bluuebunny/crossref_metadata_2025 huggingface dataset:
The Double-Edged Sword Mediatized Integration Processes during the COVID-19 Pandemic
Authors: Görland Stephan O.
Published: December 2023

The issue of media appropriation by refugees experienced a boom in 2015, but since then the topic has received less attention over the years. In addition, refugees have faced significant challenges since the appearance of COVID-19. In this paper, I discuss how Syrian migrants and refugees who have lived in Germany for at least four years used media technologies during COVID-19. I present findings from twelve guided interviews conducted in a northern German city. In summary, media use in general has increased, as has that of the majority society. On the other hand, media use during the pandemic has proven to be a double-edged sword: Some refugees had great(er) problems coping with the situation, while others gained self-empowerment and agency through using media during the pandemic.
The role of working memory in probabilistic cuing of visual search
Authors: Giménez-Fernández Tamara , Vicente-Conesa Francisco , Luque David , Vadillo Miguel A.
Published: December 2023

In a typical probabilistic cuing experiment, participants are asked to find a visual target among a series of distractors. Although participants are not informed about this, the target appears more frequently in one region of the display, resulting in faster search times for targets located in this region. This bias is thought to depend on a habit-like attentional control mechanism, unconstrained by the availability of working memory (WM) resources. However, the only study that has explored this feature in the past suffers from methodological shortcomings that leave the results open to alternative explanations. In three experiments we aimed to confirm whether probabilistic cuing is unaffected by visual, spatial, and spatiotemporal WM load. For each experiment, one group of participants performed the visual search task during the retention interval of a WM task (high-load group), whereas other group of participants (no-load group) carried out the visual search task after the WM task. We hypothesized that the probabilistic cuing effect would be larger for the no-load group compared to the high-load group. This hypothesis was confirmed in one experiment, but exploratory analyses suggest that the results can be highly dependent on the analytic approach, casting doubts on its robustness. Overall, our results provide partial support for the hypothesis that probabilistic cuing is not affected by a secondary task. However, given that some analyses reveal an effect of WM load, we conclude that it might be premature to rule out the possibility that the expression of this attentional bias requires WM resources.
Unfortunately, everything is under control: A plea for stronger statistical considerations about the use of control variables
Authors: Blötner Christian
Published: December 2023

Control variables are frequently employed when assumed relations between constructs of interest should be corrected for extraneous effects. However, researchers rarely justify the inclusion of control variables, and the statistical impacts receive only little attention. This paper provides critical reflections on the commonly carefree use of control variables. Furthermore, two statistical methods to evaluate the influence of control variables on latent properties in structural equation models were probed. To this end, a simulation study was conducted in which the strengths of associations between the substantial constructs as well as the effects of the control variable were manipulated. Adding a control variable did not affect the model-implied covariance structure, but the parameter estimates of the structural equation model. In conclusion, better theoretical and statistical considerations are required when dealing with control variables and parameters should be compared between models with and without control variables.
Preprint: Bodily Awareness: Religious Culture’s Associations with Interoceptive Sensibility
Authors: Van Cappellen Patty , LePage Drummond Tehya Moriah
Published: December 2023

Religions, as cultural systems, influence how people view and attune to their body. This research explores whether individual differences in various dimensions of religiosity are associated with interoceptive sensibility (IS), i.e., one’s perceived ability to detect and interpret bodily signals. In Study 1, Christians, Muslims, and Hindus (N = 1570) reported their religiosity and completed the Multidimensional Assessment of Interoceptive Awareness, a well-validated measure of IS. Results show that religious identity moderates the relationship between the centrality of religion in one’s life and IS such that the association is positive and medium for Christians, large for Muslims and Hindus. In addition, the medium positive correlation between frequency of religious practice and IS was similar across religious groups. Study 2 (N = 450) extended these results by measuring additional dimensions of religiosity and spirituality as well as investigating religious-related beliefs about the body, both positive (e.g., My body is holy) and negative (e.g., My body is sinful). Associations between religiosity and IS are replicated and found for spirituality as well. Interestingly, mediation analyses reveal that belief in the body as holy partially explains the association between religiosity and IS, but belief in the body as sinful suppresses such association. We discuss how religion, as a cultural factor, may influence beliefs about the body and bodily awareness, with implications for emotion regulation and mental health.
An EZ Bayesian hierarchical drift diffusion model for response time and accuracy
Authors: Chávez De la Peña Adriana Felisa , Vandekerckhove Joachim
Published: December 2023

The EZ-diffusion model is a simplification of the popular drift diffusion model of choice response times that allows researchers to calculate diffusion model parameters directly from data with no need for expensive computations. The EZ-diffusion model is based on a system of equations in which the diffusion model's drift rate, boundary separation, and nondecision time parameters are jointly used to predict three summary statistics (the accuracy rate and the mean and variance of the correct response times). These equations can then be inverted to obtain estimators for the three parameters from these summary statistics. Here, we describe a probabilistic formulation of the EZ-diffusion model that can serve as a hyper-efficient proxy model to the drift diffusion model. The new formulation is based on sampling distributions of summary statistics and consists only of normal and binomial distributions. It can easily be implemented in any probabilistic programming language. We demonstrate the validity of the proxy model through extensive simulation studies and provide multiple examples (via osf.io/bzkpn), including an implementation in JASP. We conclude that, although the recovery of some parameters with the proxy model is biased, the recovery of regression parameters is good, making the method useful for explanatory cognitive modeling. Casting the EZ-diffusion model in the broad family of Bayesian generative models allows us to benefit from mature implementations, practical workflows, and powerful extensions that are not possible without a probabilistic implementation and not feasible with the regular drift diffusion model.
Mortality impact of the Israel-Gaza conflicts (2008-2023): A comparative analysis of civilians versus combatants
Authors: Ayoub Houssein H. , Chemaitelly Hiam , Abu-Raddad Laith J.
Published: December 2023

Background: There is a need for statistical methodologies that scrutinize civilian casualties in conflicts, evaluating the degree to which the conduct of war affects civilians and breaches the laws of war. Employing an epidemiological method, this study introduced, developed, and applied a novel approach for investigating mortality of civilians versus combatants in conflicts.Methods: A deterministic mathematical model, structured by age and sex, was developed to describe the process of conflict-related deaths among both combatants and civilians. The model was calibrated using demographic and conflict-related data from different Israel-Gaza conflicts. To quantify the extent of the impact on civilians and determine whether they are the primary focus of a conflict, a statistical metric, the index of killing civilians, along with associated criteria, was devised.Results: The model-estimated proportion of deaths in Gaza categorized as combatants was 62.1% (95% uncertainty interval (UI): 57.6-66.2%), 51.1% (95% UI: 47.1-54.9%), and 12.7% (95% UI: 9.7-15.4%) in the 2008-2009, 2014, and 2023 Israel-Gaza conflicts, respectively. The index of killing civilians was 0.61 (95% UI: 0.51-0.74), 0.96 (95% UI: 0.82-1.12), and 7.01 (95% UI: 5.50-9.29) in the 2008-2009, 2014, and 2023 conflicts, respectively. These index values indicate strong evidence for civilians being an object of war in the 2008-2009 and 2014 conflicts, but combatants were still identified as the primary focus of the conflict. In the 2023 conflict, there is robust evidence for civilians being an object of war, with civilians identified as the primary focus of the conflict. Conclusions: Findings imply a progressive shift in Israel's rules of engagement over time, with a trend towards a higher threshold for acceptable civilian casualties. The 2023 conflict stands apart from preceding Israel-Gaza conflicts, with civilians identified as the primary focus of the conflict.
Publishing Hierarchies in Sociology
Authors: Wang Rachel
Published: December 2023

In this study, I ask how publishing hierarchies refract and maintain social disparities in the valorization of sociological knowledge. I conducted interviews with sociologists and an analysis of the characteristics of authors published in the American Journal of Sociology (AJS) and the American Sociological Review (ASR), journals consistently placed at the top of the field’s publishing hierarchy. While interviews elucidated a consensus about the professional and social capital gained from publishing in one of these elite journals, I observed that women and gender minorities expressed less self-confidence and belief in themselves around submission decisions. The analysis of author characteristics revealed that, in comparison to the demographics of the sociology discipline at large, Black and Hispanic/Latinx scholars were underrepresented, while White and Asian American/Pacific Islander scholars were overrepresented. The majority of the published scholars earned their Ph.D. from or were affiliated with elite institutions. These findings underscore the disparities in access, along identity lines, to publication in these preeminent journals. Amidst recent calls within the field for greater reflexivity into how the discipline reproduces social inequalities, publishing hierarchies deserve further scrutiny.
Measuring and Controlling Subway Fare Evasion: Improving Safety and Security at New York City Transit Authority
Authors: Reddy Alla V. , Kuhls Jacqueline , Lu Alex
Published: December 2023

New York City Transit (NYCT) has a comprehensive framework for assessing, managing, and combating subway fare evasion. The automated fare collection (AFC) system, implemented 1994~97, features lessons learned from field trials of prototypes specifically designed to limit fare abuse. Subway crime has decreased 68% since 2000, and annual average subway evasion rate remains low at approximately 1.3%. Today, the Authority measures fare evasion with independent silent observers using stratified random sampling techniques, classifying passenger entries into 19 categories. Evasion rate peaks at 3pm due to students dismissal, otherwise hovers around 0.9% peak, 1.9% off-peak. Busy times and locations have higher evasions per hour but lower evasions per passenger. More evasions occur in lower-income neighbourhoods. Staff presence apparently doesn’t reduce evasions. Results are released to the press on request, promoting transparency and accountability. To combat evasion, NYCT increased fines from 60 to 100 U.S. dollars in 2008. Police issued 68,000 summonses and made 19,000 evasion arrests in 2009. Arrests are a more effective deterrent than summonses; the proportion of arrests versus summonses increased in 2010. Video monitoring equipment is used to identify and apprehend chronic fare abusers, particularly “swipers” who sell subway entries by abusing unlimited fare media.
Violence as a Lens to Viking Societies: A Comparison of Norway and Denmark
Authors: Bill Jan , Jacobson David , Nagel Susanne , Strand Lisa Mariann
Published: December 2023

Comparing Viking Age Norway and Denmark, the article examines the primary proposition that as centers of authority become progressively more robust, violence will be proportionately contained. The article introduces a new approach in using indications of violence as a focal point to elicit broader social practices. The disciplines employed in this study – archaeology, osteology, philology, and sociology – are used together in the study of covariance of different indicators across a societal range. The indicators for assessing violence include skeletal trauma and weapon frequency. For assessing the steepness of the social pyramid, we use runestones, indicating variations in social stratification, and monumental constructions as a measure of power to command labor. Among the findings: weapons and interpersonal violence in Norway was much more widespread than in Denmark, and the social pyramid in Denmark was progressively steeper and more complex than in Norway. “Official” executions accounted for the preponderance of violence in Denmark, while rare in Norway. Denmark was evidently a more “civilianized” society than Norway. The comparative research supports the primary proposition. The research, furthermore, suggests that Denmark and Norway were sociologically distinct societies, which accords with recent findings that the respective regions displayed distinct, though still similar, genetic profiles.
Whole genome sequencing (WGS) has become a powerful tool in accessing food-borne infections
Authors: Khanal Hemanta
Published: December 2023

Research Prospective
Factors Affecting Academic Achievement of B.Sc. Students of Tribhuvan University Constituent Campuses in Province - 1, Nepal.
Authors: Ghimire Roma
Published: December 2023

An attempt has been made to assess the factors affecting academic achievements of bachelor’s level students under Institute Science and Technology of Tribhuvan University in Province No. 1, Nepal. The academic achievement has been considered as a dependent variable and the gender, caste/ethnicity, socio-economic status and learning facilities as independent variables. A cross-sectional research design was used. The sample size of this research was 130 and the sample was drawn using simple random sampling technique. A well-designed questionnaire was used to collect the data. The Binary logistic regression model was used to find the association of various factors with the academic achievement of the students and the goodness of fit test of the model was assessed through Hosmer and Lemeshow test. The study concluded that the internet facility at libraries, as a learning facility, contributed significantly to the students’ academic achievement whereas the remaining variables had no significant effect on the academic achievement of students’ Moreover, this research also discusses the implications for improving academic achievement.
Optimization and Quality Evaluation of Oats (Avena sativa) Flour Incorporated Paneer
Authors: Khatri Sabin Bahadur , Khadka Kiran , Gautam Navin , Khadka Nabin , Raut Bicky
Published: December 2023

Efforts were initiated to prepare a carbohydrate, calcium and fibre rich paneer by addition of oat flour (Avena sativa).  Six samples’ formulations were prepare including control paneer, (100% milk curd). The different formulations of (oats flour: milk curd) in the ratio as: sample (1:99), sample (1.5:98.5), sample (2:98), sample (2.5:97.5) and sample (3:97) to access the quality and acceptability of paneer. The experiment was designed by central composite mixture design and the obtained data was analyzed statistically by Genstat Discovery Edition 3 (DE3), for Analysis of Variance (ANOVA) at 5% level of significance version 12.1. The oats flour and milk curd for the development of value-added product, and evaluate proximate and sensory characteristics of product.

The sensory evaluation revealed sample (1:99) was found to be best by comparing sensory score of overall acceptance given by the panelists and functional components. Crude protein, crude fat, total ash and carbohydrate of control product were found to be 41.43%, 49.7%, 4.39% and 4.44% whereas for best product the results were 40.54%, 48.97%, 4.39% and 5.92% respectively. The calcium content of best paneer and control paneer were found to be 467.08 mg/100 g and 399.12 mg/100 g respectively. The fiber contents were zero and 0.156% in control and best product sample (1:99) respectively. Therefore, it was concluded that the incorporation of oats flour for the formulation of value-added paneer will be helpful for developing value-added dairy products for the developing countries.
Length-Weight Relationship of Fishes in Some Rivers of Morang, Nepal
Authors: Shrestha Sharada , Tamang Ganesh , Limbu Jash Hang , Rajbanshi Dipak
Published: December 2023

The length-weight relationship is a crucial aspect of fishery assessments, providing valuable biological information. The length-weight relationship is expressed by the equation W = aLb, where W represents the total weight of the fish and L denotes the standard length. The LWR equation was transformed into a linear form using logarithmic transformation: LogW = a + bLogL. The biometric data obtained from this study includes information on species, sample numbers (N), standard length range, total weight range, and the length-weight relationship constants (a and b) for each species. In this study, we estimated the length-weight relationship of 16 freshwater fish species from some rivers of Morang district, Eastern Nepal. A total of 1,600 fish specimens, representing 16 different species from 5 families were studied from September 2022 to February 2023. The fishes were captured from the river and preserved in 20% formalin for subsequent biometric measurements in the laboratory. Biometric measurements were taken as follows: for each fish, length measurements were listed as standard length or fork length (SL in cm) from mouth to where the caudal fin is lobate. Length measurements were taken with a regular ruler validated against a Vernier Calliper, with an accuracy of 0.1 cm. Weight measurements were obtained using an electronic digital balance with a precision of 0.01 g. While listing weight, a fish consistency was maintained concerning the degree of wetness of the body to ensure accuracy. Among the species listed in the Morang district, Puntius terio has the smallest range of standard length (2.7 cm - 7.4 cm) and total weight (1.07 g - 7.06 g) while Garra gotyla gotyla has the largest range of standard length (4.3 cm - 18.6 cm) and total weight (4.5 g - 15.6 g). These variations indicate the natural size differences among the species. The analysis of the length-weight relationships revealed that all the studied fish species exhibited a negative allometric growth pattern. This means that as the length of the fish increases, its weight increases at a slower rate. The findings of this study contribute to our understanding of the growth patterns of freshwater fish species in the study area.
Practice of Healthcare Workers during the COVID-19 pandemic at the Emergency Department of Nepal
Authors: Chaudhary Ritesh , Bhandari Rabin , Poudel Masum , Giri Rajani , Yadav Ajay Kumar , Aryal Bijaya Devi
Published: December 2023

Background: The study intends to explore the effects and practice of healthcare workers during COVID-19 pandemic at the emergency department of B. P. Koirala Institute of Health Sciences.
Methods: A cross-sectional study was done among the healthcare workers of the Emergency Department of B. P. Koirala Institute of Health Sciences from August 2020 to Jan 2021. Data were collected by using a semi-structured interview among all the participants in the survey. A convenient sampling method was used and analysed using descriptive statistics. A p value < 0.05 was considered statistically significant.
Results: Majority of the healthcare workers (90%) stated that their role has increased during COVID 19 first wave pandemic. A similar percentage (71%) noticed change in their duty hours and subsequently Isolation/ Quarantine. More than half (53%) stated that efforts been undertaken to bring additional health care workers to emergency department on basis of safety and preservation of workforce. The institute was able to train (47%) health care workers regarding proper handling of personal protective equipment despite of its insufficient (70%) supply.
Conclusion: The results take exceptions in the emergency department despite insufficient supply of personal protective equipment, longtime exposure to large numbers of infected patients and insufficient care to quarantine a majority of the healthcare workers during COVID-19 pandemic.
Prevalence of Tumor Budding and its Significance for Predicting Lymph Node Metastasis in Carcinomas at Tertiary Care Center
Authors: Paudel Ashish , Karki Smriti , Shah Niharika , Shrestha Brijesh , Baral Alina
Published: December 2023

Background: “Tumor budding” basically means the presence of clusters of less than 5 malignant cells in the tumor stroma, located ahead of the invasive front of tumor. Various studies have been carried out regarding tumor budding, its significance in tumor metastasis involving head and neck, breast, gastrointestinal tract, pancreas and cervix and is now evolving in cancer reporting templates. We conducted this study in regards to growing importance of tumor budding in cancer metastasis with objectives to find out the prevalence of tumor budding in carcinoma and to know the association of tumor budding with lymph node, perineural and lymphovascular invasion.
Methods: All the resected specimen with regional lymph node were examined for presence or absence of tumor buds. It was graded as high/ low grade based on the number of buds. Association of the tumor buds with lymph node metastasis, lymphovascular and perineural invasion was calculated. The study was conducted from January 2019 to January 2020. Purposive sampling was used. Ethical clearance was ensured from the institutional review board before the start of study (IRC 1322/ 018). All surgically resected specimen of carcinomas with regional lymph nodes were included in the study whereas autolysed specimen and patient who refused to give consent were excluded from the study.
Result: Total 37 cases of resected specimens of gastrointestinal tract, breast, head and neck were evaluated. The prevalence of tumor budding was 91.9%. In every instance where tumor budding existed, there was an observation of high-grade tumor bud. Tumor budding was strongly associated with lymph node invasion (p = 0.005). Significant value was not observed in the correlation of tumor budding with lymphovascular and perineural invasion.
Conclusion: Tumor budding holds an important role in predicting lymph node metastasis in carcinomas, highlighting its importance in the histopathological reports of resected specimen.
Orthodontic-Surgical Management of Impacted Maxillary Central Incisor Related to Supernumerary Tooth: a Case Report
Authors: Rai Amita , Giri Jamal , Sah Barun Kumar , Koirala Bandana , Dali Mamta , Shrestha Sneha
Published: December 2023

Anterior teeth play an important role in maintaining esthetics and phonetics in human beings. Missing anterior teeth might result in rotation, shifting, and root resorption of the adjacent teeth, loss of eruption space, underdevelopment of the anterior part of the maxilla, and crossbite. Adolescent patients are very conscious about how they look, and missing anterior teeth lowers their selfesteem. Due to the above reasons, missing anterior teeth should be managed as early as possible. The present case report highlights the orthodontic traction of the impacted maxillary central incisor caused by a supernumerary tooth. At the same time, the treatment outcome regained smile in an 11-year-old patient who had stopped smiling because his peers had started to call him by the name “toothless”.
Non-interactive Activities in Teaching-Learning
Authors: Upadhyaya Paricha
Published: December 2023

A medical curriculum may have teaching learning modalities involving both large group and small groups. Fostering student Interaction, engagement and collaboration is relatively easier in small group. Many of the small group teaching strategies are also applied for effective collaboration and communication to a large group. However, student motivation is the key to student engagement and learning. This editorial explores some of the very simple strategies which allow students opportunities to prepare for their learning as well as to reflect upon their learning. The activities enlisted are simple methods like quiz, practice test, providing lecture slides and lecture videos and giving assignments to students. What is emphasized here is to carry out these activities in a nonthreatening manner without pressure of ‘grades’.The best way would do this is through an online platform hence the provision of learning management system in a teaching institute is emphasized. Using online medium for these activities has two advantages: (i) it will allow the students to carry out the given work in solitude and it will enable us teachers to give one to one feedback or feedback in the form of corrected response. (ii). There is also an advantage of students getting exposed to a blend of both physical teaching learning, during lectures and small group teaching and an opportunity for using online platforms for activities.
Retrograde Intrarenal Surgery versus Mini-Percutaneous Nephrolithotomy for Lower Calyceal Stones of ≤ 2 cm
Authors: Shah Rajiv , Kandel Tika Devi , Adhikari Deepak
Published: December 2023

Introduction: Renal stones are one of the common urological problems. The optimal management of lower calyceal renal calculi of 1-2 cm is still debatable. The objective of this research is to assess the safety, efficacy, and stone-free rate of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy for the management of lower calyceal stones of 1-2 cm.
Methods: A prospective comparative study was conducted among 30 patients which were divided in two group (A and B) prospectively with lower calyceal stones of 1-2 cm. Group A were treated with retrograde intra renal surgery while Group B were treated with mini percutaneous nephrolithotomy.
Results: The mean age of patient in Group-A was 44.27±17.10 year and in Group-B was 45.27±16.11 year. The hospital stay in Group-A was 3.47±0.62 and in Group-B was 4.50±0.73 days. The stone size in Group-A was 13.30±2.21 mm and in Group-B was 15.60±2.55 with p-value of 0.381. The duration of operation time in Group-A was79.37±13.96 minutes and in Group-B was 62.53±7.41 minutes with p value of 0.091.
Conclusions: Both retrograde intrarenal surgery and mini-percutaneous nephrolithotomy procedure are comparable. Mini percutaneous nephrolithotomy has a better stone free rate and haematuria is more common but retrograde intrarenal surgery has less hospital stay and post operative pyrexia is more common.
Antibiotics Prescribing Pattern of Outpatients in a Tertiary Level Hospital in Nepal
Authors: Sapkota Kalyan , Pokharel Deviram , Basel Shailesh , Dhakal Bijaya
Published: December 2023

Introduction. Antibiotics are most abundantly used drugs of major global concern for rapid ongoing emergence of resistant strains, increase overall cost of treatment and impact on national economy. Optimized use of antibiotic on the basis of proper diagnosis, prescriber’s attention about the problem and antimicrobial stewardship programs may become a way to rationalize the use.

Methods. This is a cross-sectional descriptive study done in patients visiting to various OPD of tertiary referral hospital. Prescriptions were randomly selected and Antibiotics utilization was assessed by WHO prescribing Indicator form. Prescribed drugs were checked for adherence to guidelines and essential medicine list.

Results. Among 731 sampled prescriptions, 384 (52.53%) were found with at least one antibiotic; 214 prescriptions (55.72%) were of female patients. Mean age was 37.71 years with SD 25.01. Highest numbers of patients (21.09%) belong to the 15-29 age group.  Highest number of patients 158 (41.15%) treated with antibiotics were seen in patient attending Medicine department, 30 antibiotics were prescribed for 577 times. Amoxicillin-Clavulanate 70 (12.13%) was the most frequently prescribed followed by Azithromycin and Metronidazole with frequency of 39 (6.76%). Drug availability is 50.36%, in the facility and only 2.4 % of drugs were prescribed in generic.

Conclusions. More than half of the patients were prescribed with antibiotics and all antibiotics were prescribed empirically. Newer generation antibiotics with broad spectrum efficacy were used in remarkable frequency. This study provides evidence for antibiotic stewardship, drug use review and establishment of institutional guidelines.
Blood Pressure and Hematoma Expansion in Hemorrhagic Stroke
Authors: Bikram Prasad Gajurel  , Pukar Ghimire  , Pradeep Panthee  , Sumit Shahi  , Rajeev Ojha  , Reema Rajbhandari  , Ragesh Karn
Published: December 2023

IntroductionHematoma expansion after hemorrhagic stroke can lead to devastating consequences. An important factor associated with this is high blood pressure. This study was carried out to find out what proportion of patients with hemorrhagic stroke develop hematoma expansion and whether blood pressure during presentation could be associated with it.MethodsThis prospective observational study was carried out over a period of one year in patients who were admitted with the diagnosis of hemorrhagic stroke. The collected data were entered into and analyzed by using the Statistical Package for the Social Sciences version 26 after obtaining approval from the Institutional Review Committee of the Institute of Medicine, Tribhuvan University. ResultsOut of 83 patients included in the study, history of hypertension was present in 72 (86.7%). Hematoma expansion occurred in 11 (13.3%). There was no statistically significant associations between mean systolic, diastolic, and mean blood pressures between patients with and without hematoma expansion [(168.9±35.6, 164.5±28.5, t(81)=0.47, p=0.64), (101.8±18.9, 101.2±19.6, t(81)=0.10, p=0.92) and (124.2±23.6, 122.3±21.5, t(81)=0.27, p=0.79) respectively (values in mmHg)]. Majority of patients with hematoma expansion had high absolute systolic blood pressure (27.3% vs 26.4%) and high absolute diastolic blood pressure (54.5% vs 38.9%); however, the associations were not statistically significant (p= 1.00 and 0.33 respectively).Conclusions High blood pressure is highly prevalent but hematoma expansion is not common in patients with hemorrhagic stroke. There was no statistically significant association between history of hypertension, gender, patient age, absolute and mean blood pressures, and hematoma expansion in our study.
Comparison of Culprit Artery Patency Between Diabetic and Non-Diabetic Patients Undergoing Thrombolysis with Streptokinase for ST Elevation Myocardial Infarction
Authors: Shrestha Manoj , Bhusal Pramod , Pradhan Manohar
Published: December 2023

IntroductionMyocardial Infraction is the leading cause of mortality and mortality globally. Thrombolysis with streptokinase is well established therapeutic intervention in Myocardial Infraction. Timely intervention with adequate myocardial reperfusion is associated with better clinical outcome whereas failed reperfusion due to incomplete or non-reopening of culprit artery is associated with complications. This study aims to compare diabetic and non-diabetic patients with acute myocardial infraction in term is culprit artery patency.
MethodsThis analytical cross-sectional study was carried out in Cardiology Department, Collage of Medical Sciences, Bharatpur from 1st June 2023 to 30th October 2023. Total 80 patients with acute Myocardial Infarction were enrolled in the study. Blood sugar level and twelve leads ECG of each patients were recorded before giving intravenous 1.5 million units of streptokinase over one hour for acute ST elevation myocardial infarction. Coronary angiogram was done after 24 hours of thrombolysis. Patency of the culprit artery was assessed in each patients and compared between diabetics and non-diabetics.
ResultsThe study included 57.5 % (n=46) male and 42.5 % (n=34) female patients. Mean random blood sugar level was 160.87 ±40.8 mg/dl. Mean age of the study population was 52.9 ±10.8 years. 40 % (n= 32) of patients were diabetics. The percentage of culprit artery patency was lower in diabetic patients as compared to non-diabetic patients (43.75 % vs 75%).
Conclusions Among both male and female patients the success of thrombolysis in term of culprit artery patency was higher in non-diabetic patients as compared to diabetic patients.
Parental Satisfaction Regarding Online Education of Their Children During COVID-19 Pandemic
Authors: Soti Harikala , Singh Nitu Kumari , Sah Indu , Paudyal Laxmi
Published: December 2023

IntroductionCOVID-19 has emerged as a pandemic and started online education. Online education can play a vital role in the process of teaching and learning and parental satisfaction is extremely important in effective implementation of the online education in their children, especially at homes where newly adopted during COVID-19.The purpose of this study was to assess the parental satisfactions regarding online education of their children during COVID-19 pandemic.
MethodsThis descriptive cross-sectional study was conducted from21st August 2021 to 25th January 2022 in a Phoolbari 11, Pokhara. Ethical approval was taken from the Gandaki Medical College Institutional Review Committee. Purposive sampling method was used. The data were collected using a questionnaire through face to face interview whose children had participated in online education.
ResultsOut of 216 respondents, the study revealed that more than half of the respondents (52.8%) had low satisfaction. The highest satisfaction experienced by parents was social interaction (11.98±2.88) followed by instructional support (14.97±3.11). There was significant association between level of satisfaction with parental sex (p=<0.002), parents’ education (p<0.001), parents’ occupation (p=<0.005), monthly income (p=<0.011) and status of living (p=<0.020). Likewise, there was significant association between level of satisfaction with child sex (p<0.001), fast internet at home for online learning (p=<0.001) and children participate in online class with laptop/tab/mobile phone (p<0.001).
Conclusions It is concluded that respondents have low level of satisfaction. Therefore, intervention for increasing satisfaction should be conducted by the concerned authority.
Outcome of Medial Plating for Fracture Shaft of Humerus
Authors: Gupta Hemant Kumar , Hamal Rajkumar Ravi , Lamichhane Suman
Published: December 2023

IntroductionFracture shaft of humerus is commonly seen fracture which is managed by nonoperative and operative methods. Operative fixation allows early return to daily work with ease in rehabilitation and less complication. This study was conducted to evaluate outcome of fracture shaft of humerus treated with plating by anteromedial approach on medial surface of humerus.
MethodsA hospital based prospective study including 164 cases of humerus fracture shaft surgically managed with medial plating over a period 15th July 2017 to 14thJune 2022with the mean follow-up duration of 24 weeks was performed. The final outcome was evaluated on the basis of radiological union and Modified Stewart and Hundley Scoring criteria.
ResultsFracture united in 49.39% of cases within 12 weeks, 28.65% case united in 12-24 weeks time and 19.61% cases united later than 24 weeks. Non union seen in 4 cases in our study treated with bone grafting healed. Functional outcome was measured as per Modified Stewart and Hundley Scoringcriteria, it was excellent in 67.08% of cases, good in 18.29%, satisfactory in 7.93 % of cases. Poor results were seen in 6.7 percent of cases.
Conclusions Anterolateral approach with medial plating was found to be better option for fixation of fracture shaft of humerus as per our study as it has fewer complication with comparable results to other literature.
Diagnostic Utility of NT-Pro BNP in Elderly Patients Presenting With Acute Dyspnea in Emergency Department
Authors: Shrestha Manoj , Bhusal Pramod
Published: December 2023

ABSTRACT

BACKGROUND:  Acute dyspnea may be related to lungs pathology or cardiac pathology or due to involvement of both. Rapid diagnosis of the cause of dyspnea in emergency can help in early start of treatment preventing further progress of the symptoms, prolong hospital stay, need of more invasive medical procedures like intubation and ventilation thereby decrease the morbidity and mortality of the patients.

METHODOLOGY: The study was conducted for three months i.e, from 16th May 2023 till 17th August 2023. 150 patients fulfilling inclusion criteria were taken. Clinical diagnosis in these patients was established based on medical history as well as echo and chest X-ray. Based on their clinical diagnosis, the patients were divided into three groups: group A diagnosed with pulmonary dyspnea (PD), group B diagnosed with congestive heart failure (CHF), and group C diagnosed with combined dyspnea (CHF+PD). NT-proBNP level in these patients was measured and compared.

RESULTS: The study population constituted 60% males and 40% female with mean age of 68.9±10.99. Out of 150 patients presenting with acute dyspnea in emergency department, 65 patients were diagnosed with congestive heart failure, 55 patients were diagnosed with pulmonary dyspnea and 30 patients diagnosed with combined dyspnea. Average NT-proBNP among group A patients was (1300±175) ng/l, among group B patients was (275±70) ng/l and among group C patients was (1276±165) ng/l.

CONCLUSION: NT-proBNP is the reliable marker to differentiate the cardiac and pulmonary causes of acute dyspnea among elderly patients presenting to emergency.

 

KEY WORDS: N-terminal pro-B-type natriuretic peptide (NT-proBNP), emergency, elderly patients, dyspnea, biomarker
Diagnostic Value of Bronchoalveolar Lavage in Sputum-Smear Negative Pulmonary Tuberculosis
Authors: Pokharel Apar , Bhandari Chhanya , Sharma Bibek , Bhandari Ramesh , Paudel Yubraj
Published: December 2023

Introduction: Bronchoalveolar lavage has a high diagnostic utility for cytology and bacteriology. The aim of this study was to assess the diagnostic value of bronchoalveolar lavage (BAL) which underwent routine bronchoscopy for evaluation of lung disease. Materials and Methods: This is a hospital based descriptive study done from July 1, 2022, to June 30, 2023. Eighty bronchoalveolar lavage (BAL) cases were analyzed for differential count, cytological evaluation and bacteriological examination. All cases were included which were sent as BAL specimen to the laboratory department. Bronchoscopy was done as an outpatient procedure and lavage fluid obtained was analyzed. Result: Out of 80 cases, 51 were male and 29 were female. The age ranged from 10 to 80 years. The prevalence of tuberculosis in sputum smear negative cases was found to be 29%. Among 80 cases, eight cases were unsatisfactory, twenty-three cases were of tuberculosis, one case was of fungal infection, two cases were of malignancy, forty cases were of small airway infection and six cases were satisfactory but with no diagnostic value. Conclusion Bronchoalveolar lavage is valuable in diagnosis of tuberculosis, infections and malignancies.
Trends and Predictors of Readmission among Coronary Artery Disease Patients in a Community Heart Hospital in Nepal
Authors: Dhungel Sachin , Samir Gautam  , Samir Gautam  , Bishal KC  , Mazhar Khan  , Rajesh Panjiyar  , Abhishesh Shakya  , Manisha Yadav  , Prayatna Bhattarai  , Lakshmidhawal Dhawal  , Subash Baral
Published: December 2023

Introduction: Patients of Coronary artery disease after index hospitalization gets readmitted to the same or different hospital for cardiac or noncardiac causes. To study  trends of readmission pattern and different factors determining  readmission .
Methodlogy: The study is retrospective hospital based study for one year.
Result: Out of 749 admitted patient with coronary artery disease, 143(19%) patients were readmitted. Mean age was 63.3 ± 13.4. There were 88(61.5%) male and 55(38.5%) female. Readmission rate for 30 days was 2.9%, 6 month 7.3% and 1 year 11.2 %. Forty (38%) of readmitted patients had been admitted more than one time. Common presentations were chest pain 60(42%), shortness of breath 42(29.4%), fever 11(7.7%), epigastric pain 9(6.3%), hemiparesis 8(5.6%), dizziness 4(2.8%), hematemesis 2(1.4%), hempoptysis 2(1.4%), black stool 1(0.7%), palpitation 1(0.7%) and loose stool 1(0.7%). Top factors were enlisted  were presence of  wall motion abnormalities 96(67.1%), anemia 83(58%), diagnostic invasive procedure in past 80 (55.9%), hypertension 76(52.4%), low systolic function 75 (52.4%) , angina 60(43%), diabetes 59(41.3%), heart failure 50(35%) , revascularization( PCI) 50 (35%), infarction 39(27.3 ), COPD 32(22.4%), infections 29(20.3%),acute kidney injury 25 (17.5), hypothyroidism 16(11.2), dyslipidemia 15(10.5), CKD 14(9.8), CVA 13(9.1), APD 12 (8.4), arrhythmia 10 (7%)  h/o CABG,10(7%) and UGI bleeding 10 (7%).
Conclusion: Readmission forms nineteen percentage of total admissions and readmission rate calculated within 30 days of admission as 2.9%.
Mathematical Derivations of Actuarial Present Value for the Fully Continuous Whole Life Assurances from the Theoretical Market Price
Authors: Ogungbenle Michael Gbenga , Ezekiel Kessel
Published: December 2023

Many current mortality tables are computationally Makehamised but technically devoid of continuous key life table functions such as  and  because of the underlying sophisticated mortality functions and the complex methods of computation which usually do not incorporate the market price. The computationally advanced Moore’s model, which does not endorse the market pricing mechanisms offers one of the most complex analytical results that seems not user friendly in actuarial literature. As a result of the Moore’s complexity, we offer the Gradshteyn and Ryzhik’s analytic integral as an alternative solution to examine the contingency issues involving the estimation of actuarial present values of the continuous whole life annuities. In this study, the objective are to (i) estimate the parameters of GM (1,2) through the method of equidistant points according to the natural order of human age (ii) Apply the mean value theorem to construct the survival probability function under the framework of policy modifications (iii) Develop a closed form pricing formula for the continuous whole life annuity and continuous whole life insurance.  The Gradshteyn and Ryzhik’s analytic integral has eliminated the Moore’s complexities associated with symbolic computations such that the continuity assumption applied allows us to compute the continuous life annuity with expedience. Computational evidence further shows that the continuous life annuity reduces with age confirming that life annuities is a decreasing function.
Exploring the Critical Barriers Towards Women Participation in Surveying and Geo-Informatics Practices
Authors: Gbenga Precious Oluwatofunmi , Bello Abdulkabir Opeyemi , Olaniyi Abdulmalik Mobolaji , Idris Abdullahi
Published: December 2023

Surveying and geo-informatics stand as a significant field at the intersection of science, technology, and spatial management, playing a crucial role in informing decision-making across various industries. However, the surveying and geo-informatics field suffers from the underrepresentation of women professionals. This underrepresentation carries significant implications hindering diversity of knowledge and skills. In order to build a more inclusive and equitable professional environment, the study aims to identify and analyse the identified barriers to offer insight and strategies to enhance women's participation. Data were gathered using a mixed-methods (sequential exploratory) approach, which included interviews and structured questionnaires (five Likert scale) with professionals in the field. Twenty-five participants and 138 responses were considered for the study. Statistical tests such as Cronbach's Alpha, mean ranking, one sample t-test, Chi-square, Kruskal Wallis, and factor analysis were conducted to investigate the significance and relationship between the identified barriers. The result shows that the participation of women in the surveying and geo-informatics field is low. Similarly, the study shows that the barriers are critical to the participation of women in the field, considering their significance level. In addition, a rotation of the component matrix reveals three dimensions: equity and inclusion, career advancement and assistance, and gender equality and empowerment. These factors offer a thorough foundation for comprehending the many difficulties women in the field encounter. The study developed various strategies tailored to mitigate each barrier component. The findings of this study add to the body of knowledge on gender differences in surveying and geo-informatics practises and offer policymakers, organisations, and stakeholders valuable insights. Eliminating these obstacles will improve gender diversity, encourage inclusivity, and fully utilise the talents of women, ultimately resulting in a more innovative and sustainable surveying and geo-informatics profession in Nigeria.
Association of Meibomian Gland Dysfunction with Serum Lipid Profile: A Hospital-based Cross-sectional study
Authors: Shakya Prasansa , Parajuli Sanket , Sharma Sadhana
Published: December 2023

Introduction: Meibomian gland dysfunction (MGD) frequently leads to ocular surface disease, yet its impact on patients’ overall health is often overlooked. With increase in sedentary lifestyle, decreased physical activities and exposure to the digital world people have been facing increasing incidence of dyslipidemia.
Objectives: To investigate the association between serum lipid profile with severity of meibomian gland dysfunction.
Materials and methods: This was an observational, analytical, cross-sectional study carried out in the department of Ophthalmology of Shree Birendra hospital from January 2019 to January 2020. Oxford grading scale was used to grade the severity of MGD as none (grade 0), mild (grade I and II), moderate (grade III), and severe (grade IV and V). Serum lipid profile was obtained from all patients with MGD and analysis was carried out.
Results: Among 100 patients in this study majority of the participants were from the age group 61-70 (n, 40%) among whom 54 (54%) were females and 46 (46%) were males. Statistically significant association was noted between increase in total cholesterol, LDL, and TG levels with severity of MGD. However no significant association was found between HDL and the stage of MGD.
Conclusion: This study demonstrated that patients with increasing severity of meibomian gland dysfunction had greater abnormalities in their serum lipid profiles with respect to total cholesterol, LDL and triglycerides