healthcare workers (HCWs) in the Jazan region of Saudi Arabia, as well as to determine whether there exists an association between hospital level and needlestick and sharps injuries rate. Design A cross‐sectional survey was conducted among 609 randomly selected HCWs from nine general hospitals. Methods A self‐administered questionnaire, which covered the structure and process of injection safety, was used for data collection. Results The overall needlestick and sharps injuries incidence rate was 24%. The needlestick and sharps injuries rates were 30% and 14% in secondary and tertiary hospitals, respectively. HCWs working in tertiary hospitals were 61% less likely to have needlestick and sharps injuries than those employed in secondary hospitals. This was mainly the impact of better and continuous training. High safety level maintenance and health education provision are vital in such settings.

One main incentive for the utilization of opinion mining (OM) in social media is the impossibility of manually analyzing millions of opinions. However, applying OM for decision-making requires imitating human brain reasoning for more pragmatic results. Analyzing opinions with human-like intelligence is vital for avoiding misleading results. This occurs when the process can properly excogitate social influence and environmental uncertainty. In this study, an OM model for Twitter is proposed to handle perspectivism and opinion ambiguity. For perspectivism, social network analysis (SNA) is conducted, where users are ranked and then weighted using the UCINET tool and neural networks. An uncertainty classifier is used to integrate users’ influence levels with the polarity scores of their texts, providing a new polarity score that can reflect the real-world reasoning of opinions. The polarity scores needed for integration are done using the lexicon resource TextBlob. In the proposed model, three uncertainty classifiers are tested: type1 fuzzy logic (T1-FL), type2 fuzzy logic (T2-FL), and neutrosophic logic (NL). A comparative analysis of the methods shows the ability of NL to deal with the uncertainty existing in the data more accurately, proving the benefit of NL in improving the power of OM in social media.

The contemporary speed at which opinions move on social media makes them an undeniable force in the field of opinion mining (OM). This may cause the OM challenge to become more social than technical. This is when the process can determinately represent everyone to the degree they are worth. Nevertheless, considering perspectivism can result in opinion dynamicity. Pondering the existence of opinion dynamicity and uncertainty can provide smart OM on social media. This study proposes a neutrosophic-based OM approach for Twitter that handles perspectivism, its consequences, and indeterminacy. For perspectivism, a social network analysis (SNA) was conducted using popular SNA tools (e.g., Graphistry). An influence weighting of users was performed using an artificial neural network (ANN) based on the SNA provided output and people’s reactions to the OM analyzed texts. The initiative adoption of neutrosophic logic (NL) to integrate users’ influence with their OM scores is to deal with both the opinion dynamicity and indeterminacy. Thus, it provides new uncertainty OM scores that can reflect everyone. The OM scores needed for integration were generated using TextBlob. The results show the ability of NL to improve the OM process and accurately consider the innumerable degrees. This will eventually aid in a better understanding of people’s opinions, helping OM in social media to become a real pillar of many applications, especially business marketing.

Background: There is a paucity of research that tracks changes in liver and kidney function among pesticide applicators. The aim of the current study was to investigate the role of repeated seasonal exposure to the organophosphorus pesticide, chlorpyrifos, on serum measures of liver and kidney function. Methods: Pesticide exposure was assessed by measuring the urinary concentrations of 3,5,6-trichloro-2 pyridinol (TCPy), a specific biomarker for chlorpyrifos. Chlorpyrifos exposure and 8 serum markers of liver and kidney function were measured at 15 timepoints over 3 years prior to, during, and following the end of seasonal pesticide application among adolescent applicators and non-applicators from 4 field stations in Menoufia, Egypt. Results: Urinary TCPy levels showed increases during the application cycles and recovery at the end of each application season. Altered serum markers of liver and kidney function were associated with chlorpyrifos exposure, with some markers recovering 3 months after the end of exposure each year, while other measures demonstrated progressive increase up to 300% the baseline levels at the end of 3 years. Conclusion: The study demonstrated that frequent assessment of liver and kidney function is a sound practice to evaluate cellular injury following chronic repeated occupational and environmental exposure to chlorpyrifos.

Introduction Thyroidectomy is a common procedure. Certain swallowing problems could happen after this surgery and affect the quality of life of the patient. Objective To evaluate swallowing after thyroidectomy in the early and late postoperative periods and to correlate subjective and objective parameters. Methods A prospective study with100 patients who underwent total thyroidectomy at our institution from April 2018 to September 2019. Each patient was assessed by the Arabic version of the Eating Assessment Tool (EAT-10) questionnaire and the fiberoptic endoscopic evaluation of swallowing (FEES) preoperatively, and in the early postoperative (EPO) and late postoperative (LPO) periods. Results The rate of dysphagia was of 82% in the EPO period, and of 36% in the LPO period. Two groups were compared regarding vocal fold mobility using the FEES. Group I included 89 patients with normal vocal fold mobility, 42% of whom had early dysphagia, and only 22% had late dysphagia. Regarding swallowing, we found that in the EPO period, the rates of delayed triggering, aspiration, penetration and residue were of 12.4%, 0%, 0%, and 42.7% respectively. Group II (unilateral immobile vocal fold) included 11 patients in the EPO evaluation, and all of them had early dysphagia. Conclusion Swallowing problems can occur in patients after thyroidectomy regardless of alterations in larynx mobility, and they are characterized by delayed triggering and stasis of food, which are also noticed in the LPO period, though more frequently in the EPO period. Moreover, there is a highly significant correlation between the subjective and objective parameters of swallowing in both EPO and LPO periods.

Cisplatin (CP) is a conventional chemotherapeutic agent with serious adverse effects. Its toxicity was linked to the stimulation of oxidative stress and inflammation. As a result, this study explored the protective effect of baicalein and alpha-tocopherol in nephrotoxicity induced by cisplatin. Until receiving an intraperitoneal injection of CP (3 mg/kg BW), rats were given baicalein orally 100 mg/kg for seven days or/and a single intraperitoneal injection of α-tocopherol 250 mg/kg. Renal function was tested to explore whether baicalein and α-tocopherol have any beneficial effects; blood urea nitrogen (BUN), serum creatinine, malondialdehyde (MDA) content, antioxidant activity biomarkers and histopathology of renal tissue, oxidative stress biomarkers, inflammatory response markers, and histopathological features of kidney architecture were measured. Cisplatin treatment resulted in extreme renal failure, as measured by high serum creatinine and BUN levels and severe renal changes. Cisplatin therapy resulted in increased lipid peroxidation and decreased glutathione and superoxide dismutase levels, reflecting oxidative stress. Upon treatment with α-tocopherol, baicalein, and combined therapy, there was augmentation in the antioxidant status as well as a reduction in IL-6, NF-κB, TNF, TLR2, and TLR4 and a significant increase in Keap-1 and NRF-2. The combined treatment was the most effective and the nearest to the normal status. These findings suggest that baicalein and α-tocopherol may be useful in preventing cisplatin-induced nephrotoxicity.