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Background: There has been increasing interest in exploring the capabilities of artificial intelligence (AI) in various fields, including education. Medical education is an area where AI can potentially have a significant impact, especially in helping students answer their customized questions. In this study, we aimed to investigate the capability of ChatGPT, a conversational AI model in generating answers to medical physiology exam questions in an Indian medical school.Methods: This cross-sectional study was conducted in March 2023 in an Indian Medical School, Deoghar, Jharkhand, India. The first mid-semester physiology examination was taken as the reference examination. There were two long essays, five short essay questions (total mark 40), and 20 multiple-choice questions (MCQ) (total mark 10). We generated the response from ChatGPT (in March 13 version) for both essay and MCQ questions. The essay-type answer sheet was evaluated by five faculties, and the average was taken as the final score. The score of 125 students (all first-year medical students) in the examination was obtained from the departmental registery. The median score of the 125 students was compared with the score of ChatGPT using Mann-Whitney U test.Results: The median score of 125 students in essay-type questions was 20.5 (Q1-Q3: 18-23.5) which corresponds to a median percentage of 51.25% (Q1-Q3: 45-58.75) (P=0.147). The answer generated by ChatGPT scored 21.5 (Q1-Q3: 21.5-22), which corresponds to 53.75% (Q1-Q3: 53.75-55) (P=0.125). Hence, ChatGPT scored like that of the students (P=0.4) in essay-type questions. In MCQ-type questions, ChatGPT answered 19 correctly in 20 questions (score=9.5), and this was higher than the median score of students (6) (Q1-Q3: 5-6.5) (P

Norbelladine derivatives have garnered attention in recent years due to their diverse biological activities and pivotal role in the biosynthetic pathway of Amaryllidaceae alkaloids. This study reports the synthesis and biological evaluation of four O,N-methylated derivatives of norbelladine. These derivatives were synthesized through a three-step process: forming imine intermediates from benzaldehydes with tyramine, hydrogenating them to secondary amines, and N-methylating these amines. The products were purified and characterized by 1H and 13C NMR spectroscopy. Their biological activities were assessed by evaluating their ability to inhibit Alzheimer’s disease-related enzymes acetylcholinesterase and butyrylcholinesterase. Additionally, the cytotoxic activity of the novel derivatives was tested against cancer cell lines derived from hepatocarcinoma (Huh7), adenocarcinoma (HCT-8), and acute myeloid leukemia (THP-1) cells, and their antiviral properties against a human coronavirus (HCoV-OC43), a flavivirus (dengue virus), and a lentivirus (pseudotyped HIV-1). Docking analysis was performed to understand the impact of the N-methylation on their pharmacological relevance. The results indicate that while N-methylation does not significantly affect antiviral activity, it enhances butyrylcholinesterase inhibition for N-methylnorbelladine and 4′-O,N-dimethylnorbelladine. Overall, this work enhances our understanding of norbelladine derivatives, provides new tools for Alzheimer’s disease research, and lays the groundwork for future pharmaceutical developments.

Background: Left atrial volume (LAV) has prognostic value. Guidelines propose indexation to body surface area (BSA), however studies demonstrate this can overcorrect for body size. Limited studies investigate indexation across different ethnicities. We sought to evaluate the effect of ethnicity on indexation. Methods: Using data from the World Alliance of Societies of Echocardiography (WASE) cohort, healthy subjects were classified by race as White, Black, Asian, or Other. Biplane LAV was indexed to traditional isometric measurements (BSA, height, weight, ideal body weight (IBW) and IBW derived BSA (IBSA)), as well as previously-derived allometric height exponents (2.7 and 1.72). Additionally, an allometric height exponent for our cohort was derived (linear regression of the logarithmic transformation of LAV = a(height)b) as 1.87. All indices were then assessed using Spearman correlation, with a good index retaining correlation of LAV/index to raw LAV (r∼1), while avoiding overcorrection by the index (r∼0). Results: There were 1366 subjects (White: 524, Black: 149, Asian: 523, Other: 170; median age 44 years, 653 females (47.8%)). In the entire group, BSA, IBSA, height1.87 and height1.72 performed well with retaining correlation to raw LAV (r > 0.9 for all), and minimising overcorrection to body size (r

Abstract Background Theoretically, artificial intelligence can provide an accurate automatic solution to measure right ventricular (RV) ejection fraction (RVEF) from cardiovascular magnetic resonance (CMR) images, despite the complex RV geometry. However, in our recent study, commercially available deep learning (DL) algorithms for RVEF quantification performed poorly in some patients. The current study was designed to test the hypothesis that quantification of RV function could be improved in these patients by using more diverse CMR datasets in addition to domain-specific quantitative performance evaluation metrics during the cross-validation phase of DL algorithm development. Methods We identified 100 patients from our prior study who had the largest differences between manually measured and automated RVEF values. Automated RVEF measurements were performed using the original version of the algorithm (DL1), an updated version (DL2) developed from a dataset that included a wider range of RV pathology and validated using multiple domain-specific quantitative performance evaluation metrics, and conventional methodology performed by a core laboratory (CORE). Each of the DL-RVEF approaches was compared against CORE-RVEF reference values using linear regression and Bland–Altman analyses. Additionally, RVEF values were classified into 3 categories: ≤ 35%, 35–50%, and ≥ 50%. Agreement between RVEF classifications made by the DL approaches and the CORE measurements was tested. Results CORE-RVEF and DL-RVEFs were obtained in all patients (feasibility of 100%). DL2-RVEF correlated with CORE-RVEF better than DL1-RVEF (r = 0.87 vs. r = 0.42), with narrower limits of agreement. As a result, DL2 algorithm also showed increasing accuracy from 0.53 to 0.80 for categorizing RV function. Conclusions The use of a new DL algorithm cross-validated on a dataset with a wide range of RV pathology using multiple domain-specific metrics resulted in a considerable improvement in the accuracy of automated RVEF measurements. This improvement was demonstrated in patients whose images were the most challenging and resulted in the largest RVEF errors. These findings underscore the critical importance of this strategy in the development of DL approaches for automated CMR measurements.

Cerebral small-vessels are generally located in the brain at branch points from major cerebral blood vessels and perfuse subcortical structures such as the white matter tracts, basal ganglia, thalamus, and pons. Cerebral small-vessel disease (CSVD) can lead to several different clinical manifestations including ischemic lacunar stroke, intracerebral hemorrhage, and vascular dementia. Risk factors for CSVD overlap with conventional vascular risk factors including hypertension, diabetes mellitus, and hypercholesterolemia, as well as genetic causes. As in cardiovascular disease, treatment of CSVD involves both primary and secondary prevention. Aspirin has not been established as a primary prevention strategy for CSVD among the general population; however, long-term antiplatelet therapy with aspirin alone continues to be the mainstay of secondary stroke prevention for non-cardioembolic ischemic stroke and high-risk TIA.

Abstract Background This study evaluated the timing of dog owner ectoparasiticide purchases to estimate administration compliance and assess the consequent impact of dose purchase gaps on the proportion of time that dogs were protected over a 12-month period. Methods Ectoparasiticide purchase transactions over a 12-month period were evaluated for 626 US veterinary hospitals to determine dose purchase timing and identify consequent gaps between dose administration in dogs. Orally administered prescription ectoparasitic medications with active ingredients from the isoxazoline family (afoxolaner, fluralaner, lotilaner, or sarolaner) were included in the analysis. A period was calculated for each of the four isoxazoline-containing medications that represented the duration of protection provided by two doses of ectoparasiticide plus the average gap between these two doses. The maximum percentage of time possible for ectoparasiticide protection for this aggregate period was then calculated for each active ingredient. Results Ectoparasiticide transaction records of owners were analyzed for 506,637 dogs. These showed that 43% of dog owners purchased just one dose over the 12-month period considered. If a dog owner purchased more than one dose, then the timing of their transactions could create a time gap between the completion of ectoparasite protection from the first dose and onset of protection from the subsequent purchase and administration of the second dose. Such gaps were observed in purchases made by 31–65% of dog owners, depending on the selected active ingredient and number of doses. The average gap duration between dose purchases was calculated for all possible dose combinations over 12 months of ectoparasite protection. Time gaps between the first and second doses are as follows: for sarolaner, 20.3 weeks; for afoxolaner, 12.9 weeks; for fluralaner ,12.8 weeks; and for lotilaner, 8.9 weeks. The proportion of time when protection was provided during the aggregate period between administration of the first and second doses was as follows: for fluralaner, 65%; for lotilaner, 49%; for afoxolaner, 40%; and for sarolaner, 30%. Conclusions Dog owner ectoparasiticide purchase transactions showed that there were time gaps between doses leading to reduced ectoparasite protection. The longer re-administration interval for fluralaner, a consequence of its extended duration of activity, resulted in dog owners gaining the greatest proportion of ectoparasite protection time with this medication compared with shorter-acting monthly re-treatment medications. Graphical Abstract

Lemon (Citrus limon) Rutaceae) is one of the most popular world fruit crops, contains active phytochemicals that are polyphenolic compounds, flavonoids, vitamin C, folic acid, potassium, pectin etc. The bioactives compound of lemon are preventing radical-mediated diseases like cancer, diabetes, neurodegenerative disorders but no one reported that effect of Citrus limon juice on scopolamine induced amnesia model in animal. Rats were divided into five groups. Group 1 rats (normal control) received 1 ml/kg normal saline for 14 days intraperitoneally (i.p.). Group 2 rats received scopolamine (3 mg/kg, i.p.) 30 min prior to the trial on the 14th day. Group 3 rats received 3 mg/kg/day of donepezil as pre-treatment for 14 days and scopolamine (3 mg/kg, i.p.) 30 min prior to the trial on the 14th day. Group 4 and 5 rats received Citrus limon juice (0.6, 1.2 ml/kg/day) for 14 days and scopolamine (3 mg/kg, i.p) 30 min prior to the trial on 14th day respectively. On the day 14, working memory and long-term memory in rats were tested by experimental paradigms and Morris Water Maze (MWM) task. On day 15, 6 rats of each group were sacrificed and brain tissue of these rats was isolated for the estimation of biochemical parameters, histopathological examination and western blot analysis. Scopolamine treated rats showed significantly increased escape latency (p

Cities are growing and sustainable urban mobility planning (SUMP) is gaining in importance with it. The problems in the domain often involve multiple stakeholders with conflicting or competing objectives. The stakeholders and objectives can be local to certain neighborhoods or apply to the global city-wide scale. We present a methodology to address such problems with the help of modern simulators and multi-objective evolutionary algorithms. The methodology brings all stakeholders to the table and presents to them a near optimal set of alternatives to choose from. As an example, we consider the problem of minimizing vehicular noise in a particular neighborhood while also minimizing city-wide emission for heavy vehicles. We describe the requirements and capabilities of the simulator and the optimization algorithm in detail and present a methodology to model both local (noise reduction) and global (emissions) objectives simultaneously. We apply our methodology on two large city scale case studies and present our findings.

Abstract Background The study objective was to examine cat owner ectoparasiticide purchases in the United States and estimate the impact of purchase gaps on timely ectoparasite protection administration. These purchase gaps lead to periods of time when cats are unprotected from ectoparasites. Methods Ectoparasiticide purchase transactions for individual cats from 671 U.S. veterinary clinics from January 1, 2017 through June 30, 2019 were evaluated to determine time “gaps” between doses of ectoparasiticides purchased in a defined 12-month period. Ectoparasiticides examined were topically applied products that contained fluralaner, fipronil/(S)-methoprene/pyriproxyfen, imidacloprid/pyriproxyfen or selamectin as active ingredients. The duration of protection following administration of one dose was 8–12 weeks for the fluralaner-containing product and one month for the other products. Results Ectoparasiticide purchase records were obtained from 114,853 cat owners and analysis found that most owners bought ≤ 6 months of protection during the year, with 61–75% (depending on the product) purchasing just 1–3 months of protection. The size of the average purchase gap was determined for all dose combinations out to 12 months of protection (5–7 doses for fluralaner and 12 doses for the other three products dosed monthly. The largest gaps occurred between the first and second doses and the second and third doses. Average purchase gaps for the four different products between doses 1 and 2 ranged from 11.2 to 13.9 weeks and between doses 2 and 3 ranged from 7.7 to 12.2 weeks. The fraction of purchases separated by gaps and the average length of the gap tended to decrease with increasing number of doses purchased. Owners purchasing the 8 to 12-week duration product containing fluralaner provided ectoparasite protection (“doses plus gap period”) for a larger proportion of each 2-dose period compared with owners purchasing products administered monthly. Conclusions When cat owners purchase flea and tick medication, gaps between subsequent purchases reduces the proportion of time ectoparasite protection can be provided. The duration of the gap between doses has an impact on the effectiveness of flea/tick medication because it inserts a period without flea and tick protection between doses of flea and tick medication. The gaps between purchases were shorter and the period of ectoparasite protection was larger for owners purchasing a 12-week product than for owners purchasing a monthly product.

Traumatic ventricular septal defects due to penetrating cardiac injury are uncommon. Transthoracic echocardiography is an essential tool in diagnosis. Options for closure include either surgical or percutaneous repair. We present a case of a trauma-related ventricular septal defect in a young patient that was successfully repaired by using a percutaneous approach. (Level of difficulty: Intermediate.)

Current understanding that progressive tricuspid regurgitation (TR) is associated with worse outcomes has highlighted the clinical need for a more accurate assessment of TR morphology and severity. This need has been further emphasized owing to the development of a myriad of percutaneous right-sided interventions, which may offer successful treatment of TR in selected patients. Understanding the etiology and quantification of the severity of TR has important implications in the selection of novel therapeutic strategies, i.e., medical vs. percutaneous vs. surgical approaches. Newer grading schemas that better reflect the TR lesion severity have been recently proposed and may facilitate monitoring of the evolution of TR following percutaneous and/or surgical treatment. In this review, we summarize contemporary concepts regarding tricuspid valve morphology, TR etiology, and associated mechanisms and echocardiographic approaches to grade TR severity.

Fluvoxamine's (FLX's) anticancer potential was investigated in pre-clinical research utilizing a DMH-induced colorectal cancer (CRC) rat model. qRT-PCR and immunoblotting validated the mechanistic investigation. The CRC condition was induced in response to COX-2 and IL-6, however, following FLX therapy, the condition returned to normal. FLX's anti-CRC potential may be attributable to COX-2 inhibition since this molecular activity was more apparent for COX-2 than IL-6. FLX repaired the altered metabolites linked to CRC rats, according to 1H-NMR analysis. FLX was shown to be similar to 5-FU in terms of tumor protection, which may be useful in future medication development.

This interventional study was designed to evaluate the effectiveness of buzz session teaching in large groups and assess undergraduate medical students' perceptions of the buzz session teaching method. The study involved 100 first-year medical students divided into two groups, i.e., "group I" as "buzz first" and "group II" as "didactic first" comprising 50 students each. The topic "Physiology of the Cerebellum" was taught to "group I" through a buzz session and to "group II" through a didactic lecture. After a week, group I received a didactic lecture on the topic "Anterolateral Pathway in the Spinal Cord," whereas "group II" was taught the same by a buzz session. The students of both groups underwent a multiple choice question exam related to the taught topic immediately and again after 15 days of the teaching session. All students were provided feedback on a five-point Likert scale for the buzz session. According to students' perceptions, buzz sessions boosted communication skills and confidence levels by 94.8% and 96.3%, respectively. Of the students, 93.7% felt that the buzz session helped them retain more information and 94.1% thought they made the classroom environment more lively. More buzz sessions were desired by 94.8% of the participants. There was no difference in the marks gained for the acquired topics using buzz sessions and didactic lectures as teaching methods (P > 0.05). The students scored more marks in the tests taken after the buzz session than after the didactic lecture at 15 days of instruction (P < 0.05). The study concluded that students enjoyed the buzz session teaching method. The buzz session increased short-term retention. NEW & NOTEWORTHY: In this current interventional study, we assessed the effectiveness of a buzz session as a novel teaching tool for large-group physiology instruction in first-year undergraduate medical students. Furthermore, we assessed student responses to see how the buzz session was perceived. Experimental evidence indicates that the buzz sessions led to greater retention after 15 days than the didactic lecture approach for physiology teaching in a preclinical context.

Emotional intelligence (EI) has a positive correlation with the academic performance of medical students. However, why there is a positive correlation needs further exploration. We hypothesized that the capability of answering higher-order knowledge questions (HOQs) is higher in students with higher EI. Hence, we assessed the correlation between EI and the capability of medical students to answer HOQs in physiology. First-year undergraduate medical students (n = 124) from an Indian medical college were recruited as a convenient sample. EI was assessed by the Schutte Self-Report Emotional Intelligence Test (SSEIT), a 33-item self-administered validated questionnaire. A specially designed objective examination with 15 lower-order and 15 higher-order multiple-choice questions was conducted. The correlation between the examination score and the EI score was tested by Pearson's correlation coefficient. Data from 92 students (33 females and 59 males) with a mean age of 20.14±1.87 yr were analyzed. Overall, students got a percentage of 53.37±14.07 in the examination, with 24.46±9.1 in HOQs and 28.91±6.58 in lower-order knowledge questions (LOQs). They had a mean score of 109.58±46.2 in SSEIT. The correlation coefficient of SSEIT score with total marks was r ¼ 0.29 (P ¼ 0.0037), with HOQs was r ¼ 0.41 (P < 0.0001), and with LOQs was r = 0.14 (P = 0.19). Hence, there is a positive correlation between EI and the capability of medical students to answer HOQs in physiology. This study may be the foundation for further exploration of the capability of answering HOQs in other subjects.

Twenty four clinical cases of dogs having the history of the accidents irrespective of their age and sex were included in this study. The definite diagnosis was made on the basis of haematobiochemical, radiographic, ultrasonographic and laparoscopic findings. The animals were divided randomly into 3 groups, viz. A, B and C comprising equal number of animals. After the definite diagnosis, patients were subjected to surgical intervention i.e. splenectomy. The animals of groups A, B, and C were subjected to the administration of anaesthetic combination of atropine sulphate, diazepam and thiopental sodium just to pass endotracheal tube followed by either isoflurane (2–2.5%) or sevoflurane (3–3.5%) and also subjected to whole blood transfusion of cattle, buffalo and dogs in groups A, B & C respectively either during the operation or just after the operation.The efficacy of blood transfusion was judged on the basis of effects on various clinicophysiological and haematobiochemical parameters recorded before and after the administration of blood. Electrocardiographic studies were also made. It was concluded that in case of the trauma of spleen, homogenous transfusion of the blood in traumatized patient is most beneficial however in case of the emergency condition, heterogenous blood transfusion from cattle and buffaloes may also be made to save the life of the patients.

Introduction: The fixation of cytological smears using ethanol is the gold standard. But, there exists a quench to search a new alternative for it due to it being expensive, carcinogenic and not freely available. Honey has various properties, like dehydrant, anti-bacterial and antioxidant. The use of honey as a preservative in funerary practices is well documented. A thorough search in the literature did not reveal any matter for the utility of honey as a fixative in cytological smear, but its use in histopathology is well recognized. Aims: To analyze the efficacy of cytological smears fixed in ethanol and 20% unprocessed honey and to compare the efficacy between the two fixatives. Materials and Methods: The study group comprised of 30 normal healthy individuals who willingly gave written consent. Prior to the collection of buccal cells, subjects were asked to rinse their mouth with water. Buccal cells were collected using a wooden ice cream stick. Two smears were collected from each subject. One smear was fixed in ethanol and the other was fixed in unprocessed 20% honey. The slides were washed in tap water for about 30 s, following which they were subjected to the conventional Papanicolaou staining procedure. The slides thus fixed were evaluated separately for ethanol and honey. The cytoplasmic and nuclear details were scored for 50 cells in each slide. Data were statistically analyzed using the chi-square test and P < 0.05 was considered statistically significant. Results: Ninety percent of the ethanol-fixed (EF) smears were adequately fixed as compared with the honey-fixed (HF) smears, which were 80% adequate. The P-value obtained was 0.47 and the data were statistically insignificant. Conclusion: Both EF and HF smears were at par with each other, and honey can be safely used as a substitute to ethanol.