bluuebunny/crossref_metadata_2025 huggingface dataset:
Angiographic classification of chronic subdural hematoma
Authors: Kupka Michael Josef , Thurner Patrick , Schubert Tilman , Hainc Nicolin , Germans Menno Robbert , Kulcsár Zsolt
Published: June 2024

Background and purpose – Chronic subdural hematoma (cSDH) is a challenging pathology with high recurrence rate after surgical treatment and may seriously affect the patient’s quality of life. Membrane formation with angiogenesis plays an important role in the evolution of the disease, providing a promising target for endovascular therapy. Our goal is to categorize angiographic patterns of chronic subdural hematoma for standardized reporting purposes. Methods – In our retrospective analysis of prospective data collection, we analyzed angiographic properties of all high recurrence risk patients with cSDH, who were treated by embolization in our hospital between February 2019 and June 2020. Altogether 17 patients were included in the analysis. Results – Based on superselective angiography of the middle meningeal artery (MMA) in the two standard, AP and lateral views, three distinct categories of dural supply were defined: normal vascular pattern (Grade I), cottonwool appearance without enlargement of the MMA branches (Grad II) and strong cottonwool like staining with dilatative remodelling of the MMA branches (Grade III). Conclusion – The proposed grading system of the angiographic appearance of cSDH, representing the pathophysiological evolution of the disease should be correlated to therapeutic success rates and could be applied in future clinical studies.
Az arteria meningea media embolisatio szerepe a krónikus subduralis haematoma kezelési algoritmusában, legújabb evidenciák és saját tapasztalataink
Authors: Oláh Csaba Zsolt , Papp János Gyula , Sas Attila , Oláh Benedek , Czabajszki Máté , Demeter Béla
Published: June 2024

A krónikus subduralis haematoma az egyik leggyakoribb idegsebészeti-műtéti megoldást igénylő kórkép, ami a legtöbb esetben legyengült idősek betegsége. A standard idegsebészeti nyílt műtétek (trepanáció és craniotomia) mellett alternatív megoldásként az arteria meningea media embolisatiója is szóba jön. Számos összefoglaló tanulmány igazolta az endovascularis kezelés nagyon magas arányú sikerességét és veszélytelenségét. Tíz egymást követő, reziduális krónikus subduralis haematoma miatt végzett arteria meningea media szelektív embolisatiós beavatkozásunk technikai részleteit és eredményeit mutatjuk be. Minden beavatkozás szövődménymentes zajlott, és teljes gyógyulást eredményezett.
Vanishing white matter disease, a rare leukodystrophy with mutation in the EIF2B5 gene
Authors: Sinkó Gabriella , Tompa Márton , Kiss Zsuzsanna , Kálmán Bernadette
Published: June 2024

Background – Leukodystrophies, a heterogeneous group of brain and spinal cord disorders, often pose challenges in establishing molecular etiology. Vanishing White Matter Disease (VWMD) is a rare subtype of leukodystrophies presenting with characteristic clinical and MRI features, nevertheless, achieving diagnostic certainty requires genetic studies. Case presentation – Our patient is a nine year old girl, who developed progressive gait difficulties at around 3-4 years of age. Her brain MRI showed confluent lesions with in­creased signal intensity in the cerebral and cerebellar white matter on T2/FLAIR sequences, within which hypointense regions appeared with signal intensity resembling that of the cerebrospinal fluid on T1 sequences. Whole exome sequencing identified a homozygous likely pathogenic variant within the EIF2B5 gene in the proband, which was present in a heterozygous state in both asymptomatic parents. Having the clinical and molecular genetic diagnosis established, we explored therapeutic possibilities for the patient. Conclusion – VWMD is a severe form of leukodystrophies with little or no disease modifying therapy available until recently. A better understanding of its molecular pathogenesis offers some hope for new inventive therapies.
„Verseny az idővel”: a POEMS szindróma
Authors: Rónaszéki Benedek , Sandi Dániel , Ónodi Ádám , Szabó Nikolett , Dézsi Lívia , Tajti János , Piukovics Klára
Published: June 2024

Célkitűzések – A POEMS szindróma egy potenciálisan jól menedzselhető betegség napjainkban, egyre bővülő terápiás arzenállal. A szindróma korai felismerése, ami a gyakorló orvosok számára továbbra is kihívást jelent, nagy jelentőségű a súlyos többszervi károsodás megelőzése szempontjából. Az alábbi két eset bemutatásával a szerzők a betegség késői szövődményeire hívják fel a figyelmet, illetve az elérhető terápiás lehetőségeket mutatják be POEMS szindrómában. Eredmények – Az alábbiakban két olyan beteg esete kerül bemutatásra, akiknél hosszú kivizsgálás és kezelés történt tisztázatlan polyneuropathia miatt. Az esetek jól mutatják, hogy milyen súlyos többszervi eltérés jön létre a késői diagnózisig, illetve hogy az alkalmazható kezelés súlyos esetben is javíthat a beteg állapotán. Bár a POEMS szindróma diagnózisának felállítása továbbra sem könnyű, eszünkbe kell, hogy jusson és kellően körültekintőnek kell lennünk, amikor polyneuropathia miatt kezelést indítunk.
The role of authenticity, involvement and experience quality in heritage destinations
Authors:   Akdeniz University, Manavgat Tourism Faculty, Tourism Management Department, Turkey, Uslu Abdullah , Recuero-Virto Nuria ,   Universidad Complutense de Madrid, Faculty of Commerce and Tourism, Marketing Department, Madrid, Spain, Eren Ramazan ,   Akdeniz University, Manavgat Tourism Faculty, Tourism Management Department, Turkey, Blasco-López Maria Francisca ,   Universidad Complutense de Madrid, Faculty of Commerce and Tourism, Marketing Department, Madrid, Spain
Published: June 2024

This research explores the impact of authenticity and involvement on destination image, aiming to comprehend visitor satisfaction, experience quality, re-patronage intentions, willingness to pay more, and word-of-mouth. Structural equation modelling was employed for analysis using data from 394 visitors to Side, Turkey. According to research findings, authenticity and involvement positively influence destination image. The findings demonstrate that developing re-patronage intentions, word-of-mouth recommendations, and willingness to pay more can be facilitated through experience quality and satisfaction. Also, it is proved that satisfaction is positively influenced by destination image. Moreover, authenticity and involvement positively influence destination image. According to research results, to increase willingness to pay, it is imperative to offer a high-quality cultural tourism experience, wherein tourists gain knowledge about the heritage destination and enjoy the experience while deeply engaging with the surroundings. Furthermore, public and private organisations should design visitor experiences that consider authenticity and involvement to enhance destination image and increase customer satisfaction.
The Lamina Propria of the Oral Mucosa Harbors a Neural Crest-Like Stem Cell Population Resistant to Hyperglycemia Induced by Diabetes Type II
Authors: Arie Ina , Pal Amit , Dan Gal , Kuperman Shiri , Pitaru Sandu
Published: June 2024

Oral mucosa stem cells (OMSC) are contained within niches in the lamina propria of the oral mucosa. In vitro, OMSC exhibit a primitive neural crest-stem cell phenotype and differentiate into neural crest-derived cell lineages. Clinical evidence indicate that wound healing of oral mucosa is scarless and negligibly affected by diabetes. Since stem cells play an important role in wound healing we hypothesized that in contrast to adult mesenchymal stem cells, OMSC are negligibly affected by diabetes type II hyperglycemia. The capacity of murine OMSC (mOMSC) obtained from diabetic db+/db+ mice (DmOMSC) to proliferate, express pluripotency-associated markers (PAM) (oct4, sox2, nanog) and neural crest stem cell markers (NCSM) (Klf4, c-Myc, twist, nestin), and differentiate along neural crest cell lineages was compared to that of OMSC derived from background WT C57BL/6 mice (WT-mOMSC) and to those of murine adipose tissue stem cells (mASC) derived from the same animals used for generating mOMSC. WT-mOMSC capacity to proliferate, express PAM and NCSM and differentiate was higher than that of WT-mASC. Diabetes reduced the proliferation rat of DmOMSC and db+/db+ derived mASC (DmASC) by 35% and 42%, respectively. Diabetes did not affect the expression of PAM and NSCSM in DmOMSC and nor their differentiation as compared to WT-mOMSC, but the diabetic state substantially reduced these parameters in DmASC as compared to WT-mASC and DmOMSC. We demonstrated that WT-mOMSC administration enhances wound healing in the db+/db+ diabetic wound skin model. To test the effect of diabetes on the therapeutic functionality of DmOMSC, the ability of these cells to enhance diabetic wound healing was assessed in this model. The results indicate that DmOMSC increased the rate of wound healing in db+/db+ mice as compared to placebo treated controls. The magnitude of this therapeutic effect is statistically equivalent to that of WT-mOMSC. Collectively, these data demonstrate that: i) diabetes decreased moderately DmOMSC proliferative ability; ii) in contrast to mASC, mOMSC withstand the detrimental effects of diabetes; and iii) the therapeutic properties of DmOMSC are mildly affected by long standing diabetes.
The Influence of Low-Dose Radiotherapy on Paraoxonase-1 and Inflammatory Biomarkers in COVID-19 Pneumonia Patients
Authors: Royo Laura , Árquez Miguel , Acosta Johana , Arenas Meritxell
Published: June 2024

The COVID-19 pandemic will be remembered for its significant health and economic impact worldwide. Severe pneumonia could often progress to acute respiratory distress syndrome (ARDS), this being a critical complication characterised by an exaggerated inflammatory response, known as cytokine-release syndrome (CRS). Amid debates regarding the efficacy of conventional treatments, low-dose Radiotherapy (LDRT) has emerged as a potential therapy due to its anti-inflammatory effects. LDRT modulates immune responses by polarizing macrophages towards an anti-inflammatory phenotype and reducing oxidative stress. While studies investigating LDRT for COVID-19 pneumonia have shown promising results, conflicting data has been published and challenges persist in patient selection and treatment timing. Biomarkers such as paraoxonase-1 activity hold promise for predicting treatment outcomes. LDRT presents an alternative approach to modulating the immune response in COVID-19 pneumonia, offering hope for improved clinical outcomes. Further research is warranted to validate its efficacy and elucidate underlying mechanisms. This article provides summary of the radioimmunological mechanisms and the results of biomarkers research in this context.
Prevalence of Glucose-6-Phosphate Dehydrogenase deficiency among Hausa and Fulani ethnics in Kano, North-West Nigeria
Authors: I Jelani , HL Abdullahi , AJ Alhassan , MM Dalhatu , MA Dangambo , FZ Abacha , S Haruna , RI Mahmud , HD Hamza , R Abdu , U Wali
Published: June 2024

Background: Glucose-6-phosphate dehydrogenase catalyzes the rate-determining step in the pentose phosphate pathway. Its activity is a key determinant of the reduced nicotinamide adenine dinucleotide phosphate to oxidized nicotinamide adenine dinucleotide phosphate (NADPH-to-NADP+) ratio in the cytoplasm and thus contributes to the replenishment of the antioxidant glutathione system. Glucose-6-phosphate dehydrogenase deficiency is a common X-linked human enzyme defect of red blood cells. Individuals with this gene defect appear normal until exposed to oxidative stress which induces haemolysis but it is infrequently taken into consideration in health practices. Aim: The present work was designed to determine the frequency of occurrence of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency among Hausa and Fulani ethnics. Material and methods: Cross-sectional comparative study in which 5 mL of venous blood samples were collected from 1000 individuals (596 males and 404 females) all of whom gave informed consent were screened for G-6-PD-deficiency by qualitative methaemoglobin reduction and quantitative enzyme activity measurement techniques. Results: Glucose-6-phoshate dehydrogenase deficiency was found in 194 (19.4%) of participants studied. Of these 10.3% were Fulani and 22.2% were Hausa with mean G-6-PD enzyme activity of 2.5 IU/gHb in a range from 1.4 to 2.4 IU/gHb. G-6-PD deficiency was found in 121 of 596 (20.3%) males and 73 of 404 (18.1%) females screened. Conclusions: These results suggest high occurrence of phenotypic G-6-PD deficiency in Hausa ethnics of Kano with lower enzyme status among males living with G-6-PD deficiency.
Navigating the Ethics of Genome Editing and Heritability
Authors: Pandos Olga
Published: June 2024

This article explores the role of ethics in contributing to a deliberative discussion on the necessary principles that ought to shape future governance of an emerging technology – Heritable Human Genome Editing (‘HHGE’). An ethical evaluation will be undertaken to identify some of the considerations pertaining to its intergenerational impact. This will be explored through the lens of genetic exceptionalism, human dignity and welfare as guiding ethical principles. The identification of and compliance with key ethical principles reflects a deontological approach. In practice, these principles are applied to achieve an outcome that maximises the welfare of future offspring. While this underlying rationale reflects a utilitarian approach, the practical enforcement of these ethical theories raises questions pertaining to their potential permeability. It is recognised these theories are rightly independent schools of thought. However, in practice, they can be permeable. Ethics, as applied in practice, does not necessarily require a “one theory fits all” approach to an ethical evaluation of this technology. While an outcome which maximises the welfare of future offspring is paramount, the means to achieve this are also important. These principles should inform the basis of an ethical evaluation in determining permissible uses of HHGE. Specifically, to prevent, treat or correct genetic disease.
Public Health Nutrition around the world is not going through its most glorious times
Authors: Schuftan Claudio
Published: June 2024

The purpose of this letter is to elicit your response as a reader to the thesis I present here below. The topic is indeed sensitive and calls for concerted new efforts worldwide. You can send your reaction to be published in the next issue of this journal and I will be glad to respond. We are reaching the end of the United Nations Decade of Nutrition and have little to show for for its achievements.1 True, the COVID pandemic and natural and man-made disasters set us back, but still, seen from the global perspective, the progress has been scant, if any. Let us look at the roots of my pesi/optimist outlook in terms of expected future nutritional outcomes and processes currently under way.
Hypersensitivity pneumonitis from Diagnosis to Treatment: A Cases Series with Literature Review
Authors: Ajim A. , Rebbouh K. , Jabri H. , Chahbounia M. , Elkhattabi W. , Bougteb N. , Arfaoui H. , Afif M. H. , Rebbouh K. , Moussali N. , Merzem A. , Belgadir H. , Amriss O. , Benna N. El
Published: June 2024

Hypersensitivity pneumonitis (HP) classified as an interstitial lung disease is characterized by a complex immunological reaction of the lung parenchyma in response to repetitive inhalation of a sensitized allergen. The estimated worldwide incidence of hypersensitivity pneumonitis is extremely rare and highly dependent on climatic, geographical, occupational and industrial factors. It might be secondary to a domestic or professional exposure, usually occurs in people who work in places where there are high levels of dust, fungus, or molds. Long-term exposure can lead to lung inflammation and acute lung disease. Over time, the acute condition turns into long-lasting (chronic) lung disease. Thus, we distinguish 2 mains aspects fibrotic HP and Nonfibrotic HP. The diagnosis of HP maybe sophisticated especially in fibrotic form. The prognosis of this disease depends on early diagnosis with complete antigen avoidance and most often corticosteroid therapy. This work aims to study the epidemiological, clinical, paraclinical aspects of hypersensitivity pneumonitis as well as therapeutic management, through a series of eight cases of HP carried out at the Pulmonology Department 20 August 1953, University Hospital Center IBN ROCHD, between January 2020 and January 2022, analyzed using a pre-established exploitation sheet. The average age of the patients studied was 51 years with a female predominance (sex-ratio M/F= 0.34). Domestic and occupational exposures of our patients were equal. The clinical symptomatology is dominated by almost constant dyspnea in all patients. Physical signs increased by crackles, objectified in 75% of patients. Computed tomography (CT) remains a great diagnostic contribution. Thus, allowing to have two categories of patients, depending on the presence or absence of signs of pulmonary fibrosis. In our study, five patients had fibrotic HP, and three cases had non- fibrotic HP. Precipitins were positive. Plethysmography objectified a restrictive ventilatory disorder in 62.5%. All patients benefited from antigenic eviction with long-term corticosteroid therapy. The evolution was favorable in 87.5% of cases.
Assuring the Quality of Patient Experience and Outcomes in All-Virtual Nurse Telehealth Programs: A Case Report Illustration
Authors: Adamczyk Mary , Butterworth Susan , Dawson Carrie , Potempa Stacia , Flaherty-Robb Marna , Calarco Margaret , Furspan Philip , Potempa Kathleen
Published: June 2024

There are many approaches to evaluating patient-centered care used by health systems in acute care environments. Yet a growing proportion of care is happening in remote ways, using telehealth methods for chronic care management programs or health coaching for ‘patients’ living in the community, often rarely seen through in-person visits. The typical means of assuring patient-centered approaches may be overlooked or inappropriate for assessing the patient experience in telehealth or online venues. The HealthyLifetimeTM is a community-based, virtual nurse health coaching program for adults with one or more chronic diseases or risk factors. Our quality assurance program will be described, including an assessment of nurse competency using our six strategies, patient-centeredness and personalized approach to coaching, the quality and completeness of core program activities, and patient outcomes and satisfaction with the program. We use a patient case study to describe the program's phases and quality assurance process. While patient satisfaction is an indicator of experience, the quality of the nurse-patient communication dynamic as it relates to the patient’s evolving behavior change and outcome achievement is a critical factor. We developed and validated natural language analysis methods, the Nurse Health Coaching Assessment, to assess the nurse’s use of our six strategies and the patient’s cognitive-behavioral responses – the Indicators of Health Behavior Change – which, combined, assess the quality of nurse-patient communication dynamic. The case illustrates how the program's total quality assurance approach impacts the nurse’s notes, core program elements, and patient outcomes. Additionally, we discuss the cost and value of the program.
Management Considerations and Challenges in Older Individuals with Diffuse Large B-cell Lymphoma
Authors: Giese Noah , Adroja Shubham , Hassanain Hala , Khosla Meera , Rios Jacqueline , Pingali Sai , Burns Ethan
Published: June 2024

Diffuse Large B-cell Lymphoma (DLBCL) is classically a disease of older individuals. However, varying definitions of “older” age, underrepresentation in clinical trials, and significant patient heterogeneity requires a highly personalized treatment approach. Older patients often have comorbidities leading to decreased tolerance with standard of care therapies; however, predictive tools such as the simplified Comprehensive Geriatric Assessment may help tailor treatments accordingly. Several approaches have been introduced to augment therapeutic tolerance in the front-line setting, including prephase therapies, attenuation of current standard of care chemoimmunotherapy dosing, or alternative chemotherapeutic agents when prohibitive comorbidities such as cardiovascular disease are present. In the relapsed and refractory disease setting antibody-based therapies have improved outcomes and demonstrated therapeutic tolerance in older patients. Cellular therapies and bone marrow transplantation remain options for fit patients who are eligible and should be considered. The aim of this review is to focus on patient assessment and treatment recommendations in older patients with DLBCL.
On the efficacy of facial masks to suppress the spreading of pathogen-carrying saliva particles during human respiratory events: Insights gained via high-fidelity numerical modeling
Authors: Seyedzadeh Hossein , Craig Jonathan , Khosronejad Ali
Published: June 2024

Respiratory fluid dynamics is integral to comprehending the transmission of infectious diseases and the effectiveness of interventions such as face masks and social distancing. In this research, we present our recent studies that investigate respiratory particle transport via high-fidelity large eddy simulation coupled with the Lagrangian particle tracking method. Based on our numerical simulation results for human respiratory events with and without face masks, we demonstrate that facial masks could significantly suppress particle spreading. The studied respiratory events include coughing and normal breathing through mouth and nose. Using the Lagrangian particle tracking simulation results, we elucidated the transport pathways of saliva particles during inhalation and exhalation of breathing cycles, contributing to our understanding of respiratory physiology and potential disease transmission routes. Our findings underscore the importance of respiratory fluid dynamics research in informing public health strategies to reduce the spread of respiratory infections. Combining advanced mathematical modeling techniques with experimental data will help future research on airborne disease transmission dynamics and the effectiveness of preventive measures such as face masks.
Fecal Microbiota Transplantation promotes disease remission in a patient with active Crohn’s disease: A Case Report
Authors: Lauridse Hengameh , Mollerup Sarah , Jensen Betina , Andersen Lee , Nielsen Henrik , Helms Morten , Petersen Andreas
Published: June 2024

ackground: A woman aged 46 years presented with moderate to severe Crohn’s disease (CD). Sigmoidoscopy revealed proctitis, with Harvey-Bradshaw Index (HBI)=7. The patient experienced up to six bloody stools per day, stool samples showed increased fecal calprotectin, and low albumin. Method: Case Report. Therapy with 1 portion fecal microbiota transplantation (FMT) capsules every day as add on treatment for 2 weeks was initiated. Hereafter, FMT therapy was tapered off for 21 weeks and stopped. Results: The patient achieved disease remission at week 21. From 2020 till 2023, when the patient experienced disease relapses (up till twice a year), the patient was treated with FMT capsules (one portion per day) for 1-2 weeks, which promoted disease remission. At the age of 49, the patient was examined by colonoscopy, blood tests and fecal calprotectin. Endoscopy and biopsies (macroscopic and microscopic) showed mild inflammation around the appendix and anal regions and no inflammation in the remaining part of the colon and ileum. Blood samples and fecal calprotectin collected prior to colonoscopy were normal. Conclusion: This study suggests that FMT may promote disease remission in CD patients with moderate to severe disease. Microbiome data shows that the patients gut microbiome changed to resemble the donor microbiome. FMT therapy was able to change the intestinal microbiome in a patient with CD accompanied by clinical disease remission.
Introduction to NJWLS 2024-2
Authors: Buch Anders
Published: June 2024

This summer issue of Nordic Journal of Working Life Studies compiles four research articles from Sweden, Iceland and Finland (...)
Knowledge Claims on Municipalities in the Swedish Labor Market Policy
Authors: Ulmestig Rickard
Published: June 2024

Activation is crucial for beating unemployment for those with high thresholds for entering the labor market. The municipalities in Sweden have become an important factor in the activation. However, no formal argument or decisions were ever made to support the inclusion of municipalities in labor market policy. A government report was, however, compiled and sent to different stakeholders for comments. The present study is based on an analysis of the comments, here termed knowledge claims. The analysis shows that there is a low level of interest from different stakeholders except for the municipalities who are burdened with the cost of social assistance when the unemployed do not find work. The municipalities legitimize and reproduce a dual system for labor market policy. The Public Employment Service (PES) prioritizes unemployed persons who have unemployment insurance and a low threshold for entering the labor market, and the others are left to the municipalities to deal with.
E-Health Implementation Challenges and HIS Evaluation in Accordance with EMRAM in Iran
Authors: Ayat Masarat
Published: June 2024

The implementation of electronic health (e-Health) in healthcare organizations consistently encounters numerous challenges. These barriers hinder the widespread adoption of this promising technology within healthcare settings. This study addresses the challenges of implementing e-Health across various hospitals and also aims to evaluate the maturity of hospital information systems (HIS) in Iranian hospitals based on the electronic medical record adoption model (EMRAM). Through two rounds of literature review and case studies, a comprehensive understanding of these previously unexplored issues has been developed. The findings identify 13 social and technical challenges, including the lack of standard applications, high costs associated with e-Health and training, legal issues, security concerns, inconsistencies and diversities in perceived e-Health benefits and barriers, lack of proficiency, and difficulties healthcare professionals face in integrating e-Health into their daily tasks. There are also negative perceptions among physicians and patients regarding the use of e-Health software, the lengthy implementation times for HIS systems, technical difficulties due to platform diversity, resistance to change, and the limited use of pilot projects, particularly in Iran. Moreover, the maturity of hospital cases in Iran is at 3 stages, in contrast to the 7 stages of EMRAM. These results underscore the need to develop an effective strategy to address the challenges identified in this research. Additionally, a specific program should be implemented for developers to enhance the maturity of HISs and advance them to higher stages of EMRAM.
Estimating the Economic Burden of Type 2 Diabetes Among the Elderly in Tehran Province
Authors: Ghorbani Salar , Rezapour Aziz , Jahangiri Reza , Bagheri Faradonbeh Saeed , Ghotbiyan Niloofar , Saeedian Elham
Published: June 2024

Background: The prevalence of non-communicable diseases such as diabetes tends to rise with age, peaking among the elderly population. Objectives: This study aimed to estimate the economic burden of type 2 diabetes mellitus (T2DM) among the elderly in Tehran province.
Methods: This research employs a descriptive-analytical approach, focusing on T2DM patients who attended the specialized diabetes clinic of Tehran province in 2019. A total of 1256 cases were included in the study. Data collection involved reviewing hospital records and accessing information from the accounting department. Data analysis was conducted using Excel software.
Results: The economic burden of T2DM amounted to 432,471,301,510 Rials. Among this, 230,841,323,930 Rials (53.3%) were attributed to the costs of diagnosis and treatment, while 180,365,897,580 Rials (41.7%) were associated with treating disease complications. Additionally, 9,043,200,000 Rials (2%) accounted for non-medical direct costs (NMDC), and 12,220,880 Rials (0.3%) were attributed to NMDC due to complications.
Conclusions: Given the substantial financial burden incurred by elderly T2DM patients and the constraints on healthcare resources, it is imperative to prioritize preventive and therapeutic measures for this demographic. Comprehensive efforts are needed to mitigate the costs and consequences of this disease within the healthcare system.
A Scoping Review to Improve Universal Health Coverage for Pediatric Dental Services Policies
Authors: Pouraghasi Leila , Olyaeemanesh Alireza , Jafari Mehdi
Published: June 2024

Background: Poor oral and dental health significantly affects public health, impacting over half the world’s population. Dental caries can undermine children’s academic success and career prospects. Social inequities result in unequal access to oral healthcare, particularly among populations with lower socioeconomic status (SES). National policies that improve access to oral health can reduce these disparities. Objectives: This study aims to compile policies implemented by various countries to achieve universal health coverage (UHC) for pediatric dental services.
Methods: This scoping review was conducted according to Arksey and O’Malley’s framework and is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A systematic search was conducted on databases including Scopus, PubMed, Magiran, SID, Irandoc, Google Scholar, the WHO website, and the databases of Iran’s Ministry of Health. The search aimed to identify literature discussing governmental steps taken to achieve UHC for pediatric dental health, published between January 1, 2011, and December 31, 2022. The results were charted and presented in a table.
Results: This review included 22 studies. Six themes were identified based on the roles played by key players in this field, including schools, government policy and support, community-oriented preventive plans, insurance support, parents’ awareness, and inequality in accessing dental services.
Conclusions: A comprehensive policy that reduces barriers to access, increases utilization, and engages all stakeholders—including parents, schools, and community centers—can effectively achieve UHC for pediatric dental health.
Enhancing Healthcare Decision-Making: Comparison Between Health Technology Assessments and Access to Medical Care in a High-income Country vs. Low/middle Income Countries
Authors: Pankaj Shashwati , Karun Arya , Bhate Jignesh , Rao KS Guruprasad
Published: June 2024

Background: Healthcare decision-making is a complex process that involves evaluating the value, efficacy, and accessibility of medical technologies and interventions. Health Technology Assessments (HTA) in high-income countries (HICs) have become a cornerstone of evidence-based healthcare decision-making. This systematic evaluation framework, exemplified by its robust, impartial examination of various medical technologies, plays a pivotal role in establishing the clinical effectiveness and cost-effectiveness of health technologies. In contrast, low and middle-income countries (LMICs) frequently contend with resource constraints and intricate healthcare systems characterized by fragmentation and limited access to advanced medical technologies. As formalized HTA processes may be less established, limiting comprehensive evaluations, decision-making may rely on regulatory approval, clinical guidelines, or international recommendations in LMICs.
Similarly, access to medical care in high-income settings, such as the presence of universal healthcare coverage and well-developed health systems, contributes to equitable access to a wide range of medical services. In LMICs, challenges related to healthcare infrastructure, funding, and health workforce shortages hinder access to essential medical care, leading to inequities in health outcomes. This short review aims to compare the approaches to healthcare decision-making in high-income and low/middle-income countries, with a specific focus on HTAs and access to medical care.
Determination of Serum Vitamin D Levels in Patients with COVID-19
Authors: Noraldinvand Nasim Kazemi , Bashi Zadeh Fakhar Haniyeh , Rostami Forouzan , Rangraz Shaghyegh , Shahidi Parnian Sadat
Published: June 2024

Background: In 2019, the first cases of an acute respiratory infectious disease were announced in the city of Wuhan, China. In places where the speed of transmission and the resulting high prevalence and death from this virus is high, it is important to find things that help prevent and reduce the symptoms and complications of the disease, one of these things. Things are serum levels of vitamin D. As a result of this study, serum levels of vitamin D were measured in patients with Covid-19.
Methods: From December to March of 1400, 100 samples of people hospitalized in Khurshid laboratory were examined to identify the RNA of the Covid-19 virus by Real Time PCR method and at the same time to check the serum levels of vitamin D. The data was statistically analyzed using SPSS software.
Results: The average age of the patients was between 12.45 and 40.8 years. Comparison the two Covid-19 positive and negative groups in terms of symptoms, it was found that the patients with RH positive had more positive PCR percentage and a significant difference was reported between RH positive and Covid-19 (p=0.006). In comparing the relationship between disease symptoms and the rate of PCR positive reports of gastrointestinal symptoms, history of significant disease, cough, fever, a significant difference was reported (p<0.001). Also, 50% of the samples were PCR positive. Based on the t-test, a significant difference was reported between the serum levels of vitamin D and Covid-19 (p<0.001).
Conclusion: The results showed that the vitamin D is an acceptable protective factor against Covid19 infection and its deficiency increases the probability of infection.
Relationship between Blood Groups and the Risk of Covid-19 Infection; a Cohort Study
Authors: Mahjoor Mohamad , Askari Abolfazl , Khaledi Mansoor , Afkhami Hamed , Sadeghi-Dehsahraei Hamed , Arabpour Javad , Fathi Javad , Valizadeh Amir , Esmaeil Amini Mohammad , Esmkhani Mohammad , Safarinia Reza , Mottaghiyan Zahra
Published: June 2024

Background: ABO blood types are not known to cause diseases directly, but they can be vulnerable and surrender to diseases and health problems. This study aimed to evaluate the susceptibility to COVID-19 in individuals with different blood groups at different ages.
Methods: An electronic health record was used in this retrospective cohort study at Shahid Beheshti Hospital. We studied 858 patients who were referred to Shahid Beheshti Hospital, we identified 434 of them as COVID-19 patients using RT-PCR. An analysis of the electronic record involved collecting retrospective laboratory data and demographic information, including age, sex, and blood type. Next, we examined the differences between the ABO blood groups of COVID-19 patients and the control group (1991 case). We used SPSS26 for statistical computations. Data were scrutinizeed with the χ2 test. P < 0.05 was considered statistically outstanding.
Results: Based on the distribution of ABO blood groups in 434 COVID-19 patients, it was revealed that 288 of them were male and 146 were female, and the majority of them were in their third decade of life. A total of 159 patients (36.6%) had type B blood, 116 had type A (26.7%), 109 had type O (25.1%), and 50 had type AB (11.5%). COVID-19 patients had a higher percentage of type B and AB blood than the control group.
Prevalence and Antimicrobial Resistance Pattern of Uropathogenic Escherichia coli at a Tertiary Care Hospital: A Retrospective Study
Authors: Hemmati Haniyeh , Taher Mohammad , Shahbazi Ali Ehsan , Malekzadegan Yalda
Published: June 2024

Background: Uropathogenic Escherichia coli (UPEC) is the most common cause of urinary tract infection in humans including cystitis and pyelonephritis. Antimicrobial resistance (AMR) in UPEC is one of the global public challenges that is due to prevalent use of antibiotics in healthcare setting. Therefore, the purpose of this study is to investigate the frequency and antibiotic resistance pattern of UPEC isolated from patients admitted to Modares Hospital in Saveh, Iran.
Methods: In this study, in total 633 isolates were evaluated. UPEC isolates were obtained from patients with urinary tract infection and identified using conventional microbiological protocols. Antibiotic resistance pattern of UPEC against different antibiotic were determined using disk diffusion method. SPSSTM software was used for statistical analysis
Results: In this study, the most sample was related to outpatients and the lowest sample was related to the CCU wards. The highest antibiotic resistance showed against cephalothin (63.8%) and nalidixic acid (62.2%) antibiotics. The highest effective antibiotics for the tested UPEC was nitrofurantoin (90.7%) and gentamicin (77.3%). Cephalothin and nalidixic acid in hospitalized patients in ICU and emergency wards, respectively, showed the highest antibiotic resistance. Out of 633 UPEC, the rate of Multi Drug Resistant (MDR) isolates were 343 (54.2%).
Conclusion: The result of this study highlighted the role of UPEC as one of the important cause of UTI in individuals. Also, nitrofurantoin then gentamicin are the most effective antibiotics against UPEC infections. Logical prescription of antibiotics and infection control strategies are needed for prevention and control of nosocomial infections especially urinary tract infection.
Avrupa Fetva Meclisi’nin Fetva Yöntemine Dâir Bazı Eleştiriler
Authors: Dadaş Mustafa Bülent
Published: June 2024

Avrupa Fetva Meclisi, çoğu Batı’da ikame eden hem şerî delilleri hem de vâkıayı bilen kıymetli âlimleri bünyesinde toplamış ilmi bir müessesedir. 1997 yılında Yûsuf el-Karadâvî’nin (1926-2022) başkanlığında kurulmuştur. Bu tarihten itibaren özellikle de Batı’da yaşayan müslümanları ilgilendiren ve müslüman ülkelerde gözlemlenen problemlerden ciddi manada farklılaşan önemli fıkhî meseleleri gündemine taşımış, ürettiği çözümlerle hem oradan yaşayan hem de benzer problemlerle yüzleşen Müslümanlar için referans niteliğinde karar ve fetvalara imza atarak, kendisine başvurulan ilmi bir merci haline gelmiştir. Kuruluşundan günümüze Meclis’in yapısını konu edinen ve genel ya da aile hukuku veya muamelat gibi, özel bazı meseleler bağlamında izlediği fetva yöntemine ilişkin farklı dillerde bazıları akademik tarzda pek çok çalışma yapılmıştır. Meclis, 2023 yılında İstanbul’da icra ettiği toplantısını bu tarihe kadar yaptığı çalışmalar ve kendisine yöneltilen tenkitlere hasretmiş, toplantıda Meclis’i farklı yönleriyle değerlendiren çok sayıda bildiri sunulmuştur. Bu çalışma da aynı gayeye hizmet etmek maksadıyla Meclis’in fetvalarını neşrederken izlediği metodu, fıkıh ve fetva usulü kuralları bağlamında eleştirel bir bakış açısıyla değerlendirmek üzere kaleme alınmıştır. Değerlendirme, fetvanın muteber sayılabilmesi için müftüde aranan ilmi ehliyet ve adalet şartlarıyla sınırlandırılmıştır. Bu bağlamda öncelikle fıkıh meclislerinin fıkıh ilmine yaptığı katkıdan bahseden bir giriş yapılmış, ardından Meclisle ilgili tanıtıcı kısa bir malumat verilerek, “ekalliyyât fıkhı” olarak da bilinen alanda doldurduğu boşluk başta olmak üzere, diğer fıkıh meclislerinden olumlu yönde ayrıldığı hususiyetlerine değinilmiştir. Fetvanın kabul edilmesi için gerekli şartlar meşhur usul kitaplarıyla iktifa edilerek tahlil edilerek aktarılmış, Meclis’in neşrettiği fetva ve kararların bu kurallara uygunluğu tartışılarak, diğer fıkıh meclisleriyle mukayese imkânı oluşturabilmek için onlar tarafından neşredilmiş karar ve fetvalara da yer verilmiştir. Çalışmanın sonucunda Meclisin, karar ve fetvaların kimler tarafından alındığını ilan etmemek suretiyle kriter olarak belirlenen fetva usulü kurallarına riâyet etmediği anlaşılmış, diğer fıkıh meclislerinin de çoğunlukla aynı problemle malul olduğu sonucuna varılmıştır. Çalışma, tespit edilen problemlerin çözümü için bazı tavsiyelerin de yer aldığı bir sonuçla tamamlanmıştır. Çalışmanın, ulaştığı sonuçlarla fetva müesseselerinin bu faaliyeti icra ederken fetva usulü çerçevesinde hareket etmelerine rehberlik edecek ölçüler ortaya koymak suretiyle alana katkı sağlaması umulmaktadır. Bunun yanında, hangi isimle anılırsa anılsın kurumsal olarak fetva neşreden müesseselerin, özelde ise Avrupa Fetva Meclisi’nin kararlarıyla amel eden ya da karar ve fetvalarını esas alarak fetva veren veya çalışmalarında istifade eden araştırmacı ve müftülerde farkındalık oluşturması ümit edilmektedir.
Kabul ve Ret Açısından Tilâveti Mensûh Âyetlere Dair Bir Değerlendirme
Authors: Ensari Abdurrahman
Published: June 2024

Kur’an ilimleri kaynaklarında yer alan, Kur’an’da neshin kısımları başlığı altında genellikle hükmü mensûh tilâveti bâki, tilâveti mensûh hükmü bâki ve hem tilâveti hem de hükmü mensûh âyetler şeklinde bir taksime gidilmiştir. Her iki kısmıyla tilâveti mensûh olan âyetler elimizdeki Mushaf’ta yer almamaktadır. Bu tür âyetlerin mevcut olduğuna delalet eden şey, bu konuda vârit olan âhâd hadislerdir. Âhâd hadislere dayanarak kavramsal anlamdaki bir Kur’ân ayetinin tilâveten neshedildiği sonucuna varılamayacağı gibi, tilâveti mensûh olduğu ifade edilen bir ayetin tevâtür şartını taşımıyor olması da ona kavramsal anlamda Kur’an ayeti denmesini engellemektedir. Bu durum bazı araştırmacıları tilâveti mensûh âyet bulunmadığını ispatlama çabasına itmiştir. Diğer bir grup da sahih hadislerle sabit olduğundan hareketle tilâveti mensûh âyetlerin bulunduğunu savunmuştur. Her iki durumda da karşımıza çözülmesi gereken bir problem çıkmaktadır. Tilâveti mensûh ayetin bulunmadığını söylemek bu konuda vârit olan sahih hadislerin âhâd olduğu gerekçesiyle reddedilmesini gerektirirken tilâveti mensûh ayetlerin var olduğunu söylemek de mütevâtir olmayan ayetlere Kur’an ayeti denmesi gerektirir. Araştırma neticesinde bu probleme çözüm olabilecek bir çalışmanın yapılmadığı anlaşılmıştır. İşte bu çalışmayla söz konusu problemin çözümü amaçlanmıştır. Bu çalışmanın sonunda tilâveti mensûh âyetlerin bulunmadığını söyleyenlerin, tilaveti mensuh ayetlerin varlığının kabul edilmesi durumunda kavramsal anlamdaki Kur’an’a zarar verilebileceği endişesini taşıdıkları ve bundan hareketle diğerlerinin delillerini reddetme çabasına girdikleri anlaşılmıştır. Ancak tilâveti mensûh âyetlerin var olduğunu söyleyenlerden hiç kimsenin, söz konusu âyetlerin kavramsal anlamdaki Kur’an âyeti olduğu iddiasında bulunmadıkları görülmüştür. Onların tilaveti mensûh ayetten kastettiklerinin, nüzulünden Mushaf haline gelinceye kadarki kısmı da içine alan Kitab’ın ayetleri olduğu anlaşılmıştır. Bu Kitap’tan sadece kavramsal anlamdaki Kur’an ayeti olmayan bazı ayetlerin tilâvetinin neshedildiği, hadislerde ifade edilenlerin de bu ayetler olduğu görülmüştür. Dolayısıyla tilavetinin neshedildiği ifade edilen ayetlerin tevatürle sabit olan Kur’an ayeti olmayıp sadece sahih sünnetle sabit olan ve yine sahih sünnetle neshedildiği bildirilen ayetler olduğu anlaşılmıştır. Taraflar arasındaki tartışmada da ‘ayet’ kelimesinin genel kullanımı ile kavramsal kullanımı arasındaki farka dikkat edilmemesinin önemli bir etkisinin olduğu söylenebilir.
The Experiences of Syrian Female Students During the Distance Education and the Insights of Religious Culture and Ethics Teachers into the Process
Authors: Tekin İshak , Ay Mustafa Fatih
Published: June 2024

Turkey has been hosting a large number of Syrian refugees since 2011 and has allowed Syrians to integrate into the general education system alongside Turkish students since 2016. This situation suggests that Turkey offers a unique experience in the education of Syrian refugees. However, Syrian girls may face disadvantages in their education due to traditional gender roles. Based on this premise, this study aims to examine the educational processes of Syrian girls during the COVID-19 pandemic from the perspectives of teachers, parents, and the students themselves. Therefore, this research seeks to identify the educational experiences of Syrian girls during the pandemic period in Turkey and to evaluate the contribution of religious culture and ethics (RCE) teachers to their ability to receive proper education. The participants of this research, which followed a qualitative design, included 10 students, 5 parents, and 5 RCE teachers selected through snowball sampling. The study's findings reveal that Syrian girls encountered difficulties in accessing and continuing distance education effectively. The data obtained were analyzed by considering the educational challenges experienced by refugee girls during the quarantine period from the perspectives of students, parents, and teachers, and discussed within psychological, social, and cultural contexts. Among these challenges, economic hardships, technical deficiencies, inadequacies in the physical environment, and social adjustment problems emerged as prominent issues. It was found that Syrian refugee girls struggled with limited financial resources, a lack of technological devices such as tablets and computers, inadequate internet access, and a shortage of appropriate learning environments. They also experienced psychological challenges, including isolation and a longing for social interaction, along with shifts in family dynamics. On the other hand, it was observed that Syrian girls and their parents frequently communicated with religious, cultural, and moral education teachers to address these issues. A significant finding that distinguishes this study from similar ones is that Syrian refugee girls, through their participation in both distance and face-to-face education, began to adapt to Turkish culture and lifestyle. According to the perspectives of both students and teachers, Syrian refugee students have become more socially integrated compared to their parents. As a result, it can be concluded that RCE teachers have assumed new, supportive roles in the education of Syrian refugee students.