bluuebunny/crossref_metadata_2025 huggingface dataset:
To Evaluate the Effect of Prophylactic Agents on the Surface Morphology of Different Orthodontic Wires at Different Temperatures: An In vitro Study
Authors: Kedia Ankita , Khanduri Mridul , Puri Taruna , Kashyap Varun , Bishnoi Anita , Narnoli Shubham
Published: April 2024

Aim and Objective:

The aim and objective are to evaluate the effect of prophylactic agents on the surface morphology of different types of orthodontic wires of different dimensions at two different temperatures.

Materials and Methods:

Stainless steel (SS), NiTi, and titanium-molybdenum alloy (TMA) wires of 0.016 inch round and 0.017 inch × 0.025-inch dimensions were immersed in prophylactic agents such as 0.2% NaF, 0.2% CHx and 1.23% APF for 1.5 h at 37°C and 45°C. A one-way analysis of variance, Bonferroni test, and intraclass correlation coefficient test was performed to eliminate the bias. Scanning electron microscope was used to evaluate the surface characteristics of wire and quantitative analysis was performed using ImageJ software.

Results:

Highest corrosion can be seen on TMA wires of 0.016 inch and 0.017 inch × 0.025 inch when exposed to 1.23% APF gel at 45°C and lowest corrosion can be seen on SS wires of 0.017 inch × 0.025 inch when exposed to 0.2% NaF mouthwash at 37°C.

Conclusion:

The results suggest that sodium fluoride is the mouthwash of choice when used with all three types of orthodontic wires used for different orthodontic purposes and APF gel should not be recommended when TMA wires are used at high temperatures as it causes corrosion which can lead to increased friction.
Sports-Related Musculoskeletal Injuries in Medical Students
Authors: Champawat Vishal Singh , Santoshi John Ashutosh , Tiwari Anurag , Behera Prateek , Selvanayagam Rajkumar , Verma Virendra Kumar
Published: April 2024

Background:

Little attention is paid to the problem of sports-related injuries in amateur or nonathletes or recreational student athletes. We investigated the prevalence of sports-related musculoskeletal (MSK) injuries in medical students and attempted to identify the risk factors for these injuries.

Methods:

We conducted a cross-sectional questionnaire-based observational study on medical students of a tertiary care teaching hospital in central India. A total of 500 medical students were approached; the questionnaire consisted of details, such as age, gender, height, weight, predominant sport played or the sport during which they sustained an injury, estimated time spent playing every week, if they had undergone any formal training for the sport, any preexisting MSK condition, details of the injury and the treatment taken, if any, after joining medical school, and duration from getting injured to return to studies and sports. The odds ratio (OR) and logistic regression were calculated for multiple parameters. Statistical significance was set at P ≤ 0.05.

Results:

Seventy-four of the 402 students who responded reported sustaining a sports-related injury; 33 and 41 students reported injury while playing contact and noncontact sports, respectively. Of these, 58 students reported that they had received formal training in sports. Football, volleyball, cricket, and kabaddi were the sports during which most injuries occurred. The injury rate was 3.7 per 1000 playing or practice hours.

Conclusions:

Almost one-fifth of the students reported sustaining a sports-related MSK injury after joining medical school. The risk factors identified for these injuries were male gender, participation in team sports, participation in noncontact sports, and lack of adequate preparation or practice.
Silicosis-Allergic Bronchopulmonary Aspergillosis Overlap—A Rare Duet!
Authors: Neenu N , Utpat Ketaki , Desai Unnati , Samuel Magizh , Bagul Rahul , Shah Hem
Published: April 2024

Silicosis is a progressive pneumoconiosis caused by inhalation of crystalline silica dust commonly seen in workers of construction sites, flour mills, and mining. Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus antigens commonly encountered in patients with asthma and cystic fibrosis. We report a case of 60-year-old flour mill worker presented with clinico-radiological features of silicosis; further evaluation was found to have an overlap of ABPA in view of severe atopic symptoms. We describe a rare duet of silicosis with ABPA overlap.
Climate Change and Occupational Heat Strain Among Women Workers: A Systematic Review
Authors: Habibi Peymaneh , Heydari Ahad , Dehghan Habibollah , Moradi Amirhossein , Moradi Gholamreza
Published: April 2024

Climate change increases heat stress exposure and occupational heat strain in tropical and subtropical regions with generally hot–humid climate conditions. The present systematic review was conducted to assess the effect of climate change on occupational heat strain among women workers. In this study, three main databases (PubMed, Scopus, and Web of Science) were searched to find relevant literature on climate change and its effects using subject headings and appropriate MeSh terms. This article has been written according to the PRISMA checklist. A total of 6,176 studies were identified for screening and 13 studies were eligible for data extraction. Scientific evidence reveals that there is an imprecise but positive relationship between climate change and occupational heat strain regarding women workers. Some complications associated with occupational heat strain among women workers include fatigue, discomfort, dehydration, reduced brain function, and loss of concentration. Climate change can lead to an increase in the occurrence of heat-related illnesses and the levels of injury risk. In addition, its adverse health effects on women workers are mentioned. This systematic study identifies key priorities for action to better characterize and understand how occupational heat strain among women workers may be associated with climate change events. Strong evidence indicates that climate change will continue to cause occupational heat strain among women workers. It is essential to implement preventive measures considering multidisciplinary strategies to reduce the adverse effects of climate change on women workers health in hot weather settings. This can limit the health risks and negative effects of climate change.
Effect of Occupational Stress on Work Behavior as Perceived by Nurses at Benue State University Teaching Hospital Makurdi
Authors: Olorunfemi Olaolorunpo , Chika Ogochukwu J.
Published: April 2024

Background:

Every work environment, especially in hospital settings must be conducive, friendly, and stress-free in order to promote quality care and the well-being of healthcare workers, whose job demands are increasing by the day.

Aims:

The purpose of this study was to determine the perceived effect of occupational stress on work behavior among nurses at Benue State University Teaching Hospital in Makurdi.

Methods:

From the facility’s population of nurses, a quantitative survey randomly chose 150 respondents nurses, for the purpose of gathering information and testing the hypothesis, a well- developed and validated questionnaire was employed to gather data. Using SPSS, the data were descriptively analyzed, and an inferential analysis with a significance level of 5% was performed using Pearson’s Chi-square test (0.05).

Results:

The majority of participants (56.6%) were men with a higher level of education. This study also shows the effect of occupational stress on work behavior as poor work performance 142 (94.7%), counterproductive work behavior 139 (92.7%), increases the incidence of absenteeism 112 (74.7%), high occurrence of medication error 120 (80%), Negative effect on teamwork 98 (65.3%), increases the incidence of Substance use disorders 95 (63.3), and aggressive attitude toward patients during nursing care 137 (91.3). Furthermore, there is a significant association between occupational stress and job satisfaction (x2 = 25.49, df = 8, and p < 0.001), patient safety (x2 = 51.07, df = 8, and P = 0.002), and nurses’ attitudes toward their patients (x2 = 86.67, df = 12, and P = 0.012).

Conclusion:

We discovered that workplace stress can affect how happy nurses are with their jobs and how they behave while providing nursing care. We recommend that hospital administrators implement a plan to create a stress-free working environment for nurses.
Crossing the Barriers of Left Ventricular Entry during Percutaneous Transluminal Mitral Commissurotomy by Agilis nxT Catheter
Authors: Hemnath C. , Sathyamurthy I. , Srinivasan Kanthallu Narayanamoorthy , Mao Robert , Karthigesan A. M.
Published: April 2024

Balloon mitral valvotomy is an effective procedure for the management of mitral stenosis. Procedural failures were reported due to difficulty in the left ventricle (LV) entry, which were addressed by veno-arterial or reverse looping of the balloon catheter. We are reporting three cases in whom LV entry was succeeded with an Agilis NxT catheter.
In Vitro Comparison of Cyclic Fatigue Resistance of ProTaper Next and TruNatomy Endodontic Rotary Files
Authors: Ramteke Payal , Prajapati Mitulkumar R. , Vashisth Diwakar , Aga Nausheen , Mohanty Rajat , Chougule Prajakta G. , Hassan Muna E. M.
Published: April 2024

ABSTRACT

Aim:

The purpose of this comparative in vitro study was to investigate the cyclic fatigue resistance (CFR) of two different rotary endodontic file systems, namely, TruNatomy and ProTaper Next filing systems.

Material and Methods:

A stainless steel artificial canal with a 60° curvature angle and a 5 mm radius of curvature was used to simulate clinical settings to carry out the test. Twenty ProTaper Next X2 files and 20 TruNatomy Prime files were used to run a total of forty instruments until a fracture occurred, and the amount of time it took for the fracture to occur was taken into account. The files were driven by an endodontic motor set when the settings were adjusted according to the manufacturer’s recommendations. A digital meter was employed to record the duration until fracture occurrence, thus ensuring precision.

Results:

The TruNatomy files had a larger mean cycle fatigue life, which indicates that they have a higher resistance.

Conclusions:

Given the constraints of this in vitro testing, the CFR of TruNatomy files was found to be significantly higher than that of ProTaper Next files.
The Evolution of Digital Dentistry: A Comprehensive Review
Authors: Gawali Nishad , Shah Priti P. , Gowdar Inderjit M. , Bhavsar Kevalkumar A. , Giri Debanti , Laddha Rashmi
Published: April 2024

ABSTRACT

Digital dentistry has revolutionized the traditional practice of dentistry, offering new tools and technologies that enhance diagnosis, treatment, and patient care. This comprehensive review explores the evolution of digital dentistry, its role in modern dental practice, and the advantages, limitations, and future prospects. By examining the current state of digital dentistry, this review aims to provide insights into its transformative impact on dental healthcare.
Study of Prevalence of Gastritis Caused by H. pylori and Correlation of Urease Test with Serology (ELISA) Test
Authors: Ranjan Maitreyi , Hameed Hany , Jain Shailesh , Garg Yogesh , Singh Roli , Tyagi Manjulika , Jain Romesh
Published: April 2024

ABSTRACT

Introduction:

H. pylori are a pathogen of global importance. Gram-negative curved flagellate bacilli are implicated as one of the most trivial complaints of and are associated with peptic ulcer disease gastritis ulcer and gastric malignancy. This study was performed to find out the prevalence of Helicobacter pylori (H. pylori) infection in patients presenting the symptoms related with gastritis with or without chemically known peptic ulcer.

Materials and Methods:

The study was undertaken with the help of the Christensen and quotes urease test on endoscopic biopsy specimen and correlated with the detection of immunoglobulin IgG in the serum against H. pylori by an ELISA technique.

Results:

A total of 67 cases were analyzed in which 29 (43%) cases were positive for H. pylori. The endoscopic findings of acid peptic diseases show 21 (31.4%) cases of stomach ulcer, and 3 (4.5%) have esophagitis, whereas 43 (64.1%) have nonulcer dyspepsia. There is strong positive association between the urease tesr and ELISA test.

Conclusion:

The urease test is a quick and inexpensive test with high specificity and sensitivity, but since it is an invasive test, it has reduced patient compliance.
Assessment of Oral Health Status among the Sevayats of Shree Sakhigopal Temple, Puri – A Cross-sectional Study
Authors: Kumar Gunjan , Dash Payal , Tripathi Ranjan M. , Khandelwal Sourabh , Sharma Oshin , Pany Gitanjali
Published: April 2024

ABSTRACT

Aim:

To assess the oral health status of the Sevayats of Sakhigopal temple, Puri, Odisha.

Methodology:

An assessment of the oral health status of 111 Sevayats at the Sakhigopal temple in Puri was carried out using a cross-sectional survey. The World Health Organization oral health assessment form for adults (2013) was used to collect data. Chi-square test and one-way analysis of variance were the statistical tests used for the investigation using Statistical Package for the Social Sciences 27 version. When the P value was less than 0.05, it was deemed statistically significant.

Results:

The mean DMFT of all the participants was 3.70 ± 1.71. The prevalence of caries was 91%. Bleeding and periodontal pocket were present in 82.9% and 83.8% of Sevayats, respectively.

Conclusion:

There was a higher prevalence of dental caries and periodontal disease among the subjects.
Exploring the Role of Ultrasound Therapy in Modern Dentistry: A Comprehensive Overview
Authors: Dhull Kanika Singh , Chintapatla Aparanjitha , Ziauddin Nowshiya , Modi Mahek , Puthenkandathil Rahul , Hemanth Rasakatla
Published: April 2024

ABSTRACT

This paper explores the use of ultrasound therapy in dentistry, focusing on its working principle, various applications, advantages, limitations, precautions, contraindications, and future directions. Ultrasound therapy presents a promising non-invasive treatment modality with a wide range of applications within the field of dentistry.
Nicotinamide adenine dinucleotide treatment confers resistance to neonatal ischemia and hypoxia: effects on neurobehavioral phenotypes
Authors: Xu Xiaowen , Wang Xinxin , Zhang Li , Jin Yiming , Li Lili , Jin Meifang , Li Lianyong , Ni Hong
Published: April 2024

JOURNAL/nrgr/04.03/01300535-202412000-00031/figure1/v/2024-05-29T122840Z/r/image-tiff

Neonatal hypoxic-ischemic brain injury is the main cause of hypoxic-ischemic encephalopathy and cerebral palsy. Currently, there are few effective clinical treatments for neonatal hypoxic-ischemic brain injury. Here, we investigated the neuroprotective and molecular mechanisms of exogenous nicotinamide adenine dinucleotide, which can protect against hypoxic injury in adulthood, in a mouse model of neonatal hypoxic-ischemic brain injury. In this study, nicotinamide adenine dinucleotide (5 mg/kg) was intraperitoneally administered 30 minutes before surgery and every 24 hours thereafter. The results showed that nicotinamide adenine dinucleotide treatment improved body weight, brain structure, adenosine triphosphate levels, oxidative damage, neurobehavioral test outcomes, and seizure threshold in experimental mice. Tandem mass tag proteomics revealed that numerous proteins were altered after nicotinamide adenine dinucleotide treatment in hypoxic-ischemic brain injury mice. Parallel reaction monitoring and western blotting confirmed changes in the expression levels of proteins including serine (or cysteine) peptidase inhibitor, clade A, member 3N, fibronectin 1, 5′-nucleotidase, cytosolic IA, microtubule associated protein 2, and complexin 2. Proteomics analyses showed that nicotinamide adenine dinucleotide ameliorated hypoxic-ischemic injury through inflammation-related signaling pathways (e.g., nuclear factor-kappa B, mitogen-activated protein kinase, and phosphatidylinositol 3 kinase/protein kinase B). These findings suggest that nicotinamide adenine dinucleotide treatment can improve neurobehavioral phenotypes in hypoxic-ischemic brain injury mice through inflammation-related pathways.
Biomarkers for neuromyelitis optica: a visual analysis of emerging research trends
Authors: Li Xiangjun , Zhang Jiandong , Zhang Siqi , Shi Shengling , Lu Yi’an , Leng Ying , Li Chunyan
Published: April 2024

Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system that differs from multiple sclerosis. Over the past 20 years, the search for biomarkers for neuromyelitis optica has been ongoing. Here, we used a bibliometric approach to analyze the main research focus in the field of biomarkers for neuromyelitis optica. Research in this area is consistently increasing, with China and the United States leading the way on the number of studies conducted. The Mayo Clinic is a highly reputable institution in the United States, and was identified as the most authoritative institution in this field. Furthermore, Professor Wingerchuk from the Mayo Clinic was the most authoritative expert in this field. Keyword analysis revealed that the terms “neuromyelitis optica” (261 times), “multiple sclerosis” (220 times), “neuromyelitis optica spectrum disorder” (132 times), “aquaporin 4” (99 times), and “optical neuritis” (87 times) were the most frequently used keywords in literature related to this field. Comprehensive analysis of the classical literature showed that the majority of publications provide conclusive research evidence supporting the use of aquaporin-4-IgG and neuromyelitis optica-IgG to effectively diagnose and differentiate neuromyelitis optica from multiple sclerosis. Furthermore, aquaporin-4-IgG has emerged as a highly specific diagnostic biomarker for neuromyelitis optica spectrum disorder. Myelin oligodendrocyte glycoprotein-IgG is a diagnostic biomarker for myelin oligodendrocyte glycoprotein antibody-associated disease. Recent biomarkers for neuromyelitis optica include cerebrospinal fluid immunological biomarkers such as glial fibrillary acidic protein, serum astrocyte damage biomarkers like FAM19A5, serum albumin, and gamma-aminobutyric acid. The latest prospective clinical trials are exploring the potential of these biomarkers. Preliminary results indicate that glial fibrillary acidic protein is emerging as a promising candidate biomarker for neuromyelitis optica spectrum disorder. The ultimate goal of future research is to identify non-invasive biomarkers with high sensitivity, specificity, and safety for the accurate diagnosis of neuromyelitis optica.
Clinical effectiveness and safety of ustekinumab in youth with refractory inflammatory bowel disease: A retrospective cohort study
Authors: Alhadab Abdulhamid , Almarhoon Amal , AlAlwan Amena , Hammo AbdelHai
Published: April 2024

Background:

Inflammatory bowel disease (IBD) incidence and prevalence has been increasing worldwide. Limited data exists on the effectiveness of ustekinumab (UST) in children. We aimed to describe the effectiveness and safety of UST in pediatric patients with IBD.

Methods:

A single-center retrospective study was conducted between January 2017 and February 2022. The study included patients ≤16 years of age who were treated with UST and followed up for ≥1 year. Clinical remission was defined as a score of the Pediatric Crohn’s Disease (CD) and Pediatric Ulcerative Colitis (UC) Activity Indices ≤10 at week 52.

Results:

Thirteen patients who had failed anti-tumor necrosis factor-α (anti-TNFα) therapy were included, eight (61.5%) with CD and five (38.5%) with UC. The median age was 13 years (interquartile range [IQR]: 11.5 to 14). UST treatment was initiated at a median age of 3 years (IQR: 2.3 to 7) after diagnosis. Ten patients (76.9%) achieved clinical remission. There were no statistically significant differences in characteristics between patients who achieved and did not achieve clinical remission. Biochemical remission (BioR) was achieved in six patients (46.2%). Body mass index (BMI) significantly improved, C-reactive protein (CRP) significantly decreased, and the need for corticosteroids significantly decreased in the remission group. Endoscopy conducted post-treatment in seven patients confirmed remission in six patients. Adverse events included two cases of infection and one of headache.

Conclusions:

UST was effective as a secondary biologic therapy for the induction and maintenance of remission in patients with anti-TNFα refractory IBD. At one year, 84% of patients remained on UST with no severe adverse reactions reported.
Understanding risks for stroke and the importance of a healthy lifestyle among stroke patients at a tertiary hospital in Saudi Arabia
Authors: Althomali Mohammed , Liberatos Penny , Mubaraki Adnan A. , Alqasim Marzouq Abdullah
Published: April 2024

Background:

Stroke accounts for 11% of deaths worldwide. Stroke prevalence has been rising in the Kingdom of Saudi Arabia (KSA), where the death rate per 100,000 is 95.93 versus 22.27 in the US.

Aim:

This study was conducted to assess knowledge about stroke risk factors and willingness to make the behavioral changes among KSA individuals who had experienced a stroke.

Methods:

A 61-item survey was orally administered to 101 stroke patients from King Abdulaziz Hospital in Taif, Saudi Arabia in July 2020. Topics covered included: knowledge of stroke risk factors; health behaviors regarding diet, physical activity, smoking, and medical adherence; and importance/barriers to changing unhealthy behaviors and willingness to make changes.

Statistical Methods:

Comparisons of risk factor knowledge as related to the other variables were made using the Chi-square statistics.

Results:

Approximately half of the participants correctly identified stroke risk factors, one-third reported poor medication adherence, 20%–30% reported engaging in unhealthy dietary behaviors, and only one-third reported any physical activity (walking). About two-thirds did not think that maintaining a healthy weight or engaging in physical activity were important and one-third did not see the importance of taking medicine on time. Knowledge of stroke risk factors was significantly related to the importance of dietary behaviors and readiness to improve medication adherence.

Conclusion:

This study found an apparent lack of knowledge of stroke risk factors and the importance of a healthy lifestyle and medication adherence, highlighting a need for broad health education of the public in the KSA.
Psychological distress of medical students in western Saudi Arabia: A mixed-methods study
Authors: Abozaid Hani Ahmed
Published: April 2024

Background:

Psychological distress such as anxiety and depression can negatively affect medical students’ academic performance and future careers.

Aim:

This study examined the prevalence and impact of psychological distress on medical students’ academic achievement, their associated learner characteristics, and how students handle stress in western Saudi Arabia.

Setting and Design:

This cross-sectional study incorporated a mixed-methods design, including quantitative and qualitative components for Phase 2 medical students.

Methods:

A self-administered questionnaire was used for quantitative components to examine the prevalence of psychological distress among medical students. In addition, a qualitative study component was conducted with students with severe psychological distress using structured interviews with a predetermined list of responses to which to select and assess factors that lead to severe psychological distress and how students handle stress. This study began on January 15, 2018, at the medical college Taif University and lasted 3 months.

Statistical Analysis Used:

The quantitative and qualitative data were coded, verified, and analyzed by a statistician using the Statistical Package for the Social Sciences software (SPSS version 22.0). Chi-squared tests were used to examine differences between proportions.

Results:

This study (n = 289) revealed that more than 69% of medical students experienced some form of psychological distress, 52% suffered from mild and moderate psychological distress, and 17% with severe psychological distress. There were no statistically significant differences between genders and years of study regarding psychological distress. Overall, there was no statistically significant association between grade point average and psychological distress scores.

Conclusions:

This study revealed a high prevalence of psychological distress among medical students. This study recommends establishing a psychological counseling unit at medical schools in western Saudi Arabia to detect psychological distress in medical students and timely referrals of those who need medical advice.
Enhancing global pediatric cardiac arrest outcomes through bystander cardiopulmonary resuscitation: A comprehensive systematic review
Authors: Yatimi Abdullah Ahmed , Alsayed Mohammed Abdu , Alomar Amro Hassan , Khedrawi Almoutazbillah Abdulrahman , Wasili Mohammed Ahmed , Muafa Khalid Ahmed , Alhamoud Abdullah H.
Published: April 2024

This systematic review investigates the impact of global bystander cardiopulmonary resuscitation (CPR) on outcomes in pediatric cardiac arrest cases. Through a meticulous examination of relevant worldwide studies retrieved from PubMed spanning 2018 to 2022, employing keywords such as “worldwide Bystander CPR (BCPR),” “worldwide out-of-hospital CPR,” and “pediatric CPR” with Boolean operators “OR” and “AND,” the study incorporates 10 selected articles out of the initially identified 13. Findings reveal that bystander-initiated CPR, predominantly chest-only CPR, is administered at rates ranging from 48% to 89% globally, with no significant gender-based disparity, but a lower likelihood observed among worldwide Black children. Return of spontaneous circulation (ROSC) is achieved in 20%–35% of cases and survival to hospital discharge in 5%–10% of instances. Factors associated with worldwide prehospital ROSC include epinephrine administration, bystander intervention before emergency medical services (EMS) arrival, older age, reduced time to EMS response, and worldwide automated external defibrillators. Notably, a shorter time to EMS arrival is the sole significant predictor of worldwide survival to hospital discharge. The study discerns no substantial distinction in achieving prehospital ROSC and favorable outcomes on a global scale. The conclusion underscores the varied worldwide outcomes in out-of-hospital cardiac arrest studies, attributing these variations to multifarious confounding factors. It identifies crucial predictors of prehospital ROSC and recommends targeted CPR training for underserved communities to enhance worldwide BCPR rates and ameliorate pediatric cardiac arrest outcomes.
Expatriate professional nurses’ experiences of preceptorship in a tertiary hospital in Saudi Arabia
Authors: Mazibu Andiswa , Downing Charlene , Rasesemola Richard
Published: April 2024

Background:

Professional nurses relocate to foreign countries as expatriate nurses due to host countries’ push or pull factors. Preceptorship programs are designed to support newly hired nurses in transitioning into a new health-care environment.

Aims:

This study aimed to understand expatriate professional nurses’ preceptorship experiences in a tertiary hospital in Riyadh, Saudi Arabia, with the goal of providing recommendations to enhance the preceptorship program and facilitate better adaptation among expatriate nurses.

Setting and Design:

This study was conducted at a tertiary military hospital in Riyadh, Saudi Arabia, and employed a phenomenological research approach.

Materials and Methods:

Based on inclusion criteria, ten expatriate professional nurses were selected by purposive sampling. Data were collected through unstructured, audio-recorded, verbatim transcribed interviews, observations, and field notes.

Statistical Analysis:

Colaizzi’s seven-step methodology was employed for data analysis.

Results:

The results identified three themes: (1) participants experienced both positive and negative aspects of preceptorship, encountering personal adjustment challenges and issues with the initial orientation program; (2) preceptors’ abilities and dedication played a crucial role in assisting participants in adjusting to their new workplace; and (3) participants reflected on their preceptorship experience, expressing their expectations and opinions of the preceptorship program.

Conclusions:

Preceptorship is an effective onboarding strategy to support expatriate nurses in their adaptation process, emphasizing the importance of teamwork and continued management support.
Allergic reaction following reintroduction of cow’s milk in a 2-month-old infant on an elimination diet for atopic dermatitis
Authors: Alzahrani Ahmad
Published: April 2024

Atopic dermatitis, a multifactorial, relapsing, and inflammatory condition, can affect the patient’s quality of life to a great extent. Simultaneous food allergy has also been noted in many patients with atopic dermatitis. Cow milk protein allergy is a commonly reported issue in children. Here, we presented a case of allergic reaction in a 2-month-old boy diagnosed with cow’s milk allergy based on mild atopic dermatitis despite the absence of immediate symptoms after milk ingestion. Dietary modifications (feeding of the exclusive hydrolyzed formula; elimination diet) were suggested; however, as there was no apparent improvement in the child’s symptoms, the parents reintroduced regular formula to his diet. The first re-exposure led to immediate reactions in the form of hives and irritability. The condition was diagnosed with an allergic reaction on presentation to the emergency room and was managed successfully. The follow-up visit confirmed the diagnosis of IgE-mediated cow’s milk allergy based on the history and the positive allergy testing to cow’s milk. Putting the child suffering from atopic dermatitis on a strict elimination diet might not be prudent as it increases the financial burden and the risk of developing severe life-threatening allergic reactions following accidental exposure to the allergen, as repeated oral exposure to allergens is very important for the development of tolerance.
Prevalence of Classical Extraintestinal Manifestations among Inflammatory Bowel Disease Patients in Saudi Arabia: A Single Tertiary Center Experience
Authors: Alotaibi Abdullah , Alhubayshi Abrar , Allehibi Abed , Almtawa Abdullah , Alotaibi Nawaf , Alghamdi Adel , Alrajhi Saad , Alqutub Adel , Aleid Ahmad , Alamr Abdulrhman , Ibrahim Bashaar , Alahmari Mohammed , Alhamidi Hussam , Ahmad Shameem , AlBayyat Hadeel , Alshaya Osama , Altannir Youssef , Alghamdi Ahmed
Published: April 2024

Background:

Patients with inflammatory bowel disease (IBD) may also experience extraintestinal manifestations (EIMs), which can affect various organ systems, and their occurrence is based on disease activity.

Objectives:

To determine the prevalence of EIMs and their most common types among IBD patients from Saudi Arabia.

Materials and Methods:

This retrospective study included all IBD patients aged 14–80 years who visited the Gastroenterology and Hepatology clinics at King Fahad Medical City, Riyadh, between February 2017 and December 2022. The collected data included demographic characteristics, disease characteristics, EIMs, and treatment.

Results:

The study included 578 IBD patients, of which 65 (11.2%) had at least one EIM, with primary sclerosing cholangitis (46.2%) and sacroiliitis (16.9%) being the most common. Patients with ulcerative colitis were more likely to have EIMs than those with Crohn’s disease (15.1% vs. 9%; P = 0.026). Patients with ileocolonic (L3) Crohn’s disease reported a higher prevalence of EIMs (7.5%) than those with other disease locations (P = 0.012), while in patients with ulcerative colitis, those with extensive colitis (E3) reported higher prevalence of EIMs (19.2%) (P = 0.001). Patients receiving 6 MP had a significantly high prevalence of EIMs (P = 0.014).

Conclusion:

The prevalence of extraintestinal manifestations among IBD patients in Saudi Arabia is 11.2%. These findings suggest the need for clinicians to screen for EIMs and manage them early. Further research is needed to understand the mechanisms underlying EIMs for the development of more effective treatments.
Unplanned Readmissions in Children with Medical Complexity in Saudi Arabia: A Large Multicenter Study
Authors: Alotaibi Futoon , Alkhalaf Hamad , Alshalawi Hissah , Almijlad Hadeel , Ureeg Abdulaziz , Alghnam Suliman
Published: April 2024

Background:

Children with medical complexity (CMC) account for a substantial proportion of healthcare spending, and one-third of their expenditures are due to readmissions. However, knowledge regarding the healthcare-resource utilization and characteristics of CMC in Saudi Arabia is limited.

Objectives:

To describe hospitalization patterns and characteristics of Saudi CMC with an unplanned 30-day readmission.

Methodology:

This retrospective study included Saudi CMC (aged 0–14 years) who had an unplanned 30-day readmission at six tertiary centers in Riyadh, Jeddah, Dammam, Alahsa, and Almadina between January 2016 and December 2020. Hospital-based inclusion criteria focused on CMC with multiple complex chronic conditions (CCCs) and technology assistance (TA) device use. CMC were compared across demographics, clinical characteristics, and hospital-resource utilization.

Results:

A total of 9139 pediatric patients had unplanned 30-day readmission during the study period, of which 680 (7.4%) met the inclusion criteria. Genetic conditions were the most predominant primary pathology (66.3%), with one-third of cases (33.7%) involving the neuromuscular system. During the index admission, pneumonia was the most common diagnosis (33.1%). Approximately 35.1% of the readmissions were after 2 weeks. Pneumonia accounted for 32.5% of the readmissions. After readmission, 16.9% of patients were diagnosed with another CCC or received a new TA device, and the in-hospital mortality rate was 6.6%.

Conclusion:

The rate of unplanned 30-day readmissions in children with medical complexity in Saudi Arabia is 7.4%, which is lower than those reported from developed countries. Saudi children with CCCs and TA devices were readmitted approximately within similar post-discharge time and showed distinct hospitalization patterns associated with specific diagnoses. To effectively reduce the risk of 30-day readmissions, targeted measures must be introduced both during the hospitalization period and after discharge.
Quality and Readability Assessment of Web-based Arabic Health Information on Early Childhood Caries
Authors: Alkhuwaiter Shahad S. , Alssafi Fatimah , Alshunaiber Renad , Ahmed Yasser Bin , Albdah Bayan
Published: April 2024

Background:

Patients are increasingly using the internet for searching health-related information. However, the quality and readability of the information available on the internet need to be assessed. To date, no study has assessed the quality and readability of web-based Arabic health information on early childhood caries.

Objectives:

To evaluate the quality and readability of patient-oriented online Arabic health information regarding early childhood caries.

Materials and Methods:

For this infodemiological study, the Google and Yahoo search engines were searched using specific Arabic terms for early childhood caries, and the top 100 searches from both search engines were considered. Eligible websites were categorized in terms of affiliation as commercial, health portal, dental practice, professional, and journalism. The quality of the websites was assessed using the QUality Evaluation Scoring Tool (QUEST), and readability using the Gunning Fog index (GFI).

Results:

A total of 140 websites were included after applying the exclusion criteria, of which 50.7% websites were of journalism. The majority of the websites (70%) had an overall low-quality level, with a QUEST score <10. The quality of websites retrieved from Google searches was of significantly higher quality than those from Yahoo (P < 0.0001). More than half (51.4%) of the websites had good readability, with a GFI score ≤8. Journalism websites had a significantly higher proportion of websites with poor readability level (62%) compared with other affiliations (P = 0.0072).

Conclusion:

The web-based Arabic information regarding early childhood caries is currently of low quality and moderate readability level, thereby indicating a need for improving such patient-facing content.
Development of an Energy Planning Model Using Temporal Production Simulation and Enhanced NSGA-III
Authors: Li Xiaojun , Ni Yilong , Yang Shuo , Feng Zhuocheng , Liu Qiang , Qiu Jian , Zhang Chao
Published: April 2024

This paper presents an innovative model of Energy Planning Model which allows navigating the complexities of modern energy systems. Our model utilizes a combination of Temporal Production Simulation and an Enhanced Non-Dominated Sorting Genetic Algorithm III to address the challenge associated with fluctuating energy demands and renewable sources integration. The model represents a significant advancement in energy planning due to its capacity to simulate energy production and consumption dynamics over time. The unique feature of the model is based on Temporal Production Simulation, meaning that the model is capable of accounting for hourly, daily, and seasonal fluctuations in energy supply and demand. Such temporal sensitivity is crucial for optimization in systems with high percentages of intermittent renewable sources, as existing planning solutions largely ignore such fluctuations. Another component of the model is the Enhanced NSGA-III algorithm that is uniquely tailored for the nature of multi-objective energy planning where one must balance their cost, environmental performance, and reliability. We have developed improvements to NSGAIII to enhance its efficiency when navigating the complex decision space associated with energy planning to reach faster convergence and to explore more optimal solutions. Methodologically, we use a combination of in-depth problem definition approach, advanced simulation, and algorithmic adjustments. We have validated our model against existing models and testing it in various scenarios to illustrate its superior ability to reach optimal energy plans based on efficiency, sustainability, and reliability under various conditions. Overall, through its unique incorporation of the Temporal Production Simulation and an improved optimization algorithm, the Energy Planning Model provides novel insights and practical decision support for policymakers and energy planners developed to reach the optimal sustainable solutions required for the high penetration of renewables.
A Numerical Analysis of Terrain and Vehicle Characteristics in Off-Road Conditions through Semi-Empirical Tire Contact Modelling
Authors: Zerbato Luca , Vella Angelo Domenico , Galvagno Enrico , Vigliani Alessandro , Data Silvio , Sacchi Matteo Eugenio
Published: April 2024

In the last decades, the locomotion of wheeled and tracked vehicles on soft soils has been widely investigated due to the large interest in planetary, agricultural, and military applications. The development of a tire-soft soil contact model which accurately represents the micro and macro-scale interactions plays a crucial role for the performance assessment in off-road conditions since vehicle traction and handling are strongly influenced by the soil characteristics. In this framework, the analysis of realistic operative conditions turns out to be a challenging research target. In this research work, a semi-empirical model describing the interaction between a tire and homogeneous and fine-grained soils is developed in Matlab/Simulink. The stress distribution and the resulting forces at the contact patch are based on well-known terramechanics theories, such as pressure-sinkage Bekker’s approach and Mohr-Coulomb’s failure criterion. The force exerted by the soil on the sidewall of the tire is accounted through the Hegedus blade method. The radial flexibility of the tire is included following the approximated Bekker’s circle substitution method. The contact model is integrated in an 8 Degrees Of Freedom (DOF) vehicle for the simulation of conventional handling maneuvers adopting different soil characteristics on a flat road. A comparison between different driveline layouts is carried out in terms of longitudinal and lateral performance. Moreover, the vehicle is tested using tires with several geometrical and operational characteristics to highlight their influence on tractive and handling behavior.
Engine-out Gaseous Emissions in a Diesel Engine using Methanol as a Low-carbon Fuel under Dual-fuel Operation
Authors: Cung Khanh , Wright Nolan , Briggs Thomas , Smith Edward , Michlberger Alexander , Bitsis Daniel Christopher , Bachu Pruthvi , Meruva Prathik , Aussi Yehya
Published: April 2024

In this study, engine-out gaseous emissions are reviewed using the Fourier Transform Infrared (FTIR) spectroscopy measurement of methanol diesel dual fuel combustion experiments performed in a heavy-duty diesel engine. Comparison to the baseline diesel-only condition shows that methanol-diesel dual fuel combustion leads to higher regulated carbon monoxide (CO) emissions and unburned hydrocarbons (UHC). However, NOX emissions were reduced effectively with increasing methanol substitution rate (MSR). Under dual-fuel operation with methanol, emissions of nitrogen oxides (NOX), including nitric oxide (NO), nitrogen dioxide (NO2), and nitrous oxide (N2O), indicate the potential to reduce the burden of NOX on diesel after-treatment devices such as selective catalytic reduction (SCR). Other unregulated gaseous emissions, such as formaldehyde (CH2O) methane (CH4), increased with higher MSR, but their emissions can be mitigated if advanced injection timing or increased intake temperature is used as reported in our separate study. In summary, this study suggests the potential use of methanol as a low-carbon fuel (LCF) to meet emissions regulations but indicates a slight increase in emissions of unregulated species.
Trends in Driver Response to Forward Collision Warning and the Making of an Effective Alerting Strategy
Authors: Nasir Mansoor , Kurokawa Ko , Singhal Neha , Mayer Ken , Chowanic Andrea , Osafo Yeboah Benjamin , Blommer Michael
Published: April 2024

This paper compares the results from three human factors studies conducted in a motion-based simulator in 2008, 2014 and 2023, to highlight the trends in driver's response to Forward Collision Warning (FCW). The studies were motivated by the goal to develop an effective HMI (Human-Machine Interface) strategy that enables the required driver's response to FCW while minimizing the level of annoyance of the feature. All three studies evaluated driver response to a baseline-FCW and no-FCW conditions. Additionally, the 2023 study included two modified FCW chime variants: a softer FCW chime and a fading FCW chime. Sixteen (16) participants, balanced for gender and age, were tested for each group in all iterations of the studies. The participants drove in a high-fidelity simulator with a visual distraction task (number reading). After driving 15 minutes in a nighttime rural highway environment, a surprise forward collision threat arose during the distraction task. The response times from the FCW event were recorded and analyzed. The results indicated no statistically significant difference in driver response times between the baseline-FCW condition and the two new variants of the 2023 study. However, a trend of longer driver response times was seen when comparing the results from 2023 study to previous studies. First, the median response times for the baseline-FCW group increased from 2008 to 2023 by about 0.25s. Furthermore, in the 2008 study, a few cautious drivers in the control group had reacted even before the distraction task had finished. However, in the 2023 study, all participants only reacted after the distraction task had finished. Finally, there was a statistically significant difference between the 2023 fading-FCW chime variant and the 2008 baseline-FCW. All of this indicates that drivers are likely becoming more complacent to warnings and are less situationally aware due to distraction from non-driving activities.
CFD Simulation of Visor for cleaning Autonomous Vehicle sensors: Focus on a Roof Mounted Lidar
Authors: Khajeh Hosseini D. Navvab , Basso Davide , Schigelone Michael , Krishnan Venkatesh , Hupertz Burkhard , Jiang Tao
Published: April 2024

The performance of autonomous vehicle (AV) sensors, such as lidars or cameras, is often hindered during rain. Rain droplets on the AV sensors can cause beam attenuation and backscattering, which in turn causes inaccurate sensor readings and misjudgment by AV algorithms. Most AV systems are equipped with cleaning systems to remove contaminants, such as rain, from AV sensors. One such mechanism is to blow high-speed air over the AV sensors. However, the cleaning air can be hindered by incoming headwind, especially at higher vehicle speeds. An innovative idea proposed here is to use a visor to improve the cleaning performance of AV cleaning systems at higher vehicle speeds. The effectiveness of a baseline visor design was studied using computational fluid dynamics (CFD) air flow analysis and Lagrangian rain droplet tracking. The baseline visor improved the AV sensor cleaning performance in two ways. First, the visor protects the cleaning air flow from being disturbed by headwind. And second, it deflects incoming rain droplets from landing on the sensor. Further visor design exploration and optimization was performed to find designs that do not block the lidar field of view (FOV) while optimizing lidar cleaning performance. One hundred designs were explored using the STAR-CCM+ design exploration tool, and the best designs showed that they can completely deflect incoming headwind at high vehicle speeds while not obstructing the FOV. Therefore, a visor can be a key feature to improve AV sensor rain management.
Eco-Routing Algorithm for Energy Savings in Connected Vehicles Using Commercial Navigation Information
Authors: Rajakumar Deshpande Shreshta , Bhagdikar Piyush , Gankov Stanislav , Rengarajan Sankar , Sarlashkar Jayant , Hotz Scott , Bhattacharjya Shuvodeep
Published: April 2024

Vehicle-to-everything (V2X) communication, primarily designed for communication between vehicles and other entities for safety applications, is now being studied for its potential to improve vehicle energy efficiency. In previous work, a 20% reduction in energy consumption was demonstrated on a 2017 Prius Prime using V2X-enabled algorithms. A subsequent phase of the work is targeting an ambitious 30% reduction in energy consumption compared to a baseline. In this paper, we present the Eco-routing algorithm, which is key to achieving these savings. The algorithm identifies the most energy-efficient route between an Origin-Destination (O-D) pair by leveraging information accessible through commercially available Application Programming Interfaces (APIs). This algorithm is evaluated both virtually and experimentally through simulations and dynamometer tests, respectively, and is shown to reduce vehicle energy consumption by 10-15% compared to the baseline over real-world routes. This paper describes the development, implementation, and validation of the algorithm.