bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurse managers on healthy environments for adolescents living with intellectual disabilities
Authors: Malapela Rakgadi G.
Published: November 2024

Background: Providing care for adolescents living with intellectual disabilities (ALWIDs) within healthcare settings is a complex challenge. These adolescents require an environment that is specialised and conducive to their health, alongside tailored care, treatment and rehabilitation services. Nurse managers play a crucial role in supporting these adolescents, particularly given the difficulties parents face in meeting their unique needs.Objectives: This study aims to explore nurse managers’ perspectives on the creation of a healthy environment for ALWIDs in health facilities.Method: An explorative qualitative study design was conducted. A purposive sampling method was used to select 13 nurse managers from three institutions relevant to the study’s interests. Nurse managers with over 2 years of direct experience in the care, treatment and rehabilitation of ALWIDs were eligible to participate in the study. Selecting these nurse managers ensured the study captured their firsthand experiences and expertise in managing nursing services. Data were collected through face-to-face and telephonic semi-structured interviews, recorded digitally. Braun and Clarke’s six-step thematic analysis was used for data analysis.Results: A safe environment; multi-disciplinary team involvement; competent and adequate staff and a conducive physical environment for structural support are beneficial for ALWIDs.Conclusion: To promote the well-being of ALWIDs, it is essential to establish a spacious and safe environment equipped with sufficient material and non-material resources. Engaging a multi-disciplinary team is vital for addressing their diverse needs.Contribution: This study provided information on what constitutes a healthy environment for ALWIDs to inform clinical practice, nursing education, policy makers and research.
Assessing the Effectiveness of Student-generated Scenario-based Questions as a Tool for Active Learning
Authors: Dhar Dipak Kumar , Saiyad Shaista , Mahajan Neeraj
Published: October 2024

Background:

Active learning is not new as an educational philosophy and its benefits over passive learning modes are well known. In a competency-based framework, active learning is one of the key thrust areas. However, across the globe studies have shown that its implementation is wrought with challenges and limitations. The present study explored the implementation and effectiveness of an innovative technique of active learning where students in small groups of 5–6 construct structured scenario-based questions (SBQs) and learn in the process of making questions.

Objectives:

The study was done with the objective of assessing the effectiveness and feedback of student-generated SBQs as a method of active learning among medical students.

Materials and Methods:

Sensitization about the project was done followed by deciding the topics which could be covered with this method. The method was implemented in Physiology for Phase 1 MBBS students. During implementation, two small groups (25 students each) were randomly assigned into a “study group” and two into a “control group.” The students were given trigger topics, learning resources and then asked to make SBQs in sub-groups of 5–6. The questions were then opened to discussion, comments and answering by the peers. Knowledge obtained was compared by a pre-post analysis within-group using paired t-test. Between-group analysis was done using independent sample t-test. Feedback was collected both from faculty and students on a Likert Scale.

Results:

The study group recorded a statistically significant higher score (11.92 ± 2.2) after the activity as compared to control group (8.04 ± 2.24). Feedback received from participants and faculty was positive with a mean score of more than 4 on a 5-point Likert Scale for all items, except feasibility in which the faculty feedback score was 3.67. Out of 49 participating students, 31 students commented on qualitative feedback that it was engaging. More than half (26) students mentioned they “want more such sessions.”

Conclusion:

The present study showed that this activity can be implemented in small group teaching hours of the timetable. It retains the benefits of active learning both in terms of learning outcomes and experientially. It can also be used as a means to implement problem-based learning and early clinical exposure.
E-portfolio in Learning and Assessment of Community Medicine for Medical Undergraduate Students
Authors: Mathur Medha , Samuel Sangeetha , Mathur Navgeet , Kaur Manjinder , Badyal Dinesh K.
Published: October 2024

Background:

A portfolio is a specific collection of student work and achievements in various areas. E-portfolio is an electronic collection that serves the purpose of storage and showcase with the ease of access for both students and evaluators. The knowledge and skills regarding immunization in medical students are of utmost importance for the successful implementation and conduction of the Universal Immunization Program in the country. Hence, this study proposed to use e-portfolio for learning and assessment of immunization in medical undergraduates.

Aim and Objectives:

The aims of this study were as follows: to develop an e-portfolio for learning and assessment in community medicine, to improve the knowledge of immunization schedules of undergraduates using e-portfolio, to improve the vaccination and counseling skills of undergraduates using e-portfolio, and to obtain feedback regarding the e-portfolio from students and faculty.

Methodology:

This interventional educational study was conducted at a tertiary care medical college including 48 students of Phase III MBBS after informed consent was signed. Prevalidated questionnaire and checklist were used for data collection. Students wrote reflections and uploaded their videos of immunization skills and counseling on the e-portfolio and 5 faculty members assessed the students and provided feedback to students. Feedback on the e-portfolio was taken at the end, and descriptive and qualitative analysis was done. Ethical approval for the study was obtained from the institutional ethics committee.

Results:

The e-portfolio was found to be effective in showcasing the progress and learning of the students. E-portfolio improved knowledge, skills, self-directed learning, and reflective writing. The competency of immunization improved after the use of e-portfolio (P < 0.001). Faculty and students had high satisfaction with the e-portfolio and found the e-portfolio to be innovative, convenient to use, and easily accessible.

Conclusions:

E-portfolio is user-friendly and effective in imparting and assessing immunization competency. The use of this intervention for other topics is recommended.
Coexistence of congenital superior rectus muscle fibrosis and Marcus Gunn jaw-winking phenomenon
Authors: Zhu Binbin , Yan Jianhua
Published: November 2024

A 6-year-old male involving a coexistence of congenital fibrosis of the superior rectus muscle (SR) with Marcus Gunn Jaw-Winking phenomenon presented with an elevation of the upper eyelid along with a chronically open mouth that had been present since early infancy. There was extropia and hypertropia, a limitation of elevation and depression in the right eye, and an abnormal head posture (AHP) with a left head tilt, right face turn, and a chin-up head position. He also displayed an upper eyelid retraction and a 2-mm lagophthalos in the right eye. Results of the forced duction test indicated a constricted SR of the right eye. A dissection of the SR from the levator palpebrae superioris and a 5-mm SR recession was performed within the right eye. At 2 months post surgery, there was a 3 prism diopters (PD) hypertropia in the right eye when the left eye was fixated on the target and a 10 PD hypotropia in the left eye when the right eye was fixated on the target, along with an improvement in his AHP. In this rare case with a coexistence of congenital fibrosis of the SR and Marcus Gunn jaw-winking phenomenon, we found that the performance of an individualized surgical protocol proved effective in reducing the vertical deviation and improving AHP.
Bilateral serous retinal detachment in HELLP syndrome associated with post-partum sepsis and acute kidney injury: A case report
Authors: Ramnani Vinita , Tripathi Vidyanand , Trivedi Divya , Ramnani Sakshi
Published: November 2024

Serous retinal detachment (RD) can occur either during or after pregnancy, and is often associated with hypertensive disorders in pregnancy. A variant of pre-eclampsia–atypical pre-eclampsia–may present without proteinuria or hypertension. We report a case of a 26-year-old normotensive primigravida who developed sudden blurring of vision in both her eyes during puerperium. Fundoscopy revealed serous retinal detachment in both eyes. Optical coherence tomography (OCT) demonstrated sub-retinal fluid (SRF) in both eyes, and fundus fluorescein angiography (FFA) displayed leakage with pooling of dye all over the posterior pole. She responded well to oral and topical steroid eyedrops, and topical non-steroidal anti-inflammatory eyedrops. Her best-corrected visual acuity improved within a month, with resorption of subretinal fluid. Awareness about serous retinal detachment during/after pregnancy in the absence of hypertensive disorders is noteworthy. The visual prognosis is usually favorable, and this knowledge can allay fear and anxiety among patients.
Retro mode imaging signatures in choroidal nevus: A case series
Authors: Sen Parveen , Saurabh Kumar , Datta Devlina
Published: November 2024

To report the retro mode (RM) imaging signatures of choroidal nevus. This was a consecutive case series of individuals with choroidal nevus, a benign choroidal tumor. Fundus photography and RM imaging were performed using the Mirante system ((Nidek Co. Ltd, Gamagori, Japan). Four eyes of four patients were included. Choroidal nevus was observed as hyporetroreflective in all four patients. RM image was able to distinctly delineate the margins of the nevus. Overlying drusen was variably imaged with RM, appearing as isoretroreflective in one eye and not visualized in another. RM imaging was able to depict choroidal nevus as a dark lesion with well-delineated margins. It may have a role in the documentation and follow-up of eyes with choroidal nevus.
Sudden visual loss after COVID-19 infection with diabetic ketoacidosis
Authors: Tuli Laxmi , Narang Subina , Kansal Mahima , Dhayal Nitesh
Published: November 2024

We report a case of an atypical optic neuritis (AION) in an adolescent male, diagnosed with diabetic ketoacidosis in the setting of a coronavirus disease 2019 (COVID-19) infection. On the third day of admission, he developed sudden profound visual loss and ocular examination revealed bilateral pale disc edema. Examination and investigations were conclusive of bilateral optic neuritis. Optic neuritis in the setting of pale disc edema was unusual, and the pallor could be due to an episode of AION that was superadded by optic neuritis during the cytokine storm. The patient was given a trial of i.v. steroids. However, the vision loss could be recovered partially only. Thus, through this case report, we would like to highlight the importance of a close follow-up of patients following COVID-19 infection and a possible association of metabolic acidosis in precipitating the episode of optic neuritis.
Atypical presentation of sphenoid wing meningioma mimicking idiopathic orbital inflammation
Authors: Vishwanath Prithvi , Backiavathy Varsha , Subramanian Krishnakumar
Published: November 2024

Sphenoid wing meningiomas (SWMs) are slow-growing tumors that commonly present with proptosis and progressive visual deterioration. Due to the proximity of the sphenoid bone to key structures in the orbit, it may occasionally be misdiagnosed as other inflammatory and other neoplastic orbital diseases. This case report highlights an atypical presentation of SWM that mimics idiopathic inflammatory orbital disease, underscoring the importance of differential diagnosis.
Topiramate-induced uveal effusion with myopia without angle closure: A case report
Authors: Singh Harsh V , Kalita Iva R , Nayak Swatishree , Deka Ratul Charan
Published: November 2024

Topiramate-induced acute angle closure is a well-known entity with onset of symptoms at 2 weeks following treatment initiation. We report a 24-year-old female with blurring of vision 2 days after increasing the topiramate dose for migraine prophylaxis. Examination showed increase in manifest myopia with normal intraocular pressure and absence of angle closure. Provisional diagnosis of topiramate-induced myopia (TIM) was made, confirmed by presence of uveal effusion on B-scan and ultrasound biomicroscopy. Early presentation during the course could be the reason for isolated myopia. She was advised to stop topiramate and was started on cycloplegics. This case highlights that awareness about TIM among patients helps in prompt management, thus preventing the site-threatening acute angle closure.
Carotid–cavernous sinus fistula with functional filtering bleb: A case report
Authors: Okada Yo , Mieno Hiroki , Ueno Morio , Mori Kazuhiko
Published: November 2024

We describe a rare case of carotid-cavernous sinus fistula (CCF) in a 91-year-old woman's right eye with a functional filtering bleb. Upon examination, best-corrected visual acuity was light perception and intraocular pressure (IOP) was 14 mmHg, and a shallow anterior chamber, a swollen filtering bleb, dilated episcleral veins, choroidal detachment, and ocular manifestations accompanied with CCF were observed. During the healing process post transcatheter arterial embolization (TAE), significant hypotony and prolonged choroidal detachment were observed. Generally, IOP elevation is known to be a common ocular manifestation in CCF cases. When CCF develops in an eye with a functional filtering bleb post trabeculectomy, no IOP elevation is observed because the aqueous humor drains from the bleb. Dilated episcleral veins and a shallow anterior chamber may be observed, and although significant hypotony can occur soon after TAE, closure of the CCF results in recovery of vision without ophthalmic intervention.
A rare case of secondary glaucoma complicated by Eisenmenger syndrome
Authors: Reddy Anusha Devi , Menon Meena Gopinath , Shanmugam Mahesh P
Published: November 2024

We report an interesting case in a 52-year-male patient, a known case of Eisenmenger syndrome who developed uveal effusion syndrome (UES) secondary to elevated episcleral venous pressure after undergoing trabeculectomy for open-angle glaucoma. The patient was initially managed medically and then treated surgically by performing a lamellar sclerectomy to enhance the uveoscleral outflow. This report highlights a rare case of UES in conjunction with Eisenmenger syndrome, which, to our knowledge, is the first documented instance in the literature. By sharing this case, we aim to give importance to the systemic associations in such conditions.
A rare case of isolated congenital anterior urethrocutaneous fistula misinterpreted as urethral duplication
Authors: Sharma Girraj P. , Shekar Ashwin P. , Moirangthem Thoiba
Published: October 2024

While most of the causes of urethrocutaneous fistulae are complications caused by hypospadias repair surgery, congenital anterior urethrocutaneous fistula (CAUF), in the isolated form, is an extremely rare anomaly that had been reported only a few times in literature. In this study, we report the case of 3-year-old uncircumcised boy, who presented with the condition of passing urine through an opening located on the ventral side of his penis since birth. On local examination, a clearly apparent fistula measuring 4 × 3 mm was observed on the ventral side of the shaft of the penis. Distal to that fistula, the glans was intact with a normal wide urethral meatus at its tip, and the prepuce was intact. Voiding cystourethrogram findings were suggestive of a partial duplication of the urethra. On examination under anesthesia, a urethroscopy revealed isolated congenital anterior penile urethrocutaneous fistula. For treatment of this condition, he underwent a single-stage closure of the fistula in layers with the tunica vaginalis as a waterproofing layer. Postoperatively, the catheter was removed on day 10, and he voided well with no fistula. In addition to awareness about the condition, a careful clinical examination, evaluation, and an appropriate surgical technique are required to achieve an optimal functional and esthetic outcome.
Synthesis and Characterization of Nanosilica-Coated Antibiotics, TAP: A Comprehensive Study Utilizing XRD, EDS, FTIR, SEM, and TEM – Invitro Study
Authors: Hameed Mahaboob S. , Antony S. Delphine P. , Shanmugam Rajeshkumar , Raghu Sandhya
Published: October 2024

Aim:

To synthesize nanosilica and investigate its properties, focusing on its interaction with antibiotics, particularly triple antibiotic paste (TAP). Various analytical techniques, including X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDS), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and transmission electron microscopy (TEM), were employed.

Materials and Methods:

The synthesis of nanosilica involved the meticulous combination of ammonia, ethanol, water, and tetraethyl orthosilicate in a sterile conical flask, followed by centrifugation and drying. Nanosilica was further explored by being combined with antibiotics, including doxycycline, Flagyl, and ciprofloxacin, to create novel antibiotic-coated variants. These combinations were subjected to various analytical techniques to assess their properties.

Results:

The FTIR spectra of silica nanoparticles revealed specific peaks associated with silicon-oxygen bonds and siloxane structures. Nanosilica coated with antibiotics exhibited distinctive peaks indicating the presence of organic components and Si-O-Si bonds, offering insights into their potential applications in drug delivery systems. SEM images displayed uniformly dispersed spherical particles, while TEM images and histograms provided valuable data about the size distribution of nanosilica, essential for applications like drug delivery. XRD analysis confirmed the crystalline nature of silica nanoparticles and offered insights into their crystallographic structure.

Conclusion:

This comprehensive study showed the synthesis and characterization of nanosilica and its antibiotic-coated variants, with a particular focus on TAP. The findings contribute to our understanding of their structural and compositional properties, providing potential avenues for applications in diverse scientific and technological fields, including drug delivery and nanotechnology.
Effect of Acidulated Phosphate Fluoride Gel on Zirconia Intaglio Surface: An In-Vitro Study
Authors: Hasan Nadia H. , Alkhalidi Emad Farhan , Qasim Ammar Abdulghani
Published: October 2024

Abstract

Aim:

To evaluate the micro-shear bond strength (µ-SBS) of resin-modified glass ionomer cement and to assess the chemical and topographical changes in the zirconia fitting surface induced by acidulated phosphate fluoride (APF) gel using scanning electron microscope (SEM) analysis and Fourier transform infrared (FTIR) spectroscopy.

Materials and Methods:

Thirty-two samples were prepared from two zirconia materials, UPCERA HT White and BruxZir® Solid Zirconia, milled by a computer-aided design/computer-aided manufacturing system. From each zirconia sample, six plates were prepared for FTIR and SEM testing. Following sintering, the samples were divided into control and test groups for each material. The APF gel (1.23%) was applied to the intaglio surface of each test group. To measure the µ-SBS between the zirconia materials and luting cement, 20 rectangular samples of zirconia material were prepared. Ten samples were obtained from Upcera and ten from Bruxzir, with five assigned to the control and five to APF groups.

Statistical Analysis:

For the µ-SBS test, independent samples t test was conducted to determine the level of significance between the tested groups.

Results:

FTIR spectroscopy revealed new bands for Upcera and Bruxzir zirconia owing to ion exchange between the formed sodium phosphate and the zirconia surface and the formation of zirconium phosphate by an ester reaction. SEM assessment identified lines, scratches, or surface dissociation that appeared on the intaglio–zirconia surface after conditioning. The µ-SBS test, as indicated by the independent samples t test, showed a significant increase in bond strength of 1.266 and 1.566 MPa for Upcera and Bruxzir zirconia, respectively.

Conclusion:

This study offers new practical, cost-effective, and accurate tests to enhance the µ-SBS of luting cement to yttria-stabilized tetragonal zirconia polycrystal ceramics.
Repair Bond Strength of Composite Resin to Dental Ceramic Using Various Surface Treatments: An In Vitro Study
Authors: Al-Askary Raghad A. , Al-Ashou Wiaam M. O. , Hassoon Saif Nadhim
Published: October 2024

Abstract

Aim:

This research aims to evaluate and compare the effect of various surface treatments and adhesive types on the bond strength between composite resin and two types of ceramic materials.

Materials and Methods:

A total of 98 disk-shaped of 10 mm diameter and 4 mm thickness were fabricated for each of the zirconia (H. C. Starck) and lithium disilicate (IPS E-Max computer-aided design), which were implanted individually in the acrylic resin mold leaving one surface exposed. The disks in each group were sub-divided according to the surface treatments into seven groups (n = 14): [hydrofluoric acid (HF, 9.5%), air abrasion, bur, laser, HF + bur, HF + air abrasion, HF + laser]. Each sub-group was further divided into two groups (n = 7) according to the type of adhesive used for the repairing procedure [G-Premio Bond universal adhesive group and intraoral repair kit (BISCO) group]. Each adhesive was applied depending on manufacturer instructions and, then, the composite cylinder (4 mm in diameter and 4 mm in height) was built on the pre-determined treated ceramic surface area by the addition of rubber mold. Then the samples were stored in distal water for 24 h. After that, all groups were submitted to a shear bond test using an Instron testing machine (TSTM 02500; Elista Ltd., Istanbul, Turkey) at 0.5 mm/min a crosshead speed. The data were analyzed by three-way analysis of variance and Tukey post hoc test at (P ≤ 0.05).

Results:

The HF + air abrasion groups registered the higher bond strength but with no statistically significant difference from groups of HF + bur. While the laser groups showed the lowest mean bond strength. Generally, E-Max registered significantly higher bond strength in comparison to zirconia. Finally, the BISCO repair system registered a significantly higher bond strength value in comparison to G-Premio.

Conclusion:

Combined surface treatment of HF + air abrasion with an intraoral repair kit can provide a promising method for repairing cracked ceramic restorations. However, repairing lithium disilicate is more predictable and successful than zirconia.
Lung Isolation Techniques for Challenging Airway Scenarios: A Narrative Review
Authors: Konduri Sushma , Naik Vibhavari Milind , Rayani Basanth Kumar , Bharuka Aanchal Rajkumar , Anne Poornachand , Christopher M. Asiel
Published: October 2024

Lung isolation is a critical aspect of patient management during thoracic cancer surgeries. While conventional techniques are well established for patients with normal airway anatomy, anatomical alterations in the upper or lower airways, especially due to cancer, can pose significant challenges. This review thoroughly examines the available lung isolation techniques for challenging airway scenarios, aiming to guide clinicians in selecting the most appropriate approach for each patient. Here, we explore the intricacies and nuances of one-lung ventilation in patients with altered airway anatomy. A comprehensive literature search was conducted using PubMed from January 2000 to May 2024, and additional references were identified through manual review. A tailored approach using available techniques is warranted in difficult airway scenarios, especially in patients with complex anatomical variations. The techniques such as a single-lumen endotracheal tube with bronchial blocker and a double-lumen tube insertion using a video laryngoscope or paediatric fibre-optic bronchoscope are discussed in difficult upper airway abnormalities. In some of the lower airway abnormalities, diverse lung isolation techniques mentioned in the literature are described.
Prediction of Diabetes in Middle-Aged Adults: A Machine Learning Approach
Authors: Addo Gideon , Yeboah Bismark Amponsah , Obuobi Michael , Doh-Nani Raphael , Mohammed Seidu , Amakye David Kojo
Published: October 2024

Background:

Diabetes is a serious health concern requiring effective diagnostic strategies, particularly since its symptoms overlap with those of other conditions. Despite extensive research on early diabetes detection across various age groups, middle-aged adults have been relatively underexplored. This study focuses on this demographic to examine symptom-diabetes associations, examine the influence of symptoms in diabetes prediction, and determine an optimal machine learning (ML) model for diabetes prediction.

Materials and Methods:

This study utilized data from a previous cohort study conducted in Bangladesh. The original dataset included demographic and symptom-related information from 520 patients visiting the ABC Hospital in Bangladesh, India. The participants comprised both diabetic and non-diabetic individuals showing diabetes-like symptoms. For our study, data from 296 middle-aged adults (aged 40–60 years) were extracted. Chi-square tests assessed diabetes-symptom associations, and the Boruta algorithm examined feature influence. Seven ML classification models were evaluated for predictive accuracy.

Results:

Results showed that 60% of the 296 participants were diabetic. Symptoms like polyuria, polydipsia, weakness, sudden weight loss, partial paresis, polyphagia, and visual blurring were significantly associated with diabetes. All demographic and symptom-related features were influential in diabetes prediction, with polyuria, polydipsia, gender, alopecia, and irritability emerging as the most influential. Among the ML models tested, the random forest model exhibited the highest sensitivity (98.59%) and outperformed others in accuracy (96.58%) and area under the curve score (96.00%), making it the most efficient model for predicting diabetes in middle-aged adults.

Conclusion:

Diabetes associated symptoms provide valuable diagnostic opportunities for early diabetes detection in middle-aged adults. Future research should explore genetic, lifestyle, and environmental factors to improve diagnostic accuracy.
Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case Report
Authors: Samajdar Shambo S. , Mukherjee Shatavisa , Saboo Bansi , Chatterjee Nandini , Pal Jyotirmoy , Joshi Shashank
Published: October 2024

Background:

The management of cardiovascular diseases often includes the use of statins, which, while reducing cardiovascular risk, can interact with other medications leading to significant adverse effects. This case report explores the complex interactions between atorvastatin, clopidogrel, and repaglinide, which precipitated severe hypoglycemia and myopathy in a patient with multiple comorbidities.

Case Presentation:

We describe a 68-year-old female with a history of type 2 diabetes mellitus, hypertension, and ischemic heart disease, who developed severe hypoglycemia and myopathy following the adjustment of her statin therapy post-cardiac diagnosis. Her treatment regimen was modified to include an increased dose of atorvastatin and the introduction of clopidogrel, shortly after which she presented with hypoglycemia and symptoms of myopathy. Investigations revealed significantly elevated muscle injury markers and magnetic resonance imaging findings consistent with myositis.

Discussion:

The pharmacokinetic interactions between clopidogrel with repaglinide and repaglinide with atorvastatin exacerbated by the increased dose of atorvastatin, likely led to the observed clinical manifestations. This case highlights the critical need for careful monitoring of drug interactions, especially in patients with polypharmacy. Adjustments in drug dosages and consideration of alternative medications with fewer interaction risks are essential components of managing similar cases.

Conclusion:

This case underscores the importance of vigilant therapeutic management and individualized patient care in the context of complex drug regimens. Understanding and anticipating drug interactions can prevent significant adverse effects and improve patient outcomes in a population at high risk of polypharmacy complications.
Investigating the Prevalence of Undiagnosed Diabetes and Its Associated Factors Among Healthcare Workers: A Cross-sectional Study in South of Iran
Authors: Zamani Ali , Assadian Kasra , Masoumi Seyed Jalil , Dashtaki Nadia Mohammadi , Ardekani Fariba Moradi , Mansouriyekta Elahe , Mirahmadizadeh Alireza
Published: October 2024

Context:

Undiagnosed diabetes mellitus (DM) is a hidden aspect of the diabetes epidemic. Globally, over 50% of cases are estimated to be undiagnosed. Undiagnosed DM poses serious public health concerns due to increased risks of complications.

Aims:

This study aimed to investigate the prevalence and associated factors of undiagnosed diabetes among healthcare workers in southern Iran.

Settings and Design:

This cross-sectional study analyzed baseline data from the Shiraz University of Medical Sciences Employees Health Cohort Study, involving 5918 healthcare workers aged from 20 to 70 years.

Materials and Methods:

Participants completed questionnaires, underwent anthropometric measurements, and provided blood samples for clinical laboratory tests. Undiagnosed diabetes was defined as fasting plasma glucose ≥126 mg/dL in those without a previous diagnosis.

Statistical Analysis Used:

Univariate and multivariate logistic regression analyses were used to determine associated factors.

Results:

The prevalence of undiagnosed diabetes was 1.2%. Diagnosed diabetes had a prevalence of 3.1%. Together, undiagnosed cases accounted for 27.4% of total cases. Age (odds ratio [OR] = 1.09, 95% confidence interval [CI] [1.05–1.12]), male gender (OR = 1.67, 95% CI [1.01–2.74]), general obesity (OR = 3.64, 95% CI [2.45–5.91]), abdominal obesity (OR = 2.62, 95% CI [1.52–4.52]), hypertension (OR = 1.84, 95% CI [1.06–3.17]), and dyslipidemia were associated factors for undiagnosed diabetes.

Conclusions:

Although lower than national estimates, over one-quarter of diabetic cases among health workers remained undiagnosed, highlighting the need for improved screening, especially in high-risk groups. Expanding screening programs, raising health literacy, and increasing community access to preventive services are essential steps in addressing the public health issue of undiagnosed diabetes.
Perceived Barriers to Leisure-time Physical Activity among Individuals at Risk of Type 2 Diabetes in India
Authors: Thirunavukkarasu Sathish , Fil Farah El , Prokou Maria , Venkatachalam Aravind , Kumar Siya , Shifaly Fathimath , Oldenburg Brian
Published: October 2024

Background:

Research on barriers to physical activity among adults in India is limited, and even less is known about this issue among individuals at high risk of developing diabetes.

Objectives:

We aimed to identify the perceived barriers to leisure-time physical activity among individuals at risk of developing type 2 diabetes in an Indian population.

Materials and Methods:

This cross-sectional study utilized baseline data (collected in 2013) from 1007 participants enrolled in the Kerala Diabetes Prevention Program. These participants were randomly selected from 60 polling areas (electoral divisions) in the Trivandrum district of Kerala state. Standardized questionnaires were employed to collect information on socio-demographics, leisure-time physical activity levels, and perceived barriers to physical activity. Statistical analyses comprised chi-square and t tests.

Results:

More than three-fourths (79.6%) of participants reported being physically inactive during their leisure time, with females showing a higher prevalence (84.6%) than males (75.2%; P < 0.001). The most common perceived barriers for both males (52.4%) and females (51.0%) in participating in leisure-time physical activities were “other priorities,” such as time constraints, family obligations, and work commitments. Females were significantly more likely than males to cite “lack of exercise skills,” “lack of social support,” and “exercise is not important” as barriers to leisure-time physical activity (all P < 0.05).

Conclusion:

Our study shows concerning levels of physical inactivity during leisure time among participants, particularly among females. Furthermore, the findings underscore the critical need for implementing interventions specifically targeted at addressing gender-specific barriers to leisure-time physical activity.
Case Report of a Patient with Different Types of Calcifications in the Head and Neck Region
Authors: Ertas G , Aydogdu M , Adısen MZ
Published: October 2024

The deposition of calcium minerals in soft tissue leads to soft tissue calcification or ossification. Calcifications observed in the head and neck region are usually asymptomatic and are detected by chance during routine radiographic examinations. It is essential to identify and differentially diagnose these calcifications to determine appropriate treatment and identify any underlying systemic diseases that may be responsible. Conventional radiographs and advanced imaging techniques can be utilized to locate the calcifications and evaluate their local relationships with anatomical structures. Panoramic radiography is useful in detecting calcifications in the head and neck region but may be insufficient due to several limitations. This unique case report focuses on cone beam computed tomography (CBCT) images of a patient with six different types of calcifications incidentally detected in the head and neck region during a dental examination. Localizations, similarities, and differences in calcification types were evaluated by 3D imaging.
The possible protective role of glucosamine versus zoledronic acid on osteopenic effect of pantoprazole in adult male albino rats
Authors: Hamad Mona G. , Haiba Doaa A. , Estfanous Remon S. , Ibrahim Sarah
Published: October 2024

Background

Osteopenia is an asymptomatic condition till fragility fractures occur and may be linked to prolonged use of pantoprazole.

Aim

To determine osteopenic effect of long-term use of pantoprazole and study the possible protective role of glucosamine versus zoledronic acid on this effect in adult male albino rats.

Patient and methods

A total of 60 rats were divided equally into six groups; group I subdivided equally into IA received no treatment and IB received normal saline. Group II received glucosamine. Group III received zoledronic acid. Group IV received pantoprazole. Group V received pantoprazole and glucosamine. Group VI received pantoprazole and zoledronic acid. After 12 weeks, the left femurs were subjected to radiography and measured bone mineral density from the proximal end (neck). The right proximal ends of femurs were processed for histological, immunohistochemical, and scanning electron microscopic studies.

Results

Groups V and VI showed restoration of normal trabecular histology with a highly significant increase in trabecular thickness and a highly significant decrease in inter-trabecular spaces and mean area% of osteopontin compared with group IV. However, it seemed that group V had a more anabolic effect revealed by significant increase in bone mineral density, Z-score, and mean area% of osteocalcin compared with group VI.

Conclusion

Long-term use of pantoprazole led to osteopenia. Concomitant use of either glucosamine or zoledronic acid with pantoprazole reduced the severity of trabecular damage induced by pantoprazole. However, it seemed that glucosamine exerted a more anabolic effect than zoledronic acid.
How the ETAS models were created, used, and evolved -- Personal views and perspectives
Authors: Ogata Yosihiko
Published: October 2024

Statistical seismology originated in Japan 130 years ago. Through the marriage with stochastic point processes in about half a century, we can now provide on-line estimation, real-time forecasting and direct diagnosis of seismic activity. This manuscript describes the origin and recent development of the ETAS models, their relationship to forecasting problems, and their diagnostic studies of the physical phenomena of seismic activity. I will take this opportunity to focus on my research experiences and views.
New Formats of U.S. Nuclear Alliances and Their Impact on the Treaty on the Non-Proliferation of Nuclear Weapons
Authors: Ustinov R. A.
Published: November 2024

This article examines the impact of new formats of nuclear cooperation launched by the United States with its allies on the international nonproliferation regime established by the Treaty on the Non-Proliferation of Nuclear Weapons (NPT). The two examples of such cooperation outlined in this article are the AUKUS partnership between Australia, United Kingdom and Untitled States that involves transfer to Canberra of a large amount of highly-enriched uranium for use in nuclear-powered submarines, as well as the extended deterrence between the United States and the Republic of Korea. This material presents the analysis of how (if at all) these initiatives are compatible with the NPT and what the most problematic elements are in each case in relation to the Treaty and its regime. It derives from the research that has been conducted that the new formats of United States’ nuclear cooperation are undermining the NPT regime and its international standing. As a result of such cooperation the NPT loses its unique international legal core that for more than half a century has allowed to stop proliferation of nuclear weapons. The norms that lied in the basis of the Treaty are also being eroded. Such tendencies create a completely new environment and inevitably affect security calculus of other States Parties to the NPT. Against this backdrop further decrease of the political weight of the Treaty cannot be excluded, together with its role in upholding international peace and stability. Such transformations may require a brand new look at and approach to the international nonproliferation regime in the future.
Assessment of Lacto-N-tetraose (LNT) as a Novel Food for Use in Food and Food Supplements (RP2101)
Authors:   Food Standards Agency,   Food Standards Scotland
Published: October 2024

Chr. Hansen, Denmark (“the applicant”) submitted a novel food application for the authorisation of lacto-N-tetraose (LNT) as a novel food to each nation of Great Britain in September 2023.

The novel food is intended to be used as a source of human identical milk oligosaccharide, LNT, and is manufactured by microbial fermentation using a genetically modified strain of Escherichia coli BL21 (DE3), and then refined to yield the purified powder.

This new application is seeking to use the novel food within the following food categories: food for special medical purposes and food supplements for the general population including those for vulnerable groups (pregnant and breastfeeding women, and the elderly); food for infants and young children including infant formula and follow-on formula. Food supplements are not intended to be used if other foods with added LNT or breast milk are consumed the same day.

This novel food had its application for authorisation assessed by the European Food Safety Authority (EFSA) which was published in March 2022. The Food Standards Agency (FSA) and Food Standards Scotland (FSS) have reviewed the information available, including the EFSA opinion, and confirmed that LNT is safe under the proposed conditions of use. The anticipated intake levels and proposed use in food and food supplements was not considered to be nutritionally disadvantageous.

This safety assessment represents the opinion of the FSA and FSS.
The Necessity and Importance of Research and its Role in Afghan Society
Authors: Yar Fayaz Gul Mazloum
Published: October 2024

This research examines the necessity and importance of scientific research in Afghan society and its role in the economic, social, and cultural development of the country. Given the numerous challenges faced by Afghanistan, including war, poverty, and political instability, research is recognized as a vital tool for identifying and analyzing problems and providing data-driven and evidence-based solutions. The research employs a qualitative methodology based on semi-structured interviews with researchers, university professors, and policymakers. Findings indicate that scientific research can contribute to economic development by enhancing educational quality, improving infrastructure, and increasing innovation. Additionally, the results suggest that institutional, cultural, and financial resource barriers are among the main challenges to advancing research in Afghanistan. Ultimately, this study emphasizes the need for investment in research and the creation of suitable infrastructures to achieve sustainable development and improve the quality of life in Afghanistan.
«Прашал еси о неких, иже купят челядь»: о христианском отношении к рабам и слугам на Руси
Authors: П.И. Гайденко
Published: November 2024

Канонические ответы митрополита Иоанна II — древнейший канонический памятник. Он уже давно привлекает внимание исследователей, однако за всю свою историю он не получал полного, насколько это позволяют возможности, комментария. Представленный вниманию читателей очерк — опыт комментария одного из правил этого канонического свода. 22 правило Канонических ответов посвящено проблеме продажи рабов-христиан иноверцам, «поганым». Предварительный анализ текста позволяет говорить о том, что на Руси при продаже рабов не ориентировались на законодательство Византии, как, например, это было при организации церковной жизни. Очевидно, что митрополит Иоанн крайне негативно относился к имевшей место практике. Однако при этом он не решался вмешаться в происходящее, оставив этот вопрос на волю духовников.

The canonical answers of Metropolitan John II are the oldest canonical monument. It has long attracted the attention of researchers, but throughout its history it has not received a full, as far as possible, commentary. The essay presented to the attention of readers is a commentary on one of the rules of this canonical code. Rule 22 of the Canonical Answers is devoted to the problem of the sale of Christian slaves to Gentiles, the “pagans.” A preliminary analysis of the text allows us to say that in Rus’, when selling slaves, they were not guided by the legislation of the Byzantine Empire, as, for example, it was when organizing Church life. It is obvious that Metropolitan John had an extremely negative attitude towards the practice that took place. However, he did not dare to intervene in what was happening, leaving this issue to the will of confessors.
К проблеме миссионерских переводов богослужебных текстов на языки коренных народов России до 1917 г.
Authors: К. Джункова
Published: November 2024

В статье рассматривается проблема миссионерских переводов литургии св. Иоанна Златоуста в историческом контексте, обращается внимание на необходимость нового подхода к христианизации коренных народов империи в первой половине XIX в., после массового отпада от православия в регионе Поволжья. Переломным моментом является миссионерская программа Н. И. Ильминского, по которой были созданы переводы литургии на основе местных разговорных языков. Рассмотрены переводы богослужения на абхазский, алтайский, бурятский, карельский, коми, марийский, татарский, удмуртский, чувашский и якутский языки. Указывается, что именно перевод на карельский язык 1911 г. содержит большинство славянских заимствований. Хотя традиция христианской проповеди была во время СССР прервана, на сегодняшний день священнослужители некоторых регионов вновь обращаются с исправлениями к миссионерским переводам XIX–XX вв.

The article deals with Russian Orthodox missionary translations of the Liturgy of St. John Chrysostom into the languages of the indigenous nations of the Russian Empire in the historical context. Attention is paid to the phenomenon of apostasy from Orthodoxy in the Volga region, which required a new approach to the Christianisation of the indigenous peoples in the early-mid 19th century. The turning point was the missionary programme of N.I. Ilminsky, according to which translations of the liturgy were created based on spoken local languages. The missionary translations of the liturgy into Abkhazian, Altai, Buryat, Chuvash, Karelian, Komi, Mari, Tatar, Udmurt, and Yakut languages are considered. It is pointed out that the liturgical translation into Karelian (1911) contains the largest number of Slavic borrowings. Although the tradition of Christianisation was interrupted during the Soviet period, nowadays priests turn to the old missionary liturgical translations in some regions, making some linguistic revisions.
Церковно-правовые и пастырские аспекты указов 1981–1993 гг. архиепископа Вологодского и Великоустюжского Михаила (Мудьюгина; 1912–2000)
Authors: Н.А. Тарнакин
Published: November 2024

В статье рассмотрены 17 указов 1981–1993 гг. архиепископа Михаила (Мудьюгина, 1912–2000), которые систематизированы по трем группам: 1) решения с каноническими прещениями; 2) решения со снятием или смягчением наказания, а также с назначением воспитательных мер; 3) содержащие различные аспекты церковного права. Проведен анализ указов с точки зрения Канонического корпуса Православной Церкви. Показано, что 1) архиепископ Михаил не ссылается на канонические правила; 2) судебные решения принимаются им только по внутреннему убеждению, без учета канонов и предусмотренных ими санкций; 3) корреляция между решениями архиепископа Михаила и временем их принятия не обнаружена. Отмечается особое значение, которое архиепископ Михаил придавал пастырскому воздействию на церковного правонарушителя. Делаются выводы, что судебная деятельность архиепископа Михаила: 1) является примером живого церковного правотворчества конца XX в.; 2) показывает реальную возможность разрешения проблематики, заявленной на Всероссийском Поместном Соборе 1917–1918 гг., а именно отделения суда от администрации. Статья написана на основе доклада, сделанного автором на IV Барсовских чтениях (С.‑ Петербургская Духовная Академия, 7 декабря 2020 г.).

The article deals with 17 decrees of 1981–1993 by Archbishop Michael (Mudyugin, 1912–2000). The author systematized the decrees into three groups: 1) decisions with canon sanctions; 2) decisions with removal or mitigation of punishment, as well as with the appointment of educational measures; 3) decrees containing various aspects of ecclesiastic law. The article analyzes the decrees from point of view of the Canonical Code of the Orthodox Church. The author concludes that 1) Archbishop Michael does not refer to Canonical rules; 2) he makes judicial decisions only on inner conviction, without taking into account the canons and the sanctions provided; 3) found no correlation between the decisions of Archbishop Michael and the time of their adoption. The article notes the special importance that Archbishop Michael attached to pastoral influence on a Church offender. Finally, the judicial activity of Archbishop Michael 1) is an example of living ecclesiastical law-making in late 20th century; 2) shows the real possibility of resolving the issues raised at the 1917–1918 Local Council of the Russian Orthodox Church, namely, the separation of ecclesiastic court from administration. The article is written based on the report made at the 4th Barsov Readings (St. Petersburg Theological Academy, December 7, 2020).