bluuebunny/crossref_metadata_2025 huggingface dataset:
Türk Melodram Sinemasında Kadın Suçlular
Authors: Arslantepe Mehmet , Atmaca Demir Bahar
Published: June 2024

1960–1970 yılları arası Türk Sineması’nın “Altın Çağı” olarak kabul edilmektedir. Yeşilçam dönemi olarak da adlandırılan, toplamda 1710 adet filmin çekildiği bu dönemde filmlerin çoğu melodram türündedir. Yeşilçam melodram filmlerinde, kalıp öyküler ve kalıp tipler, iyi-kötü, yoksul-zengin, masum-günahkâr karşıtlıkları, kadere razı gelme, fedakârlık, yanlış anlamalar, tesadüfler, itiraflar, tuzaklar, engeller, erteleme ve gecikmeler gibi anlatı kodları bulunmaktadır. Bu çalışmada, film öyküsünün merkezinde kadınların bulunduğu melodramlarda kadınların hangi durum ve koşullarda suç işleyebildiklerine yönelik bir araştırma yapılması amaçlanmıştır. Çalışma, 1960’lı yıllarda melodram türünde filmler çekmiş olan yönetmenlerden Ülkü Erakalın, Türker İnanoğlu ve Nejat Saydam’ın yönettiği filmler ile sınırlandırılmıştır. İzlenen filmlerdeki kadın film kişileri tarafından işlenmiş olan “insan öldürme, insan öldürmeye teşebbüs, tehdit, suça iştirak (yardım ve azmettirme)” suçları tespit edilmiş ve bu suçların nedenlerinin “namus, kıskançlık, intikam, aşk ve para” olduğu sonucuna ulaşılmıştır. Betimsel olarak analiz edilen veriler sayısallaştırılarak grafik halinde sunulmuştur. İzlenen filmlerde kadınların namuslarına yönelik iftira, fiziksel veya psikolojik bir şiddet sonunda yaşanılanları unutmadıkları ve sonunda mutlaka intikam aldıkları tespit edilmiştir. Filmlerde en çok adam öldürme suçunun işlendiği ve bunun da en çok namus nedenli olduğu saptanmıştır. Ayrıca, izlenen filmlerdeki kadınlar filmin anlatımı/metni/kurgusu gereği namusları söz konusu olduğunda işledikleri suçlardan dolayı asla pişmanlık duymamakta ve cezasını çekmeye razı olmaktadır. Öldürmeye teşebbüs, tehdit ve suça iştirak da filmlerde işlenen diğer suçlar arasında olup, namustan sonra sırasıyla intikam, kıskançlık, aşk ve paranın da suç işlemede etkili olduğu görülmüştür. Toplumsal yaşamda meydana gelen kadın suçlarının filmlerde yansıtılan hali ile benzerlik gösterdiği gözlemlenmiş ve bununla birlikte toplumsal yaşamın sinemaya yansıdığı sonucu ortaya çıkmıştır. Türk Sineması’nda kadının suç işlemesi ile ilgili araştırmaların sınırlı olması bakımından bu çalışmanın alanyazına katkı sağlayacağı düşünülmektedir.
Hybrid Approach for the Financial Assessment of Companies using Fuzzy Multi-Criteria Decision-Making and Self-Organizing Maps
Authors: Yiğit Fatih
Published: June 2024

This paper presents a 3-stage innovative approach for company assessment, integrating financial ratios with the Fuzzy Analytic Hierarchy Process (FAHP) and using an unsupervised artificial intelligence method, Self-Organizing Maps (SOM), for classification. Addressing the challenges of decision-making in resource allocation, the study combines accurate data with robust tools essential in turbulent economic times. FAHP, known for handling complex, uncertain information, is applied to refine the traditional company assessment methods by integrating different experts' opinions and conversion to numerical values. This study presents an innovative framework by integrating financial ratios, commonly used in company evaluation methodologies, with FAHP, which is capable of processing complex and uncertain data. The integration of financial ratios into FAHP enhances the accuracy and clarity in decision-making processes for evaluating and ranking companies while also allowing for the management of the inherent uncertainties in economic data. Furthermore, SOM, an unsupervised artificial intelligence method for company classification, is used. Net Profit Margin is the financial ratio evaluated with the highest weight among financial ratios by 0.38. After the FAHP phase, financial ratios obtained from the income statements and balance sheets of companies are multiplied by the respective weights for valuation. In the final phase, a total of 6 companies listed in the Borsa Istanbul Insurance Index are divided into 3 classes. The two companies receiving the highest valuation, AGESA (Agesa Life and Pension) and ANHYT (Anadolu Life Pension Joint Stock Company), have been classified as Class A. To show the performance of the proposed model, companies registered in the Electricity Sector XELKT registered 31 companies. Classification also performed well in that set. The paper contributes to the field by providing a detailed literature review, methodology, case study results, and discussions on the practical implications of this integrated assessment method and possible areas for further research and applications.
Development of a renewable corrosion-inhibiting agent from Acacia auriculiformis seed oil
Authors: Chakraborty Anirban , Dhar Sharmistha , Ghosh Mahua , Mitra Debarati
Published: June 2024

Corrosion is a costly problem all over the world. Current approaches to controlling corrosion have some paucity of efficiency, which triggers the search for novel materials that are green and cheap and made from renewable resources. In this study, an attempt was made to prepare an Acacia auriculiformis-seed-oil (ASO)-based fatty amide through a simple reaction route involving aminolysis of ASO fatty acid and diethylenetriamine. Fourier transform infrared spectroscopy and hydrogen-1 (1H) nuclear magnetic resonance were used to determine the structural characteristics of the synthesised amide. Properties such as acid value, amine value, refractive index and specific gravity were measured. The coating films were prepared by using a standard formulation, in which the synthesised fatty amide was added in different proportions. The performance of the cured films was evaluated and compared. The hydrophobicity test revealed that the hydrophobicity of film increases with the addition of fatty amide up to 2% and then decreases. The effect of the synthesised product on mild steel was investigated according to the standard protocol. The results revealed that developed fatty amide inhibited the corrosion of carbon steel up to a certain concentration (2%) in the film.
Facile synthesis of bimetallic metal–organic frameworks for highly efficient UV shielding
Authors: Ma Xiangmei , Wu Yiqing , Wang Bin
Published: June 2024

As an important kind of material with a porous structure, metal–organic frameworks (MOFs) have been applied extensively in many fields due to their outstanding properties. Herein, the authors proposed a facile approach for preparing a bimetallic MOF (Ce/Fe–NH2–UiO-66) with excellent ultraviolet (UV)-blocking properties. Based on the as-obtained particles, flexible MOF/poly(vinyl chloride) (PVC) composite films were readily fabricated. According to the characterizations, the as-prepared composite films exhibited splendid performance on UV blocking and a rhodamine B solution showed a much slower degradation rate under the radiation of UV light with the protection of MOF/PVC composite films, which demonstrated the distinguished UV-blocking ability of the as-prepared MOF particles. However, the PVC thermal degradation was not fully developed. The UV-shielding and thermal stabilization mechanism for PVC was discussed. It is expected that this approach will have potential for the large-scale preparation of MOF materials with excellent UV-blocking performance.
Effect of nanomaterials on the melting/freezing characteristics of phase-change material
Authors: Paulsamy Sivasamy , Pandian Pitchipoo , Balasubramani Jegan , Kaliswaran Karthik , Dharmaraj Mahadevi , Natarajan Gnanakumar
Published: June 2024

A novel variant of composite phase-change material (PCM) was developed by incorporating 0.5 wt% aluminum oxide (Al2O3), silicon dioxide (SiO2), copper (II) oxide (CuO) and silver (Ag) nanomaterials into myristic acid. In this formulation, myristic acid served as the foundational material, while aluminum oxide, silicon dioxide, copper (II) oxide and silver were employed as supporting components. The morphology and crystalline structure of the nanomaterials were studied using field-emission scanning electron microscopy and X-ray diffraction analysis, respectively. The composite PCMs were fabricated using a two-step process. The phase-change properties of the composite PCMs were assessed using differential scanning calorimetry. The nanomaterials (0.5 wt% aluminum oxide, silicon dioxide, copper (II) oxide and silver) were suspended in myristic acid separately to investigate the heat-transfer performance of the composite PCMs during phase-change processes (melting and freezing). The results clearly indicated that the duration of the melting and freezing processes of the composite PCMs decreased compared with that of the pure PCM. Thus, the newly prepared composite PCMs are potential candidates for harvesting solar energy for low-temperature heating applications.
Prediction of alkali–silica reaction expansions of mortars containing glass waste
Authors: Mezaouri Sarra , Kameche Zine El-Abidine , Mamoune Sidi Mohamed Aissa , Siad Hocine , Houmadi Youcef , Lachemi Mohamed
Published: June 2024

The majority of existing findings regarding expansion (EXP) risks in concretes containing waste glass stem from experimental studies. There is a need for rapid assessment methods to ensure safer recycling of glass waste in cementitious composites. In this study, an artificial neural network (ANN) model was developed to accurately predict alkali–silica reaction EXP/mitigation resulting from the integration of glass waste in mortars. The analysis considered glass incorporation either separately as waste glass powder (WGP) and waste glass aggregates (WGAs), or in combination, at contents of up to 100% for WGA and 30% for WGP. A set of 175 mixtures was analysed, considering five distinct variables, which encompassed different mix proportions, involving varying components of cement, natural aggregates, WGP and WGA, in addition to the duration of environmental exposure. The results show that the EXP of WGA mortars decreased with the increased incorporation of WGP. The EXP values obtained from validation and experience confirm the high accuracy of the developed ANN model, with validation coefficients reaching up to 98.061% and a small value of the mean square error.
About successes and failures in Bernoulli schemes
Authors: Ahsanullah; Mohammad , Ananjevskii Sergey M. , Nevzorov Valery B. Nevzorov
Published: June 2024

One of the most popular areas in the probability theory is the research related to Bernoulli random variables. In this paper we will consider the random variable \(N_{1,\ell}(n)\) that will take on a value equal to the number of successes before the \(\ell\)-th failure occurs if the \(\ell\)-th failure occurred before time \(n\) and a value equal to the number of successes that occurred by time \(n\) if the \(\ell\)-th failure did not occur by \(n\)-th trial. Some variations of \(N_{1,\ell}(n)\) will also be considered.
Metabolic programs drive function of therapeutic NK cells in hypoxic tumor environments v1
Authors: R Kennedy Philippa
Published: June 2024

A collection of protocols associated with the publication 'Metabolic programs drive function of therapeutic NK cells in hypoxic tumor environments' by Kennedy et al.
Recovery and preparation for transplantation of cryopreserved vmDA progenitors for transplantation. v1
Authors: Fraser Tyra , Thompson Lachlan
Published: June 2024

This protocol outlines the recovery of cryopreserved vmDA progenitors. After recovery, this outlines the process to prepare these cells for xenotransplantation.
Preparation of ventral midbrain cells for transplantation v1
Authors: Fraser Tyra , Thompson Lachlan
Published: June 2024

This protocol outlines the preparation of iPSC derived ventral midbrain progenitors for xenotransplantation.
Legal principles of state control over international transfers of dual-use goods
Authors:   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, Sevostianenko Denys
Published: June 2024

Background. The need to control international transfers of dual-use goods remains an urgent need of the entire International Community in the twenty-first century, as such processes are accompanied by the risk of obtaining these goods by international terrorist groups, international criminal organizations and governments of states against which restrictive measures have been introduced. The purpose of the article is to provide a theoretical justification for the administrative and legal model of state control over international transfers of dual-use goods. Methods. In the course of the study, the author used the general scientific methods of analysis, synthesis, induction, deduction, as well as the formal legal method. Results. The analysis of the study, conducted by representatives of the Kyiv School of Economics and the Yermak-McFaul International Working Group, resulted in the identification of the necessary information on the volume of imports by the aggressor state of certain types of dualuse goods, as well as on the routes of supply of such goods. As it turned out, a third of such imported goods were manufactured by companies registered in states that have imposed certain restrictions on such transfers and many of which are parties to the Wassenaar Arrangement. It is worth noting that this agreement does not provide for the exchange of information on transferred dual-use goods (except for those covered by the Sensitive List and the Very Sensitive List). The existence of a provision establishing the need to exchange information on international transfers of all dual-use goods to states that are not parties to the specified export control regime will encourage governments of member states to strengthen national control over international transfers of such goods. Conclusions. Several conclusions and proposals have been developed to improve the regulation of state control over international transfers of dual-use goods. In particular, the need for the Ministry of Foreign Affairs of Ukraine to develop, first, draft amendments to the Wassenaar Arrangement's founding documents to launch the exchange of information between member states on the transfer of all dual-use goods to nonparties to the agreement, and, second, a plan to reach consensus with other member states on the implementation of such amendments.
DEVELOPMENT OF THE PARADIGM OF RISK-BASED MARKETING STRATEGIES AT THE CONSUMER GOODS MARKET
Authors:   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, Ponomarenko T.
Published: June 2024

The marketing strategies are being replaced with the risk-based ones at the background of the high competition level at the consumer goods, increase in the level of the buyers' requirements for the products, introduction of product standardisation and certification (especially at the European markets), and increase in the level of availability of goods and information on their quality. The article summarises the theoretical framework of the paradigm of risk-based marketing strategies in the context of probable risks due to the spontaneity of marketing actions, the need to continuously monitor the structure of the industry, information on the market and competitive position of the company. The paradigm of the riskbased marketing strategies started to develop in the 1970-1980s of the twentieth century in the context of separation of the main attributes of corporate strategies: planning or spontaneity. The main reasons for development of the risk-based marketing strategies are determined: growth of the current market information that influences the company's actions, decisions on the product prices in the short term; high market requirements for the quality, costs and speed of delivery of products, growing expectations of customers; need to certify products and introduce standardisation schemes; high level of complexity in managing relations with a large number of suppliers. The paradigm of the risk-based marketing strategies must be considered in the context of ideas of entrepreneurship, marketing and risk as fundamental related economic categories. These concepts are always characterised by innovation and risk subject to the type of consumer market.
Determining the rate of mother-to-child human immunodeficiency virus transmission among pregnant women in An Giang province
Authors: Tran Quang Hien
Published: June 2024

Background: Determining the rate of pregnant women infected with human immunodeficiency (HIV) is one of the important factors for planning HIV prevention policies. This study aims to determine the rate of HIV infection among pregnant women in An Giang province in 2010.
Methods: This is an epidemiological investigation study with analysis. The subjects are all pregnant women who are from An Giang and reside in An Giang province. They came for prenatal check-ups and gave birth at all medical facilities in communes, districts, and the province of An Giang from 01 January 2010 to 31 December 2010.
Results: The rate of pregnant women infected with HIV in An Giang province is 0.29%, which is at an average level compared to the whole country. The occupation of pregnant women is related to HIV infection; compared to the occupation of civil servants, the occupation of trading has an 18.7 times higher risk of HIV infection (RR=18.7, p<0.01); the occupation of laborer has a 13 times higher risk (p<0.05); the occupation of farmer has a 6.3 times higher risk (p<0.05); the occupation of Housewife has a 4 times higher risk (p<0.05).
Conclusions: The rate of pregnant women infected with HIV in An Giang province in 2010 was 0.29%. The occupational factor of pregnant women shows a correlation with HIV infection.
Combining ability of maize (Zea mays l.) inbred lines adapted to sub-humid central highland of Ethiopia
Authors: Mitiku Takele , Nepir Gudeta , Negera Demoz
Published: June 2024

The production of maize, a primary food crop in Africa, is hampered by a lack of high-yielding cultivars, biotic and abiotic stressors. In order to create high-yielding maize varieties, choosing promising germ plasm that have good combining ability, and heterotic groups is so important. Estimating the GCA and SCA of grain yield and other yield-related traits of maize inbred lines was the goal of this work.  In 2019 using line by tester mating design, 26 inbred lines were crossed with two testers to produce 52 F1 hybrids. The experiment was carried out in the Ambo and Kulumsa Agricultural Research Centres in the 2020 cropping season using an alpha lattice design with two replications. Analysis of variance revealed significant mean squares attributable to crosses and lines in each location and across locations for targeted traits. The finding of the line x tester ANOVA showed significant mean squares for lines, testers, and cross for grain yield, anthesis date, silking date, plant height, ear height, kernel row per ear, and number of ears per plant. This show inconsistency of inbred lines traits across testing sites. While crossings L1xT2, L17xT1, L8xT1, L10xT1, L14xT1, L20xT2, L24xT2, and L26xT1 were effective particular combiners, inbred L2, L4, L5, L7, L10, and L13 were strong general combiners for grain yield. The best particular combiners for plant and ear height traits were L11xT1, L17xT1, and L11xT1, L26xT2, while L14, L21, and L22 worked well for EPP and L14 for KPR with T1.
A Non-Inferiority Study of the Speed and Success of Nasotracheal Intubation in Maxillofacial Surgeries Using Macintosh Direct Laryngoscope versus Sanyar® Video Laryngoscope
Authors: Pourfakhr Pejman , Sadeghi Mehran , Etezadi Farhad , Kianpour Parisa , Biderafsh Azam , Khajavi Mohammad Reza
Published: June 2024

Background: The recently developed blade design of the Sanyar® video laryngoscope yields an exceptionally precise visualization of the larynx, thereby easing the process of tracheal intubation.
Objectives: A non-inferiority clinical investigation, to assess the efficacy of the Sanyar® as compared to the Macintosh® direct laryngoscope for nasotracheal intubation in the context of maxillofacial surgeries.
Methods: 78 patients for maxillofacial surgery were divided randomly into two groups and intubated through the nose using either the Sanyar® or Macintosh® laryngoscope after anesthesia was induced. The study measured intubation time and secondary objectives included success rate, attempts, and hemodynamic changes in two groups.
Results: 40 eligible patients in the Sanyar® and 38 in the Macintosh® group were involved. Of all, 42(53.8%) were men and 36(46.2%) were women. The average age of patients in the Sanyar® and Mackintosh groups was (31.62±13.41) and (30.81±10.89), respectively. 39(98%) of the Sanyar® group and 33(86%) of the Macintosh® group had successful laryngoscopy and intubation, with a P-value<0.034. Sanyar® group had a significantly shorter intubation time than Macintosh® (P-value<0.001). Hemodynamic changes before and after laryngoscopy and intubation had no significant differences between the two groups.
Conclusion: The Sanyar® video laryngoscope reduced the time of nasal tracheal intubation in maxillofacial surgery compared to direct laryngoscopy and improved the success rate of the first intubation attempt.
Investigating the Role of Dexmedetomidine and Propofol on Fertility Rate in IVF Candidate Patients
Authors: Behnaz Faranak , Tizghadam Atiyeh , Mohseni Gholamreza , Nazari Leila
Published: June 2024

Background: One of the most important treatments used in women with infertility is IVF, and improving its results can affect the success of assisted reproductive techniques. It was previously shown that anesthetics can enter the follicular fluid (FF), so there is concern about the accumulation of anesthetics in the FF and their negative effects on fertilization and fetal growth under general anesthesia. The use of drugs that have both analgesic and sedative effects but do not have hemodynamic side effects is of particular importance and dexmedetomidine is one of the drugs introduced in this field. On the other hand, the use of sedatives such as midazolam and propofol may cause hemodynamic disturbances and severe hypotension in these patients, which limits the use of such drugs. Accordingly, and considering the importance of the issue, in this study, we decided to evaluate and compare the effect of propofol and dexmedetomidine on fertility in IVF candidates.
Methods: In this clinical trial study, 78 infertile patients who underwent IVF were randomly examined. After dividing the patients into two groups receiving dexmedetomidine and propofol or standard recording doses, the fertility rate of the patients in the two groups was evaluated using chi-square and Fisher tests at a significance level of 0.05.
Results: The use of dexmedetomidine for (P = 0.0348) Pressure_After_Dia, HR_Before (P = 0.0204), Injection_Time (P =0.000) and Recovery Time (P =0.000) indices caused a significant increase compared to the propofol group.
Conclusion: The results of the present study did not show a significant difference in the use of these two drugs on fertility.
Comparison of Analgesia Produced by preoperative Ultrasound-guided Femoral Nerve Blocks and Postoperative Intravenous Administration of Opioids in Patients Undergoing Hip Replacement Surgery
Authors: Zolfaqari Moloud , Mokaram Dori Mehrdad , Khademi Seyed Hossein , Gilani Mehryar Taghavi , Ziaee Maliheh , Ghanei Tayyebe
Published: June 2024

Background: Perioperative pain management can improve surgery results and patient outcomes. Moreover, multimodal methods for pain control have been advised so this study was conducted to assess the beneficial impact of preoperative ultrasound-guided femoral nerve blocks in hip replacement surgery.
Methods: This study is a double-blinded clinical trial including 60 individuals who were candidates for joint replacement surgery. The intervention group (n = 30) received a femoral nerve block prior to general anesthesia.
Results: After surgery, patients received morphine, Apotel, and morphine + Apotel, all of which were administered at lower doses in the intervention group (femoral nerve block) than in the control group. Pain intensity in first hour (P= 0.01), 4 hours (P= 0.003), 8 hours (P= 0.01), 12 hours (P= 0.001), and 24 hours (P= 0.01) after surgery and average pain 4 hours (P= 0.01), 8 hours (P = 0.01), 12 hours (P = 0.02), and 24 hours (P= 0.01) after surgery was significantly less in the intervention group (femoral nerve block) than in the control group.
Conclusion: The findings of our investigation demonstrated the efficacy of ultrasound-guided femoral nerve blocks in the improvement of pain control following hip replacement surgery.
Intraoperative Administration of Diphenhydramine Attenuates Postoperative Catheter Related Bladder Discomfort in Patient Following Percutaneous Nephrolithotomy
Authors: Khajavi Mohammad Reza , Maroofia Mohammad , Akhavizadegan Hamed
Published: June 2024

Background: We intend to evaluate the effect of intraoperative diphenhydramine administration on incidence and severity of catheter related bladder discomfort (CRBD) and pain after percutaneous nephrolithotomy.
Methods: In a double blind randomized clinical trial, adult male patients undergoing percutaneous nephrolithotomy were enrolled. They were randomized into two groups by a computerized digital random allocation method. Before anesthesia induction, group D (Diphenhydramine group) (n = 48) received 5 ml normal saline containing 0.5 mg/kg of diphenhydramine intravenously. In group C (Control group) (n = 48), 5 ml of normal saline was injected in the same manner. Induction and maintenance of anesthesia were identical in both groups. The incidence and severity of CRBD and postoperative pain were assessed at recovery room.
Results: The incidence of CRBD was significantly lower in group D than in group C (14% vs. 63%, P=0.001). The severity of CRBD was milder in group D in comparison to group C (P<0.05). Postoperative pain score was significantly lower in group D (P<0.05).
Conclusion: Intraoperative administration of diphenhydramine is an effective practice for the prevention of CRBD after percutaneous nephrolithotomy in male patients and can reduce postoperative pain as well.
Quality of Life Comparison between Front-Line Residents and Medical Students during COVID-19 Pandemic
Authors: Nabavian Omid , Samadi Shahram , Beigi Shabnam , Sahebi Leyla , Eslami Babak , Montaseri Alireza , Hosseini Seyedeh Azadeh
Published: June 2024

Background: The Covid-19 disease was the most significant pandemic of the century. Health care providers showed great sacrifices in managing this disease and saving humanity, and they suffered many injuries. So, this study aimed to investigate the effect of Covid-19 on the resident’s quality of life and comparison with medical students.
Methods: This cross-sectional study was performed on 223 Residents and 225 medical students. Using a random sampling method, WHOQOL-BREF 26 questionnaire was distributed among the participants. The collected data were analyzed with SPSS 21 software using T-test and ANCOVA.
Results: The results showed that covid-19 had caused a decrease in the quality of life of residents compared to medical students (P value<0.001). In addition, more advanced statistical analyzes showed that high work and study hours, irregular sleep, work history in COVID-19 wards, and the experience of CPR and intubation conditions of covid-19 patients have independent effects on the quality of life.
Conclusion: Covid-19 hurt all aspects of the quality of life of residents. Considering the essential role of residents in educational and treatment hospitals, it is necessary to make plans to improve the quality of life and psychological support of these people to prevent the decline in the quality of healthcare services.
Hip to Neck Circumference Ratio as an Independent Predictor of Difficult Intubation in Obese Patients
Authors: Kheirabadi Dorna , Shafa Amir , Rasouli Mohammadreza , Honarmand Azim , Safavi Mohammadreza
Published: June 2024

Background: Anaesthesiologists face difficult intubation (DI) more frequently in obese patients. Thus, we aimed to test if central obesity indices including hip circumference (HC), neck circumference (NC) or waist circumference (WC) can effectively predict DI and difficult mask ventilation (DMV) in them.
Methods: HC, NC, WC, mask ventilation grade, intubation difficulty scale (IDS), history of snoring and obstructive sleep apnoea (OSA) were measured in 300 patients with BMI ≥ 30 kg/m2. Receiver operating characteristic curve (ROC) and multivariate, logistic regression were employed to identify predictors of DI (IDS ≥5) and DMV define as mask ventilation grade of 3 or 4.
Results: DI and DMV were, respectively, detected in 14.7% and 12.7% of subjects. According to Multiple logistic regression analysis BMI (Odds ratio (OR):1.17, 95% confidence interval (CI): 1.08-1.28, p<0.001), NC (OR: 1.26, 95% CI: 1.04-1.52, p=0.01), HC (OR:1.06, 95% CI: 1.03-1.10) and HC/NC ratio (OR: 4.9, 95% CI: 1.64-14.92, p= 0.004) considered as independent predictors of DI. The same analysis recognized BMI (OR:1.13, 95% CI: 1.03-1.24, p=0.006), WC (OR: 1.06, 95% CI:1.01-1.11, p=0.01), and HC/BMI ratio (OR=0.18, 95% CI:0.06-0.53, p=0.002) as DMV predictors. Sensitivity of BMI >35.8 kg/m2, NC >39.9 centimetres (cm), HC>118cm and HC/NC ratio >2.9 were determined as 70.5%, 68.2%, and 69.3% respectively for prediction of DI. Sensitivity of BMI >36.6 kg/m2 and WC >118 cm for predicting DMV were identified as 71.0% and 73.6%.
Conclusion: This study proposes to simultaneously consider the HC/NC ratio and WC as a predictor of difficult airway in the obese.
Current State of Ventilator Setting and Their Relationship with Mortality Rate in Patients under Mechanical Ventilation: A Cross-Sectional Study
Authors: Sayadi Leila , Rozveh Ali Karimi , Norouzrajabi Samira
Published: June 2024

Background: Given the importance of implementing lung protective strategies to prevent lung injury caused by ventilators and death of patients, it is necessary to monitor the current condition of hospitals and examine the relationship between the parameters set on the ventilators and patient mortality. This study conducted to determine the current state of ventilator setting and their relationship with mortality rate in patients under mechanical ventilation: a cross-sectional study.
Methods: This is a cross-sectional study that was conducted between June to December 2020 in one of the hospitals affiliated to Tehran University of Medical Sciences. The initial tidal volume set on the ventilator was recorded for 304 patients under mechanical ventilation and then, their heights were measured and their tidal volumes were determined based on the standard formula. Other parameters set on the ventilator as well as systolic and diastolic blood pressures of patients were also recorded and their survival rate was investigated. The data was analyzed by SPSS software, using descriptive statistics and logistic regression model.
Results: Among patients, who were under mechanical ventilation, 77.6% were hospitalized in intensive care units and the rest were hospitalized in general wards. The mean adjusted tidal volume for patients was 472.91 ± 32.13 ml. The mean peak inspiratory pressure and plateau pressure were 28.00±6.98 and 13.88±4.93 CmH2O, respectively. Also, 37.2% of patients died during the hospitalization. The results of adjusted odds ratio based on multivariate logistic regression model for predictors of mortality rate showed that the variables of patients' age [OR=1.040 (1.019-1.062)], the hospital’s general ward in comparison with the ICU [OR=11.379 (5.130-25.240)] and the peak inspiratory pressure [OR=1.072 (1.007-1.141)] had a direct and significant relationship with mortality rate (in all cases P<0.05). Meanwhile, the plateau pressure [OR=0.886 (0.808 -0.972)] had an inverse and significant relationship with mortality rate (P<0.05).
Conclusion: Despite the recommendations regarding lung protective strategies, in some cases, some parameters set in the ventilator are outside the recommended levels, which can effect on patients mortality. So monitoring and controlling the implementation of lung protective strategies and paying attention to controlling pressures set on the ventilator are among measures that should be taken in medical centers in order to prevent lung injuries and maintain patient safety.
Dabigatran for Dental Procedures in Patients with High Risk Bleeding
Authors: Akbari Hossien , Shahmoradi Mohsen , Bagheri Abbass , Dehkordi Nazanin Roqani , Boostanifard Parisa , Moradimajd Parisa
Published: June 2024

Background: Management of patients with high risk of bleeding during oral and dental procedures faces many challenges. The aim of this study was review strategies for facing high risk of bleeding patients taking dabigatran under dental procedure.
Methods: Articles and scientific texts will be searched in the six main databases, such as PubMed, Scopus, Web of Science, Science Direct, Google Scholar and Cochrane Library from 2007 to 2022, with keywords “dabigatran” AND “bleeding” AND “dental procedures” OR “dental care”. The inclusion criteria for articles included in the study were papers published about treatment patients with dabigatran and undergoing a dental procedure, English language and design of case reports, case series, quasi-experimental studies and clinical trials. This study was performed using PRISMA.
Results: At first, 43 references included and finally 8 articles that met the inclusion criteria were select. CASP and STORBE checklists used for quality evaluation. Two reviewers checked eligibility of the selected articles, separately. Challenging Controversial results were found in selected studies. 4 studies demonstrated that Dabigatran should be interrupted at least 12 hours before invasive dental procedures. Some studies highlight that discontinuing Dabigatran depends on the patient's renal function. Also, it showed that deciding whether to stop Dabigatran or not by cardiologists determine based on elective or emergency high-risk patients.
Conclusions: Based on the results of the included studies, it is better to decide to stop or continue dabigatran before any dental treatment based on the type of intervention, the risk of bleeding and the patient's clinical situation. However, is preferred to discontinue taking this drug in high risk of bleeding dental procedures.
Large Pulmonary Bullae, Resulting from Tuberculosis, in the Context of Extensive Pneumothorax Caused by a Penetrating Chest Wound
Authors: Dahmardeh Alireza Rahat , Heidari Mehdi , Keykha Aliakbar
Published: June 2024

Pulmonary bullae typically occur either idiopathically or in the context of chronic obstructive pulmonary disease and pulmonary infections. Clinical manifestations of pulmonary bullae include cough, shortness of breath, and chest pain. In some cases, they may be asymptomatic. Differentiating between pneumothorax and pulmonary bullae can be challenging when they coexist. Therefore, obtaining a detailed patient history, conducting a physical examination, performing laboratory tests, and utilizing radiology studies are essential diagnostic tools that should be employed simultaneously. In this case report, we present a patient who developed a wide pneumothorax due to a penetrating chest wound caused by a knife. Initially, the large lung cavity, which had already formed due to tuberculosis, was misdiagnosed as a loculated pneumothorax.
Regional Anaesthesia with Non Invasive Ventilation and Conscious Sedation: An Alternative to General Anaesthesia in Morbidly Obese Patients with Obstructive Sleep Apnea in Retrograde Intrarenal Surgery
Authors: Agarwal Ankit , Varshney Pragya , Padhee Alok , Chaudhary Ravi
Published: June 2024

Obstructive sleep apnea(OSA) is a syndrome characterized by obstruction in the upper airway during sleep. OSA patients undergoing procedures under GA are at increased risk for hypoxemia, pneumonia, difficult intubation, atelactasis, myocardial infarction making it a challenge for anesthesiologist. Retrograde intrarenal surgery(RIRS) is normally performed under GA to prevent respiratory embaracement. There are very few studies focusing on Regional anesthesia in RIRS procedure.
A Sixty-three-year-old male known case of morbid obesity (BMI- 35 kg/meter square), OSA (on CPAP support at night) presented with left renal pelvis calculus, STOP BANG score (=5) therefore making it a case of difficult airway. Respiratory discomfort improved at 30-35-degree head up due to existing OSA considering the severe OSA and anticipated difficult airway, the surgery was planned under Lumbar subarachnoid block with preparation for management of difficult airway if conversion to GA required. 3 ml of 0.5 percent Bupivacaine heavy and 25 mcg fentanyl injected into subarachnoid space. T6 level block acheived after 3 minutes. The patient was put on his home CPAP machine with 5cm H2O PEEP. The patient was maintained on sponatneous ventilation and monitored using Etco2 at aliquot of 1mg midazolam given to mimic natural sleep pattern.
The surgery was uneventful and the risk of induction of GA and difficult intubation was succesfully avoided.
Patient with regional anaesthesia who are prone to converted to GA due to multiple risk factors, i.e., OSA with anticipated difficult airway can create a chaotic situation. So as a preliminary step NIV can be used, and along with it, mild sedation can be supplemented to improve acceptance and to avoid asynchrony. In this case NIV was used as a preemptive ventilation strategy even before actual requirement of BiPAP by mimicing the natural sleep pattern and make patient comfortable while a smooth conductance of the procedure.
Epidural Blood Patch in Subdural Hematoma Due to Spontaneous Intracranial Hypotention: A Case Report and Literature Review
Authors: Ganjifard Mahmoud , Espahbodi Ebrahim , Tafakhori Abbas
Published: June 2024

Spontaneous intracranial hypotension (SIH) is an orthostatic headache syndrome with variable symptoms and complications which is often misdiagnosed at initial manifestations. SIH results from spontaneous CSF leakage leading to brain sag. The typical findings on cranial MR imaging consist of subdural fluid collections, enhancement of the pachymeninges, engorgement of venous structures, pituitary hyperemia, and sagging of the brain. Subdural hematoma may occur as a result of tearing of bridging veins and usually develop into chronic subdural hematoma. The majority of patients with SDH due to SIH have chronic DSH and, therefore, rarely present with neurological deficits. Evacuation of SDH may be performed for large SDH with ME (mass effects), or when dilated or asymmetric pupil is present. However in most cases, evacuation of the hematoma is not necessary and may result in worsened outcomes. The epidural blood patch (EBP) is a treatment of choice. Fortunately, most of these subdural hematomas can be handled with treatment directed at the underlying spinal CSF leak without the need for surgery.
We report the case of 42-year-old man with the chief complaint of orthostatic headache. He was admitted to neurology ward and after imaging studies, it was found that he has bilateral subdural hematoma. Due to the lack of history of trauma, underlying disease, and coagulation disorder, and considering the imaging findings, the patient was referred to the pain department to perform an epidural blood patch. After performing the epidural blood patch, the patient's pain was relieved immediately, and during a three-month follow-up period, the epidural hematoma was completely absorbed.
Spontaneous intracranial hypotension (SIH) is a highly misdiagnosed and underdiagnosed disorder and requires a high index of suspicion for diagnosis. During the last decades, a much larger number of spontaneous cases are identified. Literature is a bit confusing, with some authors recommending evacuation of subdural fluid in cases of deteriorating consciousness and few others recommending EBP first even in patients with comatose state but epidural patch is often an important part of treatment.
Comparative Evaluation of Digital and Conventional Workflows for the Fabrication of Multi-Unit Implant-Supported Fixed Restorations: An Empty Review
Authors: Mahmoud Hashemi Ali , Hasanzadeh Mahya , Khraisat Ameen , Alikhasi Marzieh
Published: June 2024

Objectives: This study aimed to do a comprehensive systematic review on the comparison of digital and conventional workflows regarding prosthetic outcomes, accuracy of implant impressions, framework passivity and fit, and clinical fabrication of multi-unit implant-supported fixed restorations.
Materials and Methods: The EMBASE, PubMed, Scopus, and Cochrane Library databases were searched for relevant articles published up until April 2020.
Results: No in-vivo article was found to compare full digital and conventional workflows regarding the accuracy of implant impressions, passivity and fit of frameworks, and prosthetic outcomes. There was no study to investigate full digital and conventional workflows for clinical fabrication of multi-unit implant-supported fixed restorations.
Conclusion: This empty review highlights the need for further research to compare full digital and conventional workflows for implant-supported restorations.
Predictors of the Intention to Perform Preventive Behaviors Against the Occurrence of Breast Cancer
Authors: Faryabi Reza , Jafarnezhad Aboubakr , Dehghan Salman
Published: June 2024

Background: Breast cancer is the most common cancer in women. The purpose of study was to determine the predictors of the intention to perform preventive behaviors against the occurrence of breast cancer (BC) based on the protection motivation theory (PMT).
Methods: This research was a cross-sectional study that was conducted on 400 women aged 18 to 70 living in Babol city with a multi-stage sampling method. The data collection tool was a researcher-made questionnaire containing demographic information, questions on BC risk factors based on the constructs of PMT. data was entered into SPSS V20 and analyzed with chi-square, independent t-test, ANOVA, Pearson correlation-test and linear regression at a significance level of 0.05.
Results: More than of the participants were single. 66% of participants had no risk factors, 12.5% had one risk factor, 7.5% had three risk factors, and 1.5% had more than four risk factors. The strongest predictors of the intention to perform preventive behaviors against BC were perceived severity (β = 0.280), number of risk factors (β = 0.206), death of a relative due to BC (β = 0.147), and self-efficacy (β = 0.141). Among PMT constructs, perceived severity and self-efficacy constructs were the strongest predictors of preventive behaviors against BC.
Conclusion: The PMT plays an important predictive role in the intention to perform cancer prevention behaviors. In this context, it is necessary to design and implement training programs based on these constructs of this model, especially the perceived intensity, self-efficacy and response efficiency.
The Glutamatergic System in Depression: A Review of the Clinical Evidence of Medications and Supplements Affecting Through It
Authors: Shamabadi Ahmad , Akhondzadeh Shahin
Published: June 2024

Current therapies for depression are moderately effective, as response and remission rates were reported at 50% and 15-40%, following the first trial with current medications, respectively, and electroconvulsive therapy is not beneficial for more than half of the resistant patients. Recent research suggests that medication with glutamatergic modulatory properties may have antidepressant effects and would be of benefit to refractory patients. This study aims to review the efficacy of these medications in the treatment of unipolar depression. Ketamine, as the leading drug acting through the glutamatergic system, appears to be effective in treating depression IV and orally and in combination with electroconvulsive therapy. There is also clinical evidence of the promising effects of amantadine and lanicemine. Supplements and herbs such as L-carnosine, Crocus sativus (saffron), and Cinnamomum tamala, which were reported to be effective in randomized controlled trials on patients with depression, may act through this system as an antidepressant. Taken together, glutamate receptor modulators are alternative drugs for patients with resistant depression. Further high-quality clinical studies are recommended.
The Prevalence of Dysphagia in Parkinson’s Disease: A Systematic Review and Meta-Analysis
Authors: Aghaz Alireza , Ghelichi Leila , Shahriyari Arash , Noori Saeed , Banari Akbar
Published: June 2024

Background: There is still disagreement about the prevalence and incidence of dysphagia in Parkinson’s Disease (PD). Since the prevalence of dysphagia has been reported very differently in the related literature, it is imperative to estimate pooled prevalence in PD patients. Thus, we conducted a systematic review and meta-analysis to estimate the pooled prevalence of dysphagia in PD overall and separately for each assessment method (subjective and objective).
Methods: These databases were searched: ScopusPubMed Web of Science ,and Google Scholar, January 1990 to October 2021. A random-effects model was used to pool the prevalence rates reported in the included studies by the Comprehensive Meta-Analysis (CMA( software .All designs of the studies were included.
Results :Thirty-nine articles entered the current meta-analysis. The global estimation of the overall prevalence of dysphagia in PD patients was 50.4% )95%CI:42.2-58.6) in all the 39 studies, which proved statistically heterogeneous (p<0.001). Moreover, the pooled prevalence by the subjective (30 studies) and objective (19 studies) methods of assessment were estimated to be 39.5 and 68.8%, respectively. There was also a significant relationship between the prevalence of dysphagia and age of Parkinson’s patients )r=0.44, p=0.011) and also between the prevalence of dysphagia and the duration of PD (r=0.55, p=0.006).
Conclusion: Based on the results, one in two patients with PD has dysphagia. This is proven that dysphagia is common in PD. The prevalence of objective dysphagia and subjective dysphasia were very different. It suggests that all Parkinson’s patients should be evaluated for swallowing disorders regularly with objective tools.
The Perception and Preference of Patients towards Disclosure of Medical Errors: A Report from Guilan Academic Hospitals
Authors: Abdollahi Elahe , Soltanipour Soheil , Sedighinejad Abbas , Haghighi Mohammad , Taramsari Morteza Rahbar , Biazar Gelareh , Farahbakhsh Yasin
Published: June 2024

Background: It is well known that disclosure of Medical Errors (MEs) is the duty of physicians and it is the right of patients to be aware of any error occurring in their medical care process. This study was planned to asses to what extent the patients expect to be informed of the occurrence of MEs, they prefer who reports the medical error to them, and what are the influential factors in taking legal action against physicians in disclosed MEs from their point of view.
Methods: In this cross-sectional study, eligible patients admitted to academic hospitals of Guilan (Poorsina; Razi; Alzahra; Amir Al-Momenin; Dr. Heshmat), were interviewed directly and a questionnaire which was divided into four sections was filled out. The first part was about socio-demographic data of the responders and the next three sections included their preferences towards the type of MEs to be disclosed, who is responsible for this task, and in which conditions they sue against the medical team.
Results: About 96.6% of the patients believed that MEs had to be disclosed to the patients. Moreover, 29.3% preferred to be informed about all MEs that occurred during their medical care even if it caused no harm. 51.1% expected that physician who committed the error informs the error. On the whole age, gender, employment status, residency and education were among the influential factors of the patients’ willingness and point of view and filing a lawsuit against physicians.
Conclusion: Based on the findings of this study, it is recommended that all minor and major MEs should be disclosed sympathetically by the physician who committed the error.