bluuebunny/crossref_metadata_2025 huggingface dataset:
The Mediated Impact of Health Care Insurance Inclusion Between Hospital Management and Operation Efficiency in Saudi Arabia
Authors: Otaibi Abdullah Matar Al , Tham Jacquline , Ahmad Albattat
Published: October 2023

The healthcare scene in Saudi Arabia has been experiencing notable changes, characterised by an increasing focus on enhancing the quality and availability of medical services. Given the significant role that hospitals play in the provision of healthcare services, it is essential to comprehend the interplay between management strategies and operational efficiency. In a country without fixed and implanted national health care insurance program, like KSA, it is a challenge to modify the weak existed program to a big project of national health care insurance program. This inclusion despite making high beneficial for health care of the human but making high challenge for health care management and could affect the Management Efficiency which was almost affected by different variables like Management Staff Satisfaction. Facilities Availability, Management Cost Reduction and Patient Safety Improvement Plan Healthcare providers had to have compensatory shift that healthcare administrator had to provide after healthcare insurance changes. This study will benefits hospital management practises on operational efficiency results, using well-established theories of organisational management and healthcare economics. Furthermore, the research investigates the degree to which the existence of health care insurance coverage acts as a mediator in this association. The presence of health care insurance plays a pivotal role in shaping patients' ability to get medical services and has the potential to influence the efficacy of hospital management approaches. In order to accomplish these aims, quantitative research have been used. Quantitative data is collected by means of surveys and archive hospital performance measures, derived from interviews and focus group discussions conducted with important players within the healthcare sector of Saudi Arabia.
Age-Related and Side-Dependent Differences in Hip Range of Motion among Female Indian Athletes: Establishing Reference Values
Authors: Anbupriya M , Meyyappan RM
Published: October 2023

Restricted hip mobility and flexibility are always associated with increased risk for lower extremity injury and poor athletic performance in female athletes. Reference values for hip motions in female athletes by age and sports are lacking. The primary aim of the study is to document the active and passive range of motion of hip joint among adolescent and adult Indian female athletes. Next, to compare between the sides and age group in the same population. This is a cross-sectional study involving 498 healthy female athletes of age group 15-21 years involved in the high impact sports were conveniently selected for the measurements of hip active and passive range of motion with a Universal goniometer. Participants with recent history of musculoskeletal injury and neurological pain syndromes were excluded from the study. Comparing the baseline values of active and passive range of motion of hip joint, between adolescent and adult female athletes, revealed a significant difference (p<0.05) in both dominant and non-dominant leg except for passive hip abduction (p>0.05). However, adolescents demonstrated higher hip flexion, internal rotation, and external rotation, and adults showed greater hip extension. Active and passive reference values for hip range of motion is documented for South Indian female athletes in relation to age and high impact sports. Future research involving injury prediction, prevention and rehabilitation protocol among female sports can utilize these values.
Handmade Paper Formation from Onion Peels
Authors: Rajas Neha , Kudal Om , Magar Gaurav , Marewar Amol , Bilal Mohammad , Pardeshi Shivraj
Published: October 2023

Every year above 15 million trees are cut down for various purposes. In which around 8 million trees are only cut down for paper production. This number is increasing every year which is causing climate calamities, disappearance of wildlife, emission of greenhouse gases, soil erosion, etc. We can’t stop the use of paper, but we can find an alternative for making of it. Every year tons of onion waste are produced worldwide in which outer onion skin contributes up to 70% of this waste. This waste can cause environmental problems when not properly treated.  In this paper, an attempt has made for production of paper using onion peels. For the pulping of onion skin soda process has been used. Paper produced was light and white and can be used for decorative purposes.
Role of Judiciary in Protecting Witnesses in the Criminal Justice System: A Critical Analysis
Authors: Parwez Zahid , Sarangi Narayan Chandra , Jabbal Dolly
Published: October 2023

Witnesses are the eyes and ears of the Criminal Justice System. Witnesses being the only spectator of an offence are the indispensable aid in the Criminal Justice Delivery System but are yet at a vulnerable position that they turn victims at several instances. Starting from the investigation stage to the trial proceedings of the court witness assist the Court in every possible way to punish the accused person by deposing every relevant fact which can lead to a fair justice delivery and conviction of the accused person without getting any gain. Witnesses are often subjected to threatening, inducement, harassment, and different kinds of intimidation to them and also their family members. Due to this, in many cases due to lack of Witness Protection Laws the witnesses not getting adequate protection they become victims. Unlike the accused, the witnesses or victims have no rights for their protection. And when the state agencies fail to do their duty, as has often happened in many cases in the recent past, the witnesses turn out to be a victim and subsequently left to suffer injustice silently. Protection of witness is also one of the attributes of fair trial which is guaranteed under Article 21 of the Constitution of India wherein proper safety and security should be ensured. But due to lack of effective Witness Protection Regime and statutory framework for giving protection in our country the witness has lost confidence when it’s about their safety and security. This has also given rise to high acquittal rate and decrease in convictions in the justice administration system. The Judiciary has actively given importance for having witness protections Laws in India and at the same time has enumerated the duties of Witnesses towards the state when the state is providing protection.
Relevance of School-Based Mentorship and Support on Mathematics Teachers’ Competences in Tanzania: Stakeholders’ Perspectives
Authors: Kyaruzi Florence , Fulgence Katherine , Kavenuke Patrick Severine , Urio Perpetua , Mwakabenga Rehema Japhet , Oziambo Betweli
Published: October 2023

Teacher mentorship has been increasingly gaining popularity in recent years among experts in the field of education. This study examined the relevance of school-based mentorship and support on Mathematics teachers’ competence in nine regions in Tanzania. A total of 700 (46 per cent, female) educational stakeholders - mathematics teachers and tutors, secondary school students, and other educational leaders participated in the study. The findings indicated that over time, stakeholders’ understanding of mentorship and support was improved. This was realised during the midterm review when they started indicating a specific but broader conceptualisation of mentorship as an ongoing practice that can be done virtually or in person, between a knowledgeable teacher and a novice one. Furthermore, the findings highlighted that teacher mentorship and support improved their knowledge and skills, promoted teachers’ attitudes towards mathematics and improved students’ performance in Mathematics. The findings call for improved school-based mentorship and support practices to improve teacher practices and promote students’ performance.
Behaviour of Investors towards Asset Management Companies of India
Authors: Premkumar N. , Silambarasan P.
Published: October 2023

Asset management professionals performing services for their clients is to maximise returns while minimising risk for their clients. An in-depth study shows “How investors choose their best asset management companies”, thereby getting the best investment opportunities in the ever-changing environment for futuristic needs. The ultimate outcome of their investment is to make profitable investments. Source of information getting under survey methods for different types of investors for different asset management companies in India. Choosing the right choice of investment in asset management companies is purely based on investor behavioural decisions. Using survey methods, data is collected from 400 investors under different investor categories, like conservative, moderate, aggressive. The main aim of the presenting paper is to find out the investors' behaviour in asset management companies. Used survey methods, for measuring the various phenomena. analysed the collected data effectively and efficiently to draw the sound outcomes. However, a number of statistical techniques such as, Correlation, Reliability Statistics and ANOVA is used for analysing the predominant factors responsible for investment in asset management companies.
Assessment of Public Perception and Awareness on Water Management Practices in Maharashtra
Authors: Dadve Jagannath V. , Turkar Virendra B.
Published: October 2023

Water management in Maharashtra faces complex challenges due to its varied climatic conditions and diverse population. This research aims to fill a critical gap by assessing public perception and awareness regarding existing water management practices in both urban and rural areas of the state. Through a survey-based methodology, the study explores the public's understanding of water scarcity, policy effectiveness, and their roles in sustainable water management. The findings indicate a significant disparity in awareness levels between rural and urban communities and offer insights into the public's willingness to engage in water-saving behaviors. These results have important implications for policymakers, suggesting a need for targeted educational and awareness campaigns. By understanding public perception and awareness, this study hopes to contribute to the development of more effective, community-oriented water management strategies in Maharashtra.
An In-Depth Analysis of Pythonic Paradigms for Rapid Hardware Prototyping and Instrumentation
Authors: Aljrah Isra , Alomari Ghaith , Aljarrah Maymoona , Aljarah Anas , Aljarah Bilal
Published: October 2023

This in-depth examination review about pythonic paradigms for quick hardware prototyping and instrumentation to solve the widening gap between the fluidity of software development and the more conventional methodology used in hardware design. The proliferation of specialized hardware and accelerators has resulted in an increased necessity for development strategies that are flexible. Reconfigurable hardware, such as FPGAs and coarse-grain reconfigurable arrays, enables incremental changes in early design stages, which is a key component of agile software development. This article goes into modern agile development methods, emphasizing the integration of services, repositories, and specialized tools to meet particular users' requirements. Continuous improvement in areas such as software and hardware design, testing, analysis, and evaluation, as well as collaboration with current development tools, are all supported by an ecosystem that has been successfully integrated.
Preventing Excessive Noise Exposure in Infants, Children, and Adolescents
Authors: Balk Sophie J. , Bochner Risa E. , Ramdhanie Mahindra A. , Reilly Brian K. ,   COUNCIL ON ENVIRONMENTAL HEALTH AND CLIMATE CHANGE, Bole Aparna , Balk Sophie J. , Byron Lori G. , Huerta-Montañez Gredia Maria , Marcus Steven M. , Nerlinger Abby L. , Newman Nicholas C. , Patel Lisa H. , Philipsborn Rebecca , Woolf Alan D. , Zajac Lauren , Bernstein Aaron , Landrigan Philip J. , Briskin Jeanne , DeNicola Nathaniel G. , Gray Kimberly A. , Karwowski Matt , Ward Mary H. , Spire Paul ,   SECTION ON OTOLARYNGOLOGY–HEAD AND NECK SURGERY, Sobol Steven E. , Rosbe Kristina W. , Baldassari Cristina Marie , DiGoy G. Paul , Jatana Kris R. , Meyer Anna Katrine , Kelley Peggy Elaine , Margolies Raynor Eileen , Reilly Brian Kip , Simons Jeffrey Philip , Thorne Vivian B.
Published: October 2023

Noise exposure is a major cause of hearing loss in adults. Yet, noise affects people of all ages, and noise-induced hearing loss is also a problem for young people. Sensorineural hearing loss caused by noise and other toxic exposures is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, and quality of life. Children and adolescents have unique vulnerabilities to noise. Children may be exposed beginning in NICUs and well-baby nurseries, at home, at school, in their neighborhoods, and in recreational settings. Personal listening devices are increasingly used, even by small children. Infants and young children cannot remove themselves from noisy situations and must rely on adults to do so, children may not recognize hazardous noise exposures, and teenagers generally do not understand the consequences of high exposure to music from personal listening devices or attending concerts and dances. Environmental noise exposure has disproportionate effects on underserved communities. In this report and the accompanying policy statement, common sources of noise and effects on hearing at different life stages are reviewed. Noise-abatement interventions in various settings are discussed. Because noise exposure often starts in infancy and its effects result mainly from cumulative exposure to loud noise over long periods of time, more attention is needed to its presence in everyday activities starting early in life. Listening to music and attending dances, concerts, and celebratory and other events are sources of joy, pleasure, and relaxation for many people. These situations, however, often result in potentially harmful noise exposures. Pediatricians can potentially lessen exposures, including promotion of safer listening, by raising awareness in parents, children, and teenagers. Noise exposure is underrecognized as a serious public health issue in the United States, with exposure limits enforceable only in workplaces and not for the general public, including children and adolescents. Greater awareness of noise hazards is needed at a societal level.
An academic writing program as displacement space: New stories and new positions
Authors: Fisher Rick , Brock Cynthia H. , Welsh Kate Muir , Swarts Gabriel P.
Published: October 2023

This qualitative study examined recounted experiences of nine faculty Academic Writing Fellows who participated in a year-long writing initiative that sought to foster productive academic writing practices. The initiative (including weekly writing groups, national writing mentors in each Fellow’s discipline, and two-weekend writing retreats) was designed to encourage habits and attitudes for successful academic writing through a community-based approach. Using Positioning Theory as an analytical lens, this study explored Fellows’ enactment of rights and duties and their evolving identities as academic writers. Our analyses indicate that the program functioned as a displacement space that allowed Fellows to explore their self-positioning as writers and to re-story themselves in productive ways. We argue that both spatial and temporal displacement contributed to participants’ opportunities for meaningful repositioning.
Perceptions of choice in writing of university students
Authors: Aitken Angelique , Graham Steve
Published: October 2023

There is an assumption in education that allowing students to choose their writing topics and positions is beneficial; however, there is little research to support this belief, particularly from the students’ perspectives. In the present study, we conducted 20 semi-structured interviews with students at a large university in the Southwest of the United States after they completed two in-class argumentative writing assignments in a course on exceptional children, one where they chose their writing position and one where they were assigned their writing position. As a group, these 20 students (13 female, 7 male) were above average writers in their first to third year of study, and the majority of them were education majors (70%), followed by arts and sciences (25%), and design and the arts (5%). The interview protocol focused upon their shifting perspectives on the underlying motivational construct of choice related to this and other writing assignments. Taking a grounded theory approach to thematic analysis, findings indicated that having choice in writing was important because it allowed students to write about topics that they find easier, more interesting, and possess greater knowledge. Choice also allowed students to demonstrate their autonomy, which they believed, influenced their motivation and writing quality/grades. While the university students in this study generally preferred choice, a majority of them identified benefits of not choosing, including opportunities to improve writing tenacity, enhance their writing skills, and achieve new perspectives.
Fleshing out your text: How elaboration and contextualization moves differentially predict writing quality
Authors: Pander Maat Henk , De Glopper Kees , Raaijmakers Kay , Veerbeek Joris , Vermeulen Dennis
Published: October 2023

This study explores the relation between writing quality and contextualization and elaboration moves, two kinds of textual expansion devices crucial for building common ground between writers and readers. We ask whether elaboration and contextualization features differentially predict writing quality and whether their quality contributions differ between genres. We also ask to what extent elaboration and contextualization are tied to individual writers, and can be explained by writer characteristics. To examine these issues, we annotated descriptive and argumentative texts of Dutch adolescents. Text quality was rated holistically, using benchmark scales.
    As regards elaboration, depth affects quality more than breadth does. It also contributes across genres, whereas breadth only contributes in argumentations. Depth shows a large individual consistency across tasks, which is substantially related to students’ school type, grade and gender. Breadth shows weaker links to individual writers and their characteristics.
    With regard to contextualization, opening and closing moves play a modest role in text quality. Initial support moves contribute to quality across tasks; concluding moves contribute more in argumentations. Concluding moves are most consistent within writers; however, for all contextualization moves, the writer variance is substantially explained by writer characteristics. This study opens up new avenues for explicating writing quality and writing skill.
A systematic review of blunt abdominal aortic injury and analysis of predictors of death
Authors: Li Mingxuan , Wang Chaonan , Tu Haixia , Zhu Haitao , Guo Zhen , Guo Lianrui
Published: October 2023

At present, research on blunt abdominal aortic injury (BAAI) is limited, with the majority being case reports. Consequently, there is a significant knowledge gap concerning this condition. To address this, we conducted a systematic review by extensively searching major databases. We included all literature that provided individual (non-identifiable) data on BAAI patients, irrespective of the study design. Furthermore, we undertook regression analyses to identify predictors of death after BAAI. The search yielded 2,099 results, leading to the inclusion of 102 case reports and one conference abstract. Using the Joanna Briggs Institute (JBI) checklist for assessment, all studies were deemed of medium to high quality. In total, 133 patients were included, with a median age of 34 years, and 73.7% being male. The predominant clinical manifestation was pain, reported in 65.6% of patients. The most frequently observed aortic lesion severity was grade A (intimal tear or intramural hematoma) at 46.9%, and the most common lesion location was zone III (infrarenal aorta) in 88.3% of cases.  The overall mortality after BAAI was 15.3%. Multivariate regression analyses revealed the following predictors of death after BAAI: lower limb ischemia (relative risk [RR] = 7.137, 95% confidence interval [CI] 1.154 - 44.161), cardiopulmonary arrest (RR = 10.250, 95% CI 1.452 - 72.344), and injuries to body parts other than the abdomen and lumbar spine (RR = 2.593, 95% CI 1.189 - 5.655). In conclusion, this review provides a detailed quantitative summary of BAAI's clinical manifestations, diagnosis, treatment, and prognosis, emphasizing its high mortality rate and identifying three critical variables as predictors of death.
Optimization and Hepatoprotective Activity of Herbal Formulation of Methanolic Extracts of Ruta Graveolens and Angelica Sinensis
Authors: Chawale Prajakta Anil , Sutar Ravindra Chandrakant , Julekha Kazi , Panigrahy Uttam Prasad , Patil Kiran Dongar , Kaushik Lokesh , Patel Ankur , Sharma Mahesh
Published: October 2023

The goal of this study was to evaluate the antioxidant and hepatoprotective effects of RAAS, a specially created herbal mixture that contains methanol extracts of Ruta graveolens and Angelica sinensis. A range of in vitro tests were performed as part of the study to assess any potential health advantages of RAAS. The laboratory assays employed to assess the antioxidant capacity of RAAS included the total antioxidant activity assay, the reducing power assay, and the DPPH radical scavenging assay. These evaluations showed that RAAS has strong antioxidant characteristics, demonstrating its capacity to counteract oxidative stress and disarm dangerous free radicals. Additionally, the study examined the hepatoprotective effects of RAAS utilizing a cellular model that included HepG2 cells and carbon tetrachloride-induced liver injury (CCl4). According to the findings, RAAS significantly protected HepG2 cells from the negative effects of CCl4-induced liver damage. In conclusion, this study highlights the prospective antioxidant and hepatoprotective properties of RAAS, an herbal formula made from methanol extracts of Ruta graveolens and Angelica sinensis. Strong in vitro antioxidant activity and the capacity to prevent CCl4-induced damage to liver cells show the potential therapeutic utility of RAAS in reducing oxidative stress and liver-related diseases. Deeper understanding of its uses in boosting liver health and general wellbeing may come from additional studies in the clinical setting and other fields of study.
IL-6, IL-8, TNF-α, and C-Reactive Protein Levels in the Diagnosis and Prognosis of Neonatal Sepsis
Authors: Ruken Yildirim  , Mehmet Celal Devecioğlu
Published: October 2023

Objective: This study aimed to determine the importance and reliability of interleukin-6 (IL-6), IL8, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) levels in terms of diagnosis and prognosis in neonatal sepsis. Methods: Thirty newborns who were followed up and treated in the neonatal intensive care unit with a pre-diagnosis of neonatal sepsis and 20 healthy newborns who were born without any problem from mothers without any disease were included in the study.Gender, gestational age, postnatal age, place and mode of delivery, birth weight, IL-6, IL-8, TNF-α, and CRP levels were recorded. Results: Of the 30 cases diagnosed with sepsis, 16 (53.3%) were male and 14 (46.7%) were female. In the control group of 20 cases, 11 (55%) were male, and 9 (45%) were female. Of the cases diagnosed with sepsis, 8 were considered early-onset (26.6%) and 22 were considered late-onset (73.4%) neonatal sepsis. The mortality rate in early-onset sepsis was 25%, while this rate was 36.3% in late-onset sepsis cases. The levels of CRP, IL-6, and IL-8 were significantly higher in the sepsis group than in the control group. The difference between the groups in terms of TNF-α levels was not statistically significant. IL-6 (P = 0.001) and IL-8 (P = 0.007) levels were found to be statistically significantly higher in the deceased cases than in the healing cases. Conclusion: CRP, IL-6,and IL-8 levels were found to be useful parameters in the diagnosis of neonatal sepsis, while TNF-α was not found to have diagnostic value.IL-6 and IL-8 levels were found to be significant in the prognosis of neonatal sepsis.
Level and Determinants of Physical Activity in Chronic Hemodialysis Patients at the Donka National Hemodialysis Center
Authors: Fousseny Diakite  , Ali Traore  , Mamadou Saliou Balde  , Sého René Audrey Alladakan  , Mohamed Lamine  Tegui Camara  , Alpha Oumar Bah  , Mohamed Lamine Kaba
Published: October 2023

Introduction: Regular physical activity plays a protective role over the cardiovascular system and also against cardiovascular risk factors, and improves the prognosis of patients. The aim of this study was to assess the overall level of physical activity in chronic hemodialysis patients and the factors associated with low levels of activity. Research subjects and methods: A four-month long cross-sectional descriptive and analytical study was performed on chronic hemodialysis patients of all ages, regardless of sex, who agreed to take part in the study. There were both quantitative and qualitative variables in this study, and the Baecke questionnaire was used. Results: Out of 237 hemodialysis patients, 211 were included in our study, i.e., a frequency of 89.02%. The work activity index was low in 91% of cases, the sports activity index was low in 19 out of 20 patients, and the leisure activity index was low in 63% of patients. Meanwhile, the overall physical activity level was low in 76.8% of patients. In our study, low physical activity was significantly correlated with the gender of patients, unemployment of patients since starting dialysis, diabetic nephropathy, diabetes, obesity, dilated cardiomyopathy, a sedentary lifestyle, or interdialytic weight gain ≥ 3kg. Conclusion: The assessment of patients’ physical activity should be integrated into hospital practices for better management of chronic hemodialysis patients.
Assessment of depression in diabetic patients
Authors: Kotwal Shivwani D. , Kour Navneet , Gadda Irfan R. , Devraj
Published: October 2023

Background: Diabetes is one of the most common chronic conditions in the world. The worldwide prevalence of diabetes mellitus (DM) has risen dramatically over the past two decades because of increasing obesity and reduced activity levels. The purpose of this study was to show the association between depression and diabetes.
Methods: It was a cross-study. The study included 240 patients who were chosen randomly with no gender bias. A convenient subject of 240 diabetic patients was interviewed.
Results: Out of the total 240 diabetic patients, included in this study, the majority of patients, 52.63% in the age group of 60 years had depression with a Hamilton score of >19 while 47.37% of patients in the age of 40 to 50 years had Hamilton score of >19. 84.21% of males had depression with a Hamilton score >19 as compared to females who had a Hamilton score of 15.79%. The patients within the age group of 40-59 have 2.5 times more risk of having depression as compared to the age group of 20 to 39 and patients in the age group >60 years have 4.23 times higher risk of depression as compared to patients in the age group of 20 to 39 years. The association between gender and depression shows that males have a higher rate of depression (78.17%) as compared to females (21.81%) with an odd's ratio of 3.0.
Conclusions: Our study showed a high prevalence of depression and anxiety in male patients and the elderly age group. Planning and implementation of screening for mental health issues in the elderly population diagnosed with a lifestyle disease-such as type 2 diabetes mellitus-with existing comorbidities should be recognized as one of the most important goals of the public health system. It seems necessary to involve medical teams in the screening process to verify the symptoms, promptly establish the diagnosis, and initiate the appropriate depression treatment. In diabetic patients, depression remains underdiagnosed and an important aspect of the diabetic specialists would be the awareness of this quite common co-morbidity.
Embryology, anatomy and physiology of the liver: Review
Authors: Sumadewi Komang Trisna
Published: October 2023

The liver, located within the peritoneal cavity, is in the right upper quadrant of the abdomen. Additionally, it should be noted that the liver holds the distinction of being the largest gland within the human body, as well as the most extensive visceral tissue situated within the abdominal cavity. One of the factors contributing to the early migration of the developing intestines to an extracoelomic location during fetal development is their relatively bigger size in children, weighing between 1400 and 1800 g in adults. It contributes to the development of a distended abdomen in pediatric populations. The liver is situated in the right upper quadrant of the abdomen and spans across the midline to the left upper quadrant. The heart remains susceptible to regular injuries despite the protective presence of ribs and cartilage. The liver, functioning as an accessory organ in digestion, undertakes several metabolic processes, including drug metabolism, bile production, and bilirubin synthesis, alongside numerous other functions. For a considerable period, medical professionals and anatomists have encountered challenges in comprehending the complex functions of the liver. Significant advancements in the comprehension of liver anatomy have contributed significantly to the notable progress observed in various surgical and interventional radiologic procedures involving hepatic artery infusion pumps, liver ablation, transplantation, transarterial chemoembolization, selective internal radiation therapy, and portal vein embolization. The existence of hepatic structure is crucial for developing and implementing gradual therapies. This page aims to provide an academic overview of the embryology, anatomy, and function of the liver.
The link between gut microbiota and atherosclerosis
Authors: Patel Divyakshi , Mahajan Gauri , Mahajan Neeraj
Published: October 2023

Infections have been linked to development of cardiovascular complaint and atherosclerosis. Cardio vascular conditions like atherosclerosis are the major cause of mortality and morbidity in the ultramodern society. The rupture of atherosclerotic plaque can induce thrombus conformation, which is the main cause of acute cardiovascular events. Lately, numerous studies have demonstrated that there are some connections between microbiota and atherosclerosis. There are three metabolite pathways by which gut microbiota can affect atherosclerosis. Either original or distant- causing inflammation which might lead to atherosclerotic plaque formation and rupture. Second, metabolism of lipids and cholesterol by gut microbiota can affect atheromatous atheromatous plaque conformation. Third, diet and specific factors that are metabolized by gut microbiota can have various effects on atherosclerosis; for illustration, salutary fiber is beneficial, whereas the bacterial metabolite trimethylamine- N- oxide (TMAO) is considered dangerous. We'll conclude by discussing new remedial strategies for targeting gut microbiota to ameliorate atherosclerosis and related cardiovascular issues.
A systematic review on physiological role of yoga and pranayama in management of orthostatic hypotension and vasovagal syncope
Authors: Balaji P A  , Varne Smitha R
Published: October 2023

OH and VVS are increasingly recognized as important causes of impairment of quality of life and potentially of poor prognosis. Existing management therapies have modest effect. Recently few studies have emerged and have demonstrated the efficacy of yoga and pranayama in disorders having autonomic imbalance, suggesting its possible efficacy in OH and VVS.

This review aims to determine the effectiveness of yogic practices in patients with orthostatic hypotension (OH) and recurrent vasovagal syncope (VVS).

A Medline search was done in Google chrome to review relevant articles in English literature considering the eligibility criteria that the article should focus on yoga and pranayama and its physiological effects on OH and VVS. The main outcome expected was attenuation of OH and frequency of attacks of syncope and presyncope.

: Out of the total 86 articles searched, 7 articles (3 RCTs, 3 observational/interventional, 1 review) full filled the eligibility criteria and depicted that yogic practices can have positive impact in attenuation of orthostatic hypotension and reduce the frequency of attacks of syncope and presyncope, among patients with recurrent VVS. However, we recommend higher-quality RCTs in future to confirm our results.
Morphometric analysis of adult human mandible and their ratios
Authors: Shroff Neeta Gautam , Shaikh Shamama , Shroff Gautam A , Mandhana Vaishali , Khan Sana
Published: October 2023

Mandible is the strongest bone in the face region required for the process of mastication. The inferior alveolar nerve travels inside the bone in the mandibular canal to supply the lower teeth. The measurement of various parameters of mandible allows the proper localisation of nerve for anaesthetic block. Also, the ratios between factors assists during surgeries.

A cross-sectional observational study was conducted on 97 dry adult human mandibles. Height of symphysis menti, ramus breadth and height, and distance of mandibular foramen from mandibular notch and base of mandible of both sides are measured. Ratios between ramus height and breadth and distances of mandibular foramen from above mentioned landmarks were computed.

The mean height of symphysis menti was found to be 25.52 ± 4.32 mm. The mean values of height of ramus on right side was 46.18 ± 4.43 mm and on left was 46.57 ± 4.24 mm. The mean breadth of ramus was 32.29 ± 3.57 mm (right side) and 32.59 ± 3.75 mm (left side). It was found that mandibular foramen was closer to the mandibular notch than to the base of mandible on both sides. The ratios between the right and left side showed no significant differences.

Inferior alveolar nerve block is required in various dental procedures for which mandibular foramen localisation is must. Dimensions of mandible help in surgical restructuring. Similarly, it aids in understanding the evolution of the bone.
Patent umbilical artery in medial umbilical fold: Cadaveric study and clinical implications
Authors: Rani Neerja , Kaushal Parul , Dada Rima , Kumar Sanjay , Harisha Kusuma , Singh Seema
Published: October 2023

Minimally invasive surgery has become one of the most accepted surgical options across the globe. In most laparoscopic surgeries, medial umbilical fold (MUF) containing the umbilical artery (UA) serves as an important landmark for creation of peritoneal flap. 50% of gynaecological laparoscopic injuries occur at the time of entry into the anterior abdominal wall, as it involves blind insertion of the trochar or veress needle in the peritoneal cavity. Any variation in the structures of the anterior abdominal wall may affect the placement location of the trocar, which is a crucial aspect to ease the surgeon’s ability to manoeuvre the abdominal cavity. The presence of cords and/or dense ligamentous structures in the anterior abdominal wall may complicate trocar insertion and restrict the probe movement during laparoscopic procedures. Hence, the aim of the present study was to classify and observe the variations in the MUF in the anterior abdominal wall.

The cadavers in the study were formalin fixed through femoral artery perfusion method. Out of the 35 (23 males; 12 female) cadavers (70 MUF), studied, 34 cadavers (69 MUF) followed the pattern of the existing classification proposed by Tokar and Yucel, (2009). However, the right MUF of one male cadaver presented, patent umbilical artery (PUA) associated with a long mesentery. Based on safe presentations for laparoscopic exploration, MUF was given grades. Grades 0 and 1 were categorised as safe as compared to grade 2 and the novel variant observed, based on the morphology of MUF. No significant difference was noted in the occurrence of safe presentations of MUF amongst males and females.

MUF with a patent vessel and a mesentery may cause technical difficulties to the surgeon by decreasing the laparoscopic port work space and obscuring the view of lateral pelvic wall during surgeries. Furthermore, persistent UA can compress the ureter and vas deferens resulting in myriad of symptoms ranging from unexplainable flank pain, hydronephrosis to male infertility. Awareness of such variants is of relevance to urologists in determining the cause of these unexplained symptoms and to surgeons in determining the site of safe trocar insertion. The findings also, highlight the fact that anterior abdominal wall anatomy is not mirror image on both the sides.
Assessment of learning styles using VARK model in first year undergraduate medical students
Authors: Gowda N R Vikram , Kurian Nisha
Published: October 2023

In the assimilation and processing of information, students favor different choices. Fleming described the VARK learning style model that includes a questionnaire which enables us to recognize a person’s sensory modality preference in learning. It categorizes the learning styles into four: visual (V), aural (A), read/write (R), and kinesthetic (K).

1) To assess the learning styles of first year MBBS students of a Private Medical College in Kerala and find out prevalence of unimodal and multimodal learners. 2) To find association between scores of students in anatomy, biochemistry and physiology and their VARK categories. 3) To determine the association between gender and VARK categories.

A cross-sectional self-administered questionnaire survey was conducted among first year undergraduate medical students in a private medical college in Kerala. VARK questionnaire, consists of 16 multiple choice questions, was distributed to the participants after obtaining written consent. Scores of their internal assessment were also collected. The data was analyzed and the learning styles were presented as percentages. Chi-square test, Mann-Whitney U test, and Kruskal-Wallis tests were used to find the association between learning styles and gender, and the scores in internal assessment.

The total number of students enrolled for the study was100. Age ranged from 17 to 22 years and females constituted 62%. It was observed that 84% students were unimodal, out of which Kinesthetic (45.2%) was the most preferred. There were 12 bimodal and 4 trimodal learners. No association between learning styles and gender as well as between learning styles and academic performance based on written and practical exams of Anatomy, Physiology and Biochemistry were found. We found there were notable differences between males and females in unimodal kinesthetic and auditory learners in certain scores.

The present study reported that unimodal learners were more frequent than bimodal and trimodal learners. There were no quadrimodal learners. The preferred method of learning amongst unimodal learners was the kinesthetic style. We found no association between gender and the preferred learning style. The study also found that there was no association between academic performance (scores) and their learning styles.
High origin of radial artery in mid-arm and possible complications: A cadaveric case study
Authors: Rathi Pankaj Kumar
Published: October 2023

The radial artery is a vital vessel supplying the forearm and hand. Variations in its origin can occur, leading to potential complications during clinical procedures. This cadaveric case study investigates the high origin of the radial artery in the mid-arm and its associated complications. Two cadaveric specimens were examined, at Department of Anatomy, Maulana Azad Medical College, New Delhi, and the anatomical variations were documented. The study highlights the importance of recognizing such variations and their implications in clinical practice, aiding healthcare professionals in minimizing procedural complications and optimizing patient outcomes. The tortuous course and kinking observed in this study may predispose the artery to thrombosis, spasm, or occlusion, potentially leading to ischemic complications in the forearm and hand.
A case report on multiple accessory muscles and nerve variations in upper limb
Authors: Stephen Priyanka Clementina , Sankaran Nikilesh , Raman Ambiga , Verma Suman , Kishore Aravindhan
Published: October 2023

During routine dissection of formalin fixed cadavers, the brachial plexus and other upper limb structures were observed for variations. In 65-year-old male cadaver, bilateral upper limb neuromuscular variations were identified. On the left side, median nerve had three roots (one medial and two lateral) and biceps brachii had an additional head which was originating from the mid shaft of humerus and joined with the main muscle at the lower third of arm, and was innervated by musculocutaneous nerve. On the right side, the brachioradialis muscle had an accessory head which took origin from the lateral side of humerus near deltoid tuberosity and joined with main tendon in the lower part of the forearm, and was innervated by radial nerve. The association of nerve variations and accessory muscles is clinically significant. As accessory muscle may lead to nerve or artery entrapment in the limb and is likely to cause palsy or ischemia, knowledge about the neuromuscular variations is clinically significant.
A cadaveric case study of the fibulo calcaneus internus muscle as a rare accessory muscle of calf region
Authors: Madhukar Lahange Sandeep , Bhatnagar Vikash , Bhangare Archana Nivrutti , Gupta Suwalal
Published: October 2023

The fibulocalcaneus (peroneocalcaneus) Internus (FCI) muscle which is also called as Peroneo calcaneus Internus (PCI) muscle (of MacAlister) is a rare variation of calf muscle with a low prevalence of <1%-3% in cadaveric dissection and imaging studies. The FCI arises from the posterior-medial aspect of the distal 1/3 of the fibula, descends posterior and lateral to the flexor hallucis longus (FHL) muscle. It than traverses the tarsal tunnel inferior to the sustentaculum tali of the Calcaneus, and get inserted into the plantar surface of the calcaneus. However, controversy exists concerning the exact location of the insertion site of FCI muscle. Recently the insertion of the FCI muscle has been described as distal to the coronoid fossa, a small depression between the anterior tuberosity and the anterior apex of the sustentaculum tali of the calcaneus. However, chronological descriptions described the FCI as inserting into either the sustentaculum tali itself or a small tubercle on the medical surface of the calcaneus distal to the sustentaculum tali.

During routine dissection for under graduate students, about 56-year old Indian male, a Fibulocalcaneus (peroneocalcaneus) Internus (FCI) muscle was identified, which originated from the posterior medial surface of distal third of the fibula and tendon merges with 2 slip of flexor digitorum longus and get inserted on base of distal phalanx of second toe. Knowledge of the FCI muscle is important due its involvement with various ankle pathologies, including predisposing individuals to tarsal tunnel syndrome, FHL tenosynovitis, and posterior ankle impingement and pain. The FCI muscle is one of the least common muscular variants associated with the ankle joint, and it has been implicated in posterior ankle pain and impingement. This muscle is often confused with the flexor digitorum accessorius longus (FDAL) muscle. Additionally, this study describes ways to differentiate between the FCI and FDAL muscles in the lower leg. Radiologists and clinicians should be aware of this anomalous muscle when considering various diagnoses, interpreting radiographs, and pursuing surgical involvement to reduce symptoms of posterior ankle region.
Menstrual complications in school children
Authors: Chillara Tejaswi , Mannem Akhila , Rachakonda Shravya
Published: October 2023

Menstruation is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. It is characterized by the rise and fall of hormones. In women, various physical changes are brought about by fluctuations in hormone levels during menstrual cycle. Women may experience dysmenorrhea, amenorrhea, oligomenorrhea, menorrhagia, hypomenorrhea and UTI.

Menstrual complications in school children.

A prospective observational study was conducted for duration of 6 months, and study has been performed through an offline survey and 600 school children were recruited in our study according to inclusion criteria. By using data collection form student history was collected.

The study has been performed through an offline survey and 600 school children were analysed using data collection form and student history interview. Out of 600 school individuals, students with dysmenorrhea 167(27.8%) individuals, oligomenorrhea 27(4.5%), hypomenorrhea 12(2%), anemia 1(0.1%), dysmenorrhea and anemia 7(1.1%), dysmenorrhea and menorrhagia 169(28.1%), dysmenorrhea, oligo and UTI 1(0.1%), dysmenorrhea, oligo and menorrhagia 26(5.2%), dysmenorrhea and UTI 10(1.6%), dysmenorrhea and hypomenorrhea 23(3.8%), dysmenorrhea, hypomenorrhea and anemia 2(0.3%), dysmenorrhea, oligo and anemia 2(0.3%), oligo and menorrhagia 6(1%), oligo and hypomenorrhea 37(6.1%), UTI 2(0.3%), menorrhagia 30(5%), oligo and anemia 14(2.3%).

With our overall six months work, we concluded that oligomenorrhea, dysmenorrhea are the most common menstrual complications in school children during menstruation. The underlined cause to these complications is lack of proper nutrition, low BMI, and poor economic status. By conducting awareness programs in schools about menstruation and diet, basic knowledge has been provided, this may reduce further menstrual complications.
Tendencias en tecnologías convergentes en la industria 4.0: una revisión de literatura
Authors: Rodríguez-Correa Paula Andrea , Echeverri-Gutiérrez Camilo Andrés , Valencia-Arias Alejandro , Acosta-Agudelo Leidy Catalina , Echeverri-Gutiérrez Mauricio
Published: October 2023

De cara a los desafíos que ha traído consigo la industria 4.0 para las organizaciones, las tecnologías convergentes han cobrado gran importancia para responder a algunas de las necesidades de la actualidad. Por tanto, este estudio se propone como objetivo central identificar las tendencias temáticas en estudios de tecnologías convergentes en la Industria 4.0. Con base en esto se incluyen cuatro preguntas de investigación. Se realiza un análisis bibliométrico a partir de la declaración PRISMA. Se seleccionan las bases de datos Scopus y Web of Sciences y finalmente, se seleccionan 137 documentos para realizar el análisis. Los resultados permiten identificar los principales actores investigativos, es decir, los principales referentes en términos de autores, revistas y países que generan mayor impacto en el tema. También se analiza el comportamiento evolutivo de las temáticas de investigación en función de las palabras claves más recurrentes por año. Se identifican clústeres temáticos y los temas más frecuentes y vigentes en la literatura a partir del software VOSviewer. De esta manera, se propone una agenda investigativa en la que se marcan las futuras líneas de investigación y las preguntas que se deben responder con base en los vacíos académicos identificados. Los hallazgos permiten identificar un mayor interés por los temas relacionados con la inteligencia artificial, el cuidado de la salud y las farmacéuticas y la automatización en las ciencias de la salud.