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Purpose of the study:  To evaluate the performance of Best Practice Recommendation (BPR) compliance in reporting abdominal aortic aneurysm findings on imaging, comparing the results before and after its deployment.Methods: Best Practice Recommendations for AAA were deployed in 2020 at a large radiology practice site. Reports between January 2018 through October 2022 were reviewed, representing studies read prior to and subsequent to the implementation of the reporting standards. Cases of abdominal aortic aneurysms ≥ 2.6 cm were counted by year. Adherence to the BPR for each year was calculated as [total number of confirmed cases of ≥ 2.6 cm AAAs with compliant reports] * 100 / [the total number of confirmed ≥ 2.6 cm AAAs]. A secondary analysis was performed to determine whether there was a statistically significant difference in the proportion of BPR-compliant reports for AAA cases before (from 2018 to 2019) and after (from 2020 to 2022) BPR deployment using a chi-square test. Results: From January 2018 to December 2022, there were 8,693 reports referencing AAA. After excluding cases of suspected AAA (N = 2,131), confirmed AAAs with indeterminate sizes (N = 103), and confirmed AAAs with sizes < 2.6 cm (N = 85), the number of AAA cases ≥ 2.6 cm in size was 6,374. Concordance with the BPR standards for the remaining cases with sizes ≥ 2.6 cm were 1.6% and 4.1% in 2018 and 2019, respectively. Post-implementation of BPRs, there was a substantial improvement in guideline adherence to 32.1%, 84.3%, and 83.6% in 2020, 2021, and 2022, respectively. In general, the proportion of BPR-compliant reports of AAA cases in the pre-deployment (3.6%) period statistically differs (p - value < 0.0001) from those in the post-deployment period (73.9%)Conclusion: Adherence to reporting standards increased after the BPR deployment in 2020. The inclusion of management recommendations in the radiology report when AAA is identified is a simple and cost-effective way of improving outcomes for patients with AAAs through appropriate follow-up treatment.

Background: In line with the so-called “embodiment concept”, human bodily experience is characterized by the immediate feeling that our body is localized in a certain position in space and that the self is localized within these body limits. Aim: To verify in a cohort of patients affected by unilateral spatial neglect (NSU) secondary to cerebrovascular damage the possible correlation between a comprehensive neuromotor/neuropsychological rehabilitative treatment and the modification of body representation. Setting: A rehabilitation institute for the treatment of neurological gait disorders and neuropsychological failures. Methods: 12 patients (7 males, 5 females; mean age 60 ± 2yy) affected by NSU secondary to cerebral stroke and recovered in the Neurological Rehabilitation Section of the Clinical Institute Città di Brescia were recruited for the aim of this study. In accordance with our inclusion criteria we recruited 4 patients affected by ischemic stroke and 8 patients affected by haemorragic stroke; 9 patients of our study group arrived from a coma state period. Recruited patients underwent at time T0 (hospitalization day) to a functional impairment evaluation (Motricity Index = MI; Trunk Control Test = TCT; Functional Ambulation Category = FAC) and to a neuropsychological evaluation (Behavioural Inattention Test = BIT; Representional drawing; Personal Neglect evaluation scale); each evaluation was repeated in the same way at time T1 (intertime between 2 and 4 months after hospitalization) and time T2 (inter time between 5 and 6 months after hospitalization). At time T0 each patient began an individualized integrated (motor and neuropsychological) rehabilitative treatment course. Results: In all patients recruited a statistical significant modification was observed for the MI LL left, the TCT and the FAC; no significant statistical modification was observed for the MI UL left, the MI UL and the MI LL right. The t-test showed a significant statistical modification of the personal neglect evaluation scale while no significant statistical modification was defined for the spontaneous human figure drawing test proceeding from time T0 to time T1. The spontaneous drawing of the human figure showed an individual different trend and modification in all patients recruited. A correlation analysis was made comparing the mean value of all motor scales (G1) with the mean value of all neuropsychological scales (G2) and no statistical significant correlation was observed between G1 (T0) and G1 (T1), G1 (T0) and G2 (T0), G1 (T0) and G2 (T1), G2 (T0) and G1 (T1), G2 (T0) and G2 (T1), G1 (T1) and G2 (T1). A second correlation analysis was made comparing all single motor scales with the neuropsychological scales, for the group made by 12 patients and the group made by 5 patients. For the group made by 12 patients, we observed the subsequently significant correlations: MI UL left (T0) correlates with MI LL left (T0); MI LL left (T0) correlates with MI LL left (T1); MI UL left (T1) correlates with MI LL left (T1); MI LL left (T1) correlates with FAC (T1); TCT (T1) correlates with FAC (T1). For the group made by 5 patients, we observed the subsequently significant correlation: TCT (T2) correlates with FAC (T2). In the group made by 12 patients, the mean amelioration of the time related normalized (T0-T1) motor scales is equal to 49% while to 63% was observed for the neuropsychological scales. The mean amelioration of the neuropsychological scale proceeding from time T0 to T1 is equal to 26% with an increase equal to 57% proceeding from time T1 to T2. The neurocognitive amelioration can be observed especially between the 5th and 6th month from the ischemic cerebral damage with a mean increase from 26% to 57%. Conclusions: It would certainly make sense to treat patients with NSU from the neuropsychological point of view in the long term and from the neuro-motor point of view in the first 3-4 months after stroke; in all this, we cannot exclude that an improvement of the visuo-spatial exploration, emphasized by the neuropsychological treatment, can positively influence also patient’s motor outcome.

Background: Absence of nocturnal decrease in Blood Pressure (BP) (“non-dipping”) has been shown to be a strong and independent predictor of cardiovascular events, target organ damage, cardiovascular sequela and cardiovascular mortality. Obstructive Sleep Apnea (OSA) has been associated with non-dipping with an estimated prevalence of approximately 50%, but factors associated with non-dipping in OSA patients remain poorly understood. In this study, we examined clinically relevant variables associated with non-dipping in OSA.Methods: Patients (n = 35) undergoing overnight valuation for OSA, laboratory-based polysomnography, structured clinical interviews, and comprehensive metabolic and anthropometric evaluations, and ambulatory BP monitoring for 24 hours. Patients were classified into a) dipping BP group or b) non-dipping BP group, based on (a) a nocturnal systolic BP decrease of 10% - 20% or (b) a systolic BP decrease of < 10%. Results: Patients had moderate and severe OSA (AHI = 34.8 ± 29.1), and 42.9% demonstrated a non-dipping BP pattern. The severity of OSA measures did not differ between dipping group and non-dipping group. However, Wake after Sleep Onset (WASO) and chronicity of insomnia predicts non-dipping BP independent of demographics, sleep stages, anthropometrics, metabolic measures, or arterial stiffness. Conclusion: These findings contribute to a better understanding of the cardiovascular impacts of OSA and indicate that sleep quality should be incorporated into clinical assessments and management of OSA patients.

This study explores the dynamics of social exclusion in healthcare settings within the rural Ganderbal district of Kashmir, focusing on the availability of health facilities and the health-seeking behaviors of socially disadvantaged populations. Through a mixed-methods approach, combining quantitative data from interviews and qualitative insights from observation, the research reveals significant disparities in healthcare access between rural and urban areas. Key findings indicate that rural residents face exclusion due to a scarcity of hospitals, unavailability of 24-hour medical staff, inadequate infrastructure, staffing shortages, and systemic biases, compounded by environmental and occupational challenges. Communicable diseases predominate, with majority of respondents affected, and traditional healers and medical shops serve as primary care sources over formal institutions like government hospitals. Socio-economic factors, including low literacy, reliance on agriculture, and poverty, exacerbate these issues. The study highlights higher infant mortality and malnutrition rates in rural areas compared to urban centers, underscoring the need for attitudinal shifts among healthcare providers and systemic improvements in infrastructure and policy to enhance health equity. By addressing an underexplored gap in rural health research in India, this work aims to inform strategies for inclusive healthcare delivery, potentially yielding broader societal benefits through improved well-being and demographic dividends.

Water deficit is a fundamental factor in public health and economic growth. Water supply and population growth are directly linked to water demand. The physio-chemistry and microbiology analysis of water is utmost significance in dietary requirements. Drinking water has the main concern especially it affects food security. This study includes a number of representative sites where 24 water samples (from wells, reservoirs and tap water) were analysed. These sites are located in the western villages of Baalbeck, the main city of the Bekaa Plain in Lebanon where the analysed water is used mainly for domestic needs and for irrigation. This study  investigates the physiochemical and microbiological properties. Among the selected sites, Hawsh Barada site shows a strong contamination by nitrate. At the Nabi Rashaded (tap), Beit Shema and Bednayel (borehole and tap), contamination above the norm by zinc ion was noted. From a microbiological point of view, Hawsh barada, Nabi-Rashadeh, Hawsh-bay, and Beit shema are markedly polluted and do not meet the standard for drinking water. Hence, water quality in Hawsh barada, Nabi-Rashadeh, Hawsh-bay, Beit shema and Bednayel are not suitable for drinking, and this must be informed to decision makers who can act implementing environmental controls for health protection in the studied region.

Micronutrients are critical components of an athlete’s diet, affecting both performance and cardiovascular health. This review summarizes current studies on the importance of micronutrients in sports cardiology, focusing on their effects on energy metabolism, antioxidant defense, and cardiac function. Key findings emphasize the relevance of micronutrient sufficiency in improving athletic performance and avoiding long-term health issues linked to strenuous training programs. Micronutrients like B vitamins help energy generation pathways, while antioxidants like C and E reduce exercise-induced oxidative damage. Minerals like magnesium and iron are important for muscle function and oxygen delivery, which are required for endurance and recovery. Effective nutritional practices include balancing food intake and, if required, supplementing under medical supervision to address individual needs and enhance performance results. Future research paths will focus on individualized nutrition techniques based on genetic and metabolic profiles, allowing for more precise food recommendations for athletes. Collaboration between sports medicine and nutrition disciplines is critical for establishing evidence-based practices and improving cardiovascular health in athletes.

Background: Human 30kb coronaviruses entered through the ACE-2 receptors causing fibrosis of the lungs and causing six million deaths worldwide. Here, we have investigated the mutations, deletions and insertions of the recent JN.1 omicron coronaviruses to demonstrate that coronaviruses have reached the pre-elimination stage. Methods: We multi-aligned the genomes of recent JN.1 variants using NCBI Virus Portal and CLUSTAL-Omega. The spike proteins are multi-aligned using MultAlin software and CLUSTAL-Omega.Results: The 17MPLF spike insertion was confirmed to compensate 24LPP, 31S, 69HV, 145Y, 211N and 483V deletions. The 49nt deletions in the 3’-UTR were found in 4997 JN.1 sequences although 26nt deletion was initiated previously in JN.1 as well as BA.5, BF.7, BQ.1 and XBB.1.5 omicron viruses. We first compare 3-D structures of spike proteins with or without 17MPLF four amino acids insertion and nine amino acids deletions using SWISS MODELLING. The JN.1 viruses caused a more stable trimeric spike involving Thr342, Lys436, Lys440, His441, Ser442, Gly443, Tyr445, Lys479, Ser489, Tyr490, Arg493, Pro494, Thr495, and Gln501 amino acids to interact with ACE-2 receptors. The FLiRT spike mutations were found in most KP.2 variants and other changes occurred at the NH2 terminus.Conclusion: We claimed that pre-death changes were initiated in JN.1 COVID-19 lineages and computer simulation showed that the Howard spike with 17MPLF spike insertion appeared more stable than the Oppentrons-spike without 17MPLF insertion. Surely, conflicts of COVID-19 spike sequences must be resolved.

Objective: To study the use of cefazoxime sodium for injection in inpatients of the Third People’s Hospital of Yancheng City, and to provide reference for the rational clinical use of cefazoxime sodium. Methods: A retrospective study method was used to retrieve the medical records of patients discharged from 2 departments of urology and general surgery of the hospital using cefazoxime sodium in June-August 2023, and the rationality of the clinical use of injectable cefazoxime sodium was evaluated with reference to the relevant standards. Results: A total of 328 valid cases were included, of which 6 cases did not meet the dosage criteria, 10 cases did not meet the treatment time criteria; 44 cases did not meet the indication criteria. The comprehensive judgement of the reasonableness of the clinical use of cefazoxime sodium for injection resulted in 272 cases of reasonable use of the drug; 56 cases of unreasonable use of the drug. Conclusion: The clinical use of cefazoxime sodium for injection in this hospital is irrational and needs to be further strengthened and corrected.

This study used smartphones as an Instructional tool to determine their effects on students’ Interest and retention in Agricultural Water Engineering in Colleges of Education, Benue State, Nigeria. Five purposes of the study were stated, five research questions were posed and answered with means and standard deviations, and five hypotheses formulated and tested at 0.05 level of significance using Analysis of Covariance (ANCOVA). Quasi-experimental design of non-randomized pre-test post-test control group design was utilized. The research was carried out in two Colleges of Education in Benue State, Nigeria, with a population of 410 NCE Students. The population size of 200 NCE III students was sampled from colleges of Education, Katsina-Ala and Oju in the study area. The research instruments were ‘Basic Agricultural Water Inventory Test’ (BAWEIIT) and Basic Agricultural Water Retention Test (BAWERT), AND were validated by three experts. The reliability coefficient of the instruments was 0.74. The study found that the students who were taught with SIT demonstrated positive interest and enhanced their retention (XS=3.92) in Basic Agricultural Water Engineering than those taught without Smartphones. Also, there was no significant difference in the mean interest and retention rating scores (XS = 1.24 > 0.05), in Basic Agricultural Water Engineering (AGE, 324) concepts with Smartphone as an instructional tool (SIT). Based on findings, recommendations were made that smartphone (SIT) should be included among instructional materials in the scheme of lesson delivery for lecture by the National Commission for Colleges of Education (NCCE) in the curriculum for both teaching and learning activities at the Colleges of Education in Benue State. There should be constant, strong Wi-Fi connections power National Commission for Colleges of Education instructional via College administrators should orient lecturers and students by organizing workshops and seminars on how to effectively utilize smartphones for their academic activities. College administrators should endeavour to supervise implementation of smartphones as instructional tools in Agricultural Water Engineering and NCE courses for students

This comprehensive review examines the impact of Artificial Intelligence (AI) on family medicine, focusing on its potential to improve diagnostic accuracy, optimize treatment, and enhance administrative efficiency. Analyzing literature from 2019 to 2024, the study highlights the use of AI applications, including machine learning, natural language processing (NLP), and clinical decision support systems (CDSS), in streamlining workflows, predicting health risks, and personalizing patient care. Key findings reveal significant benefits like reduced diagnostic errors, automated documentation, and proactive management of chronic conditions. However, considerable challenges remain, including algorithmic bias, data privacy concerns, limited explainability of AI outputs, and disparities in implementation across healthcare settings. Ethical considerations—such as equity, clinician autonomy, and patient trust—are emphasized as essential for the sustainable integration of these practices. The review concludes that while AI holds transformative potential for family medicine, its future success depends on collaborative design with clinicians, rigorous validation in primary care, and the establishment of ethical frameworks to ensure equitable and patient-centered adoption.