Objective:To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.Methods:This cross-sectional study conducted from May to July 2021 enrolled 694 participants.An ...Objective:To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.Methods:This cross-sectional study conducted from May to July 2021 enrolled 694 participants.An online questionnaire based on Google Forms was developed to collect the data.Participants were assessed using the validated Perceived Stress Scale and the Coping Resources Inventory Scale.Results:The age of participants were 27(23-52)years old.The majority of respondents(73.5%)felt moderately stressed.Of the 694 participants,83.0%of the 576 participants had average stress management skills.Sex,marital status,and profession were significantly associated with perceived stress.In addition,marital status and profession were significantly associated with coping capacity.Conclusions:The majority of participants have moderate stress levels and average coping skills.Frontline healthcare workers have to maintain mental and physical health.Achieving this requires early screening and stress management for healthcare workers.展开更多
Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinom...Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinoma(LUAD)and squamous cell carcinoma(LUSC)[1].Researchers use immunohisto-chemistry,next-generation sequencing,and single-cell RNA sequencing to study genetic alterations,tumor heterogeneity,and tumor microenvironments,aiming to identify potential therapeutic options for specific NSCLC subtypes[2].展开更多
Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tu...Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tumors and ossifying renal tumor of infancy.Tumor with low grade malignancy includes mesoblastic nephroma.Malignant tumors are nephroblastoma,clear cell sarcoma,malignant rhabdoid tumor,anaplastic sarcoma and Ewing sarcoma.Additionally,there are molecularly defined renal tumors,which includes renal cell carcinoma(RCC)with MiT translocations,ALK-rearranged RCC,eosinophilic solid and cystic RCC and SMARCB1-deficient renal medullary carcinoma.These tumors apart from having characteristic clinical presentation and histomorphology,also carry typical molecular mutations and translocations.Certain renal tumors have association with various genetic syndromes such as Beckwith-Weidmann syndrome,Wilm’s tumor,aniridia,genitourinary anomalies and mental retardation syndrome,Denys-Drash syndrome,rhabdoid tumor predisposition syndrome and DICER syndrome.This review article focusses on molecular characteristics,histomorphology and syndromic association of pediatric renal tumors,their immunohistochemical approach to diagnosis with recent updates in molecularly defined renal tumors.展开更多
Rationale:Central nervous system(CNS)actinomycosis is rare,spreading hematogenously from distant infections.Cutaneous actinomycosis with skull/meninges spread is especially unusual.Patient concerns:A 57-year-old man p...Rationale:Central nervous system(CNS)actinomycosis is rare,spreading hematogenously from distant infections.Cutaneous actinomycosis with skull/meninges spread is especially unusual.Patient concerns:A 57-year-old man presented with complaints of discharge from the back of his scalp for six months,an ataxic gait,and bilateral upper and lower limb weakness and numbness over the past 4-5 months.Diagnosis:CNS actinomycosis.Interventions:Intravenous injection of ceftriaxone followed by oral amoxicillin-clavulanic acid therapy.Outcomes:The patient was able to walk without support,with complete resolution of sinus discharge.Lessons:In patients presenting with discharging sinuses especially when accompanied by CNS symptoms,actinomycosis should be considered as a differential,along with tuberculosis,non-tubercular mycobacterial infection,and aspergillosis.Microbiological confirmation should be attempted wherever possible,for accurate diagnosis and treatment,as clinic-radiological picture alone may not differentiate these infections,as treatment of each is diametrically opposite and patients can be cured with timely and appropriate treatment.展开更多
BACKGROUND Post-transplant diabetes mellitus(PTDM)adversely affects graft survival and is an independent predictor of adverse cardiovascular events.Observational studies in the general population as well as the post-t...BACKGROUND Post-transplant diabetes mellitus(PTDM)adversely affects graft survival and is an independent predictor of adverse cardiovascular events.Observational studies in the general population as well as the post-transplant setting suggest an association between the plasma 25-hydroxyvitamin D[25(OH)D]level and onset of type 2 diabetes mellitus.Literature is very limited in the context of PTDM.AIM To study the relationship between vitamin D deficiency at the time of kidney transplant and PTDM in the post-transplant period.METHODS In this single center study,72 patients who underwent kidney transplant were included.Blood samples for serum vitamin D level were collected on the day of transplant and analyzed at the end of study.The LIAISON®25(OH)D assay was used for quantitative estimation of total 25(OH)D in the serum.PTDM was diagnosed by either fasting plasma glucose(>126 mg/dL),2-h post prandial plasma glucose(>200 mg/dL),or 2-h oral glucose tolerance test after 45 days post-transplant.Hemoglobin A1c was not used to diagnose PTDM.Vitamin D levels were labeled as sufficient(≥30.0 ng/mL),insufficient(20.0-29.9 ng/mL),and deficient(<20.0 ng/mL).Patients were reviewed at 45 days and 1 year post transplant for the occurrence of PTDM.RESULTS In our study cohort 72 patients completed the study.Overall,32(43.8%)patients developed PTDM during the follow up of 1 year,44(61.1%)patients had deficient(<20 ng/mL)25(OH)D levels.Twenty-six(81.2%)patients with PTDM had deficient vitamin D levels as compared with 18(45.0%)patients without PTDM(P=0.007).This association was also significant when univariable[odds ratio(OR)=5.3,95%confidence interval(CI):1.79-15.67,P=0.003)]and multivariable(OR=8.21,95%CI:2.19-30.75,P=0.002)regression analysis was performed.A higher proportion of subjects having PTDM(15.6%)had a positive family history of diabetes mellitus than the controls(2.5%)(P=0.045).However,this association did not persist in the multivariable regression analysis(OR=12.6,95%CI:0.86-185.4,P=0.065).CONCLUSION Deficient vitamin D levels(<20 ng/mL)were significantly associated with PTDM in the post kidney transplant setting.Further studies are needed to see the effect of vitamin D replacement on PTDM.展开更多
Objective:This study aims to assess nursing faculty’s perceptions and challenges in teaching Generation Z students,providing insights into the barriers and opportunities in bridging the generational learning gap.Mate...Objective:This study aims to assess nursing faculty’s perceptions and challenges in teaching Generation Z students,providing insights into the barriers and opportunities in bridging the generational learning gap.Material and Methods:A descriptive cross-sectional study was conducted among 335 nursing faculty members in the Delhi NCR region.Participants were recruited using a snowball sampling technique,and data were collected via a self-administered structured questionnaire.The questionnaire measured faculty perceptions and challenges using a Likert scale,with reliability assessed using Cronbach’s alpha.Data were analyzed through Descriptive and inferential statistics.Results:Findings revealed that while faculty recognize the need for technology integration and student-centered learning,they face challenges such as academic integrity concerns,psychological stress,and adapting to Gen Z’s expectations for personalized learning.The correlation between faculty perceptions and challenges was negligible(r=0.020,P=0.717),indicating that faculty perceptions remain stable despite these difficulties.Conclusion:Nursing faculty need to adapt pedagogical approaches to meet the evolving needs of Gen Z students.Bridging the gap between traditional teaching methods and the evolving needs of Generation Z requires faculty training,institutional support,and curriculum innovations.展开更多
Retrospective study of 3,60916 person who were depend on Alcohol and tobacco.In this study we found the result of efficacy of rajyoga meditation very impressive.In this protocol we used early morning meditation,evenin...Retrospective study of 3,60916 person who were depend on Alcohol and tobacco.In this study we found the result of efficacy of rajyoga meditation very impressive.In this protocol we used early morning meditation,evening meditation before sleep,positive affirmation to mind,regular Murli class,traffic control l3-4 times for 3 minutes.(control and remove negative thoughts),charging water and natural cure medicine for de-addiction.The purpose of this study,the effective ness of spiritual oriented lyfe style for natural cure of physically and mentally.展开更多
Herein,we report the multi-metal atomic catalysts for solid-state dehydrogenation of MgH_(2).It aims to reveal the multi-element synergy in catalysts for solid-state hydrogen storage.The kinetic measurements and fitti...Herein,we report the multi-metal atomic catalysts for solid-state dehydrogenation of MgH_(2).It aims to reveal the multi-element synergy in catalysts for solid-state hydrogen storage.The kinetic measurements and fitting reveal two mechanisms:one shows a maximum rate at the early stage,such as V and Cr;the other needs a temperature-sensitive preparation time for its maximum rate,such as Ni.The combina-tion of two catalyst components demonstrates the best kinetics:V and Cr boost the initial dehydrogena-tion,and Ni benefits the further hydrogen transfer which alleviates the rate of decay.This work provides guidelines for the design of multi-element doped catalysts for MgH_(2) dehydrogenation.展开更多
Objectives:The objective of this study was to assess the impact of two relaxation techniques,the Jacobson’s progressive muscle relaxation technique(JPMR),and the Benson’s relaxation technique(BRT),on the levels of s...Objectives:The objective of this study was to assess the impact of two relaxation techniques,the Jacobson’s progressive muscle relaxation technique(JPMR),and the Benson’s relaxation technique(BRT),on the levels of stress and anxiety experienced by patients undergoing coronary angioplasty.Materials and Methods:Quantitative research approach with quasi-experimental pre-test and posttest control group design was conducted with seventy coronary angioplasty patients from the Institute of Medical Science,and SUM Hospital,Bhubaneswar,Odisha.The participants were purposively selected and divided into Experimental Group 1(n=35)and Experimental Group 2(n=35).Each group received either BRT or JPMR for three consecutive days.Pretest and posttest data were collected using a structured demographic questionnaire and the modified depression anxiety stress scale-21.Results:Both BRT and JPMR significantly decreased the levels of stress and anxiety among patients undergoing angioplasty compared to baseline(P<0.05).However,there was no significant difference between the two techniques based on Fisher’s exact P value.This suggests that both interventions are effective in reducing stress and anxiety among angioplasty patients.Conclusion:BRT or JPMR are noninvasive,nonpharmacological interventions that effectively reduce stress and anxiety in patients undergoing angioplasty.These findings underscore the importance of incorporating relaxation techniques into nursing practice and hospital programs to enhance patient care and promote holistic well-being post-angioplasty.展开更多
Aqueous-electrolyte-based zinc-ion batteries(ZIBs),which have significant advantages over other batteries,including low cost,high safety,high ionic conductivity,and a natural abundance of zinc,have been regarded as a ...Aqueous-electrolyte-based zinc-ion batteries(ZIBs),which have significant advantages over other batteries,including low cost,high safety,high ionic conductivity,and a natural abundance of zinc,have been regarded as a potential alternative to lithium-ion batteries(LIBs).ZIBs still face some critical challenges,however,especially for building a reversible zinc anode.To address the reversibility of zinc anode,great efforts have been made on intrinsic anode engineering and anode interface modification.Less attention has been devoted to the electrolyte additives,however,which could not only significantly improve the reversibility of zinc anode,but also determine the viability and overall performance of ZIBs.This review aims to provide an overview of the two main functions of electrolyte additives,followed by details on six reasons why additives might improve the performance of ZIBs from the perspectives of creating new layers and regulating current plating/stripping processes.Furthermore,the remaining difficulties and potential directions for additives in aqueous ZIBs are also highlighted.展开更多
Background:Magnetic resonance imaging(MRI)is crucial in modern medical diagnostics,providing detailed insights into soft tissue structures and pathological changes.Traditional grayscale images can sometimes obscure cr...Background:Magnetic resonance imaging(MRI)is crucial in modern medical diagnostics,providing detailed insights into soft tissue structures and pathological changes.Traditional grayscale images can sometimes obscure critical details,complicating accurate interpretations.Automated color coding of the MRI signal intensities may enhance the visualization of various pa-thologies,potentially leading to improved diagnostic accuracy and image quality.This paper aims to explore the effectiveness of color-coded MR image reconstruction in enhancing both diagnostic precision and overall image quality in musculoskeletal MRI.Methods:Two fellowship-trained musculoskeletal radiologists evaluated the images reconstructed with color coding,rating their diagnostic value,image quality,and visual appeal using a five-point Likert scale.To assess interrater reliability,Cohen's Kappa statistical analysis was performed.Additionally,descriptive statistics summarizing the Likert scores for diagnostic value,image quality,and visual appeal of the reconstructed images have been described.Results:Statistical analysis of the data revealed that the diagnostic value,image value,and visual appeal of the color-coded MR images were excellent in almost two-thirds of the data set.The minimum Likert score recorded was 3,signifying a good quality rating.Conclusion:Our study shows positive results,supporting the efficiency of color-coded MR imaging in aiding the conventional gray scale MR imaging to improve its diagnostic efficiency.展开更多
Obesity,a global health concern,is associated with severe health issues like type 2 diabetes,heart disease,and respiratory complications.It also increases the risk of various cancers,including melanoma,endometrial,pro...Obesity,a global health concern,is associated with severe health issues like type 2 diabetes,heart disease,and respiratory complications.It also increases the risk of various cancers,including melanoma,endometrial,prostate,pancreatic,esophageal adenocarcinoma,colorectal carcinoma,renal adenocarcinoma,and pre-and post-menopausal breast cancer.Obesity-induced cellular changes,such as impaired CD8^(+)T cell function,dyslipi-demia,hypercholesterolemia,insulin resistance,mild hyperglycemia,and fluctuating levels of leptin,resistin,adiponectin,and IL-6,contribute to cancer development by promoting inflammation and creating a tumor-promoting microenvironment rich in adipocytes.Adipocytes release leptin,a pro-inflammatory substance that stimulates cancer cell proliferation,inflammation,and invasion,altering the tumor cell metabolic pathway.Adiponectin,an insulin-sensitizing adipokine,is typically downregulated in obese individuals.It has antipro-liferative,proapoptotic,and antiangiogenic properties,making it a potential cancer treatment.This narrative review offers a comprehensive examination of the molecular interconnections between obesity and cancer,draw-ing on an extensive,though non-systematic,survey of the recent literature.This approach allows us to integrate and synthesize findings from various studies,offering a cohesive perspective on emerging themes and potential therapeutic targets.The review explores the metabolic disturbances,cellular alterations,inflammatory responses,and shifts in the tumor microenvironment that contribute to the obesity-cancer link.Finally,it discusses poten-tial therapeutic strategies aimed at disrupting these connections,offering valuable insights into future research directions and the development of targeted interventions.展开更多
Budd-Chiari syndrome(BCS) consists of a group of disorders with obstruction of hepatic venous outflow leading to increased hepatic sinusoidal pressure and portal hypertension.Clinically,two forms of disease(acute and ...Budd-Chiari syndrome(BCS) consists of a group of disorders with obstruction of hepatic venous outflow leading to increased hepatic sinusoidal pressure and portal hypertension.Clinically,two forms of disease(acute and chronic) are recognized.Mostly the patients present with ascites,hepatomegaly,and portal hypertension.In acute disease the liver is enlarged with thrombosed hepatic veins(HV) and ascites,whereas in the chronic form of the disease there may be membranous occlusion of HV and/or the inferior vena cava(IVC),or there may be short or long segment fibrotic constriction of HV or the suprahepatic IVC.Due to advances in radiological interventional techniques and hardware,there have been changes in the management protocol of BCS with surgery being offered to patients not suitable for radiological interventions or having acute liver failure requiring liver transplantation.The present article gives an insight into various imaging findings and interventional techniques employed in the management of BCS.展开更多
Upper gastrointestinal bleeding is common and often needs timely intervention for optimal outcomes.Esophageal bleeding may occur due to local advancement of malignancy or bleeding from an arterio-oesophageal fistula.W...Upper gastrointestinal bleeding is common and often needs timely intervention for optimal outcomes.Esophageal bleeding may occur due to local advancement of malignancy or bleeding from an arterio-oesophageal fistula.We discuss the management options available for such cases.展开更多
Facial nerve schwannoma occurring within the parotid gland is a rare tumour. We report a case of schwannoma within the parotid gland in a young female patient, who underwent ultrasound and magnetic resonanceimaging(MR...Facial nerve schwannoma occurring within the parotid gland is a rare tumour. We report a case of schwannoma within the parotid gland in a young female patient, who underwent ultrasound and magnetic resonanceimaging(MRI) and subsequent surgical excision of the lesion. The lesion showed hyperintensity on T2-weighted and diffusion-weighted MRI. There was no adjacent lymphadenopathy. Although hyperintensity on diffusionweighted MRI could suggest malignant tumours, the characteristic "string sign" provided the clue for the diagnosis of schwannoma.展开更多
One-dimensional nano-structured materials have attracted attention due to its unique properties afforded such as the across-linked structures and large aspect ratios.In this work,one-dimensional CoSe@N-doped carbon na...One-dimensional nano-structured materials have attracted attention due to its unique properties afforded such as the across-linked structures and large aspect ratios.In this work,one-dimensional CoSe@N-doped carbon nanofibers(CoSe@NCNFs)are successfully by combining the techniques of electrospinning and annealing.Selenium powder are directly dispersed in the polyacrylonitrile/N,N-Dimethylformamide(DMF)solution containing cobalt salt to form the product.The performance of these materials was investigated in Li-ion batteries after the annealing at different temperatures.The Co Se@NC nanofibers annealed at 550℃(CoSe@NC-550)and displayed excellent storage properties,affording a high capacity of 796 m Ah·g-1at a current density of 1 A·g^-1 for 100 cycles.Moreover,it is confirmed that the pseudocapacitive contribution of CoSe@NC-550 is up to 72.8%at the scan rate of 1 mV/s through the cyclic voltammetry analysis.展开更多
Crystal planes of a catalyst play crucial role in determining the electrocatalytic performance for CO2 reduction.The catalyst SnO2 can convert CO2 molecules into valuable formic acid(HCOOH).Incorporating heteroatom N ...Crystal planes of a catalyst play crucial role in determining the electrocatalytic performance for CO2 reduction.The catalyst SnO2 can convert CO2 molecules into valuable formic acid(HCOOH).Incorporating heteroatom N into SnO2 further improves its catalytic activity.To understand the mechanism and realize a highly efficient CO2-to-HCOOH conversion,we used density functional theory(DFT)to calculate the free energy of CO2 reduction reactions(CO2RR)on different crystal planes of N-doped SnO2(N-SnO2).The results indicate that N-SnO2 lowered the activation energy of intermediates leading to a better catalytic performance than pure SnO2.We also discovered that the N-Sn O2 (211)plane possesses the most suitable free energy during the reduction process,exhibiting the best catalytic ability for the CO2-to-HCOOH conversion.The intermediate of CO2RR on N-SnO2 is HCOO*or COOH* instead of OCHO*.These results may provide useful insights into the mechanism of CO2RR,and promote the development of heteroatomdoped catalyst for efficient CO2RR.展开更多
Background: Objective Structured Practical Examination (OSPE) is a method of assessment of clinical competence.The examination is conducted at multiple stations.Besides practical and problem-solving skills,theoretical...Background: Objective Structured Practical Examination (OSPE) is a method of assessment of clinical competence.The examination is conducted at multiple stations.Besides practical and problem-solving skills,theoretical knowledge is also tested.OSPE can be traced back more than 40 years.OSPE has been included more than two decades,as a part of assessment in the College of Nursing,All India Institute of Medical Sciences (AIIMS),New Delhi.Objectives: This study was carried out to determine nursing students' attitudes towards OSPE as an assessment tool.Participants: The responses of all the 252 Undergraduate nursing students studying at the College of Nursing,AIIMS were obtained for this study (77 from B.Sc.(H) Nursing first year,61 from the second year,69 from the third year and 45 from the fourth year).Methods: The students attitudes towards OSPE were assessed by using a validated questionnaire containing 28 item statements on Likert's 5-point scale (LS) and 11 bipolar adjectives on Osgood's 7-point Semantic'Differential Scale (OSDS).Result: Most of the students approved of OSPE and felt that it was fair,useful,good,effective,exciting,interesting,practical,skill oriented but also taxing.The study also revealed that amongst the second years' students there was a strong correlation between Overall Rank in the Class and Assessment of OSPE.Conclusion: The study supports the introduction of OSPE as one of the methods of assessment of B.Sc.(Hons.) Nursing students.展开更多
AIM:To evaluate whether glaucomatous visual field defect particularly the pattern standard deviation(PSD)of Humphrey visual field could be associated with visual evoked potential(VEP)parameters of patients having prim...AIM:To evaluate whether glaucomatous visual field defect particularly the pattern standard deviation(PSD)of Humphrey visual field could be associated with visual evoked potential(VEP)parameters of patients having primary open angle glaucoma(POAG).METHODS:Visual field by Humphrey perimetry and simultaneous recordings of pattern reversal visual evoked potential(PRVEP)were assessed in 100 patients with POAG.The stimulus configuration for VEP recordings consisted of the transient pattern reversal method in which a black and white checker board pattern was generated(full field)and displayed on VEP monitor(colour 14')by an electronic pattern regenerator inbuilt in an evoked potential recorder(RMS EMG EP MARK II).RESULTS:The results of our study indicate that there is a highly significant(P【0.001)negative correlation of P100 amplitude and a statistically significant(P【0.05)positive correlation of N70 latency,P100 latency and N155 latency with the PSD of Humphrey visual field in the subjects of POAG in various age groups as evaluated by Student’s t-test.CONCLUSION:Prolongation of VEP latencies were mirrored by a corresponding increase of PSD values.Conversely,as PSD increases the magnitude of VEP excursions were found to be diminished.展开更多
文摘Objective:To assess perceived stress and coping capacity of frontline health workers from AIIMS during COVID-19 pandemic.Methods:This cross-sectional study conducted from May to July 2021 enrolled 694 participants.An online questionnaire based on Google Forms was developed to collect the data.Participants were assessed using the validated Perceived Stress Scale and the Coping Resources Inventory Scale.Results:The age of participants were 27(23-52)years old.The majority of respondents(73.5%)felt moderately stressed.Of the 694 participants,83.0%of the 576 participants had average stress management skills.Sex,marital status,and profession were significantly associated with perceived stress.In addition,marital status and profession were significantly associated with coping capacity.Conclusions:The majority of participants have moderate stress levels and average coping skills.Frontline healthcare workers have to maintain mental and physical health.Achieving this requires early screening and stress management for healthcare workers.
基金support through Manipal University Jaipur for the Enhanced Seed Grant under the Endowment Fund(Grant No.E3/2023-24/QE-04-05).
文摘Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinoma(LUAD)and squamous cell carcinoma(LUSC)[1].Researchers use immunohisto-chemistry,next-generation sequencing,and single-cell RNA sequencing to study genetic alterations,tumor heterogeneity,and tumor microenvironments,aiming to identify potential therapeutic options for specific NSCLC subtypes[2].
文摘Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tumors and ossifying renal tumor of infancy.Tumor with low grade malignancy includes mesoblastic nephroma.Malignant tumors are nephroblastoma,clear cell sarcoma,malignant rhabdoid tumor,anaplastic sarcoma and Ewing sarcoma.Additionally,there are molecularly defined renal tumors,which includes renal cell carcinoma(RCC)with MiT translocations,ALK-rearranged RCC,eosinophilic solid and cystic RCC and SMARCB1-deficient renal medullary carcinoma.These tumors apart from having characteristic clinical presentation and histomorphology,also carry typical molecular mutations and translocations.Certain renal tumors have association with various genetic syndromes such as Beckwith-Weidmann syndrome,Wilm’s tumor,aniridia,genitourinary anomalies and mental retardation syndrome,Denys-Drash syndrome,rhabdoid tumor predisposition syndrome and DICER syndrome.This review article focusses on molecular characteristics,histomorphology and syndromic association of pediatric renal tumors,their immunohistochemical approach to diagnosis with recent updates in molecularly defined renal tumors.
文摘Rationale:Central nervous system(CNS)actinomycosis is rare,spreading hematogenously from distant infections.Cutaneous actinomycosis with skull/meninges spread is especially unusual.Patient concerns:A 57-year-old man presented with complaints of discharge from the back of his scalp for six months,an ataxic gait,and bilateral upper and lower limb weakness and numbness over the past 4-5 months.Diagnosis:CNS actinomycosis.Interventions:Intravenous injection of ceftriaxone followed by oral amoxicillin-clavulanic acid therapy.Outcomes:The patient was able to walk without support,with complete resolution of sinus discharge.Lessons:In patients presenting with discharging sinuses especially when accompanied by CNS symptoms,actinomycosis should be considered as a differential,along with tuberculosis,non-tubercular mycobacterial infection,and aspergillosis.Microbiological confirmation should be attempted wherever possible,for accurate diagnosis and treatment,as clinic-radiological picture alone may not differentiate these infections,as treatment of each is diametrically opposite and patients can be cured with timely and appropriate treatment.
文摘BACKGROUND Post-transplant diabetes mellitus(PTDM)adversely affects graft survival and is an independent predictor of adverse cardiovascular events.Observational studies in the general population as well as the post-transplant setting suggest an association between the plasma 25-hydroxyvitamin D[25(OH)D]level and onset of type 2 diabetes mellitus.Literature is very limited in the context of PTDM.AIM To study the relationship between vitamin D deficiency at the time of kidney transplant and PTDM in the post-transplant period.METHODS In this single center study,72 patients who underwent kidney transplant were included.Blood samples for serum vitamin D level were collected on the day of transplant and analyzed at the end of study.The LIAISON®25(OH)D assay was used for quantitative estimation of total 25(OH)D in the serum.PTDM was diagnosed by either fasting plasma glucose(>126 mg/dL),2-h post prandial plasma glucose(>200 mg/dL),or 2-h oral glucose tolerance test after 45 days post-transplant.Hemoglobin A1c was not used to diagnose PTDM.Vitamin D levels were labeled as sufficient(≥30.0 ng/mL),insufficient(20.0-29.9 ng/mL),and deficient(<20.0 ng/mL).Patients were reviewed at 45 days and 1 year post transplant for the occurrence of PTDM.RESULTS In our study cohort 72 patients completed the study.Overall,32(43.8%)patients developed PTDM during the follow up of 1 year,44(61.1%)patients had deficient(<20 ng/mL)25(OH)D levels.Twenty-six(81.2%)patients with PTDM had deficient vitamin D levels as compared with 18(45.0%)patients without PTDM(P=0.007).This association was also significant when univariable[odds ratio(OR)=5.3,95%confidence interval(CI):1.79-15.67,P=0.003)]and multivariable(OR=8.21,95%CI:2.19-30.75,P=0.002)regression analysis was performed.A higher proportion of subjects having PTDM(15.6%)had a positive family history of diabetes mellitus than the controls(2.5%)(P=0.045).However,this association did not persist in the multivariable regression analysis(OR=12.6,95%CI:0.86-185.4,P=0.065).CONCLUSION Deficient vitamin D levels(<20 ng/mL)were significantly associated with PTDM in the post kidney transplant setting.Further studies are needed to see the effect of vitamin D replacement on PTDM.
文摘Objective:This study aims to assess nursing faculty’s perceptions and challenges in teaching Generation Z students,providing insights into the barriers and opportunities in bridging the generational learning gap.Material and Methods:A descriptive cross-sectional study was conducted among 335 nursing faculty members in the Delhi NCR region.Participants were recruited using a snowball sampling technique,and data were collected via a self-administered structured questionnaire.The questionnaire measured faculty perceptions and challenges using a Likert scale,with reliability assessed using Cronbach’s alpha.Data were analyzed through Descriptive and inferential statistics.Results:Findings revealed that while faculty recognize the need for technology integration and student-centered learning,they face challenges such as academic integrity concerns,psychological stress,and adapting to Gen Z’s expectations for personalized learning.The correlation between faculty perceptions and challenges was negligible(r=0.020,P=0.717),indicating that faculty perceptions remain stable despite these difficulties.Conclusion:Nursing faculty need to adapt pedagogical approaches to meet the evolving needs of Gen Z students.Bridging the gap between traditional teaching methods and the evolving needs of Generation Z requires faculty training,institutional support,and curriculum innovations.
文摘Retrospective study of 3,60916 person who were depend on Alcohol and tobacco.In this study we found the result of efficacy of rajyoga meditation very impressive.In this protocol we used early morning meditation,evening meditation before sleep,positive affirmation to mind,regular Murli class,traffic control l3-4 times for 3 minutes.(control and remove negative thoughts),charging water and natural cure medicine for de-addiction.The purpose of this study,the effective ness of spiritual oriented lyfe style for natural cure of physically and mentally.
基金Yijing Wang acknowledges the funding support of the National Key Research and Development Program of China(No.2021YFB4000604)the National Natural Science Foundation of China(No.52271220)+6 种基金the Higher Education Discipline Innovation Project(No.B12015)“the Fundamental Research Funds for the Central Universities”Huaiyu Shao acknowledges the funding support of the Multi-Year Research Grant(MYRG)from the University of Macao(No.MYRG2022-00105-IAPME)the Joint Scientific Research Project Funding by the National Natural Science Foundation of China and the Macao Science and Technology Development Fund(No.0090/2022/AFJ)the Macao Science and Technology Development Fund(FDCT)for funding No.006/2022/ALC of the Macao Centre for Research and Development in Advanced Materials(No.2022-2024)the Natural Science Foundation of Guangdong Province(Grant No.2023A1515010765)the Shenzhen-Hong Kong-Macao Science and Technology Innovation Project(Category C).
文摘Herein,we report the multi-metal atomic catalysts for solid-state dehydrogenation of MgH_(2).It aims to reveal the multi-element synergy in catalysts for solid-state hydrogen storage.The kinetic measurements and fitting reveal two mechanisms:one shows a maximum rate at the early stage,such as V and Cr;the other needs a temperature-sensitive preparation time for its maximum rate,such as Ni.The combina-tion of two catalyst components demonstrates the best kinetics:V and Cr boost the initial dehydrogena-tion,and Ni benefits the further hydrogen transfer which alleviates the rate of decay.This work provides guidelines for the design of multi-element doped catalysts for MgH_(2) dehydrogenation.
文摘Objectives:The objective of this study was to assess the impact of two relaxation techniques,the Jacobson’s progressive muscle relaxation technique(JPMR),and the Benson’s relaxation technique(BRT),on the levels of stress and anxiety experienced by patients undergoing coronary angioplasty.Materials and Methods:Quantitative research approach with quasi-experimental pre-test and posttest control group design was conducted with seventy coronary angioplasty patients from the Institute of Medical Science,and SUM Hospital,Bhubaneswar,Odisha.The participants were purposively selected and divided into Experimental Group 1(n=35)and Experimental Group 2(n=35).Each group received either BRT or JPMR for three consecutive days.Pretest and posttest data were collected using a structured demographic questionnaire and the modified depression anxiety stress scale-21.Results:Both BRT and JPMR significantly decreased the levels of stress and anxiety among patients undergoing angioplasty compared to baseline(P<0.05).However,there was no significant difference between the two techniques based on Fisher’s exact P value.This suggests that both interventions are effective in reducing stress and anxiety among angioplasty patients.Conclusion:BRT or JPMR are noninvasive,nonpharmacological interventions that effectively reduce stress and anxiety in patients undergoing angioplasty.These findings underscore the importance of incorporating relaxation techniques into nursing practice and hospital programs to enhance patient care and promote holistic well-being post-angioplasty.
基金supported by a Discovery Early Career Researcher Award(DECRA,No.DE180101478)of the Australian Research Council and National Natural Science Foundation of China(Youth Program,No.52204378).
文摘Aqueous-electrolyte-based zinc-ion batteries(ZIBs),which have significant advantages over other batteries,including low cost,high safety,high ionic conductivity,and a natural abundance of zinc,have been regarded as a potential alternative to lithium-ion batteries(LIBs).ZIBs still face some critical challenges,however,especially for building a reversible zinc anode.To address the reversibility of zinc anode,great efforts have been made on intrinsic anode engineering and anode interface modification.Less attention has been devoted to the electrolyte additives,however,which could not only significantly improve the reversibility of zinc anode,but also determine the viability and overall performance of ZIBs.This review aims to provide an overview of the two main functions of electrolyte additives,followed by details on six reasons why additives might improve the performance of ZIBs from the perspectives of creating new layers and regulating current plating/stripping processes.Furthermore,the remaining difficulties and potential directions for additives in aqueous ZIBs are also highlighted.
文摘Background:Magnetic resonance imaging(MRI)is crucial in modern medical diagnostics,providing detailed insights into soft tissue structures and pathological changes.Traditional grayscale images can sometimes obscure critical details,complicating accurate interpretations.Automated color coding of the MRI signal intensities may enhance the visualization of various pa-thologies,potentially leading to improved diagnostic accuracy and image quality.This paper aims to explore the effectiveness of color-coded MR image reconstruction in enhancing both diagnostic precision and overall image quality in musculoskeletal MRI.Methods:Two fellowship-trained musculoskeletal radiologists evaluated the images reconstructed with color coding,rating their diagnostic value,image quality,and visual appeal using a five-point Likert scale.To assess interrater reliability,Cohen's Kappa statistical analysis was performed.Additionally,descriptive statistics summarizing the Likert scores for diagnostic value,image quality,and visual appeal of the reconstructed images have been described.Results:Statistical analysis of the data revealed that the diagnostic value,image value,and visual appeal of the color-coded MR images were excellent in almost two-thirds of the data set.The minimum Likert score recorded was 3,signifying a good quality rating.Conclusion:Our study shows positive results,supporting the efficiency of color-coded MR imaging in aiding the conventional gray scale MR imaging to improve its diagnostic efficiency.
基金supported by Sidra Medicine Research Fund to Ajaz A.Bhat(grant number:SDR400190)Ammira S.Al-Shabeeb Akil(grant number:SDR400175).
文摘Obesity,a global health concern,is associated with severe health issues like type 2 diabetes,heart disease,and respiratory complications.It also increases the risk of various cancers,including melanoma,endometrial,prostate,pancreatic,esophageal adenocarcinoma,colorectal carcinoma,renal adenocarcinoma,and pre-and post-menopausal breast cancer.Obesity-induced cellular changes,such as impaired CD8^(+)T cell function,dyslipi-demia,hypercholesterolemia,insulin resistance,mild hyperglycemia,and fluctuating levels of leptin,resistin,adiponectin,and IL-6,contribute to cancer development by promoting inflammation and creating a tumor-promoting microenvironment rich in adipocytes.Adipocytes release leptin,a pro-inflammatory substance that stimulates cancer cell proliferation,inflammation,and invasion,altering the tumor cell metabolic pathway.Adiponectin,an insulin-sensitizing adipokine,is typically downregulated in obese individuals.It has antipro-liferative,proapoptotic,and antiangiogenic properties,making it a potential cancer treatment.This narrative review offers a comprehensive examination of the molecular interconnections between obesity and cancer,draw-ing on an extensive,though non-systematic,survey of the recent literature.This approach allows us to integrate and synthesize findings from various studies,offering a cohesive perspective on emerging themes and potential therapeutic targets.The review explores the metabolic disturbances,cellular alterations,inflammatory responses,and shifts in the tumor microenvironment that contribute to the obesity-cancer link.Finally,it discusses poten-tial therapeutic strategies aimed at disrupting these connections,offering valuable insights into future research directions and the development of targeted interventions.
文摘Budd-Chiari syndrome(BCS) consists of a group of disorders with obstruction of hepatic venous outflow leading to increased hepatic sinusoidal pressure and portal hypertension.Clinically,two forms of disease(acute and chronic) are recognized.Mostly the patients present with ascites,hepatomegaly,and portal hypertension.In acute disease the liver is enlarged with thrombosed hepatic veins(HV) and ascites,whereas in the chronic form of the disease there may be membranous occlusion of HV and/or the inferior vena cava(IVC),or there may be short or long segment fibrotic constriction of HV or the suprahepatic IVC.Due to advances in radiological interventional techniques and hardware,there have been changes in the management protocol of BCS with surgery being offered to patients not suitable for radiological interventions or having acute liver failure requiring liver transplantation.The present article gives an insight into various imaging findings and interventional techniques employed in the management of BCS.
文摘Upper gastrointestinal bleeding is common and often needs timely intervention for optimal outcomes.Esophageal bleeding may occur due to local advancement of malignancy or bleeding from an arterio-oesophageal fistula.We discuss the management options available for such cases.
文摘Facial nerve schwannoma occurring within the parotid gland is a rare tumour. We report a case of schwannoma within the parotid gland in a young female patient, who underwent ultrasound and magnetic resonanceimaging(MRI) and subsequent surgical excision of the lesion. The lesion showed hyperintensity on T2-weighted and diffusion-weighted MRI. There was no adjacent lymphadenopathy. Although hyperintensity on diffusionweighted MRI could suggest malignant tumours, the characteristic "string sign" provided the clue for the diagnosis of schwannoma.
基金supported by the National Natural Science Foundation of China (Grant No. 51302079)the Natural Science Foundation of Hunan Province (Grant No. 2017JJ1008)
文摘One-dimensional nano-structured materials have attracted attention due to its unique properties afforded such as the across-linked structures and large aspect ratios.In this work,one-dimensional CoSe@N-doped carbon nanofibers(CoSe@NCNFs)are successfully by combining the techniques of electrospinning and annealing.Selenium powder are directly dispersed in the polyacrylonitrile/N,N-Dimethylformamide(DMF)solution containing cobalt salt to form the product.The performance of these materials was investigated in Li-ion batteries after the annealing at different temperatures.The Co Se@NC nanofibers annealed at 550℃(CoSe@NC-550)and displayed excellent storage properties,affording a high capacity of 796 m Ah·g-1at a current density of 1 A·g^-1 for 100 cycles.Moreover,it is confirmed that the pseudocapacitive contribution of CoSe@NC-550 is up to 72.8%at the scan rate of 1 mV/s through the cyclic voltammetry analysis.
基金supported by the National Natural Science Foundation of China (51302079)the Natural Science Foundation of Hunan Province (Grant No. 2017JJ1008)
文摘Crystal planes of a catalyst play crucial role in determining the electrocatalytic performance for CO2 reduction.The catalyst SnO2 can convert CO2 molecules into valuable formic acid(HCOOH).Incorporating heteroatom N into SnO2 further improves its catalytic activity.To understand the mechanism and realize a highly efficient CO2-to-HCOOH conversion,we used density functional theory(DFT)to calculate the free energy of CO2 reduction reactions(CO2RR)on different crystal planes of N-doped SnO2(N-SnO2).The results indicate that N-SnO2 lowered the activation energy of intermediates leading to a better catalytic performance than pure SnO2.We also discovered that the N-Sn O2 (211)plane possesses the most suitable free energy during the reduction process,exhibiting the best catalytic ability for the CO2-to-HCOOH conversion.The intermediate of CO2RR on N-SnO2 is HCOO*or COOH* instead of OCHO*.These results may provide useful insights into the mechanism of CO2RR,and promote the development of heteroatomdoped catalyst for efficient CO2RR.
文摘Background: Objective Structured Practical Examination (OSPE) is a method of assessment of clinical competence.The examination is conducted at multiple stations.Besides practical and problem-solving skills,theoretical knowledge is also tested.OSPE can be traced back more than 40 years.OSPE has been included more than two decades,as a part of assessment in the College of Nursing,All India Institute of Medical Sciences (AIIMS),New Delhi.Objectives: This study was carried out to determine nursing students' attitudes towards OSPE as an assessment tool.Participants: The responses of all the 252 Undergraduate nursing students studying at the College of Nursing,AIIMS were obtained for this study (77 from B.Sc.(H) Nursing first year,61 from the second year,69 from the third year and 45 from the fourth year).Methods: The students attitudes towards OSPE were assessed by using a validated questionnaire containing 28 item statements on Likert's 5-point scale (LS) and 11 bipolar adjectives on Osgood's 7-point Semantic'Differential Scale (OSDS).Result: Most of the students approved of OSPE and felt that it was fair,useful,good,effective,exciting,interesting,practical,skill oriented but also taxing.The study also revealed that amongst the second years' students there was a strong correlation between Overall Rank in the Class and Assessment of OSPE.Conclusion: The study supports the introduction of OSPE as one of the methods of assessment of B.Sc.(Hons.) Nursing students.
文摘AIM:To evaluate whether glaucomatous visual field defect particularly the pattern standard deviation(PSD)of Humphrey visual field could be associated with visual evoked potential(VEP)parameters of patients having primary open angle glaucoma(POAG).METHODS:Visual field by Humphrey perimetry and simultaneous recordings of pattern reversal visual evoked potential(PRVEP)were assessed in 100 patients with POAG.The stimulus configuration for VEP recordings consisted of the transient pattern reversal method in which a black and white checker board pattern was generated(full field)and displayed on VEP monitor(colour 14')by an electronic pattern regenerator inbuilt in an evoked potential recorder(RMS EMG EP MARK II).RESULTS:The results of our study indicate that there is a highly significant(P【0.001)negative correlation of P100 amplitude and a statistically significant(P【0.05)positive correlation of N70 latency,P100 latency and N155 latency with the PSD of Humphrey visual field in the subjects of POAG in various age groups as evaluated by Student’s t-test.CONCLUSION:Prolongation of VEP latencies were mirrored by a corresponding increase of PSD values.Conversely,as PSD increases the magnitude of VEP excursions were found to be diminished.
