Joshi Hospital

The rapid uptake of blockchain and artificial intelligence (AI) technologies like machine learning (ML) in particular has brought about a paradigm change that is elevating the digital ecosystem for smart cities. The development of new technology can be used to create intelligent societies within smart cities in this era of rapid digital communication. Uses of blockchain technology and ML technologies are proliferating, guaranteeing solutions for issues in a multitude of sectors, such as financial services, cryptocurrency, threat intelligence, social and public services, and the Internet of Things. These “smart cities” are constructed using various technologies, including artificial intelligence and blockchain. As a result, the way these technologies are applied in smart cities both present and future will alter not only the character of governance and human interaction but also the way business is done. The research suggests doing an experimental study to find out how blockchain technology and artificial intelligence are affecting the creation of smart cities. It tries to set the scene for queries like how traditional business models are getting ready for this disruption, what obstacles they might encounter, and what effects both technologies might have on the organization's growth. Blockchain technology and artificial intelligence have a lot of potential to help create smart cities. The results of the research will provide corporations with the rationale to start concentrating on these technologies and putting early adoption strategies into place, which will eventually cause them to change their smart city business models advance.

Background: Bilateral facial palsy is a rare disorder that significantly affects facial expressiveness, emotional well-being and social interactions. Effective rehabilitation approaches play a key role in enhancing functional and psychological outcomes of patients.Case Report: This study focuses on a 30-year-old woman with bilateral facial palsy of unknown cause. After comprehensive diagnostic evaluations excluded common causes, the patient began an 8-week multidisciplinary physiotherapy program that emphasized motor function, emotional expressiveness, and social participation. Complementary therapy, functional exercise, and patient education were included in the plan.Result: Notable improvements were observed in the patient’s social confidence, speech clarity, and facial motor function. The physical function subscale of the Facial Disability Index (FDI) scores increased from 25/100 to 90/100, whereas the social function subscale scores increased from 55/100 to 100/100. At follow-up, progress was maintained.Conclusion: Patients with bilateral facial palsy can benefit from a multidisciplinary physiotherapy strategy that combines psychological and physical rehabilitation to improve their quality of life and recovery rate. It is advised that more research be done on the differences in therapy response based on age and gender..

PurposeThe Standardization of Uveitis Nomenclature (SUN) criteria were introduced in 2021 to standardize the classification of uveitis subtypes. We evaluated the real-world applicability of these criteria for tubercular uveitis (TBU) using a computational definition mapped to the Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) registry.MethodsThis observational retrospective cross-sectional study analyzed real-world baseline data from 372 clinician-diagnosed TBU cases within the multinational OASIS registry, all collected from 17 tertiary centers across 8 countries: India, Nepal, Indonesia, Switzerland, Ethiopia, Colombia, Argentina, and Chile. We mapped the SUN criteria to corresponding variables in the OASIS registry, and Boolean operators were used to generate a computational definition for TBU. The sensitivity of the SUN criteria in capturing clinician-diagnosed cases of TBU was evaluated.ResultsThe SUN criteria identified 15.9% (n = 59) of clinician-diagnosed TBU cases at baseline. Criterion f2 (evidence of TB infection) was met in 70.7% of cases (n = 263), and criterion f1 (TBU-compatible uveitic syndrome) was satisfied in 24.5% of cases (n = 91). Exclusion criterion successfully identified 99.5% of cases (n = 370). By country and anatomical location, cases in India and those with posterior uveitis had the highest concordance at 19.8% (n = 39) and 21.8% (n = 44), respectively. Bilateral TBU was more likely to satisfy the SUN criteria (P = 0.049).ConclusionsSUN classification criteria demonstrated low sensitivity for real-world TBU diagnosis at baseline, which may limit the number of cases available for enrollment in research studies. Further diagnostic refinement, clearer definition of application context, and longitudinal validation are needed to generate diagnostic criteria for clinical application.

Guidelines recommend that the foundation four guideline-directed medical therapy (GDMT), which includes mineralocorticoid receptor antagonists (MRAs), should be initiated early in the treatment paradigm of heart failure due to mortality benefits and reduction in hospitalization for heart failure. However, the practical implementation of these guidelines in the real-world clinical scenario is lacking. Delay in initiating MRA is common, and patients often do not receive the optimum dose of MRA. The clinical considerations and guideline recommendations for early initiation and optimum dosing of MRA in HF can form the scientific basis for improving the correct usage of MRA in HF in real-world settings.

This sequential mixed-method study explores neonatal intensive care unit (NICU) nurses' awareness, attitudes, and perceptions regarding do-not-resuscitate (DNR) orders. Quantitative surveys were conducted among 50 neonatal nurses, supplemented by qualitative focused group discussions involving 10 participants. Data collection included structured questionnaires assessing awareness and attitudes toward DNR orders, alongside qualitative interviews to capture their perceptions. The mean age of the participants was 33.88±8.60years, predominantly females (98.0%), young adults (44.0%), and holding degree in nursing (68.0%). Findings indicated that over half of the neonatal nurses had poor awareness (52%) and negative attitudes (50%) toward DNR orders. Factors such as being unmarried (adjusted odds ratio [AOR]=0.01, confidence interval [CI]=0.01-0.27), <5years of NICU experience (AOR=0.04, CI=0.00-0.53), and not attending refresher course on End of Life Care (AOR=0.87, CI=0.00-0.99) significantly reduced odds of good awareness. Additionally, being Christian (AOR=0.01, CI=0.00-0.40), unmarried (AOR=0.05, CI=0.00-0.51), and <5years of NICU experience (AOR=0.03, CI=0.00-0.38) were associated with significantly lower odds of positive attitude toward DNR orders. Qualitative insights highlight emotional challenges and feelings of inadequacy among nurses during DNR order discussions with parents. The study highlights a need for comprehensive training and support for NICU nurses in navigating DNR order discussions effectively. Hospitals must prioritize regular nurse training on DNR orders. NICU settings need counseling support. Nurses' training should emphasize empathy and effective communication for sensitive DNR discussions. Most neonatal nurses lacked awareness and positive attitudes toward DNR orders, influenced by factors like marital status and NICU experience. Qualitative insights revealed emotional challenges in discussing DNR with parents.

The authors declare no conflicts of interest. The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer-review/10.1111/dom.70370. The data that supports the findings of this study are available in the Supporting Information of this article. Data S1. Supporting Information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Reduced graphene oxide nanosheets were synthesized using Asparagus officinalis (shatavari) leaves plant extract. Plant extract containing functional groups involvement in reduction of graphene oxide identified using functional group detection technique Fourier-Transform Infrared Spectroscopy (FTIR). The pure crystal structure of reduced graphene oxide (rGO) nanosheets (NSs) was confirmed using X-ray diffraction (XRD) pattern. Scanning electron microscopy (SEM) showed ultrathin graphene nanosheets morphology having thickness less than 7.5 nm. UV-Visible spectra of rGO shows absorption peak mainly at 279 nm. The elemental composition of rGO was studied by energy dispersive spectroscopy (EDS) confirms phytochemical reduction graphene oxide (GO). Specific surface area of rGO is 135 m2/g measured by Brunauer-Emmett-Teller (BET) technique. rGO NSs showed enhanced anticancer activity against human breast cancer cell line MDA-MB-231 tumour cells with 45 μg/mL. IC50 value emphasizing its role in biomedical field.

The existence of a femur implant in hip hemiarthroplasty depends on the novelty of the material used. Wear and fatigue analysis of the implant is very important to determine the life of the implant. This study comprehends molding and femur head analysis using finite element analysis, which is applied in hip replacement. Carbon-fiber-reinforced polyether ether ketone and titanium alloy with polyether ether ketone are among the materials employed for the analysis. Wear and fatigue behaviour of human interference under dynamic loading, such as climbing upstairs without rail support and climbing down stairs without rail support, is considered. SolidWorks 2021 was used for modeling, and ANSYS Workbench 19.2 was deployed for FEA. The wear depth was taken into consideration using the modified Archard's equation. The CFR PEEK has a mean stress of 10.1065 MPa during upstair and 12.3054 MPa during downstair, whereas the fatigue life of Ti-6Al-4V during upstair is 9 years and 6.756593 years during downstair. It has been calculated using the S-N curves. Equivalent stress, sliding distance, and contact pressure were the results of the FEA for every material and activity. The CFR PEEK type is the best material for the top of the femur in several actions, corresponding to the results, as well as the downstairs activity, which produced the highest stresses along with contact pressures. For proper operation, the CFR PEEK material femur head must be replaced or altered after its estimated ten-year lifespan.