bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Misoprostol with Foley Catheter vs Misoprostol alone for Cervical Ripening and Induction of Labor in Patients with Premature Rupture of Membrane: A Randomized Clinical Trial Study
Authors: PoorHosseini Seyyedeh Azam , Mirteimouri Masoumeh , RakhshaniFar Maliheh , Mousavi Vahed Seyede Houra , Haghollahi Fedyeh
Published: February 2024

Background:

This study evaluates the effect of misoprostol alone in comparison with misoprostol with Foley catheter in preparing the cervix for induction of labor in women with premature rupture of the amniotic sac.

Materials and Methods:

This randomized clinical trial study was performed from 2017 to 2019 on 206 pregnant women with singleton pregnancy and gestational age more than 36 weeks, whose rupture of the amniotic sac had occurred less than 12 hours and had a Bishop score less than 4. These women were randomly assigned to two groups of Foley catheters with misoprostol (intervention group, P = 103) or misoprostol alone (control group, P = 103) to induce labor. In both groups, sublingual misoprostol (25 micrograms) was administered at intervals of 4–6 hours. The collected data were analyzed by SPSS.21 software.

Results:

There is no significant difference between age and Bishop score in the two groups (P = 0.19, P = 0.31, respectively). Lower doses (0 to 3) of misoprostol were used in the intervention group versus 0 to 5 doses in the control group (P = 0.001). Delivery time was shorter in the intervention group (10.83 hours vs. 13.10 hours in the control group, P = 0.001). Also, the probability of complications such as fever, tachysystole, and hospitalization of an infant in the neonatal intensive care unit (NICU) did not increase.

Conclusion:

An intracervical Foley catheter with misoprostol is more effective in inducing labor in pregnancies with premature rupture of the membranes than using misoprostol alone and can be a safe and effective option.
Comparing the effect of sexual counseling based on BETTER and PLISSIT models on sexual assertiveness in women with breast cancer after mastectomy
Authors: Shalamzari Kowsar H. , Asgharipour Negar , Jamali Jamshid , Kermani Ali T. , Babazadeh Raheleh
Published: February 2024

BACKGROUND:

Sexual changes in breast cancer occur after diagnosis and treatment, including a mastectomy. Sexual assertiveness is an effective factor in sexual satisfaction, which means the ability to convey sexual feelings, beliefs, and thoughts. Given the limited studies on sexual assertiveness in breast cancer and different client participation, this study was conducted to compare the effect of sexual counseling based on two models of PLISSIT (Permission, Limited Information, Specific Suggestion, Intensive Therapy) and BETTER (Bring Up, Explain, Tell, Time, Education, Record) on sexual assertiveness in women after mastectomy.

MATERIALS AND METHODS:

This quasi-experimental intervention was conducted in 2021 in Mashhad, Iran. Seventy-eight mastectomized women with breast cancer were assigned to the BETTER (n = 39) and PLISSIT (n = 39) groups using permuted block randomization with a block size of 4 and an allocation ratio of 1:1. Both groups received four individual counseling sessions, one week apart. The research tools included a demographic information form and the Hulbert index of sexual assertiveness. Changes in the mean scores of sexual assertiveness between the two groups were evaluated before and four weeks after the intervention, and the mean changes were compared between the groups. Data analysis was conducted using the Kolmogorov-Smirnov test, independent t-test, paired t-test, and Chi-square tests using Statistical Package for the Social Sciences (SPSS) version 25 (P < 0.05).

RESULTS:

The results of the study showed that before the intervention, there was no significant difference in the score of sexual assertiveness in both groups (P = 0.253). The mean score of sexual assertiveness changes before and after the intervention in the BETTER group (8.07 ± 4.9) was significantly higher than in the PLISSIT group (5.58 ± 4.7) (P < 0.001).

CONCLUSION:

The results indicated that BETTER sexual counseling was more effective in increasing the sexual assertiveness of mastectomized women than PLISSIT counseling. Due to its simplicity and client-centeredness, this model can be used in breast cancer care programs.
Experiences of medical educational managers in the early COVID-19 pandemic: A qualitative thematic analysis
Authors: Imanipour Masoomeh , Gheiasi Seyede Fatemeh , Taheri Leila
Published: February 2024

BACKGROUND:

The coronavirus (COVID-19) pandemic changed and disrupted education at medical universities. Educational managers face new challenges and special complexities to manage this situation. This study aimed to explain the experiences of educational managers of Iranian medical universities in the early COVID-19 pandemic.

MATERIALS AND METHODS:

This descriptive-qualitative study was conducted at the Tehran University of Medical Sciences, 2020–2021. The study population included all educational managers in one of the positions of the dean of the faculty, educational Vice-Chancellor, head of the department, and other relevant educational directors in medical sciences universities during the COVID-19 pandemic. Data collected from semi-structured interviews were analyzed in MAXQDA2020 software using the thematic analysis approach.

RESULTS:

Four main themes and nine subthemes were identified: “The ups and downs of the transition from face-to-face training to virtual training,” “Crisis in educational management,” “Testing and Evaluation: Obstacles and Problems,” “Education and lessons learned from COVID-19.”

CONCLUSION:

Themes identified from the experiences of educational managers provide new information about the negative and positive effects of the COVID-19 pandemic on the learning and teaching process of medical sciences students. Lessons learned and experiences of educational managers in medical sciences universities amid the COVID-19 pandemic will help health education policymakers so that they can create transformation and innovation in the education of medical science students. Strengthening the e-learning infrastructure will help to create a foundation for a rich way of educating medical students in the post-corona era and when the outbreak of other emerging diseases is inevitable in the future.
Assessment the satisfaction level of faculty members from virtual teaching during corona crisis in Rafsanjan School of Medicine
Authors: Abbasifard Mitra , Ahmadinia Hassan , Moezi Alireza , Iranmanesh Foad , Shahabinejad Maryam , Ostadebrahimi Hamid , Heidari Fateme , Bagheri-Hosseinabadi Zahra , Hassanipour Mahsa
Published: February 2024

BACKGROUND:

Evaluating the experiences and the satisfaction level of the academic members is an important parameter in planning for virtual education during COVID-19 pandemic. The present study was designed to evaluate the satisfaction level of faculty members of Rafsanjan School of Medicine regarding virtual education in COVID-19 crisis in two stages between 2019 and 2022.

MATERIAL AND METHODS:

This descriptive study was conducted on the faculty members of Rafsanjan Medical School. The satisfaction level with virtual education during the COVID-19 pandemic was determined using a researcher-made questionnaire with appropriate validity and reliability. For analysing of quantitative variables, the Kolmogorov–Smirnov test, independent t tests and one-way analysis of variance and multiple linear regression were used.

RESULTS:

Data showed that only 15.2% of the faculty members had a previous experience of virtual teaching prior to the pandemic and 30.3% had a history of passing the empowerment course on virtual education before the COVID-19 crisis. Moreover, 68.2% passed the empowerment course on virtual education at the same time as the COVID-19 epidemic spread. The overall satisfaction with virtual education in the first and second stages of the study was 49.05 and 49.22 out of 100, respectively. The satisfaction of NAVID learning management system was 66.66 percent among faculty members. The level of satisfaction in non-clinical members was significantly more than clinical members.

CONCLUSION:

The overall satisfaction of faculty members with virtual education was at an average or medium level. From the point of view of the faculty members, some aspects of virtual education need to be improved. Therefore, it seems necessary to improve the infrastructure and empower the faculty members to enhance the quality of virtual education.
The effect of positive thinking training on anxiety and happiness among older adults: A quasi-experimental study
Authors: Pourdavarani Anis , Farokhzadian Jamileh , Forouzi Mansooreh Azizzadeh , Shahraki Sedigheh Khodabandeh
Published: February 2024

BACKGROUND:

Anxiety and depression are the most prevalent mental disorders associated with aging. Positive thinking training is a way to help older adults cope with anxiety and depression and increase their happiness. This study aimed to determine the effect of positive thinking training on anxiety and happiness among older adults.

MATERIALS AND METHODS:

This quasi-experimental study was conducted with 48 older adults referred to two comprehensive health service facilities in the southeastern Iranian province of Kerman. The intervention (n = 24) and control (n = 24) groups were randomly assigned from a convenience sample of older adults. The intervention group attended eight two-hour training sessions on positive thinking. Data were collected before and one month after the positive thinking training using Beck Anxiety Inventory and Oxford Happiness Inventory. All statistical procedures were performed in SPSS software (version 22), with the significance level set to P = 0.05.

RESULTS:

Before the positive thinking program was delivered, the mean anxiety scores in the intervention and control groups were 13.98 ± 8.61 and 19.25 ± 11.67, respectively. After the intervention was completed, the mean scores for the intervention and control groups were 4.50 ± 4.07 and 15.54 ± 9.04, indicating a significant reduction in anxiety among intervention group participants (t = -5.45, P < 0.001). The mean baseline happiness scores in the intervention and control groups were 26.58 ± 12.40 and 37.91 ± 5.57, respectively, which changed to 62.91 ± 4.66 and 35.62 ± 10.62 at the post-test. Positive thinking training improved happiness in a significant manner (t = -4.08, P < 0.001).

CONCLUSION:

Results revealed that positive thinking training decreased anxiety and enhanced happiness among older adults. Given the growing elderly population, clinical managers, clinical specialists, nurses in health care centers, and those involved in elderly care facilities can benefit from this non-pharmacological treatment program for older adults suffering from anxiety and depression. It is suggested that preventive programs based on positive psychology be developed to aid in the prevention of people’s declining happiness and increasing anxiety as they age.
Explaining the lived experiences of school principals regarding the promotion of psychological capital of high school girls through promoting their health
Authors: Mahmoodaliloo Parvin , Talebi Behnam , Khadivi Asadollah
Published: February 2024

BACKGROUND:

Psychological capital, a vital factor in adolescents’ success, interacts with health and the dimensions of health and is especially important in adolescent girls. The purpose of this research is to explain the lived experiences of school principals regarding the promotion of psychological capital of high school girls through promoting their health.

MATERIALS AND METHODS:

The present study, which is based on a qualitative approach and a descriptive phenomenological method, has been carried out through studying 23 participants who were the principals of girls’ high schools in Tabriz in 2022. Purposive sampling method was used and 23 semistructured interviews were conducted until theoretical saturation was reached. Data analysis was conducted based on the Colaizzi’s seven-step method.

RESULT:

Findings indicate that the lived experiences of school principals regarding the promotion of psychological capital of high school girls through promoting their health can be classified as follows: physical health including physical activity and sports, healthcare (teeth and mouth, eyes, skin, and hair), disease prevention, nutrition, and physical fitness; mental health including spirituality, life skills, academic skills, counselling, and peer relationships; and puberty health including awareness of puberty, appropriate modeling, and sex education.

CONCLUSION:

The programs and behaviors related to health dimensions at schools are among the key grounds promoting psychological capital of high school girls.
Community-based education: An effective policy for earthquake preparedness in Iran: Empirical study
Authors: Shams Lida , Shirzad Maryam , Atighechian Golrokh , Nasiri Taha , Shahbazi Sara
Published: February 2024

BACKGROUND:

As natural or man-made shocks, disasters are sudden events that require emergency and fundamental measures. The need to be prepared for disasters has become clearer than ever worldwide. This study aimed to investigate the effect of earthquake preparedness training using the face-to-face or cascade method in rural households living in Juybar County (Iran) in 2018.

METHODS AND MATERIAL:

Following an experimental design with a pretest and posttest, the study was performed on married women aged 10–49 living in Kurdkolay village of Juybar county (n = 372). Participants were randomly categorized into two groups of training (n = 95) and face-to-face cascade method (n = 95). Data were collected using the Disaster Preparedness Assessment Index, comprising demographic and education sections. Data were collected using the disaster preparedness assessment index and analyzed using SPSS version 24.

RESULTS:

The findings indicated improved preparedness in all five dimensions in both groups. There was a significant difference between the study groups immediately and one week after the intervention (P < 0.05); i.e. a higher impact for the face-to-face cascade method. Meanwhile, both groups presented a similar level of preparedness 90 days after receiving the intervention (P > 0.05).

CONCLUSIONS:

The face-to-face cascade method was more effective in the short term, while no difference was found in the long term. Crisis managers and policymakers should choose their preferred method based on available facilities, human resources, and context to increase preparedness against earthquakes. Mothers play a vital role in educating and nurturing their children. It is suggested to conduct educational programs at the community level using the most appropriate methods that are chosen based on the best evidence.
A survey on the effects of patient safety training programs based on SBAR and FMEA techniques on the level of self-efficacy and observance of patient safety culture in Iran hospital, Shiraz in 2022–2023
Authors: Abrishami Ramin , Golestani Kambiz , Ranjbar Mehri Farhang , Abarghouie Mohammad Hassan Ghasemie , Ghadami Ahmad
Published: February 2024

BACKGROUND AND OBJECTIVE:

Patient safety and medical personnel self-efficacy are among the main factors involved in providing quality health services. Moreover, safety culture in an organization is considered one of the most critical factors regarding patients’ safety. Therefore, the present study aimed to determine the effects of patient safety programs based on Situation, Background, Assessment, Recommendation (SBAR) and Failure Model Effects Analysis (FMEA) techniques on self-efficacy and patient safety culture in Iran Hospital of Shiraz in 2022–2023.

MATERIALS AND METHODS:

This two-stage quasi-experimental study was conducted in 2022–2033. Considering inclusion criteria, the present study included 80 nurses working in Iran Hospital. The participants were divided into groups of SBAR (40 participants) and FMEA (40 participants). All the data were collected using a Hospital Survey on Patient Safety Culture questionnaire and Sherer General Self-Efficacy Scale. Then, the collected data were analyzed using SPSS 13, Fisher’s exact test, paired t-test, and independent t-test with a significant level of P < 0.05.

RESULTS:

The mean score of total patient safety culture between the two groups was insignificant before the intervention (P = 0.58). However, it was more significant in the FMEA group than the SBAR group after the intervention (P < 0/05). In addition, the mean self-efficacy score between the two groups was insignificant before the intervention (P = 0.80). However, after the intervention, the mean score of the FMEA group was significantly higher than the SBAR group (P < 0.05).

CONCLUSION:

According to the findings of this study, there is a meaningful relationship between patient safety training programs based on SBAR and FMEA techniques on patient safety and self-efficacy of nurses; however, FMEA training has more positive effects on self-efficacy and patient safety compared to other techniques. As a result, these techniques, along with other plans, are recommended to authorities in order to help improve patient safety.
Effectiveness of comprehensive nursing intervention program (CNIP) on knowledge and practice regarding the prevention of non-insulin-dependent diabetes mellitus (NIDDM) among adults
Authors: Koirala Bhumika , Balu Venkatesan , Kamei Sonia , Devi Yumnam Sushma , Sapkota Pratima
Published: February 2024

BACKGROUND:

There are estimated 72.96 million cases of diabetes in the adult population of India. The prevalence in urban areas ranges between 10.9% and 14.2%, and the prevalence in rural India ranges between 3.0% and 7.8% among the population aged 20 years and above with a much higher prevalence among individuals aged over 50 years. This study aimed to determine the effectiveness of comprehensive nursing intervention program (CNIP) on knowledge and practice regarding the prevention of non-insulin-dependent diabetes mellitus (NIDDM) among adults.

MATERIALS AND METHODS:

A quasi-experimental one-group pretest–posttest design was chosen for the study. Adults were selected using a simple random sampling technique by the lottery method; of 120 eligible adults, 60 were selected to participate in the study. The study was conducted in an urban community, Bangalore, and data were collected from March 25, 2022, to April 23, 2022. CNIP consisted of education, demonstration of exercise, and information booklet. The pretest and posttest were collected using the structured knowledge questionnaire for assessing the level of knowledge and non-observational checklist for assessing the level of practice among adults. Data were analyzed by descriptive and inferential statistics.

RESULTS:

There was significant improvement in the mean scores of knowledge from 52.3 to 82.2 and practice mean score from 45.5 to 68.4. The paired t-test value of knowledge was 3.88, and practice was 2.97, which was significant at P < 0.05 level.

CONCLUSIONS:

The study concluded that CNIP had a great role in increasing the level of knowledge and practice among adults in the prevention of NIDDM.
Critical thinking in nursing and midwifery learning: Quantitative and qualitative review
Authors: Atif Ibtissam , Elamri Nabila , Gantare Abdellah
Published: February 2024

BACKGROUND:

This study tried to make a quantitative and qualitative review of the scientific production of the mobilization of critical thinking in nursing and midwifery learning.

MATERIALS AND METHODS:

The search was carried out in the “Web of Science” and “PubMed” databases between 2001 and 2021, resulting in 43 articles using several keywords “critical thinking,” “learning”, “nursing,” “midwifery”. The study will be split into two parts: A quantitative review in the form of a bibliometric analysis and a qualitative one in the form of a literature review. The quality of the articles has been verified by assessing the risk of bias (selection bias, detection bias, and interpretation bias) and using the Standards for Quality Improvement Reporting Excellence method.

RESULTS AND OBSERVATIONS:

The selected articles were the subject of a quantitative study leading to several results: chronology of publications, types of publications, number of publications, top journals of publications, etc. The same articles have been processed to produce a full qualitative review of the experimental studies.

CONCLUSION:

The results showed that the total and annual articles need to be higher. Experimental studies, especially quasi-experimental, are far higher than reviews or descriptive studies. The qualitative research showed a controversial relationship between critical thinking and learning improvement.
Validation of intercultural competence scale in the Ethiopian context: Exploring the factor structure and psychometric properties among university students
Authors: Bekere Tessema A. , Teketel Seleshi Z.
Published: February 2024

BACKGROUND:

Although intercultural competence is a crucial factor for university students’ academic achievement and inter-ethnic conflict resolution, psychometrically sound intercultural competence scale is not available in the Ethiopian context. The aim of the present study was to translate the original English version of intercultural competence into Amharic language and validate the scale in the Ethiopian context.

MATERIALS AND METHODS:

In the processes of retaining culturally equivalent translated measure symmetrical approach was used. Data were collected from 476 (Male = 244 and Female = 232) arbitrarily selected university students with an age mean of 22.35 enrolled in undergraduate degree programs at Ambo University. The total sample was randomly split into two equal-sized group to execute exploratory factor analysis (EFA, N = 238) and confirmatory factor analysis (CFA, N = 238).

RESULT:

The result of the study showed that both EFA and CFA supported a significantly correlated four-factor model of intercultural competence (Attitude, Awareness, Knowledge, and Skills). Moreover, the Amharic version of the intercultural competence scale showed good psychometric properties in terms of content validity, construct validity, internal consistency, and good fit indices to the data.

CONCLUSION:

This generally justifies the use of the Amharic version intercultural competence scale in the Ethiopian context. To satisfy the needs of the labor market, universities in Ethiopia should promote intercultural dialogues that improve the intercultural competence of university students.
Effect of vaccine dose on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibody levels in a vaccinated community in Gowa Regency, Indonesia
Authors: Hamsi Andi Magfirah , Amiruddin Ridwan , Arsin A. Arsunan , Abdullah Andi Zulkifli , Amqam Hasnawati , Riskiyani Shanti
Published: February 2024

BACKGROUND:

The administration of the coronavirus disease 2019 (COVID-19) vaccine aims to stimulate the production of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies. This leads to an enhanced production of neutralizing antibodies (Nabs), which naturally neutralize the virus within the body, thereby reducing the risk of COVID-19 infection. This study determined the analysis of factors affecting SARS-CoV-2 antibody levels in vaccinated individuals using data from the COVID-19 Seroepidemiological Survey of Gowa Regency.

METHODS AND MATERIAL:

This was an analytic observational study with a cross-sectional design. The COVID-19 Seroepidemiology Survey data as a whole were 851 individuals, and in this study, the number of samples was 804 individuals from all COVID-19 Seroepidemiology Survey samples who had performed the COVID-19 vaccine in Gowa Regency, selected through purposive sampling.

STATISTICAL ANALYSIS USED:

Data analysis was conducted using various statistical tests, including the independent-samples t-test, Mann–Whitney test, Kruskal–Wallis test, and multiple logistic regression. Furthermore, the analysis was performed through the STATA program version 14.0.

RESULTS:

There was a significant influence between the history of COVID-19 infection (P = 0.0006) and dose of vaccine (P = 0.0001) with SARS-CoV-2 antibody levels in vaccinated individuals. Meanwhile, vitamin consumption and comorbid history did not affect SARS-CoV-2 antibody levels. Multivariate analysis showed that vaccine dose was the most influential variable on antibody levels (P = 0.046; Odds Ratio (OR) 0.19; 95% Confidence Interval (CI): 0.036–0.968).

CONCLUSIONS:

The most influential factor was the vaccine dose on SARS-CoV-2 antibody levels in community in Gowa Regency.
Investigating the relationship between organizational health and burnout and job stress among midwives working in hospitals in 2020
Authors: Vardanjani Maryam Ghazali , Montazeri Simin , Veshare Effat Jahanbani , Ghanbari Saeed
Published: February 2024

BACKGROUND:

Despite the prominent role of midwives in improving the health of women and families, limited studies have been conducted in the occupational and organizational field and their role on the performance of this group. The purpose of this research is to investigate the relationship between organizational health, burnout, and job stress among midwives working in hospitals affiliated to Shahrekord University of Medical Sciences.

MATERIALS AND METHODS:

The present study is a cross-sectional descriptive–analytical study, which was conducted with available sampling method on 159 midwives working in hospitals affiliated to Shahrekord University of Medical Sciences in 2020. Data collection tools were: Demographic Questionnaire, Modified Hoy and Feldman Organizational Health Questionnaire, Job Stress Questionnaire, Maslach Questionnaire to measure job burnout. Finally, the obtained data were analyzed with descriptive and analytical statistical tests (Pearson).

RESULTS:

The findings of the study showed that 70.4% of the participants had moderate to severe job stress and 70.4% of the participants had moderate level of organizational health and 79.9% suffered from job burnout. The results of structural equations showed that organizational health has an inverse and significant relationship with job stress (P < 0.001, β = −0.45) and job burnout (P = 0.002, β = −0.33).

CONCLUSION:

Organizational health has an inverse and significant relationship with job stress and job burnout. The findings of this study can be useful in planning and organizational policies for midwifery professionals. It also conveys the importance of extensive studies and planning to reduce stress and burnout and then improve organizational health. As a result, it can improve the performance and productivity, and as a result, improve the health of midwives and patients under their care and, consequently, the health of the society.
The Level of Knowledge of Decompression Sickness among Divers in Saudi Arabia – A Cross-sectional Study
Authors: Jamjoom Maan , Altirkistani Bsaim , Al-Jadani Faisal , Mirza Hashem , Alhijjy Majed , Alharthi Reem Abdullah , Hakeem Iliana , Madani Anass
Published: February 2024

Introduction:

Decompression sickness (DCS) is a clinical syndrome, i.e. commonly seen in divers. The global prevalence of DCS among professional dive instructors is approximately 3.4%. This study aimed to assess the level of knowledge concerning DCS among divers in Saudi Arabia.

Materials and Methods:

This is a cross-sectional study conducted among divers in Saudi Arabia. The research team visited several diving resorts to distribute the questionnaires. Furthermore, diving instructors from different cities across the nation were requested to distribute the questionnaire to their colleagues and diving communities.

Results:

A total of 262 divers participated in the study, of which 252 (96.18%) had a scuba-certified license. The majority of divers (94.27%) reported that they were aware of DCS. Furthermore, 27.48% of the participants reported that they had experienced clinical symptoms of DCS. Only 14 (19.44%) received first aid care, and 17 (6.489%) needed a deco dive/decompression dive. Females demonstrated a higher risk of developing DCS-related symptoms than males (odds ratio = 2.57; 95% confidence interval = 5.44–1.21; P = 0.0135).

Conclusion:

Majority of the participants were familiar with the nature of the disease and were found to have practiced safe diving. Practically, one-quarter of the participants experienced DCS-related symptoms, and only very few of them received first aid and/or a deco dive. Despite the nature of the study and its small sample size, this study adds to the growing nature of published literature in giving a better understanding of the disease by divers.
Impact of Smoking in Postoperative Outcomes after Elective Surgery
Authors: Goyal Vishal , Varma Chaitanya K , Behera Mahesh , Reddy G Parmeswar , Shankar Mamadur M. Ram
Published: February 2024

Introduction:

The hazard of smoking is not only limited to the general health risks but also makes the smokers more vulnerable to various perioperative complications ranging from pulmonary complications to delayed wound healing to cardiovascular events.

Methodology:

This is an observational study in the department of general surgery of a tertiary care teaching hospital over a period of 24 months (May 2019–April 2021). Patients between 18- and 60-year age undergoing noncardiac elective surgical procedures were included in the study.

Results:

A total of 240 patients, meeting the inclusion criteria, posted for elective, noncardiac surgery were enrolled in this prospective observational study. In smoker patients’ group (n = 138) undergoing surgery, 42 (30.4%) patients developed postoperative complications as compared to 12 (11.8%) patients in nonsmoker group (n = 102). The risk of postoperative complications among smokers was 3.2 times (odds ratio [OR], 95% confidence interval [CI]: 1.62–6.63) (P ≤ 0.0009). Smokers with pack-years > 11 had 3.8 times increased risk of postoperative complications as compared to nonsmokers (OR, 95% CI: 1.85–8.098) (P ≤ 0.0003).

Conclusion:

Our study aims to add to existing evidence and improve our understanding of delayed wound healing and major complications in smoker patients as surgical cases. Nonsmokers are at a lesser risk than smokers in postoperative complications. Awareness regarding the harmful effects of smoking and its influence on postoperative wound healing, motivation for quitting, and abstinence from smoking will help in reducing postoperative complications and better treatment outcomes.
A Medical Record-based Pilot Study on the Diffusing Capacity of the Lungs for Carbon Monoxide versus Nailfold Capillaroscopy as an Early Marker for Lung Involvement in Connective Tissue Disease-related Interstitial Lung Diseases
Authors: Chopra Manu , Pandey Indramani , Vasdev Vivek , Shrinath V. , Yadav Aseem
Published: February 2024

Background:

Connective tissue disease (CTD)-related interstitial lung diseases (ILDs) are one of the most common ILDs which affect relatively younger populations and can lead to extensive lung damage and fibrosis. Early detection and initiation of anti-inflammatory therapy can curtail the extent of lung damage. The diffusing capacity of the lungs for carbon monoxide (DLCO) is a well-established early marker of ILD. While most of the studies have shown specific nailfold capillaroscopy (NFC) findings in patients with CTD-ILD, none of them has evaluated the relation between diffusion impairment and nailfold capillary changes. The present study was carried out to evaluate the relationship between DLCO and NFC as markers for lung involvement in CTD-ILDs.

Materials and Methods:

This was a medical record-based observational study wherein the medical records of 100 diagnosed patients of CTD-ILD attending the pulmonology and rheumatology outpatient department were screened. Data concerning NFC, spirometry, and DLCO were collected and analyzed.

Results:

In our study of 100 patients, the minimum age was 29 years, and the maximum age was 78 years. A majority of patients in the study were found to be males (58%) and were suffering from CTD-ILD for a duration ranging from 2 to 5 years (58%). Eighty-nine percentage had a functional impairment on spirometry in the form of reduced forced vital capacity, and 61% had impaired DLCO. Nailfold capillary abnormalities were observed in all but one patient. The most common abnormal finding was a loss of capillary density (95% of patients) and a decrease in the intercapillary distance (94% of patients). A significant correlation was seen between diffusion impairment and abnormal nailfold capillary length. However, there was no significant correlation between DLCO and overall nailfold capillary abnormalities.

Conclusion:

The study concludes that NFC cannot be used as a tool to monitor diffusion impairment of the lungs in CTD-ILD. DLCO is a better assessment method compared to NFC changes as an indicator of lung involvement in CTD-ILD.
Microsurgical Training: A Review of Existing Methods and an Innovative Practice Model
Authors: Vishwanath G. , Patil Bhushan Ramesh , Goel Sankalp
Published: February 2024

Surgery under magnification with the use of the operating microscope has seen great advances, and numerous surgical procedures today depend on optical magnification. Training (to impart basic skills) in microsurgery is particularly essential to enable surgeons to take their place in the surgical team and learn further as they progressively observe, assist, and in time, perform microsurgical procedures. Various materials and models are used and have been objectively assessed and validated for simulation in microsurgical training. One such model, the live animal model (with all its disadvantages), has been the “gold standard” for simulation in microsurgical training. We have identified and put into use a new tissue model for training in microvascular surgery – the chicken mesentery, which will offer a good practical solution where the live animal model is unavailable. Further studies using this model for training at various centers will be required for validation and comparison of this tool against existing methods.
Use of Aztreonam Plus Ceftazidime/Avibactam Combination for In vitro Susceptibility Testing of CRO Isolates in a Tertiary Care Hospital – Our experience
Authors: Patel Ankita , Kompella Kiran Kumar , Bahal Ashish , Bhatt Puneet , Mathew Ann , Mahajan Pooja , Sharma Alisha , Ninawe SM , Grover Naveen , Chawla Naveen
Published: February 2024

Background:

Infections caused by metallo-beta-lactamases (MBLs) producing Gram-negative bacteria (mainly Enterobacterales) pose a great challenge for clinicians in treating these multidrug-resistant infections. In recent times, combination antibiotic therapy with ceftazidime–avibactam (CAZ-AVI) with aztreonam (ATM) has been researched by a number of laboratories worldwide and has gained much clinical attention. This study evaluated a practical laboratory method of testing for clinically significant in vitro synergy between CAZ/AVI + ATM in New Delhi MBLs (NDM) producing Gram-negative organisms.

Materials and Methods:

A total of 100 isolates of carbapenem-resistant Enterobacteriaceae (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Enterobacter cloacae) were tested for synergy between CAZ/AVI + ATM using E-strip of CAZ/AVI and disc of ATM. The minimum inhibitory concentration value of CAZ/AVI was measured and the zone of inhibition was observed when ATM was placed parallel to the E-strip on a lawn culture of an isolate. Simultaneously, all isolates were tested for NDM and OXA-48 by Xpert Carba-R.

Results:

Of 100 isolates, 63/100 (63%) were harboring OXA-48 beta-lactamase, 54/100 (54%) were harboring NDM beta-lactamase and 18/100 (18%) were harboring both (OXA-48 and NDM). In vitro synergy between CAZ/AVI + ATM was noted in 99 isolates (99%).

Conclusion:

A significant synergy was demonstrated in vitro with CAZ/AVI + ATM combination therapy and seems to be a promising treatment strategy for infections caused by Enterobacterales harboring NDM and OXA-48 beta-lactamases.
Holmium Laser Lithotripsy in the Management of Difficult Biliary and Cystic Ductal Stones – A Case Series
Authors: Kumar Amit , Goje Harindra Kumar , Tarway Nimesh Kumar , Hande Vivek
Published: February 2024

Choledocholithiasis or common bile duct stone (CBDS) presents a unique challenge in the management of biliary stones. The clinical presentation of CBDS varies from asymptomatic CBDS, detected during the evaluation of gallstone disease to sinister presentation, like severe biliary pancreatitis. Asymptomatic liver function test abnormality, biliary colic, dilated common bile duct (CBD) on sonography for pain abdomen, and cholangitis are the part of the spectrum. Based on clinical suspicion and aided by laboratory parameters, the diagnosis is confirmed by modalities such as ultrasonography or magnetic resonance cholangiopancreatography or by endoscopic ultrasound. Endoscopic radiological cholangiopancreatography (ERCP) has evolved as a standard of care over the decades for the management of CBDS and surgical exploration of CBD is rarely resorted. ERCP is followed by laparoscopic cholecystectomy as a definitive treatment to prevent recurrence of CBDS. Multiple factors play a role in the successful extraction of CBDS. Two broad considerations are the size of stone and bilio-duodenal anatomy. Multiple studies have noted that stone size larger than 15 mm requires fragmentation for successful extraction. Mechanical lithotripsy has been cornerstone for the management of such cases. Besides size of stone, morphology and number of stones, narrow CBD (distal to stone), duodenal diverticulum and altered anatomy due to gastroduodenal surgeries pose a challenge in stone extraction and are collectively called difficult CBDS. Multiple modalities notably extracorporeal shortwave lithotripsy, holmium laser (Ho laser) lithotripsy, and electrohydraulic lithotripsy (EHL) have been studied for the fragmentation of large CBDS. Innovation in cholangioscopy and wider availability of peroral single-operator cholangioscope has brought EHL and Ho laser lithotripsy (LL) at forefront of management of difficult CBD stones. We share the experience of Ho LL for CBDS at a tertiary care hospital in Western India. The data of four patients, successfully managed with single-operator cholangioscopy (SoC)-guided Ho LL for indications ranging from large CBDS to residual large cystic duct stump stone has been discussed. These cases emphasize wider clinical application of SoC-guided Ho-LL beyond the size of the stone. Ho LL has revolutionized the management of difficult biliary stone. The major limitation is cost of care and availability of expertise.
Preventing Double Spending Attacks through Crow Search Algorithm to Enhance E-Voting System Security
Authors: Muthulakshmi S , Kannammal A
Published: February 2024

Electronic voting system is the process of polling votes and counting votes. In most of the countries voting may now be done electronically, there are still several difficulties involved, including the expense of paper, how ballots are organized, the possibility of varying results when tallying the votes, and others. Duplicate votes pose a significant concern as they can be fraudulently cast by individuals. To focus on this issue, Distributed Ledger Technology (DLT) is employed to enhance the voting procedure in a secured manner. A directed acyclic graph is used by the Internet of Things Application (IOTA), a promising distributed ledger system. Faster transaction confirmation, high scalability and zero transaction fees are achieved via the Directed Acyclic Graph structure. In both IOTA tangle and blockchain technology, the public cast duplicate votes. The unauthorized user can create duplicate votes in the blockchain as well as IOTA tangle. This can be focused in this proposed method. The double spending problem can be solved by using Crow Search Algorithm (CSA). This Optimization problem produces an improved result for resolving double spending in e-voting systems.
Smart Attendance System using Face Recognition
Authors: Viswanathan Jayaraj , E Kuralamudhan , S Navaneethan , S Veluchamy
Published: February 2024

Face recognition offers a wide range of valuable applications in social media, security, and surveillance contexts. The software used for building facial recognition algorithms is Python and OpenCV. "Attendance using Face Recognition" is a method for tracking and managing attendance that makes use of facial recognition technology. By seamlessly integrating the 'Face Recognition' module, a native Python feature, and the OpenCV library, our system excels in accuracy and dependability. The system then stores attendance records in a database and provides real-time reports. In this article, we demonstrate how to create a face recognition system in Python utilizing the built-in "Face Recognition" module and the OpenCV library. Our results show that our system achieves high accuracy and robustness while being efficient and scalable, catering to a wide spectrum of educational institutions, organizations, and enterprises.
Area and Gauss–Bonnet inequalities with scalar curvature
Authors: Gromov Misha , Zhu Jintian
Published: February 2024

The Gauss–Bonnet theorem states for any compact surface

(S,g)

that the quantity

Q^{S}_{GB}(S)=\int_{S} \operatorname{Sc}(S,s)\,\mathrm{d}s+\int_{\partial S}\mathrm{mean.curv.}(\partial S,b)\,\mathrm{d}b-4\pi\chi(S)

vanishes identically. Let

(X,g)

be a compact Riemannian manifold of dimension

n\geq 3

with smooth boundary, associated with a continuous map

{f=(f_1,\ldots,f_{n-2}) \colon X\to [0,1]^{n-2}}

, where

\operatorname{Lip}f_{i}\leq d_{i}^{-1}

for positive constants

d_{i}

. For a universal constant

C_{n}(d_{i})

depending only on

d_{i}

and

n

, we show that there is a compact surface

\Sigma

homologous to the

f

-pullback of a generic point such that each component

S

of

\Sigma

satisfies

Q_{GB}^{X}(S)\leq C_{n}(d_{i})\cdot\operatorname{area}(S)

, where

Q^{X}_{GB}(S)=\int_{S} \operatorname{Sc}(X,s)\,\mathrm{d}s+\int_{\partial S}\mathrm{mean.curv.}(\partial X,b)\,\mathrm{d}b-4\pi\chi(S).

As corollaries, if

X

has “large positive” scalar curvature, we prove in a variety of cases that if 

X

“spreads” in

(n-2)

directions “
distance-wise
”, then it
cannot
much “spread” in the remaining 2-directions “
area-wise
”.
Air quality index prediction using seasonal autoregressive integrated moving average transductive long short‐term memory
Authors: Deepan Subramanian , Saravanan Murugan
Published: February 2024

We obtain the air quality index (AQI) for a descriptive system aimed to communicate pollution risks to the population. The AQI is calculated based on major air pollutants including O3, CO, SO2, NO, NO2, benzene, and particulate matter PM2.5 that should be continuously balanced in clean air. Air pollution is a major limitation for urbanization and population growth in developing countries. Hence, automated AQI prediction by a deep learning method applied to time series may be advantageous. We use a seasonal autoregressive integrated moving average (SARIMA) model for predicting values reflecting past trends considered as seasonal patterns. In addition, a transductive long short‐term memory (TLSTM) model learns dependencies through recurring memory blocks, thus learning long‐term dependencies for AQI prediction. Further, the TLSTM increases the accuracy close to test points, which constitute a validation group. AQI prediction results confirm that the proposed SARIMA–TLSTM model achieves a higher accuracy (93%) than an existing convolutional neural network (87.98%), least absolute shrinkage and selection operator model (78%), and generative adversarial network (89.4%).
Comparison of machine learning methods for the prediction of type 2 diabetes in primary care setting using EHR data
Authors: Olwendo Amos Otieno , Ochieng George , Rucha Kenneth
Published: February 2024

Diabetes remains a major global public health challenge, thus the need for better methods for managing diabetes. Machine learning could provide reliable solutions to the need for early detection and management of diabetes. This study conducted experiments to compare a number of selected machine learning approaches to determine their suitability for early detection of diabetes in the primary care setting. A retrospective study was conducted using EHR dataset of confirmed cases of diabetes collected during routine care at Nairobi Hospital. Institutional ethical approvals were obtained, and data were retrieved from the database through stratified sampling based on gender. Diagnoses were confirmed using the ICD-10 codes. Records with 5% or so of missing values were excluded from this analysis. Data were processed by correction of errors and replacement of missing values using measures of central tendency. The data were transformed through normalization using the decimal-scaling method. Data analysis was conducted using selected supervised and unsupervised learning algorithms. Model performances were validated using metrics for the evaluation of classification and clustering results, respectively. Random Forest had the highest accuracy (0.95) and error rate (0.05), while Gradient Boosting and Multilayer Perceptron (MLP) with 3 hidden layers obtained accuracy (0.94) and error rate (0.06), respectively. The process of selecting machine learning algorithms needs to explore both supervised and unsupervised learning techniques. In addition, an appropriate architectural design of an MLP could present astounding results for classification tasks in primary care settings.
Öğretmenlerin Dijital Yeterliliklerinin İncelenmesi
Authors: Köksal Döne , Canlı Suzan
Published: February 2024

Bu araştırmanın amacı, öğretmenlerin dijital yeterlilik algılarını incelenmektir. Araştırmada anlık tarama modeli kullanılmıştır. Araştırmanın örneklemi, uygun örnekleme yöntemi ile belirlenen 149 öğretmenden oluşmuştur.  Araştırmanın verileri “Eğitimciler İçin Dijital Yeterlilik Ölçeği” kullanılarak toplanmıştır. Normal dağılım göstermediği belirlenen verilerin analizinde betimsel istatistik analizi, Mann Whitney U testi ve Kruskal Wallis H testi kullanılmıştır. Öğretmenlerin dijital yeterlilik algılarının ölçeğin tamamında, Mesleğinde Dijital Becerilerin Kullanımı, Öğretme ve Öğrenme, Öğrencilerin Dijital Yetkinliklerinin Kolaylaştırılması boyutlarında Bütünleştirici; Dijital Kaynaklar, Değerlendirme, Öğrencilerin Güçlendirilmesi boyutlarında Kâşif düzeyinde olduğu belirlenmiştir. Cinsiyet, yaş ve branş değişkenleri öğretmenlerin dijital yeterliliğinde anlamlı bir farklılık oluşturmamıştır. Görev yapılan okul türü değişkeni sadece Mesleğinde Dijital Becerilerin Kullanımı boyutunda anlamlı farklılık oluşturmuştur. Araştırmanın sonucuna göre öğretmenlerin dijital yeterlilikleri istenilen seviyede değildir. Bununla birlikte, öğretmenlerin dijital pedagojik yeterlilikleri açısından daha yetersiz oldukları sonucuna ulaşılmıştır.
Robotic Technologies in Education and Educational Robotic Applications
Authors: Çaka Cansu
Published: February 2024

Developments in information and communication technologies have triggered a process of social transformation. The spread of technology in every field from past to present has led to emergence of different perspectives on technology. Technological tools are used in almost every field, from medicine to engineering, from education to construction. In this context, robotic technologies have come to the fore as a large developing field that affects human life. When the studies on the use of robotics in education are reviewed, it is seen that developed countries see robotics as a driving force in education and attach great importance to the use of these technologies in terms of improving their education systems. The purpose of the current study designed based on the idea that robotic systems make great contributions to the field of education and will make even more contributions is to investigate robotic technologies and related concepts, the reflections of robotic technologies in the field of education and educational robotic applications. It is thought that such an investigation of the status and reflections of robotic technologies in education and the suggestions presented in this direction will shed light for the studies to be conducted on the use of robotic technologies in education and will provide guidance for researchers.