Aczel-Alsina T-norm based group decision-making technique for the evaluation of electric cars using generalized orthopair fuzzy aggregation information with unknown weights.

Data management and finding precise outcomes from large amounts of information are among the biggest challenges for scientists. The technique of multi-attribute group decision-making (MAGDM) is a valuable tool for investigating fuzzy data precisely. The key objective of the paper is to redefine the q-rung orthopair (q-RO) fuzzy set (FS) (q-ROFS) in the term of interval-valued and proposed new aggregation operators (AOs) based on the Aczel-Alsina (AA) t-norm (TN) and t-conorm (TCN) operations. The AA operational laws are a generalized form of existing TNs and TCNs and give more reliable results because they can fluctuate in their parametric values. The concept of interval-valued enlarges the space of membership degree (MD) and non-membership degree (NMD) for decision-makers. By taking qth power, the interval-valued q-ROFS (IV-q-ROFS) structure. The IV-q-ROFS can handle the uncertainty and vagueness in data, then interval-valued intuitionistic FS (IV-IFS) and interval-valued Pythagorean FS (PyFS) (IV-PyFS) and provide accurate results. The thought of power AOs (PAOs) makes the relationship between weight vectors and reduces the chances of uncertainty in aggregated results. By taking advantage of PAOs, this article is devoted to introducing the interval-valued q-ROF Aczel-Alsina power-weighted averaging (IV-q-ROFAAPWA) and interval-valued q-ROF Aczel-Alsina power-weighted geometric (IV-q-ROFAAPWG) operators. The fundamental axioms of AOs, idempotency, boundedness, and monotonicity, are also discussed. To illustrate the importance of suggested AOs, the real-life problem of electric car selection was solved by applying the MAGDM method using the proposed IV-q-ROFAAPWA and IV-q-ROFAAPWG operators. The comparison of proposed AOs with currently present AOs is also part of the article. We finally constructed solid conclusions.

Optimizing multi-objective task scheduling in fog computing with GA-PSO algorithm for big data application.

As the volume and velocity of Big Data continue to grow, traditional cloud computing approaches struggle to meet the demands of real-time processing and low latency. Fog computing, with its distributed network of edge devices, emerges as a compelling solution. However, efficient task scheduling in fog computing remains a challenge due to its inherently multi-objective nature, balancing factors like execution time, response time, and resource utilization. This paper proposes a hybrid Genetic Algorithm (GA)-Particle Swarm Optimization (PSO) algorithm to optimize multi-objective task scheduling in fog computing environments. The hybrid approach combines the strengths of GA and PSO, achieving effective exploration and exploitation of the search space, leading to improved performance compared to traditional single-algorithm approaches. The proposed hybrid algorithm results improved the execution time by 85.68% when compared with GA algorithm, by 84% when compared with Hybrid PWOA and by 51.03% when compared with PSO algorithm as well as it improved the response time by 67.28% when compared with GA algorithm, by 54.24% when compared with Hybrid PWOA and by 75.40% when compared with PSO algorithm as well as it improved the completion time by 68.69% when compared with GA algorithm, by 98.91% when compared with Hybrid PWOA and by 75.90% when compared with PSO algorithm when various tasks inputs are given. The proposed hybrid algorithm results also improved the execution time by 84.87% when compared with GA algorithm, by 88.64% when compared with Hybrid PWOA and by 85.07% when compared with PSO algorithm it improved the response time by 65.92% when compared with GA algorithm, by 80.51% when compared with Hybrid PWOA and by 85.26% when compared with PSO algorithm as well as it improved the completion time by 67.60% when compared with GA algorithm, by 81.34% when compared with Hybrid PWOA and by 85.23% when compared with PSO algorithm when various fog nodes are given.

Efficient treatment of veterinary pharmaceutical industrial wastewater by catalytic ozonation process: degradation of enrofloxacin via molecular ozone reactions.

The study focused on the efficacious performance of bimetallic Fe-Zn loaded 3A zeolite in catalytic ozonation for the degradation of highly toxic veterinary antibiotic enrofloxacin in wastewater of the pharmaceutical industry. Batch experiments were conducted in a glass reactor containing a submerged pump holding catalyst pellets at suction. The submerged pump provided the agitation and recirculation across the solution for effective contact with the catalyst. The effect of ozone flow (0.8-1.55 mg/min) and catalyst dose (5-15 g/L) on the enrofloxacin degradation and removal of other conventional pollutants COD, BOD5, turbidity was studied. In batch experiments, 10 g of Fe-Zn 3A zeolite efficiently removed 92% of enrofloxacin, 77% of COD, 69% BOD5, and 61% turbidity in 1 L sample of pharmaceutical wastewater in 30 min at 1.1 mg/min of O3 flow. The catalytic performance of Fe-Zn 3A zeolite notably exceeded the removal efficiencies of 52%, 51%, 52%, and 59% for enrofloxacin, COD, BOD5, and turbidity, respectively, achieved with single ozonation process. Furthermore, an increase in the biodegradability of treated pharmaceutical industrial wastewater was observed and made biodegradable easily for subsequent treatment.

Development of stable S-scheme 2D-2D g-C3N4/CdS nanoheterojunction arrays for enhanced visible light photomineralisation of nitrophenol priority water pollutants.

The investigation focused on creating and studying a new 2D-2D S-scheme CdS/g-C3N4 heterojunction photocatalyst. Various techniques examined its structure, composition, and optical properties. This included XRD, XPS, EDS, SEM, TEM, HRTEM, DRS, and PL. The heterojunction showed a reduced charge recombination rate and more excellent stability, helping to lessen photocorrosion. This was due to photogenerated holes moving more quickly out of the CdS valence band. The interface between g-C3N4 and CdS favored a synergistic charge transfer. A suitable flat band potential measurement supported enhanced reactive oxygen species (ROS) generation in degrading 4-nitrophenol and 2-nitrophenol. This resulted in remarkable degradation efficiency of up to 99% and mineralization of up to 79%. The findings highlighted the practical design of the new 2D-2D S-scheme CdS/g-C3N4 heterojunction photocatalyst and its potential application in various energy and environmental settings, such as pollutant removal, hydrogen production, and CO2 conversion.

Novel putative biomarkers for infective endocarditis by serum proteomic analysis: a comprehensive review of literature.

Infective endocarditis (IE) is a challenging condition with high mortality. Prompt detection of IE has become essential for early and immediate management. The authors aimed to comprehensively review the existing literature on novel putative biomarkers for IE through serum proteomic analysis. The literature reveals high levels of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) levels in IE with staphylococcal etiology, valvular lesions, and when combined with cardiac troponin I (cTnI), had a more significant value for risk stratification. A higher pro-ADM level, copeptin, NT-proBNP, and the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) all impacted mortality during the hospital stay. The biomarker matrix metalloproteinase-9 was utilized to predict new-onset embolic events in patients, thus serving as a predictive marker. Procalcitonin was an important diagnostic marker in IE complicated with severe infection. Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interferon-γ, cTnI, and NT-proBNP were also discovered to be useful as prognostic indicators. Early diagnosis and appropriate treatment are possible using antiphospholipid antibodies as a diagnostic test for definite IE. It is also concluded that antineutrophilic cytoplasmic antibody positive individuals with IE had a lengthier hospital stay. These noninvasive biomarkers can identify patients at risk and provide appropriate and early clinical management. NT-proBNP, Cystatin C, troponins, IL-6, IL-8, S100A11, and AQP9 are examples of possible markers that appear promising for further research. In conclusion, large-scale validation studies should study these biomarkers further to establish their use in clinical settings.

The Role of Global Longitudinal Strain in Subclinical Hypothyroid Patients With Heart Failure.

Introduction There is considerable evidence to suggest the role of thyroid hormone in acute coronary syndrome (ACS), but less is known about its prognostic role in heart failure (HF). We aimed to assess the role of global longitudinal strain (GLS) in patients hospitalized with HF and underlying subclinical hypothyroidism (SCHS). Methods A retrospective analysis of 161 subjects was conducted by dichotomizing them into HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) subgroups. SCHS was defined as a thyroid stimulating hormone level >4.50 mIU/L with a normal thyroxine level based on the evaluation of limits for lab markers from prior studies. HFpEF and HFrEF were defined as left ventricular ejection fraction (LVEF)>40% and LVEF≤40%, respectively, based on American College of Cardiology (ACC) guidelines. An abnormal speckled transthoracic echocardiographic (TTE) strain was defined as a left ventricular global longitudinal strain (LVGLS) value of >-15%. Results The mean age of the population was 62±8 years, and 55% were female. LVGLS was present in 121 patients with underlying SCHS (p<0.05). The patients with SCHS and abnormal LVGLS were found to have deranged left ventricular echocardiographic parameters (p<0.05). The derangements were greater for SCHS patients with HFrEF and abnormal LVGLS (p<0.05). Readmission rates at 30 days and in-hospital mortality were higher in SCHS patients with abnormal LVGLS (p<0.05). Conclusion The SCHS is associated with abnormal GLS in HF patients (either HFpEF or HFrEF) that results in remodeling and adverse outcomes, including mortality and readmission rates. Further studies are warranted to validate these findings in a larger population data pool.

Catecholaminergic Polymorphic Ventricular Tachycardia and Gene Therapy: A Comprehensive Review of the Literature.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited channelopathy. In this review, we summarize the epidemiology, pathophysiology, clinical characteristics, diagnostics, genetic mutations, standard treatment, and the emergence of potential gene therapy. This inherited cardiac arrhythmia presents in a bimodal distribution with no association between sex or ethnicity. Six different CPVT genes have been identified, however, most of the cases are related to a heterozygous, gain-of-function mutation on the ryanodine receptor-2 gene (RyR2) and calsequestrin-2 gene (CASQ2) that causes delayed after-depolarization. The diagnosis is clinically based, seen in patients presenting with syncope after exercise or stress-related emotions, as well as cardiac arrest with full recovery or even sudden cardiac death. Standard treatment relies on beta-blockers, with add-on therapy, flecainide, and cardiac sympathetic denervation as second-line treatments. An implantable cardioverter-defibrillator is indicated for patients who have suffered a cardiac arrest. Potential gene therapy has emerged in the last 20 years and accelerated because of associated viral vector application in increasing the efficiency of prolonged cardiac gene expression. Nevertheless, human trials for gene therapy for CPVT have been limited as the population is rare, and an excessive amount of funding is required.

Polyvinyl Alcohol Assisted Iron-Zinc Nanocomposite for Enhanced Optimized Rapid Removal of Malachite Green Dye.

Eliminating hazardous contaminants is a necessity for maintaining a healthy environment on Earth. This work used a sustainable method to create Iron-Zinc nanocomposites with polyvinyl alcohol assistance. Mentha Piperita (mint leaf) extract was used as a reductant in the green synthesis of bimetallic nanocomposites. Doping with Poly Vinyl Alcohol (PVA) caused a reduction in crystallite size and greater lattice parameters. XRD, FTIR, EDS, and SEM techniques were used to establish their surface morphology and structural characterization. The high-performance nanocomposites were used to remove malachite green (MG) dye using the ultrasonic adsorption technique. Adsorption experiments were designed by central composite design and optimized by response surface methodology. According to this study, 77.87% of the dye was removed at the optimum optimized parameters (10.0 mg L-1 was the concentration of MG dye at a time of 8.0 min, pH 9.0, and 0.02 g of adsorbent amount) with adsorption capacity up to 92.59 mg·g-1. The dye adsorption followed Freundlich's isotherm model and the pseudo-second-order kinetic model. Thermodynamic analysis affirmed the spontaneous nature of adsorption due to negative ΔGo values. As a result, the suggested approach offers a framework for creating an effective and affordable technique to remove the dye from a simulated wastewater system for environmental conservation.

Exploring the Causal Relationship Between Arterial and Venous Thromboembolism: A Case Series With Review of Literature.

Venous thromboembolism (VTE) occurs due to venous stasis or low flow state within the blood vessels, resulting in subsequent fibrin and platelet aggregation leading to thrombosis. Arterial thrombosis affects various arteries including coronaries and is primarily due to platelet aggregation with little fibrin deposition leading to thrombosis. Although both arterial and venous thrombosis are considered as separate entities, some studies have suggested an association between them despite having distinctive causative factors. We retrospectively reviewed patients at our institution who were admitted with acute coronary syndrome (ACS) and underwent cardiac catheterization over a decade between 2009 and 2020 to look for patients who had both venous thromboembolic events and ACS. Here, we report a case series of three such patients who were found to have both VTE and coronary arterial thrombosis. However, it is unclear if having one of venous vs arterial clot increases the risk of having other vascular conditions, and further studies are needed to evaluate this hypothesis in the near future.

Relapse of Non-Gastrointestinal Langerhans Cell Histiocytosis in the Rectum in a Child: A Case Report.

Langerhans cell histiocytosis (LCH) is a rare disorder most commonly involving skin, bone and lung. The gastrointestinal tract (GIT) is an uncommon site of disease and only a handful of case reports exist. We present a case of a 15-year old boy with treated LCH involving the skin, bones, central nervous system (CNS) and pituitary gland. He presented with rectal bleeding and on investigation was found to have a single rectal polyp which was confirmed histologically and immunologically to be LCH. Further investigation revealed no other foci of disease.

Addressing the Endometriosis Knowledge Gap for Improved Clinical Care-A Cross-Sectional Pre- and Post-Educational-Intervention Study among Pakistani Women.

This study explored the baseline knowledge and symptoms associated with endometriosis, educated women about endometriosis, and documented the improvement in endometriosis knowledge. A brief intervention with an educational brochure on endometriosis was administered among 303 female participants. A paired-sample t-test and one-way ANOVA were run to compute endometriosis knowledge scores. In total, 49.5% of the participants had consistent access to annual healthcare, 25.1% were healthcare workers, and 45.2% had an undergraduate education. The entire sample had a pre-test endometriosis knowledge score of 4.2 (SD = 2.48), and the score was 6.3 (SD = 2.3) on the post-test. One-way ANOVA yielded no significant improvement in knowledge scores across the groups with consistent and inconsistent access to annual healthcare, despite a significant overall increase in scores (t = 16.63, df = 302, p < 0.001). We identified a significant improvement in the knowledge concerning endometriosis. Educational strategies among women who are menstruating are essential for addressing diagnostic delays and bridging the endometriosis knowledge gap.

Development, validation and forced degradation studies of green liquid chromatographic method for determination of remdesivir in bulk drug and pharmaceutical formulation.

Remdesivir was recently approved by Food and Drug Administration (FDA) to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease. In this study, we report development of the green and reversed-phase liquid chromatographic method for quantitative determination of remdesivir in pharmaceutical formulations in forced degradation studies using mobile phase consisting of 0.4% trifluoroacetic acid: Acetonitrile with flow rate of 1.0mL min-1. High performance liquid chromatographic stability-indicating procedure was evaluated and impurities were profiled by subjecting the remdesivir under stress conditions i.e. acidic and alkaline hydrolysis, oxidative and thermal degradation. The developed method effectively separated the parent drug response from that of degradation products and it was validated following ICH guidelines within linearity range of 5-50µg mL-1 exhibiting correlation coefficient greater than 0.997. At all levels, the % RSD values were less than 2.0 indicating satisfactory precision. Green profile of developed method was evaluated by NEMI and AGREE tools. Comparison of proposed method with already existing chromatographic method was established using analytical eco-scale. The proposed method is eco-friendly and resulted in reliable quantification of remdesivir in dosage formulation and impurity profiling.

Quality assessment and chemometrics application on physicochemical characteristics, antioxidant properties, and 5-HMF content of Malaysian stingless bee honey from different topographical origins.

The popularity of Malaysian stingless bee honey is rising among health-conscious individuals; thus, chemical and physical evaluations of Malaysian stingless bee honey are vital to ensure the honey has achieved the optimum limits set by Malaysian and international regulatory standards so that it can be commercialized locally and internationally. Therefore, in the present study, the physicochemical characteristics (moisture content, total dissolved solids, pH, free acidity, electrical conductivity, and ash content), antioxidant properties (total phenolic and flavonoid contents), and 5-hydroxymethylfurfural (5-HMF) of Heterotrigona itama (H. itama) honey from different sites in Peninsular Malaysia were investigated. Subsequently, the correlation between these chemical and physical parameters was studied using Spearman correlation coefficients. The significant difference between H. itama honey from different topographical origins was studied using univariate analysis (one-way ANOVA followed by post hoc Tukey's test). The discrimination pattern of 45 honey samples based on their topographical origins was evaluated using cluster analysis (heatmap and dendrogram) and chemometrics analysis (partial least squares-discriminant analysis). Results showed that some samples of certain parameters (electrical conductivity, free acidity, and moisture content) have exceeded the limit set by the international regulatory standard. However, the 5-HMF content of all samples was within the allowed range. A statistically significant difference (p < 0.05) has been observed for all the parameters except electrical conductivity and ash content in terms of inter-topographical origins. Although the profiles of H. itama honey from different origins were close, most of them were separated according to their topographical origins and were validated using a permutation test.

Sustainable Synthesis of Iron-Zinc Nanocomposites by Azadirachta indica Leaves Extract for RSM-Optimized Sono-Adsorptive Removal of Crystal Violet Dye.

Environmental pollution has exacerbated the availability of clean water to mankind. In this study, Azadirachta indica leaf extract was used for sustainable synthesis of Fe-Zn nanocomposites (IZNC). The instrumental techniques of Fourier transformed infrared (FTIR) spectroscopy, energy dispersive X-ray spectroscopy (EDS), and scanning electron microscopy (SEM) were used to determine the structural and chemical composition. The overall surface was mildly acidic in nature, as the pHPZC was observed to be 6.00. The ultrasonicated adsorption experiments were designed by central composite design (CCD). The best responses, which proposed a contaminants removal of 80.39%, were assessed using the response surface methodology (RSM). By repeating experimental runs at the expected optimum operating parameters (OOP), the method was experimentally affirmed with the %mean error and %RSD9 being 2.695% and 1.648%, respectively. The interaction of CV dye and the nanocomposite showed tremendous adsorption efficiency towards crystal violet (CV) dye, as revealed by isotherm studies. Fitting kinetics and isotherm models were affirmed by root mean square error (RMSE), χ2, and a Pearson regression coefficient. Thermodynamic studies proved spontaneity of the CV dye adsorption over the nanocomposites. The values for ΔGo, ΔHo, and ΔSo were observed to be -1.089 kJ/mol, 28.59 kJ/mol, and -3.546 kJ/mol, respectively. Recovery of CV dye was carried out in a variety of media, including NaOH, NaCl, and CH3COOH. The maximum CV recovery was achieved in an acidic media. The robustness of adsorption was affirmed by the interference of various matrix ions, including KCl, LiCl, NaCl, and MgCl2, which did not significantly affect the adsorption process. The maximum adsorption capacity was obtained at a low concentration of LiCl. The results show that a green synthesis approach for nanocomposite synthesis might be an effective and economical way to remove organic contaminants from wastewater. Moreover, it is also effective for effluent treatment plants (ETP) for waste management purposes, in which it may be coupled with chlorine as a disinfectant to purify water that can be used for domestic and irrigation purposes.

Canagliflozin attenuates chronic unpredictable mild stress induced neuroinflammation via modulating AMPK/mTOR autophagic signaling.

Although vast progress has been made to understand the pathogenesis of depression, existing antidepressant remedies, with several adverse effects, are not fully adequate. Interestingly, new emerging theories implicating an altered HPA-axis, tryptophan metabolism, neuroinflammation and altered gut integrity were proposed to further identify novel therapeutic targets. Along these lines, canagliflozin (CAN), a novel antidiabetic medication with anti-inflammatory and neuroprotective activity may present an effective treatment for depression; nevertheless, no studies have explored its effect on depressive disorder yet. To this end, this study aimed to investigate the possible antidepressant activity of CAN in CUMS and the mechanisms underlying its action on the gut-brain inflammation axis as well as the alteration in the TRY/KYN pathway in addition to its role in modulating the autophagic signaling cascade. Interestingly, CAN successfully attenuated the CUMS-induced elevations in despair and anhedonic behaviors as well as the elevated serum CORT. Furthermore, it enhanced gut integrity via hampering the CUMS-induced colonic inflammation and amending colonic tight junction proteins. The enhanced gut integrity was further corroborated by a notable anti-inflammatory and neuroprotective activity manifested via the observed mitigation of immune cell activation in addition to IDO hippocampal protein content and promotion of the autophagy cascade. Our findings postulate the possible anti-inflammatory and neuroprotective effects of CAN and the implication of TRY/KYN and AMPK/mTOR signaling pathways in the CUMS-induced MDD. Hence, this study shed light to the promising role of CAN in the augmentation of the current antidepressant treatments.

Correlation coefficients for T-spherical fuzzy sets and their applications in pattern analysis and multi-attribute decision-making.

T-spherical fuzzy set is an effective tool to deal with vagueness and uncertainty in real-life problems, especially in a situation when there are more than two circumstances, like in casting a ballot. The correlation coefficient of T-spherical fuzzy sets is a tool to calculate the association of two T-spherical fuzzy sets. It has several applications in various disciplines like science, management, and engineering. The noticeable applications incorporate pattern analysis, decision-making, medical diagnosis, and clustering. The aim of this article is to introduce some correlation coefficients for T-spherical fuzzy sets with their applications in pattern recognition and decision-making. The under discussion correlation coefficients are far more advantageous than the existing and many other tools used for T-spherical fuzzy sets, because they are used completely and demonstrate the nature as well as the limit of association between two T-spherical fuzzy sets. Further, an application of proposed correlation coefficients in pattern analysis is discussed here. In addition to it, the proposed correlation coefficients are applied to a multi-attribute decision-making problem, in which the selection of a suitable COVID-19 mask is presented. A comparative analysis has also been made to check the effectiveness of the proposed work with the existing correlation coefficients.

Traumatic Carotid Cavernous Fistula Resulting in Symptoms in the Ipsilateral Eye: A Case Report.

Post-traumatic unilateral carotid cavernous fistula (CCF) with ipsilateral symptoms is a rare occurrence, so its diagnosis frequently gets overlooked for other more common conditions. Timely imaging with digital subtraction angiography (DSA) and appropriate vascular intervention is essential in preventing potentially serious sequelae in such cases. We describe a case of post-traumatic CCF in a 42-year-old man who experienced intermittent headaches and right eye redness, proptosis, and watery discharge for three months following the incident. He was diagnosed with a right CCF based on DSA. Timely endovascular embolization with the coiling method resulted in obvious relief of the ocular symptoms and an improved prognosis. This article offers a description of our patient, a brief discussion of the existing literature, the challenges of diagnosing such cases, and a variety of therapy options.

Addressing the Intra-class Mode Collapse Problem using Adaptive Input Image Normalization in GAN-based X-ray Images.

Biomedical image datasets can be imbalanced due to the rarity of targeted diseases. Generative Adversarial Networks play a key role in addressing this imbalance by enabling the generation of synthetic images to augment datasets. It is important to generate synthetic images that incorporate a diverse range of features to accurately represent the distribution of features present in the training imagery. Furthermore, the absence of diverse features in synthetic images can degrade the performance of machine learning classifiers. The mode collapse problem impacts Generative Adversarial Networks' capacity to generate diversified images. Mode collapse comes in two varieties: intra-class and inter-class. In this paper, the intra-class mode collapse problem is investigated, and its subsequent impact on the diversity of synthetic X-ray images is evaluated. This work contributes an empirical demonstration of the benefits of integrating the adaptive input-image normalization for the Deep Convolutional GAN to alleviate the intra-class mode collapse problem. Results demonstrate that the DCGAN with adaptive input-image normalization outperforms DCGAN with un-normalized X-ray images as evident by the superior diversity scores.

The impact of the COVID-19 pandemic on the career choice of medicine: A cross-sectional study amongst pre-medical students in Pakistan.

Background: The COVID-19 pandemic has significantly affected the lives of healthcare workers due to the frontline nature of their work. Their hard work and sacrifice have forged new perceptions of healthcare workers. These changes may potentially influence students' interest in medicine. This study explores how the COVID-19 pandemic has affected premedical students' decisions to pursue medicine as a career. Methods: A cross-sectional study using a self-designed online questionnaire was carried out amongst pre-medical students across Pakistan. Results: A total of 1695 students from 93 public and private schools filled in the survey. After the onset of the COVID-19 pandemic, significantly more pre-medical students want to pursue medicine (60.7%-62.9%) and less are unsure (20.2%-17%). Students are significantly more likely to be motivated to pursue medicine due to altruistic benefits to society (57% vs. 62.7%) and be deterred by the risk of contracting infections on duty (10%-14.6%). There is a minor but significant increase in the popularity of internal medicine (17.1%-18.9%), public health (4.1% vs. 5.7%), emergency medicine (3.8% vs. 5.7%), pediatrics (3.8% vs. 4.7%), and radiology (2.1% vs. 2.9%). Most pre-medical students felt that doctors routinely undergo physical and emotional turmoil (84%). Conclusions: Although awareness of hardships faced by medical professionals has increased, motivation to pursue medicine has grown. Through understanding trends in the motivations of students to pursue medicine, medical schools can accommodate the expectations of incoming students and reach out to potential applicants.