Improving the Outcome of Sick Children Referred from District Hospitals in and around Puducherry by Establishing a Communication Network: A Community-based Quality Improvement Initiative.

Introduction: Transferring patients between hospitals is an important aspect and is often the weak link in the health system. Robust real-time communication before transfer may be a valuable tool to improve the emergency care of children. Our study was aimed at developing evidence for the effectiveness of efficient communication networks between a tertiary care hospital and the referring hospitals in improving patient outcomes.

Role of 5-aminosalicylic acid in ulcerative colitis management in 8 Asian territories: a physician survey.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice.

Assessment of energy management and power quality improvement of hydrogen based microgrid system through novel PSO-MWWO technique.

A hybrid microgrid powered by hydrogen is an energy infrastructure that depends on hydrogen as its primary energy carrier within a localized network. This study proposed a novel bi-level optimization approach to enhance power quality and cost efficiency of the system. In the quest to improve energy management systems (EMS) and enhance power quality, a bi-level optimization approach named Particle swarm optimization-Modified water wave optimization (PSO-MWWO) has been proposed.

Defining the Zone of Acute Peripheral Nerve Injury Using Fluorescence Lifetime Imaging in a Crush Injury Sheep Model.

Purpose: Current technologies to define the zone of acute peripheral nerve injury intraoperatively are limited by surgical experience, time, cumbersome electrodiagnostic equipment, and interpreter reliability. In this pilot study, we evaluated a real-time, label-free optical technique for intraoperative nerve injury imaging. We hypothesize that fluorescence lifetime imaging (FLIm) will detect a difference between the time-resolved fluorescence signatures for acute crush injuries versus uninjured segments of peripheral nerves in sheep.

Temporal Dynamics of Affective Scene Processing in the Healthy Adult Human Brain.

Understanding how the brain distinguishes emotional from neutral scenes is crucial for advancing brain-computer interfaces, enabling real-time emotion detection for faster, more effective responses, and improving treatments for emotional disorders like depression and anxiety. However, inconsistent research findings have arisen from differences in study settings, such as variations in the time windows, brain regions, and emotion categories examined across studies. This review sought to compile the existing literature on the timing at which the adult brain differentiates basic affective from neutral scenes in less than one second, as previous studies have consistently shown that the brain can begin recognizing emotions within just a few milliseconds.

Quantification of L-lactic acid in human plasma samples using Ni-based electrodes and machine learning approach.

This work presents a robust strategy for quantifying overlapping electrochemical signatures originating from complex mixtures and real human plasma samples using nickel-based electrochemical sensors and machine learning (ML). This strategy enables the detection of a panel of analytes without being limited by the selectivity of the transducer material and leaving accommodation of interference analysis to ML models. Here, we fabricated a non-enzymatic electrochemical sensor for L-lactic acid detection in complex mixtures and human plasma samples using nickel oxide (NiO) nanoparticle-modified glassy carbon electrodes (GCE).

Obesity and fibromyalgia are associated with Difficult-to-Treat Rheumatoid Arthritis (D2T-RA) independent of age and gender.

Background: There is still a significant proportion of patients with rheumatoid arthritis (RA) in whom multiple therapeutic lines are ineffective. These cases are defined by the EULAR criteria as Difficult-to-Treat RA (D2T-RA) for which there is limited knowledge of predisposing factors.

Objective: To identify the clinical features associated with D2T-RA in real-life practice.

SVM directed machine learning classifier for human action recognition network.

Understanding human behavior and human action recognition are both essential components of effective surveillance video analysis for the purpose of guaranteeing public safety. However, existing approaches such as three-dimensional convolutional neural networks (3D CNN) and two-stream neural networks (2SNN) have computational hurdles due to the significant parameterization they require. In this paper, we offer HARNet, a specialized lightweight residual 3D CNN that is built on directed acyclic graphs and was created expressly to handle these issues and achieve effective human action detection.

First-line immune-based combinations or sunitinib in favorable-risk metastatic renal cell carcinoma: a real-world retrospective comparison from the ARON-1 study.

Introduction: Renal cell carcinoma (RCC) is one of the most common types of urogenital cancer. The introduction of immune-based combinations, including dual immune-checkpoint inhibitors (ICI) or ICI plus tyrosine kinase inhibitors (TKIs), has radically changed the treatment landscape for metastatic RCC, showing varying efficacy across different prognostic groups based on the International Metastatic RCC Database Consortium (IMDC) criteria.

Materials And Methods: This retrospective multicenter study, part of the ARON-1 project, aimed to evaluate the outcomes of favorable-risk metastatic RCC patients treated with immune-based combinations or sunitinib.

Efficacy and safety of nivolumab and ipilimumab with or without chemotherapy for unresectable non-small cell lung cancer: a multicenter retrospective observational study.

Introduction: Compared to platinum-based therapies, a combination of ipilimumab (anti-CTLA-4) and nivolumab (anti-PD-1) has demonstrated improved outcomes in advanced non-small cell lung cancer (NSCLC), albeit with higher rates of immune-related adverse events (irAEs). This multicenter retrospective study evaluated the efficacy and safety of nivolumab and ipilimumab with or without chemotherapy (NI and NICT) in real-world clinical settings.

Methods: We enrolled 215 treatment-naïve NSCLC patients who received NI or NICT between December 2020 and May 2023 at 14 institutions in Japan.

Real-World-Data of Treatment-Naïve and Previously Treated Patients Receiving Up to 3 Injections of Faricimab in Neovascular Age-Related Macular Degeneration.

Purpose: To evaluate visual and anatomical outcome of consecutive patients who received intravitreal injections (IVI) of faricimab for the treatment of neovascular age-related macular degeneration (nAMD).

Patients And Methods: A retrospective study of patients treated for nAMD with one to three IVIs of faricimab from October 2022 to January 2024. Demographic data, treatment history, best corrected visual acuity (BCVA), anatomic parameters, and adverse events (AEs) were collected.

Curriculum Innovations: A Novel Neurology Clinician-Educator Program.

Background And Objectives: Neurology residents serve as frontline teachers for junior trainees but often lack formal training in medical education. We developed a novel longitudinal curriculum to enhance the teaching skills and educational leadership of residents interested in pursuing careers as clinician-educators.

Methods And Curriculum Description: We developed and piloted a Neurology Clinician-Educator Program (NCEP) with the following goals: (1) improve resident satisfaction with opportunities to develop teaching skills, (2) improve resident satisfaction with opportunities to transition into a clinician-educator role after training, and (3) enhance resident teaching skills using evidence-based strategies.

Extended PROMETHEE method with (p,q)-rung linear Diophantine fuzzy sets for robot selection problem.

The introduction of (p, q)-rung linear Diophantine fuzzy set into the field of fuzzy set theory is a significant advancement, providing a broader perspective to address complicated decision-making scenarios. Alongside, the preference ranking organization method for enrichment of evaluation (PROMETHEE) emerges as a widely recognized tool for tackling multi-criteria decision-making challenges. This study contributes theoretically to the decision-making field by integrating (p, q)-rung linear Diophantine fuzzy sets into the PROMETHEE framework, improving (p, q)-rung linear Diophantine fuzzy sets adaptability and efficiency in practical aspects, the proposed framework can effectively address various intricate decision-making challenges encountered in real-world scenarios.

EMG-based wake gestures eliminate false activations during out-of-set activities of daily living: An online myoelectric control study.

Objective: While myoelectric control has been commercialized in prosthetics for decades, its adoption for more general human-machine interaction has been slow. Although high accuracies can be achieved across many gestures, current control approaches are prone to false activations in real-world conditions. This is because the same electromyogram (EMG) signals generated during the elicitation of gestures are also naturally activated when performing activities of daily living (ADLs), such as when driving to work or while typing on a keyboard.

Hemodynamic Management guided by the Hypotension Prediction Index in Abdominal Surgery: A Multicenter Randomized Clinical Trial.

Background: Postoperative acute kidney injury (AKI) after major abdominal surgery leads to poor outcomes. The Hypotension Prediction Index (HPI) may aid in managing intraoperative hemodynamic instability. This study assessed if HPI-guided therapy reduces moderate-to-severe AKI incidence in moderate-to-high-risk elective abdominal surgery patients.

Annual prevalence of geographic atrophy and wet age-related macular degeneration among Medicare Advantage enrollees in a US health plan.

Background: Geographic atrophy (GA) is an advanced form of dry age-related macular degeneration (AMD) that can lead to visual impairment. Published studies estimate approximately 1 million people in the United States have GA in at least 1 eye. There is a lack of real-world evidence from the US payer perspective on the prevalence of AMD and GA among Medicare Advantage prescription drug (MAPD) plan enrollees.

Geographic atrophy and factors associated with disease progression among Medicare Advantage enrollees.

Background: Geographic atrophy (GA) is a form of advanced age-related macular degeneration (AMD) that can cause irreversible vision impairment and is responsible for approximately 20% of legal blindness in the United States. There is limited real-world evidence assessing health outcomes and health care resource use (HCRU) among individuals with GA.

Objective: To examine the progression from GA without subfoveal involvement (SFI) to GA with SFI, progression to irreversible blindness, and HCRU among older individuals with GA enrolled in Medicare Advantage Prescription Drug (MAPD) plans.

Outcomes and Impact of Device Iterations in Mitral Valve Transcatheter Edge-to-Edge Repair: The REPAIR Study.

Background: The PASCAL P10 system for mitral valve transcatheter edge-to-edge repair has undergone iterations, including introduction of the narrower Ace implant and the Precision delivery system.

Objectives: The study sought to evaluate outcomes and the impact of PASCAL mitral valve transcatheter edge-to-edge repair device iterations.

Methods: The REPAIR (REgistry of PAscal for mltral Regurgitation) study is an investigator-initiated, multicenter registry including consecutive patients with mitral regurgitation (MR) treated from 2019 to 2024.

Ileal Predominance in Crohn's Disease Is Associated With Increased Intestinal Surgery and Biological Therapy Use, With Lower Treatment Persistence.

Introduction: Crohn's disease (CD) varies by location, potentially affecting therapy efficacy and surgery risk, although research on this topic is conflicting. This study aims to investigate the independent association between CD location and therapeutic patterns.

Methods: We analyzed patients with CD diagnosed from January 2005 to May 2023 registered in the nationwide ENEIDA registry.

The efficacy of revascularization in ischemic cardiomyopathy.

Ischemic cardiomyopathy (ICM) is characterized by myocardial dysfunction due to myocardial ischemia, associated with the presence of significant coronary artery disease (CAD). We provide a comprehensive review of the current evidence for coronary revascularization in ICM, including consideration of the different modalities of coronary artery bypass grafting and percutaneous coronary intervention. In addition to a contemporary assessment of the literature, we aim to provide real-world insights and perspectives to guide clinical decision-making in this heterogeneous and complex patient population.

Comparison of end-to-side and side-to-side anastomosis techniques in arteriovenous fistula for hemodialysis. A systematic review and meta-analysis.

Autogenous arteriovenous fistula (AVF) is the vascular access of choice for chronic kidney disease to patients requiring hemodialysis. However, there still needs to be more consensus on whether the best surgical approach is an end-of-vein to side-of-artery (ETS) or a side-of-vein to side-of-artery (STS) anastomosis. This study aims to compare venous maturation rates, mid-term patency and post-operative steal syndrome rates between ETS and STS techniques for arteriovenous fistulas.

Evaluation of current patient-based real-time quality control in clinical chemistry testing.

Introduction: To perform simulation studies on patient-based real-time quality control (PBRTQC) for aspartate aminotransferase (AST), iron (Fe), potassium (K), and thyrotropin (thyroid stimulating hormone, TSH) analytes, focusing on optimizing systematic error detection while minimizing data loss.

Methods: Clinical laboratory data for the four analytes were analyzed using various truncation methods. Among these methods, truncation limits corresponding to fixed percentiles (e.