Potential and weak links in the management of tuberculosis by Pakistani private pharmacy staff.

Introduction: The emergence of MDR-TB is a global threat and an obstacle to the effective control of TB in Pakistan. A lack of proper TB knowledge among the staff in private pharmacies and the sale of compromised quality anti-TB drugs are the main instigators of multidrug-resistant tuberculosis (MDR-TB). Thus, this study was aimed at investigating the quality and storage conditions of fixed-dose combination (FDC) anti-TB drugs along with the awareness of staff working in private pharmacies regarding the identification of potential patients with TB and dispensing the inappropriate treatment regimens contributing to MDR-TB. Methods: The study is completed in two phases. In phase I a cross-sectional study is performed using two quantitative research designs, i.e., exploratory and descriptive, to evaluate the knowledge of private pharmacy staff. The sample of 218 pharmacies was selected. While in phase II cross sectional survey is conducted in 10 facilities from where FDC anti TB drugs were sampled for analyzing their quality. Result: Results revealed the presence of pharmacists only at 11.5% of pharmacies. Approximately 81% of staff at pharmacies had no awareness of MDR-TB, while 89% of pharmacies had no TB-related informative materials. The staff identified that most of the patients with TB (70%) were of poor socio-economic class, which restricted their purchase of four FDCs only up to 2-3 months. Only 23% were acquainted with the Pakistan National TB Program (NTP). Except for MDR-TB, the results showed a significant correlation between the experiences of staff with TB awareness. Findings from the quality evaluation of four FDC-TB drugs indicated that the dissolution and content assay of rifampicin were not according to the specifications, and overall, 30% of samples failed to comply with specifications. However, the other quality attributes were within the limits. Conclusion: In light of the data, it can be concluded that private pharmacies could be crucial to the effective management of NTP through the timely identification of patients with TB, appropriate disease and therapy-related education and counseling, and proper storage and stock maintenance.

Analyzing Classification Performance of fNIRS-BCI for Gait Rehabilitation Using Deep Neural Networks.

This research presents a brain-computer interface (BCI) framework for brain signal classification using deep learning (DL) and machine learning (ML) approaches on functional near-infrared spectroscopy (fNIRS) signals. fNIRS signals of motor execution for walking and rest tasks are acquired from the primary motor cortex in the brain's left hemisphere for nine subjects. DL algorithms, including convolutional neural networks (CNNs), long short-term memory (LSTM), and bidirectional LSTM (Bi-LSTM) are used to achieve average classification accuracies of 88.50%, 84.24%, and 85.13%, respectively. For comparison purposes, three conventional ML algorithms, support vector machine (SVM), k-nearest neighbor (k-NN), and linear discriminant analysis (LDA) are also used for classification, resulting in average classification accuracies of 73.91%, 74.24%, and 65.85%, respectively. This study successfully demonstrates that the enhanced performance of fNIRS-BCI can be achieved in terms of classification accuracy using DL approaches compared to conventional ML approaches. Furthermore, the control commands generated by these classifiers can be used to initiate and stop the gait cycle of the lower limb exoskeleton for gait rehabilitation.

Retrospective cone-beam computed tomography evaluation of temporary anchorage devices.

INTRODUCTION: Miniscrew implants as temporary anchorage devices (TADs) are becoming more popular in orthodontic treatment. Their ease of use allows orthodontists to place them in locations in the mouth that are convenient for orthodontic treatment mechanics. The aims of this study were to evaluate the location of TADs placed during orthodontic treatment and to relate the placement to the surrounding dentoalveolar structures. METHODS: Three-dimensional cone-beam computed tomography scans were taken before and after placement of the TADs over a 6-month period as part of routine clinical protocol. The following parameters were recorded: placement site, length of the TAD in the alveolar bone, amount of contact with the periodontal ligament, and interroot distance between TADs. RESULTS: Thirty-five TADs (19 in the maxilla, 16 in the mandible) were evaluated. The mean lengths of the TADs in alveolar bone were 5.29 +/- 1.39 mm in the maxilla and 4.60 +/- 0.86 mm in the mandible. The amounts of contact with the periodontal ligaments were 2.54 +/- 0.81 mm (n = 13) in the maxilla and 2.72 +/- 0.49 mm (n = 10) in the mandible. The interroot distance measurements were 2.78 +/- 0.76 mm (n = 15) and 5.19 +/- 4.42 mm (n = 16) in the maxilla and the mandible, respectively. Paired t tests indicated a significant difference in the interroot distance for mandibular teeth. CONCLUSIONS: Three-dimensional cone-beam computed tomography technology allows better visualization of TAD placement. Clinicians can expect 71.2% of the length of the screw section of the TAD to be embedded in the alveolar bone; the percentage is often higher in the maxilla than in the mandible. Of the 35 TADs, 65.2% were in contact with the periodontal ligament. There appears to be more space for TAD placement in the mandible than in the maxilla.