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Purpose: This retrospective case study aims to clarify the roles played by various factors in determining the actual versus expected number of organs procured from pediatric trauma patients. Significance: Trauma patients often have injuries so extensive that there is no hope of recovery. However, if they are stabilized, they may be able to save lives through organ donation. The more organs are procured, the more lives may be saved. Strategy and Implementation: In this retrospective study, we reviewed the records of pediatric organ donors from Saint Francis Children's Hospital from 2018 to 2022 and identified seven interesting cases involving children younger than 15 years old that showed the actual and expected numbers of organs transplanted. We examined the number of organs that we expected to transplant compared with how many organs were actually transplanted and which clinical data may have affected the ability to transplant. Outcomes: The data analysis included but was not limited to the observed-to-expected ratio, donor management goals, hospital lab and biometric values before the time of referral, cause of death, age, sex, race, body mass index, blood type, kidney donor profile index, referral timeliness, donation conversations, donation conversation outcomes, hospital attending, pre-mentions of donation to potential families, referral and donation milestone date-time stamps, donor outcomes, organs recovered, organs transplanted, organs discarded, organs submitted to research, and survey responses. Based on the seven identified cases, this study shows that an observed-to-expected ratio greater than 1 is achievable. Implications for Practice: Identifying factors that affect increased observed organ procurement will increase the potential of transplantable organs, thus leading to a higher number of lives saved.

In digital communication systems, channel encoders and interleavers play a crucial role in mitigating the random and burst errors introduced by noisy channels. While information about the encoder and interleaver is typically available in cooperative scenarios, non-cooperative military communication systems often lack such knowledge. This paper explores the application of deep learning to recognize four different interleavers such as block, convolutional, helical, and random especially in non-cooperative environments. By utilizing convolutional neural network and dilation residual network models, we perform the recognition task with input data for interleavers encoded using six different channel encoders such as block, convolutional, Bose-Chaudhuri-Hocquenghem, Reed-Solomon, low density parity check, and polar. Across all cases, both convolutional neural network and dilation residual network models consistently achieve classification accuracy exceeding 95% at varying signal-to-noise ratio values. In addition, we compare the classification accuracy and testing/training time of both our proposed models (i.e. convolutional neural network and dilation residual network) with the recurrent neural network, feedforward network, and autoencoder models available in the literature. Our findings reveal that the accuracy improves with high input sample length and yielding superior results for both the models. Notably, among the five models, dilation residual network outperforms other models in terms of classification accuracy and convolutional neural network outperforms dilation residual network in terms of training/testing time. Our results show that the convolutional neural network and dilation residual network models outperform the other methods. We also compare the classification accuracy of the proposed model with the existing rank-based approach proposed in the literature. Our findings indicate that at the same bit error rate values, our model demonstrates superior classification accuracy.

The first diagnosis of diabetic retinopathy (DR) must include lesion segmentation. As it takes a lot of time and effort to label lesions, automatic segmentation methods have to be created manually. The degree of the retina’s degenerative lesions determines how severe diabetic retinopathy is. A major influence is on the early detection of illness and treatment of DR. To reliably identify the sites of related lesions and identify various abnormalities in retinal fundus pictures, deep learning algorithms are crucial. Additionally, utilizing patch-based analysis, a deep convolutional neural network is constructed. In this study, encoder-decoder neural networks along with channel-wise spatial Attention Mechanisms are proposed. The IDRiD dataset, which includes hard exudate segmentations, is used to train and evaluate the architecture. In this method, image patches are created using the sliding window technique. To determine the effectiveness of the recommended strategy, a thorough experiment was conducted on IDRiD. In order to predict the various sorts of lesions, the trained network analyses the picture patches and creates a probability map. This technique’s efficacy and supremacy are confirmed by the expected accuracy of 99.94 %. The findings of this experiment show significantly enhanced performance in terms of accuracy when compared to prior research on comparable tasks.

Abstract Background The COVID-19 pandemic and its consequent “social distancing” has fueled the use of social media platforms for educational purposes. Since the start of the pandemic, a plethora of experts and self-proclaimed experts have been keenly delivering webinars on COVID. This begs the question “Do webinars on COVID-19 really help in the improvement of knowledge base or management skills?”. The questionnaire was designed to assess information regarding COVID-webinars and their usefulness from the end-user standpoint. The response to the questions was measured using a 4- or 5-point Likert scale. The survey was open for a 4-week period with the extension of 1 week. Results The response rate was 54% as 270 out of 500 participants responded to the questionnaire. The majority of the respondents were anesthesiologists in-training, post-graduates, fellows, and seniors belonging to tertiary care settings with fewer percentages belonging to physicians and others. Most of the doctors had attended an average of 2 webinars per week. The tests of model effects showed a significant negative correlation of webinar quality ratings for district hospital healthcare setting of the attendees (of p value of 0.013) and for the number of COVID-related webinars attended per week (p value of 0.009). Conclusions Most respondents had favorable perceptions of webinars happening during the pandemic. However, there is a need for improvisation in the volume of webinars, target-audience-based delivery, and participant interaction to add value to this new dimension of teaching-learning.

Catatonic patients may develop deep vein thrombosis (DVT) and pulmonary embolism (PE) due to prolonged periods of immobility. These life-threatening conditions demand prompt recognition and management. We describe the case of a patient with catatonia who presented to anesthesia for electroconvulsive therapy (ECT) at the outset of the current coronavirus disease 2019 pandemic. She complained of breathing difficulty and was suspected to have COVID-19 infection. On further evaluation, she was found to have DVT and PE and required oxygen therapy and intensive care management. The diagnostic delay in our patient would have probably not occurred, had it not been for the existing pandemic situation.

In this study, near-equiatomic NiTi thin films were deposited on silicon (1 0 0) substrates through direct current magnetron sputtering using Ni and Ti elemental targets without intentionally heating the substrate. Thin films were annealed at 600 °C for 1 h and then aged at 500 °C for 2, 4, and 6 h. X-ray diffraction studies revealed that the degree of crystallinity increased, and the dominant phase identified at room temperature was the R-phase. The surface roughness values were obtained through atomic force microscopy. As the aging time increased from 2 to 6 h, the hardness and elastic modulus values of the films increased for different load values. The high-resolution X-ray photoelectron spectroscopy results indicated that a TiO2 (metal oxide) layer was formed on the surface of the films aged for various durations. The layer was formed because of the enhanced thermodynamic nature caused by the Ni-rich residues and Si-C precipitates in the matrix occurring immediately adjacent to the metal oxide surface layer.

The purpose of this study was to assess the prevalence of frailty and nutritional status among older adults. This population-based cross-sectional study was conducted in 163 subjects aged 60–88 years, from Hyderabad City, South India. Data were obtained on sociodemographic details and anthropometry and biochemical parameters. Dietary intake was assessed by a three-day 24 h dietary recall, and the probability of adequacy (PA) was calculated using the estimated average requirements. Frailty indicators were as follows: handgrip strength was measured by using a Jamar dynamometer, gait speed was measured by a ten-meter length walk test, and low physical activity level, weight loss, and exhaustion were assessed using a questionnaire. Among the study population, 20% of the participants were frail and 80% were nonfrail. The prevalence of frailty is higher in older (30.1%) than the younger (12.2%) age groups, and it is more so in women (32.4%) than in men (10.1%). The lower educational status and income were associated with frailty. The PA of most of the nutrients was low in the frail group. Noticeably, the mean PA (MPA) across the fourteen micronutrients was significantly higher in nonfrail (38%) compared to the frail group (25%). The prevalence of frailty was higher in the lowest tertile of most of the food groups and nutrient intake compared to the highest tertile. The study revealed a 20% prevalence of frailty among urban older adults and provided evidence that inadequate intake of nutrients is independently associated with frailty.

The death of a child is a tragedy of astronomical proportions. Pediatric trauma patients often have injuries so extensive that there is no hope of recovery. Though the tragedy can never be undone, organ donation can save lives and create a legacy for the donor and their loved ones. Organ donation is a multi-factorial and dynamic process that is further complicated in the case of pediatric trauma patients due to the sudden-onset and intense emotions experienced by the patient's family. A critical factor in the success of organ donation is the collaborative relationship between a hospital and its respective Organ Procurement Organization (OPO). Successful organ donation relies on this relationship, as neither entity can achieve this goal on its own. By examining the relationship between Saint Francis Children's Hospital in Tulsa, OK, and its OPO, LifeShare, this paper argues that a strong, collaborative relationship between a hospital and its OPO can maximize the rates of organ referrals and donations, thereby increasing the available supply of pediatric donors who have passed away., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Saint Francis Health System Institutional Research Ethics Board issued approval 2377-24. The St. Francis Health System Institutional Research Ethics Board (IREB) has reviewed your request concerning a project you wish to conduct entitled “Successful Collaboration: A Tale of a Tertiary Care Hospital and Its Designated Organ Procurement Organization.” Based on the information provided in your request, it has been determined that this project does not qualify as human subject research as defined in 45 CFR 46.102(d) and (f) and is not subject to further oversight by the SFHS IREB. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Champlin et al.)

Duchenne muscular dystrophy (DMD) results in a progressive loss of functional skeletal muscle mass (MM) and replacement with fibrofatty tissue. Accurate evaluation of MM in DMD patients has not previously been available. Our objective was to measure MM using the D 3 creatine (D 3 Cr) dilution method and determine its relationship with strength and functional capacity in patients with DMD over a wide range of ages. Subjects were recruited for participation in a 12 month, longitudinal, observational study. Here, we report the baseline data. A 20 mg dose of D 3 Cr dissolved in water was ingested by 92 patients with DMD (ages 4-25 years) followed later with a fasting urine sample. Enrichment of D 3 creatinine was determined by liquid chromatography-mass spectrometry analysis. The North Star Ambulatory Assessment (NSAA) total score was determined for ambulatory participants, and the Performance of Upper Limb (PUL 2.0) total score and grip strength for all participants. We observed a significant age-associated increase in body weight along with a substantial decrease in MM/body weight (%MM). MM and %MM were associated with PUL score (r = 0.517, P < 0.0001 and r = 0.764, P < 0.0001 respectively). The age-associated decrease in MM and %MM was strongly associated with ambulatory status. We observed very little overlap in %MM between ambulant and non-ambulant subjects, suggesting a threshold of 18-22% associated with loss of ambulation. MM is substantially diminished with advancing age and is highly related to clinically meaningful functional status. The D 3 Cr dilution method may provide a biomarker of disease progression and therapeutic efficacy in patients with DMD or other neuromuscular disorders. KEY POINTS: The non-invasive D 3 creatine dilution method provides novel data on whole body functional muscle mass (MM) in a wide range of ages in patients with DMD and reveals profoundly low functional MM in older non-ambulant patients. The difference in %MM between ambulant and non-ambulant subjects suggests a threshold for loss of ambulatory ability between 18 and 22% MM. The data suggest that as functional MM declines with age, maintaining a lower body weight may help to conserve ambulatory ability., (© 2024 The Author(s). The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

Background: Psoriasis is a chronic inflammatory skin disease. Reactive oxygen species are thought to play a critical role in inflammation and are scavenged by antioxidants., Objective: We wanted to know whether the total antioxidative capacity or single antioxidative components in sera from psoriasis patients are decreased., Material and Methods: Well-known antioxidants of the serum were measured using commercial kits or determined by HPLC in the sera of 33 inpatients with severe psoriasis and in 36 healthy control persons. The total antioxidative capacity was measured using the ability of endogenous antioxidants to scavenge the 2, 2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) radical cation., Results: Several single antioxidative components were slightly elevated when considered groupwise, namely tocopherol (p = 0.001), bilirubin (p = 0.001) and urate which was increased over controls by about 33% (p= 0.01). Other parameters such as total protein and thiol content and ascorbic acid did not differ from controls., Conclusion: To our surprise the total antioxidative activity was normal in sera from psoriasis patients although some components such as urate were even elevated.

The oncornavirus related proteins associated with the surface of normal and malignant thymocytes were studied. Three virion-associated proteins (gp69/71, p45, p30) were associated with lymphoma cells from about 70% of the tumors studied. Two virion-associated proteins (gp69/71 and p45 were associated with normal thymocytes form some but not all strains of mice. In gp69/71- mice, conversion to the gp69/71+ phenotype accompanied leukemogenesis. An interesting difference in the apparent molecular size of virus related antigens of the 70,000 dalton size class was detected in lymphoma cells present in involved spleens as compared to involved thymuses. Mice infected as neonates with Scripps leukemia virus make antibody to gp69/71 and some make antibodies to molecules associated with the surface of their own tumors. The significance of the restricted presence of antigens coded for by the viral genome to the surface of some differentiated cells is discussed in reference to (a) the relationship between virion, leukemia associated, and differentiation dependent markers, and (b) the possible consequence to the host of having similar antigenic determinants on three independent structures with replicative potential (virus, normal thymocytes, and tumor cells).

Antisera to acetylcholine receptor purified from the electric organs of Torpedo and Electrophorus were highly species specific, but showed limited cross-reaction with receptors from all mammalian species tested. Antisera to receptor purified from rat muscle cross-reacted extensively with receptor from the muscles of other mammals. Antibodies to receptor from Electrophorus cross-reacting with receptor from Torpedo were affinity purified. Subsequently these showed increased cross-reaction with receptor from mammalian muscle. Sera from patients with myasthenia gravis reacted best with receptor from human muscle, but such sera also cross-reacted with receptor from other mammals, especially squirrel monkeys. These sera cross-reacted slightly with receptor from Torpedo, but not detectably with receptor from Electrophorus,