Comprehensive Analysis of Salmonella Species Antibiogram and Evolving Patterns in Empirical Therapy: Insights From Tertiary Care Hospitals in Peshawar, Pakistan.

Background Typhoid fever presents a significant challenge in developing nations, exacerbated by the emergence of antibiotic-resistant strains due to widespread prevalence and overuse of antibiotics. This study seeks to assess the antibiogram profiles of Salmonella species isolated from blood cultures of patients hospitalized at two prominent tertiary care hospitals in Peshawar, Pakistan: Khyber Teaching Hospital (KTH) and Hayatabad Medical Complex (HMC). By examining these profiles, the research aims to provide valuable insights into the evolving landscape of antibiotic resistance in the context of typhoid fever management. Materials and Methods This retrospective cross-sectional study utilized data gathered from two hospitals in Peshawar, KTH and HMC. Cases of enteric fever were identified based on positive blood cultures for Salmonella species. The study encompasses demographic information, seasonal prevalence, and antibiogram profiles of 3,137 cases that were presented between 2017 and 2023. Results Among the total 3,137 cases, males accounted for the majority, comprising 63% (2,044 cases). Particularly notable was the clustering of cases among children and adolescents aged one to 24 years. The incidence peaked during the months of summer and spring, from April to September. In terms of Salmonella Typhi isolates, considerable resistance was noted against first-line antibiotics such as amoxicillin/clavulanate (80.1%), co-trimoxazole/trimethoprim-sulfamethoxazole (66.6%), and chloramphenicol (86.9%), as well as against ceftriaxone (79.7%) and ciprofloxacin (51.6%). Conversely, certain antibiotics displayed higher sensitivity patterns, including meropenem (97.8%), doripenem (99.5%), imipenem (97.7%), ertapenem (96.5%), polymyxin B (99.4%), colistin (98.1%), and tigecycline (97.3%). Despite a limited sample size of 214 specimens, fosfomycin demonstrated a remarkable sensitivity of 93.4%. Sensitivities of amikacin and gentamicin were 90.7% and 81.5%, respectively. However, the sensitivity of azithromycin was concerning, standing at 66.5%. The antibiogram pattern for Salmonella exhibited significant and drastic changes. Conclusion In conclusion, this study sheds light on a higher prevalence of typhoid fever among males, with a notable seasonal peak observed during the summer and spring months. The age group most affected spans from one to 24 years. Salmonella isolates displayed significant resistance to conventional first-line antibiotics, alongside ciprofloxacin and third-generation cephalosporins. Azithromycin exhibited lower sensitivity compared to amikacin, gentamicin, and fosfomycin. The research advocates for the empirical use of amikacin, gentamicin, fosfomycin, and meropenem in the treatment of typhoid fever in Pakistan. Urgent measures, including regular Salmonella antibiogram surveillance, antibiotic stewardship, public health education, and Salmonella vaccination programs, are deemed crucial for primary disease prevention.

Asymptomatic Salmonella Myocarditis: A Case Report of a Rare Entity.

Enteric fever typically displays symptoms like high fever, abdominal pain, constipation, and headaches, primarily affecting the digestive system. While it is commonly seen as a gastrointestinal infection, it can also lead to rare but significant cardiovascular issues. There have been only a few reported cases of enteric fever causing heart manifestations. We present a case of a young male with enteric fever-induced myocarditis, which, due to its rarity, can be challenging to diagnose and is essentially a diagnosis of exclusion. Cardiac MRI (CMR) is crucial for diagnosis, supported by ECG, echocardiograms, and troponin levels. The treatment involves standard approaches for cardiomyopathy, including angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and diuretics. However, our patient presented as a case of asymptomatic myocarditis and fully recovered with treatment without any long-lasting heart problems. Our study aims to contribute to the limited body of knowledge on heart-related complications of enteric fever, raising awareness among clinicians of such presentations in enteric fever cases.

Thoracic and Lumbar Spine Injury: Evidence-Based Diagnosis, Management, and Outcomes.

BACKGROUND: Traumatic thoracolumbar spine injuries are associated with significant morbidity and mortality. Targeted for non-spine specialist trauma surgeons, this systematic scoping review aimed to examine literature for up-to-date evidence on presentation, management, and outcomes of thoracolumbar spine injuries in adult trauma patients. METHODS: This review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. We searched four bibliographic databases: PubMed, EMBASE, Web of Science, and the Cochrane Library. Eligible studies included experimental, observational, and evidence-synthesis articles evaluating patients with thoracic, lumbar, or thoracolumbar spine injury, published in English between January 1, 2010 and January 31, 2021. Studies which focused on animals, cadavers, cohorts with N <30, and pediatric cohorts (age <18 years old), as well as case studies, abstracts, and commentaries were excluded. RESULTS: A total of 2501 studies were screened, of which 326 unique studies were fully text reviewed and twelve aspects of injury management were identified and discussed: injury patterns, determination of injury status and imaging options, considerations in management, and patient quality of life. We found: (1) imaging is a necessary diagnostic tool, (2) no consensus exists for preferred injury characterization scoring systems, (3) operative management should be considered for unstable fractures, decompression, and deformity, and (4) certain patients experience significant burden following injury. DISCUSSION: In this systematic scoping review, we present the most up-to-date information regarding the management of traumatic thoracolumbar spine injuries. This allows non-specialist trauma surgeons to become more familiar with thoracolumbar spine injuries in trauma patients and provides a framework for their management.

Frequency and association of Epstein-Barr Virus genotype in rheumatoid arthritis patients of Khyber Pakhtunkhwa, Pakistan.

BACKGROUND: Rheumatoid arthritis (RA) is an immune-mediated, polyarthritis linked with various genetic and environmental causative agents. Among environmental triggers, Epstein-Barr Virus (EBV) is considered the most potent etiological agent. OBJECTIVE: This study aimed to investigate the prevalence of EBV and its genotypes in RA patients and to investigate their association with clinical and laboratory parameters of RA. METHODOLOGY: This study included blood samples of RA and control healthy individuals (100 each). Blood samples along with clinical and laboratory parameters were collected from patients after consent in the Department of Rheumatology, at Lady Reading Hospital, in Peshawar Pakistan. Blood samples were processed for DNA extraction followed by PCR amplification for EBV detection and genotype discrimination. RESULTS: RA patients were 85 females and 15 males with a mean age of 40.13±14.05 years. EBV Type-1 was detected in 45% of RA and 9% of control cases. The mean disease duration of RA patients was 6.61±6.23 years. Out of 100 diseased patients, 43% were seropositive rheumatoid arthritis (SPRA) and showed a significant correlation with a family history of RA in EBV-positive individuals (P = 0.017). The demographic, clinical, and laboratory parameters of RA patients showed a non-significant association with EBV. Moreover, only a family history and Serum creatinine of RA patients showed a significant association with EBV (P = 0.0001 and P = 0.022 respectively). CONCLUSION: It is concluded that EBV-1 is prevalent and associated with RA. Further investigation is required for detailed genetic analysis of EBV to determine its possible role in modulating the immune system in RA.

Enhancement effect of AgO nanoparticles on fermentative cellulase activity from thermophilic Bacillus subtilis Ag-PQ.

BACKGROUND: Cellulase is an important bioprocessing enzyme used in various industries. This study was conducted with the aim of improving the biodegradation activity of cellulase obtained from the Bacillus subtilis AG-PQ strain. For this purpose, AgO and FeO NPs were fabricated using AgNO3 and FeSO4·7H2O salt respectively through a hydro-thermal method based on five major steps; selection of research-grade materials, optimization of temperature, pH, centrifuge, sample washed with distilled water, dry completely in the oven at the optimized temperature and finally ground for characterization. The synthesized NPs were characterized by scanning electron microscope (SEM), energy dispersive X-ray (EDX), and X-ray diffraction (XRD) to confirm the morphology, elemental composition, and structure of the sample respectively. The diameter of the NPs was recorded through SEM which lay in the range of 70-95 nm. RESULTS: Cultural parameters were optimized to achieve better cellulase production, where incubation time of 56 h, inoculum size of 5%, 1% coconut cake, 0.43% ammonium nitrate, pH 8, and 37 °C temperature were found optimal. The enhancing effect of AgO NPs was observed on cellulase activity (57.804 U/ml/min) at 50 ppm concentration while FeO NPs exhibited an inhibitory effect on cellulase activity at all concentrations. Molecular docking analysis was also performed to understand the underlying mechanism of improved enzymatic activity by nanocatalysts. CONCLUSION: This study authenticates AgO NPs as better nanocatalysts for improved thermostable cellulase biodegradation activity with the extraordinary capability to be potentially utilized in bioethanol production.

Association of IL-17F rs2397084 (E126G), rs11465553 (V155I) and rs763780 (H161R) variants with rheumatoid arthritis and their effects on the stability of protein.

Interleukin-17F (IL-17F), considered a pro-inflammatory cytokine, has been shown to contribute to skeletal tissue degradation and hence chronic inflammation in rheumatoid arthritis (RA). In this study we utilized bioinformatics tools to analyze the effect of three exonic SNPs (rs2397084, rs11465553, and rs763780) on the structure and function of the IL-17F gene, and evaluated their association with RA in Pakistani patients. The predicted deleterious and damaging effects of identified genetic variants were assessed through the utilization of multiple bioinformatics tools including PROVEAN, SNP&GO, SIFT, and PolyPhen2. Structural and functional effects of these variants on protein structures were evaluated through the use of additional tools such as I-Mutant, MutPred, and ConSurf. Three-dimensional (3D) models of both the wild-type and mutant proteins were constructed through the utilization of I-TASSER software, with subsequent structural comparisons between the models conducted through the use of the TM-align score. A total of 500 individuals, 250 cases and 250 controls, were genotyped through Tri-ARMS-PCR method and the resultant data was statistically analyzed using various inheritance models. Our bioinformatics analysis showed significant structural differences for wild type and mutant protein (TM-scores and RMSD values were 0.85934 and 2.34 for rs2397084 (E126G), 0.87388 and 2.49 for rs11465553 (V155I), and 0.86572 and 0.86572 for rs763780 (H161R) with decrease stability for the later. Overall, these tools enabled us to predict that these variants are crucial in causing disease phenotypes. We further tested each of these single nucleotide variants for their association with RA. Our analysis revealed a strong positive association between the genetic variant rs763780 and the risk of developing rheumatoid arthritis (RA) at both the genotypic and allelic levels. The genotypic association was statistically significant[χ2 = 111.8; P value <0.0001], as was the allelic level [OR 3.444 (2.539-4.672); P value 0.0008]. These findings suggest that the presence of this genetic variant may increase the susceptibility to RA. Similarly, we observed a significant distribution of the genetic variant rs11465553 at the genotypic level [χ2 = 25.24; P value = 0.0001]. However, this variant did not show a significant association with RA at the allelic level [OR = 1.194 (0.930-1.531); P value = 0.183]. However, the distribution of variant rs2397084 was more or less random across our sample with no significant association either at genotypic and or allelic level. Put together, our association study and in silico prediction of decreasing of IL17-F protein stabilty confirmed that two SNPs, rs11465553 and rs763780 are crucial to the suscetibility of and showed that these RA in Pakistani patients.

Exploring the Associations and Molecular Impacts of miR-146a/rs2910164 and miR-196a2/rs185070757 with Rheumatoid Arthritis in a Pakistani Population.

INTRODUCTION: MicroRNAs (miRNAs) are a new class of molecules that participate in post-transcriptional regulation of gene expression and hence have been reported to have a crucial role in the pathogenesis of rheumatoid arthritis (RA). We aimed to investigate the association of miR-146a rs2910164 (G/C) and miR-196a2 rs185070757 (T/G) with RA susceptibility in Pakistani patients and to bioinformatically predict the molecular function of these miRNAs. METHODS: A case-control study on 600 individuals was conducted, including 300 RA patients and 300 matching healthy controls. Genotyping was performed by tetra-primer amplification of refractory mutation system-polymerase chain reaction, and the association between variants and RA was statistically determined using different models. RESULTS: For the variant rs2910164 (G/C) in miR-146a, no difference in genotype distribution was observed between RA cases and controls, as determined using co-dominant (χ2 = 4.33; p = 0.114), homozygous dominant (C/C vs. G/G + C/G) (OR = 0.740 [0.531-1.032]; p = 0.091), homozygous recessive (G/G vs. C/C + G/C) (odds ratio [OR] = 01.432 [0.930-2.206]; p = 0.126), heterozygous (G/C vs. C/C + G/G) (OR = 1.084 [0.786-1.494]; p = 0.682), and additive (OR 0.778 [0.617-0.981]; p = 0.039) models. Similarly, the GT genotype in the rs185070757 (T/G) miR-196a2 variant did not differ between cases and controls with any models (p > 0.05). For the first time, we report no association of miR-146a rs2910164 (G/C) and miR-196a2 rs185070757 (T/G) with RA in a Pakistani population. A subsequent bioinformatic analysis revealed that the CC genotype of miR-146a rs2910164 might have a protective role against RA pathogenesis, with no effect observed with the miR-196a2 rs185070757. CONCLUSION: Our findings suggest that these miRNAs might have little-to-no impact on the RA pathogenesis in the Pakistani population.

Difference in Perception of Nasal Aesthetic Appearance Between Surgeons and Rhinoplasty Patients: A Single-Center Perspective.

BACKGROUND: Patient satisfaction is an essential outcome measure after a rhinoplasty. Yet it is not known whether the opinions of rhinoplasty patients and surgeons on nasal aesthetic appearance differ. OBJECTIVES: The aim of this study was to determine the differences between patients and surgeons in their perception of nasal aesthetic appearance. METHODS: A retrospective cohort of 300 patients seen in consultation for cosmetic, functional, or combined cosmetic and functional rhinoplasty at a single tertiary care center from June 2017 to June 2020 was studied. Based on preoperative patient images, 6 surgeons with varying levels of expertise assessed nasal aesthetics utilizing a modified Standardized Cosmesis and Health Nasal Outcomes Survey for nasal cosmesis (SCHNOS-C). These scores were then compared to the patient-reported SCHNOS-C scores. RESULTS: The cosmetic, functional, and combined subgroups consisted of 100 patients each. The mean [standard deviation] age was 35.4 [13.7] years and 64% were women. The modified SCHNOS-C scores were well-correlated among the 6 surgeons but showed only weak correlations of 0.07 to 0.20 between patient-reported scores and scores assessed by the surgeons. Compared with the surgeon's scores, patients in the cosmetic subgroup perceived their nasal aesthetic problems to be more severe whereas the those in the functional subgroup perceived their nasal aesthetic problems to be milder compared with the surgeons' assessment. CONCLUSIONS: Our findings suggest that patients and surgeons perceive nasal cosmesis differently. This difference should be considered carefully when planning rhinoplasty or assessing its outcome.

Forest Fire Detection Using New Routing Protocol.

The Mobile Ad-Hoc Network (MANET) has received significant interest from researchers for several applications. In spite of developing and proposing numerous routing protocols for MANET, there are still routing protocols that are too inefficient in terms of sending data and energy consumption, which limits the lifetime of the network for forest fire monitoring. Therefore, this paper presents the development of a Location Aided Routing (LAR) protocol in forest fire detection. The new routing protocol is named the LAR-Based Reliable Routing Protocol (LARRR), which is used to detect a forest fire based on three criteria: the route length between nodes, the temperature sensing, and the number of packets within node buffers (i.e., route busyness). The performance of the LARRR protocol is evaluated by using widely known evaluation measurements, which are the Packet Delivery Ratio (PDR), Energy Consumption (EC), End-to-End Delay (E2E Delay), and Routing Overhead (RO). The simulation results show that the proposed LARRR protocol achieves 70% PDR, 403 joules of EC, 2.733 s of E2E delay, and 43.04 RO. In addition, the performance of the proposed LARRR protocol outperforms its competitors and is able to detect forest fires efficiently.

Associations of Hearing Loss Severity and Hearing Aid Use With Hospitalization Among Older US Adults.

Importance: Hearing loss is associated with higher hospitalization risk among older adults. However, evidence on whether hearing aid use is associated with fewer hospitalizations among individuals with hearing loss remains limited. Objective: To assess the association between audiometric hearing loss severity and hearing aid use and hospitalization. Design, Setting, and Participants: This population-based cross-sectional study used audiometric and health care utilization data for respondents aged 65 years or older from 4 cycles of the National Health and Nutrition Examination Survey from 2005 to 2016. Data were analyzed from February 23, 2021, to March 22, 2022. Exposures: Audiometric hearing loss severity and participant-reported hearing aid use. Main Outcomes and Measures: The main outcome was respondent-reported hospitalization in the past 12 months. Multivariable logistic regression was performed to assess the association of hearing loss severity with hospitalization. To assess the association of hearing aid use with hospitalization, propensity score matching was performed with 2:1 nearest neighbor matching without replacement. Results: Of 2060 respondents (mean [SD] age, 73.9 [5.9] years; 1045 [50.7%] male), 875 (42.5%) had normal hearing, 653 (31.7%) had mild hearing loss, 435 (21.1%) had moderate hearing loss, and 97 (4.7%) had severe to profound hearing loss. On multivariable analysis, moderate and severe hearing loss were associated with hospitalization (moderate hearing loss: odds ratio [OR], 1.50; 95% CI, 1.01-2.24; severe hearing loss: OR, 1.71; 95% CI, 1.03-2.84). Of 1185 respondents with at least mild hearing loss, 200 (16.9%) reported using a hearing aid. Propensity score-matched analysis showed that hearing aid use was not associated with hospitalization (OR, 1.17; 95% CI, 0.74-1.84), including among respondents with moderate or severe hearing loss (OR, 1.17; 95% CI, 0.71-1.92). Conclusions and Relevance: In this cross-sectional study, hearing loss was associated with higher risk of hospitalization, but hearing aid use was not associated with a reduction in hospitalization risk in the population with hearing loss. The association of hearing aid use with hospitalization should be evaluated in larger prospective studies with reliable data on the frequency of hearing aid use.

Comparison of Radiovisiography, an Apex Locator and an Integrated Endomotor-inbuilt Apex Locator in Primary Teeth Endometrics.

Aim and objective: To compare the accuracy of radiovisiography (RVG), Root ZX mini Apex locator, and Endo radar's inbuilt Apex Locator during working length determination determination in primary teeth with the actual/direct canal length. Materials and methods: 58 primary teeth indicated for extraction in children of age group 4-12 years were selected. RVG, Root ZX mini Apex Locator, and Endo radar's Apex Locator were used to determine the working length intraorally. Following extraction of the teeth, the actual working length was determined with magnifying loupes (2.5×) using a K-file and an endodontic ruler. The data was tabulated and statistically analyzed. Results: 84 canals (58 teeth) were evaluated and Root ZX mini Electronic Apex Locator (EAL) showed no statistically significant difference with the actual measurement (p = 0.18) whereas Endo radar and RVG showed statistically significant difference. Endo radar underestimated, while RVG overestimated the working length. The most accurate method for working length measurements of the root canals in primary teeth was Root ZX mini EAL, followed by Endo radar and the least accurate was RVG. Conclusion: The Root ZX mini Apex Locator showed the most promising results and had an excellent degree of agreement with actual working length, followed by Endo radar and RVG. How to cite this article: Khan SA, Khanna R, Navit S, et al. Comparison of Radiovisiography, an Apex Locator and an Integrated Endomotor-inbuilt Apex Locator in Primary Teeth Endometrics. Int J Clin Pediatr Dent. 2022;15(S-1):S18-S21.

Dynamic Learning Framework for Smooth-Aided Machine-Learning-Based Backbone Traffic Forecasts.

Recently, there has been an increasing need for new applications and services such as big data, blockchains, vehicle-to-everything (V2X), the Internet of things, 5G, and beyond. Therefore, to maintain quality of service (QoS), accurate network resource planning and forecasting are essential steps for resource allocation. This study proposes a reliable hybrid dynamic bandwidth slice forecasting framework that combines the long short-term memory (LSTM) neural network and local smoothing methods to improve the network forecasting model. Moreover, the proposed framework can dynamically react to all the changes occurring in the data series. Backbone traffic was used to validate the proposed method. As a result, the forecasting accuracy improved significantly with the proposed framework and with minimal data loss from the smoothing process. The results showed that the hybrid moving average LSTM (MLSTM) achieved the most remarkable improvement in the training and testing forecasts, with 28% and 24% for long-term evolution (LTE) time series and with 35% and 32% for the multiprotocol label switching (MPLS) time series, respectively, while robust locally weighted scatter plot smoothing and LSTM (RLWLSTM) achieved the most significant improvement for upstream traffic with 45%; moreover, the dynamic learning framework achieved improvement percentages that can reach up to 100%.

Covid-19 fake news sentiment analysis.

'Fake news' refers to the misinformation presented about issues or events, such as COVID-19. Meanwhile, social media giants claimed to take COVID-19 related misinformation seriously, however, they have been ineffectual. This research uses Information Fusion to obtain real news data from News Broadcasting, Health, and Government websites, while fake news data are collected from social media sites. 39 features were created from multimedia texts and used to detect fake news regarding COVID-19 using state-of-the-art deep learning models. Our model's fake news feature extraction improved accuracy from 59.20% to 86.12%. Overall high precision is 85% using the Recurrent Neural Network (RNN) model; our best recall and F1-Measure for fake news were 83% using the Gated Recurrent Units (GRU) model. Similarly, precision, recall, and F1-Measure for real news are 88%, 90%, and 88% using the GRU, RNN, and Long short-term memory (LSTM) model, respectively. Our model outperformed standard machine learning algorithms.

Building a Trainee-led Research Community to Propel Academic Productivity in Health Services Research.

Academic productivity is an increasingly important asset for trainees pursuing academic careers. Medical schools and graduate medical education programs offer structured research programs, but providing longitudinal and individualized health services research education remains challenging. Whereas in basic science research, members at multiple training levels support each other within a dedicated community (the laboratory), health services research projects frequently occur within individual faculty-trainee relationships. An optimal match of expertise, availability, and interest may be elusive for an individual mentor-mentee pair. We aimed to share our experience building Surgeons Writing about Trauma (SWAT), a trainee-led research community that propels academic productivity by facilitating peer collaboration and opportunities to transition into independent researchers. We highlight challenges of health services research for trainees, present how structured mentorship and a peer community can address this challenge, and detail SWAT's operational structure to guide replication at peer institutions.

Cyber-Attack Prediction Based on Network Intrusion Detection Systems for Alert Correlation Techniques: A Survey.

Network Intrusion Detection Systems (NIDS) are designed to safeguard the security needs of enterprise networks against cyber-attacks. However, NIDS networks suffer from several limitations, such as generating a high volume of low-quality alerts. Moreover, 99% of the alerts produced by NIDSs are false positives. As well, the prediction of future actions of an attacker is one of the most important goals here. The study has reviewed the state-of-the-art cyber-attack prediction based on NIDS Intrusion Alert, its models, and limitations. The taxonomy of intrusion alert correlation (AC) is introduced, which includes similarity-based, statistical-based, knowledge-based, and hybrid-based approaches. Moreover, the classification of alert correlation components was also introduced. Alert Correlation Datasets and future research directions are highlighted. The AC receives raw alerts to identify the association between different alerts, linking each alert to its related contextual information and predicting a forthcoming alert/attack. It provides a timely, concise, and high-level view of the network security situation. This review can serve as a benchmark for researchers and industries for Network Intrusion Detection Systems' future progress and development.

Prospective study of long-term quality-of-life after rib fractures.

BACKGROUND: Long-term quality-of-life after rib fractures remains understudied. We aimed to evaluate quality-of-life of patients who had rib fractures 1 year after discharge. We hypothesized that patients with rib fractures, even as an isolated injury, have suboptimal long-term quality-of-life. METHODS: We prospectively enrolled adults admitted to our level 1 trauma center with acute rib fractures. Primary outcome was quality-of-life at 1 year after discharge, characterized using the revised trauma-specific quality-of-life questionnaire and a supplemental survey. Secondary analysis evaluated association between baseline frailty (measured using the Rib Fracture Frailty Index) and quality-of-life. Patients with low versus moderate frailty risk underwent full matching and linear mixed model analysis. RESULTS: We enrolled 139 patients, among whom 72 (52%) completed 1-year surveys. Patients reported excellent emotional well-being (median [interquartile range]: 4.8 [3.7-5.0]) and functional engagement (median [interquartile range]: 5.0 [4.3-5.0]) but poor physical well-being and recovery (median [interquartile range]: 3.2 [2.8-3.6]). Nearly 40% of patients reported some degree of rib pain, and 29% had not returned to preinjury working capacity. Patients with and without isolated rib fractures reported similar median revised trauma-specific quality-of-life scores. We did not find statistically significant association between low versus moderate frailty and any quality-of-life domain, but no patients in our cohort had high frailty risk and our study was underpowered to detect this association. CONCLUSION: Rib fractures are associated with suboptimal quality-of-life 1 year after discharge, even after isolated injury. Our sample size was limited, but our findings highlight persistent long-term consequences of rib fractures despite advances in inpatient management. Patients should be counseled on the potential for prolonged convalescence.

Development of Low-Cost Wireless Sensing System for Smart Ultra-High Performance Concrete.

This study proposes the development of a wireless sensor system integrated with smart ultra-high performance concrete (UHPC) for sensing and transmitting changes in stress and damage occurrence in real-time. The smart UHPC, which has the self-sensing ability, comprises steel fibers, fine steel slag aggregates (FSSAs), and multiwall carbon nanotubes (MWCNTs) as functional fillers. The proposed wireless sensing system used a low-cost microcontroller unit (MCU) and two-probe resistance sensing circuit to capture change in electrical resistance of self-sensing UHPC due to external stress. For wireless transmission, the developed wireless sensing system used Bluetooth low energy (BLE) beacon for low-power and multi-channel data transmission. For experimental validation of the proposed smart UHPC, two types of specimens for tensile and compression tests were fabricated. In the laboratory test, using a universal testing machine, the change in electrical resistivity was measured and compared with a reference DC resistance meter. The proposed wireless sensing system showed decreased electrical resistance under compressive and tensile load. The fractional change in resistivity (FCR) was monitored at 39.2% under the maximum compressive stress and 12.35% per crack under the maximum compressive stress tension. The electrical resistance changes in both compression and tension showed similar behavior, measured by a DC meter and validated the developed integration of wireless sensing system and smart UHPC.

Cheiloscopy and Dactyloscopy as Behavior Assessment Tool in Dental Settings: A Cross-sectional Study.

PURPOSE: Assessment of children's behavior in the dental setting and its correlation with thumb print and lip print. MATERIALS AND METHODS: The behavior pattern, lip print pattern, and thumb print pattern of 518 children aged 5-12 years were recorded in their first dental visit. The behavior pattern, lip print pattern, and thumb print pattern were determined using Frankl's Behavior Rating Scale, Tsuchihashi's classification, and Cummin's classification, respectively. The data were tabulated according to the classified criteria and statistically analyzed. RESULTS: It was observed that positive and definitely positive Frankl Behavior was associated with the children bearing an arch pattern of thumb print, whereas their lip pattern had no association with their behavior pattern, particularly in dental sittings. CONCLUSION: Thumb print pattern can aid as a behavior marker before a child's first dental appointment and this can prove beneficial for both the child and the clinician in providing a high quality of dental care and modify behavior for future dental appointments. HOW TO CITE THIS ARTICLE: Navit S, Pramanik S, Khan SA, et al. Cheiloscopy and Dactyloscopy as Behavior Assessment Tool in Dental Settings: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(2):238-242.

Social Media and Retinal Detachment: Perspectives of Providers and Patients on Instagram.

BACKGROUND AND OBJECTIVE: To evaluate the social media interactions of patients who experience retinal detachment and/or repair and how ophthalmic medical providers utilize social media. PATIENTS AND METHODS: A cross-sectional study of public posts on Instagram was performed from September 2019 to January 2020, with filtering based on the following hashtags: #retinaldetachment, #detachedretina, #retinaldetachmentsurgery, and #scleralbuckle. A categorical classification system was used for each Instagram post to review descriptive variables. RESULTS: Of the 1,797 Instagram posts analyzed, 697 (39%) were made by patients, of which 395 (57%) were positive in tone and 599 (86%) were in the postoperative period. Posts by ophthalmologists were most commonly centered on colleague education (446, 81%). CONCLUSIONS: The majority of Instagram posts by patients were of a positive tone reflecting primarily on activities of daily living and rehabilitations. Retina specialists should consider providing more social media content directed toward patients, particularly regarding their rehabilitation course following retinal detachment repair. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:391-395.].