bluuebunny/crossref_metadata_2025 huggingface dataset:
Ready Mix Concrete Production Scheduling and Truck Mixer Allocation Using Genetic Algorithm: A Case Study
Authors: Krisnawati Maria , Syailendri Fadhila  Rifda Azka , Sibarani Ayu Anggraeni
Published: April 2024

The XYZ company is engaged in the production of construction materials such as Ready-Mix Concrete (RMC). XYZ company must increase productivity in order to compete with the industry’s rapid expansion in Banyumas, Indonesia. Scheduling production is one of the methods for boosting productivity. Utilizing a mathematical model and a single-machine approach, scheduling is arranged. Using a product delivery system that is integrated with the production process, a production scheduling model and allocation of product delivery vehicles, the Truck Mixer, are developed. The Genetic Algorithm is used to find a more effective scheduling solution. The results of this study indicate that the schedule generated by the genetic algorithm has a total reduction of ten job sequence completion times of 134363 seconds or 24% more efficient than the existing schedule on average.
Applying Visualization and Analysis Data to Investigate Cyber Crimes (Case: Web Defacement)
Authors: Kusuma Mandahadi , Hariyadi Dedy , Sari Indah Daila
Published: April 2024

Even now, many website owners still find cyberattacks—typically web defacement—terrifying. The Indonesian police's Criminal Investigation Unit is still working to track down and apprehend web hackers and vandals because such activity violates the law, could negatively impact an institution's day-to-day operations, necessitates additional funding for repairs, and carries the risk of database theft. In order to map the social network of the cybercrime suspect, this study used VOSviewer as a tool and Zone-H.org as a data source. Both of these sources can be accessible by the general public and used as Open Source Intelligence (OSINT) data. We were able to map one of the suspects who was apprehended by law enforcement, who goes by the pseudonym xgxs and goes by the username 13chmod37. This allowed us to give a general picture of the parties who might have been participating in the web defacement activity. The information we gave may be used by law enforcement to conduct additional investigations and track down additional offenders who are responsible for cyber attacks, particularly site defacement activity.
Landsat Satellite Image Quality Improvement Using Discrete Cosine Transform Method
Authors: Rahmadi Deddy , Rachmawati Silvia
Published: April 2024

Landsat satellite images are images that represent the ocean and land areas of the earth. Image data can be used for various purposes such as environmental analysis, remote sensing, mapping, and others. However, the quality of Landsat imagery is often unsatisfactory due to interference or noise from sources such as sensors, transmission, atmosphere, and storage. Therefore, they can reduce the contrast, sharpness, and information of landsat satellite images. Some of these disturbances prevent people from obtaining clear geographical locations. In order to overcome this problem, an effective and efficient method of Landsat satellite image quality improvement is needed. This research uses an image improvement method, namely discrete cosine transformation. The discrete cosine transformation method is used to reduce image noise by dividing it into each basic element. The method can perform the calculation process metematically and applicatively in the process of Landsat satellite image improvement. The processed results obtained are used to design and implement Landsat satellite image enhancement using the discrete cosine transformation method.
Calculation of Absorbed Dose of 103Pd and 131Cs Sources in Prostate Cancer Brachytherapy Simulation Using Monte Carlo N-Particle 6 (MCNP-6) Software
Authors: Munggara Mumung Ridhuan , Handayani Nita , Arianto Fajar
Published: April 2024

Implant brachytherapy is one of the therapies for Low Dose Rate (LDR) in prostate cancer. This type of therapy uses a source with low energy and penetration rate so that the organs around the prostate do not receive much of the absorbed dose. This study uses a calculation method Monte Carlo N-Particle 6 (MCNP-6) to calculate the interaction of photons with organ materials. The main objective of this research is to determine the number of seeds and the ideal source activity to achieve the optimal absorbed dose in the prostate and provide the minimum absorbed dose in the surrounding organs. Organs around the prostate include the testes, small intestine, descending colon wall, descending colon, sigmoid colon wall, bladder wall, and bladder. This study uses two types of radioisotope sources namely 103Pd and 131Cs which each has a photon energy of 21 keV and 30 keV. Variations made is the addition of the number of seeds from 60 to 100 at intervals of 8 seeds symmetrically away from the center of the prostate and variation of source activity from 0.1 mCi to 0.6 mCi at intervals of 0.1 mCi for each type of source. Results of this study obtained the relationship that the more the number of seeds the greater the dose received by the prostate and surrounding organs, as well as the addition of source activity. The effect of increasing the number of seeds can increase the absorbed dose more significantly than the effect of adding activity to the organs around the prostate. Optimal absorbed dose for 103Pd is 125 Gy and 115 Gy for 131Cs. Based on the simulation results with MCNP-6, it is obtained that the ideal combination for the optimal absorbed dose is obtained from the source 103Pd is the number of seed 60 with 0.3 mCi activity, and source 131Cs is the number of seed 76 with an activity of 0.5 mCi. Source 103Pd provides a lower absorbed dose to the organs around the prostate compared to the source 131Cs.
Analysis on Students’ Academic Performance in Relation to the Results of Pre-University Examination
Authors: Qi Chong , Binti Saharan Sabariah
Published: April 2024

There is a great deal of uncertainty regarding the factors that influence their final year grade, which includes their entry qualification. This paper investigates the impact of entry qualification and pre-university CGPA on student performance at the university level. Entry qualifications are critical for educational institutions or educational providers to ensure the quality of the graduates. The goal of this study is to analyze and compare performance of Bachelor of Science (Industrial Statistics) with Honours (BWQ) students. Total of 54 students were selected form the Faculty of Applied Sciences and Technology (FAST), Universiti Tun Hussein Onn Malaysia (UTHM). The students are coming from Malaysian Higher School Certificate (STPM) and Malaysian Matriculation Programme. Paired t test and Z test were carried out to analyze the impact of pre-university’s CGPA and each semester’s GPA as well as impact of entry qualification towards their final year grade. Classification and Regression Tree (CART), K-Nearest Neighbors and Naïve Bayes were used to develop and predict the students’ performance. The findings show that there is no relation between the result obtained from previous semester towards the next semester. Meanwhile, students from STPM outperform Matriculation in terms of their GPA per semester, pre-university CGPA as well as their final CGPA. The K-Nearest Neighbors and Naïve Bayes models have been documented as the most efficient data mining techniques in predicting student performance with the highest percentage of accuracy of 100%.
Analysis of the Influence of Promotion, Price, Ease of Use, and Flexibility on Shopping Behavior of E-Commerce Users in Jabodetabek
Authors: Saputro Yusuf , Musthofa Muhammad Wakhid , Setyaningsih Ira
Published: April 2024

Online shopping has become the right choice to avoid crowds and maximize social distancing during the Covid-19 pandemic. The restrictions on activities and staying at home during the pandemic have shifted consumer behavior towards digitalization, relying on e-commerce and social media for shopping. The shopping trend in the Jabodetabek area has shifted from offline shopping in malls to online shopping through various e-commerce applications. This research aims to determine the influence of Price (X1), Promotion (X2), Ease of Use (X3), and Flexibility (X4) on the Shopping Behavior of the Jabodetabek community (Y), which has now shifted from offline stores to e-commerce. This research uses linear regression with hypothesis testing using t-test, F-test, and coefficient of determination. The results of the study indicate a significant influence of X2 on Y, X3 on Y, and X4 on Y, while there is no significant influence of X1 on Y. However, there is a significant simultaneous influence of variables X1, X2, X3, and X4 on variable Y with a determination coefficient level of 78%.
Coconut Shell, Rice Husk, and Corn Cob Pyrolysis with Zeolite Catalyst
Authors: Sa'diyah Khalimatus , Sindhuwati Christyfani , Suharti Profiyanti Hermien , Rohman Fatkhur , Lusiani Cucuk Evi
Published: April 2024

Recycling garbage with the pyrolysis technique to make liquid smoke is one effort to utilize biomass waste. Because it includes acetic acid and phenol, which aid in food preservation, liquid smoke can be used on foods. The goal of this research was to look into the usage of zeolite catalysts in the production of liquid smoke from various types of biomass via catalytic pyrolysis. Coconut shells, corn cobs, and rice husks are used as biomass. The investigation began with the activation of the zeolite catalyst, with the goal of cleansing the catalyst of impurities and boosting its activity by opening the pores. The catalytic pyrolysis process was then carried out at 350°C for 2 hours while adjusting the quantity of catalyst addition (4%, 5%, and 6%). Catalytic pyrolysis liquid smoke is collected and evaluated. As a preservative, studied liquid smoke is applied to skipjack tuna. Based on the quality of commercial liquid smoke, the results showed that coconut shell liquid smoke with a percentage of 6% zeolite added was the most optimal liquid smoke. 6.5% yield, yellowish brown hue, slightly pungent aroma, pH value 2, density 1.132 g/ml, acid content 24%, and viscosity 1.3090 cP were the features of 6% zeolite coconut shell liquid smoke.
The Effect of Adding TiO2 Filler on The Physical and Mechanical Properties of Bioplastic Based Potato Starch (Solanum tubersom L.) and Glycerol from Waste Cooking Oil
Authors: Qoirinisa Siwi , Sedyadi Endaruji , Irwanto Dodi , Karmanto Karmanto
Published: April 2024

The manufacture of bioplastic from potato starch (Solanum tuberosum L.) and glycerol from waste cooking oil with the addition of TiO2 has been done by varying the concentration of TiO2. This study aims to study the effect of the addition of TiO2 on the physical and mechanical properties of potato starch and glycerol from leech oil. The research was conducted by making glycerol from waste cooking oil, making bioplastic film with various concentrations of TiO2 (0; 1; 2; 3 and 4%), characterization of bioplastic, which includes physical and mechanical properties. The addition of TiO2 as a bioplastic filler can affect its physical and mechanical properties. The result showed that each addition of 1% TiO2 increased the thickness by 22,966 microns, the tensile strength value by 0.0853 N/mm2, the average Young’s modulus by 0.0599 MPa, and decreased elongation by 5.0987%. The best bioplastic mechanical test results were produced at a starch composition of 2.5 grams and 2% (w/w) of TiO2 particles.
Exploring the Adoption of Electric Motorcycle Based on Habits, Knowledge, Costs, and Infrastructure in Indonesia
Authors: Hanafillah Mizana , Yuniaristanto Yuniaristanto , Sutopo Wahyudi
Published: April 2024

The largest contribution to air pollution comes from the transportation sector, especially motorcycles which reach up to 60%. This is an important issue. An effort chosen by the Indonesian government to realize the emission reduction target is by transitioning conventional motorcycles to electric motorcycles. The use of electric vehicles releases lower emissions than conventional vehicles that use fossil fuels. The trend of electric motorcycles adoption in adoption innovation and early adoption is being carried out in Indonesia. Thus, it is necessary to examine the factors that influence the adoption of electric motorcycles in Indonesia with various variable development models. In this study, the influence of mobility behavior, knowledge of electric motorcycles, availability of charging stations, battery replacement costs, and energy charging costs was observed on the selection of hybrid motorcycles, electric motorcycles with batteries, and electric motorcycles battery rental systems using a multinomial logit model. The research found the most chosen motorcycles is an electric motorcycles with a battery.
Pysicomechanical Properties of Edible Film with the Addition of Red Ginger (Zingiber Officinale Var. Rubrum)
Authors: Arnamalia Astri , Sedyadi Endaruji , Irwanto Dodi , Widowati Esti Wahyu
Published: April 2024

Preparation of Edible Film with the Addition of Red Ginger Extract (Zingiber Officinale Var. Rubrum) and Its Application to Tomato (Lycopersicum esculentum) has been carried out. The purpose of this study was to analyze the optimum concentration of adding red ginger extract to edible films on the physical and mechanical properties and to analyze the optimum concentration of adding red ginger extract to edible films on the shelf life of tomatoes. The working principle of making edible films is by varying the red ginger extract 0; 0.25; 0.50; 0.75 and 1% were analyzed by testing the thickness, tensile strength, elongation, young's modulus, and WVTR as well as analyzing the addition of red ginger variations 0; 0.25; 0.50; 0.75 and 1% for testing the shelf life of tomatoes in the form of texture tests and FTIR tests. The addition of red ginger variations had a significant effect (p<0.05) on the thickness, tensile strength, elongation, and modulus of young edible film at the optimum concentration of 0.50% with a thickness value of 0.100 mm, tensile strength 4.696 Mpa, elongation 0.194%, modulus young 26.68 Mpa, and WVTR 15.85 g/m2.hour.
Exploring Sacred Texts: Leveraging Computer Science for Dataset Similarity Analysis in Religious Studies
Authors: Raffiudin Muhammad
Published: April 2024

Studying the Quran and the Hadith side by side can help us understand that the two are fundamental and two main resources and essential wellspring of Islamic knowledge and law. There are many debates about similarities between those holy scriptures from many famous preachers and scholars. Technology can be used as an alternative solution to solve these problems. There are at least two overall approaches to determine text-similarity; the vector space model and semantic similarity —define the similarity or the distance. The similarity between words is often represented by a similarity between concepts associated with the words. This paper presents a method for identifying semantic sentence similarity among each sentence from each dataset using semantic relation of word senses between different synsets using WordNet path similarity and Wu-Palmer similarity. This method is also evaluated and has acceptable accuracy. Although both Path Similarity and Wu-Palmer Similarity successfully identify the similarity between two sentences; still, they have slightly different accuracy. The Wu-Palmer similarity is superior to path similarity when identifying sentences between Quran Sahih International and An-Nawawi Forty Hadith Translation. Looking ahead, we might be able to improve our results by using multipliers such as reverse document frequency (TF-IDF), combining the results of several steps in WordNet similarity, using vector space models, and optimal matching methods.
Placement Optimization of Air Force Fighter in the National Air Defense System
Authors: Rifki R. Hakim Ar , El Achzaabi Salma , Aprilia Sherly , Riano Gagat , Ismoyo Bambang
Published: April 2024

This study used the set covering problem (SCP) method to optimize the placement of F-16 Fighting Falcon fighters in the national air defense system (Sishanudnas). Then the results of the SCP maximized the covering capability by minimizing the average distance between air bases with the P-Median Problem (PMP). The results of this study show that the Air Force needs nine F-16 squadrons, to be able to cover all Indonesian airspace. However, if the requirements must include Air Bases that currently operate fighters as squadron deployment sites, the Air Force needs 11 squadrons of F-16 aircraft.
Identification of Disease in Tomato Plants Based on Image: Systematic Literature Review
Authors: Mansur Ejah Said , Mustopa Mahmud Rizal , Habibullah Ricky , Uyun Shofwatul
Published: April 2024

Plant diseases are taken into consideration as one of the major factors affecting food production and minimizing losses in production, and plant diseases must have rapid detection and recognition. Tomato (Lycopersicon esculentum) is one of the foodstuffs that are rich in nutrition and nutrients. Tomatoes are widely consumed by many countries including Indonesia and are hunted to be created in various spices, so tomatoes have a role in the economy due to the large demand. The recent enlargement of device studying techniques has found its application in plant disease detection especially tomato plants, presenting a powerful tool with relatively accurate effects. In this study, we present a systematic literature review aimed at identifying disease images in tomato plants. In this regard, we review 16 studies selected in the last five years with different approaches to address aspects related to tomato plant disease detection.
A Systematic Literature Review on the Methods of Breast Cancer Classification
Authors: Uyun Shofwatul , Barkah Nida Muhliya , Putri Irma Eryanti , Faridah Nur
Published: April 2024

Cancer is the second most common cause of death in the world. WHO notes, deaths caused by cancer will reach 10 million cases in 2021. Of many cancers, breast cancer is a cancer with the most cases. Early diagnosis of breast cancer plays an important role in the treatment process. Various imaging methods, including magnetic mammography, are used to diagnose breast cancer. With the help of machine learning, the process of diagnosing breast cancer with mammography images is more precise and accurate. Various machine-learning methods have been developed by researchers to diagnose breast cancer. Among them is a deep learning method that can achieve good feature representation and can solve the problem of image classification and object localization. Through a systematic literature review, this research collects and analyzes related studies regarding the classification of breast cancer that have been done previously. Several aspects that will be evaluated include the methods used, data sources used, and accuracy of the method used. This research is expected to provide clear knowledge about the advantages and disadvantages of using artificial intelligence techniques for breast cancer classification. The results of this study can provide insight for researchers and medical practitioners in the further development and application of deep learning methods in the diagnosis and classification of breast cancer.
Walking a thin line between fixation and epitope binding – characterization of antigen retrieval methods suitable for eosinophil and HSV-2 staining in formalin-fixed female reproductive tissue
Authors: Wadephul Lisa Marie , Arndts Kathrin , Katawa Gnatoulma , Dietlmeier Eva , Horsnell William , Hoerauf Achim , Ritter Manuel
Published: April 2024

Antibody-based fluorescence analysis of female reproductive tissues in research of sexually transmitted diseases allows for an in-depth understanding of protein localization, interactions, and pathogenesis. However, in many cases, cryosectioning is not compatible with biosafety regulations; at all times, exposure of lab personnel and the public to potentially harmful pathogens from biological infectious material must be avoided; thus, formaldehyde fixation is essential. Due to formaldehyde’s cross-linking properties, protein detection with antibodies can be impeded. To allow effective epitope binding during immunofluorescence of formalin-fixed paraffin-embedded vaginal tissue, we investigated two antigen retrieval methods. We tested these methods regarding their suitability for automated image analysis, facilitating reproducible quantitative microscopic data acquisition in sexually transmitted disease research. Heat-based retrieval at 80°C in citrate buffer proved to increase antibody binding to eosinophil protein and HSV-2 visibly and tissue morphology best, and was the most efficient for sample processing and quantitative analysis.
Development of high-speed and precision metering device with gradient-feeding and control seed for soybean planting
Authors: Chen Xuhui , Zhang Shilin , Dong Jianxin , Liu Fang , Jia Xian , Huang Yuxiang
Published: April 2024

High-speed and precision planting was employed to improve the yields of soybean seeds. However, most mechanical seed metering devices had a lower quality index under high-speed. In this study, a high-speed and precision metering device with gradient-feeding (GF) and control-seed (CS) for soybean planting was designed to improve the quality index at high speeds. GF was designed to make soybean seeds rapidly enter seed cells. CS prevented soybean seed that was to be released from being cleared during the clearing stage. Firstly, the range of working parameters of it was determined by theoretical analysis, which included the angle of guiding-slope (α), the angle of seed-control (θ), and mutation height (∆H). Then, orthogonal center combination tests with three-factor and five-level were carried out to determine the corresponding quality index and miss index with different working parameters. The optimal working parameters were determined by regression equations between the quality index and the miss index. The high-speed and precision metering device with GF and CS was thus manufactured based on these optimal working parameters. The simulation test and bench test of it were carried out with different forward speeds of the planter. The results showed that the optimal angle of guiding-slope (α), angle of seed-control (θ), and mutation height (∆H) were 18.06°, 136.67°, and 2.77 mm, respectively. In the bench test, all quality indices were higher than 95.00%, and all miss indices were lower than 3.00% when the forward speed of the planter was 4 - 16 km/h. The results of the bench test were consistent with the results of the simulation test, with an average relative error of 2.33%. High-speed and precision metering device with gradient-feeding (GF) and control-seed (CS) can realize precision planting at high speeds.
Comparison of dosimetric parameters and three-dimensional dosimetric verification of three intensity-modulated radiotherapy plans for thymoma based on the dose-volume histogram and ArcCHECK-3DVH system
Authors: Zhou Peng , Luo Jia , Xiao He , Geng Mingying , He Xuan
Published: April 2024

Objective:

To compare the dosimetric parameters of step-shoot intensity-modulated radiotherapy (sIMRT), dynamic intensity-modulated radiotherapy (dIMRT), and volume-modulated arc therapy (VMAT) in thymoma and to study the feasibility of the ArcCHECK-3DVH system in three intensity-modulated radiotherapy plans to choose a more appropriate intensity-modulated radiotherapy for thymoma.

Materials and Methods:

Seventeen patients with thymoma were enrolled in this study. Treatment plans of sIMRT, dIMRT, and VMAT for each patient were based on the Monaco treatment planning system (TPS). Dosimetric verification was performed via the ArcCHECK-3DVH system. We compared and analyzed the 3D γ pass rates of the TPS dose calculation and ArcCHECK-3DVH system dose reconstruction with the three gamma criteria (3 mm/3%, 2 mm/2%, and 1 mm/1%) with a threshold of 10%. Dose-volume histogram analysis was used to compare the dose parameters for target volumes, and organs at risk (OARs), such as D98%, D50%, D2%, Dmax, V20, and V5. Monitor units (MUs) and delivery time were also compared.

Results:

There were significant differences in the three intensity-modulated radiotherapy plans. For target volume, VMAT showed the highest planning target volume (PTV) D98% and the lowest PTV D50% compared with sIMRT or dIMRT. The PTV D2% of VMAT was lower than that of sIMRT and higher than that of dIMRT, and VAMT demonstrated the highest conformity index and MU, lowest homogeneity index, and shortest treatment delivery time. For the OARs, VMAT is not inferior to sIMRT and dIMRT in OARs protection. For the dosimetric verification, the entire area, PTV, lungs, heart, and spinal cord of VMAT showed the highest γ pass rates than the other two techniques under the gamma 3 mm/3% criteria, which was even more pronounced when the stricter gamma criteria of 2 mm/2% and 1 mm/1% were applied.

Conclusion:

VMAT can be applied to radiotherapy of thymoma, and the accuracy of treatment plan execution can be guaranteed through the ArcCHECK-3DVH system.
Preliminary data of a game-based protocol for acute treatment of cervical spinal cord injury rehabilitation with Kinect
Authors: Morganti Luca , Ascolese Antonio , Vitelli Daniele , Spinelli Michele
Published: April 2024

Game-based rehabilitation proved its efficacy in recent years, and the areas of intervention are increasing. In this article, we report the definition of a protocol for the treatment of people suffering from acute cervical spinal cord injury and its preliminary application with five patients. A suite of serious games using Kinect as device for game sessions is adopted for upper-limb rehabilitation. The possibility to customize the training plans by selecting different games for each patient gives the chance to include game created for other training targets (e.g., balance) that train further body parts (e.g., the trunk) and that can thus adapt the training to specific patient’s needs.
An observational study to assess the feasibility of remote monitoring of patients in the early postoperative period after elective surgery
Authors: Faiz Omar , Nachiappan Subramanian , Anele Chukwuemeka , Roberts Emma-Jane , Barker Chris
Published: April 2024

Background and Objectives:

The utility of postdischarge remote monitoring with patient self-measurement of physiological parameters has not been utilized in the elective colorectal surgical setting till date. Before full application of this utility, patient-acquired measurements’ accuracy, and ability to detect deviation from normal physiological must be assessed. This study aims to ascertain the congruency of patient-measured and nurse-measured readings in the postoperative in-hospital setting, before future application in the home setting.

Methods:

This is a prospective single-institution study comparing patient and nurse measured readings of blood pressure, heart rate, oxygen saturation, and temperature, in ambulatory patients in the postoperative setting. Patients were provided with and trained on the usage of a handheld computing device with bluetooth-enabled measuring adjuncts preoperatively. Patients were instructed to acquire two sets of readings per day for 2 days. These were compared with nurse-acquired measurements and extrapolated to the modified “National Early Warning Score” system. Inter-rater concordance was analyzed using the Bland-Altman method for raw physiological measurements and for modified-National Early Warning Score (NEWS) risk and response categories.

Results:

A total of 40 elective colorectal patients were prospectively approached. Twenty-seven completed the study with 25 patients (15 males, age range 18-79, undergoing a variety of colorectal procedures) accruing a total of 98 datasets of physiological parameter readings. There were no significant differences/bias between blood pressure (P = 0.572), heart rate (0.122), and oxygen saturation (P = 0.308) readings. Patient and linked nurse measurements for all patients elicited the same modified NEWS clinical risk and required response in all instances.

Conclusion:

Patient self-measurement of physiological parameters and subsequent derived modified NEWS categories using a remote monitoring system are comparable to nurse-acquired measurements. Remote monitoring is technically feasible, and the next steps would be to trial this technology in the home setting.
Three-dimensional printing-assisted rotational osteotomy of the femoral neck in the treatment of early osteonecrosis of the femoral head
Authors: Wan Ming , He Guowen , Chen Liang , Gao Dawei , Hu Baijun , Huahui Liang , Fukai Gan
Published: April 2024

Rotational osteotomy of the base of the femoral neck involves osteotomy at the intertrochanteric level and rotation of the femoral head. That is to rotate the avascular collapse of the femoral head to the nonweight-bearing area of the hip joint, thus effectively avoiding further collapse of the femoral head necrosis. Clinical has achieved a certain effect. However, there are also some problems in the operation, such as the individual difference of the neck-shaft angle and the anteversion angle of the femoral neck of the affected hip joint among different patients, the nonunion of the osteotomy end, the mismatch of the relationship between the head and the acetabulum, and the direction and angle of the head rotation. The combined three-dimensional printing technology is expected to ensure the accuracy of osteotomy, to solve the adverse complications, and to improve the surgical efficacy.
Mental health issues in antenatal women with prior adverse pregnancy outcomes: Unmasking the mental anguish of rainbow pregnancy
Authors: Kulshreshtha Shatakshi , Siwatch Sujata , Aggarwal Neelam , Rohilla Minakshi , Grover Sandeep
Published: April 2024

Background & objectives:

Mental health issues in pregnancy have adverse implications on the quality of life, however still they go unevaluated and underreported. Women with previous history of abortions or stillbirth may have a higher risk of experiencing mental health problems. The present investigation was aimed to study the prevalence of depression, anxiety, stress and domestic violence in antenatal women with prior pregnancy losses and the need for interventions to treat the same.

Methods:

One hundred pregnant women with a history of prior pregnancy losses (group 1) and 100 women without obstetrical losses (group 2) were enrolled in this cross-sectional study carried out in a tertiary care hospital in India. Women were screened for depression, anxiety, stress and domestic violence using various questionnaires: EPDS (Edinburgh postnatal depression scale), PRAQ-2 (pregnancy-related anxiety questionnaire-revised 2), GAD 7 (generalized anxiety disorder-7) and PSS (perceived stress scale).

Results:

The prevalence of depression (EPDS scale) and pregnancy specific anxiety (PRAQ-2 scale) was significantly higher in group 1 than in group 2 (27 vs. 10%, P=0.008; and 15 vs. 6%, P=0.03). The prevalence of general anxiety (GAD 7 scale) and stress (PSS), however, was high and comparable in both the groups (33 vs. 29%, P=0.44; and 33 vs. 27%; P=0.35 respectively). Recurrent abortions was found to be an independent risk factor for depression [adjusted odds ratio=26.45; OR=28]. In group 1, 31 per cent required counselling in the psychiatry department and nine per cent required medication.

Interpretation & conclusion:

Mental health issues, especially depression, are prevalent in antenatal women with previous losses. Unrecognised and untreated, there is a need for counselling and developing screening protocols at India’s societal and institutional levels.
Prediction of pre-eclampsia in diabetic pregnant women
Authors: Kumar Ashok , Vanamail Perumal , Gupta Ram Kumar , Husain Syed Akhtar
Published: April 2024

Background & objectives:

Gestational or preexisting diabetes is one of the risk factors of pre-eclampsia. Both are responsible for higher maternal and fetal complications. The objective was to study clinical risk factors of pre-eclampsia and biochemical markers in early pregnancy of women with diabetes mellitus (DM)/gestational diabetes mellitus (GDM) for the development of pre-eclampsia.

Methods:

The study group comprised pregnant women diagnosed with GDM before the 20 wk of gestation and DM before pregnancy and the control group had age-, parity- and period of gestation-matched healthy women. Sex hormone-binding globulin (SHBG), insulin-like growth factor-I (IGF-I) and 25-hydroxy vitamin D [25(OH)D] levels and the polymorphism of these genes was evaluated at recruitment.

Results:

Out of 2050 pregnant women, 316 (15.41%) women (296 had GDM and 20 DM before pregnancy) were included in the study group. Of these, 96 women (30.38%) in the study group and 44 (13.92%) controls developed pre-eclampsia. Multivariate logistic regression analysis indicated those who belonged to the upper middle and upper class of socio-economic status (SES) were likely to be at 4.50 and 6.10 times higher risk of developing pre-eclampsia. The risk of getting pre-eclampsia among those who had DM before pregnancy and pre-eclampsia in their previous pregnancy was about 2.34 and 4.56 times higher compared to those who had no such events, respectively. The serum biomarkers [SHBG, IGF-I and 25(OH)D] were not found to be useful in predicting pre-eclampsia in women with GDM. To predict risk of development of pre-eclampsia, the fitted risk model by backward elimination procedure was used to calculate a risk score for each patient. Receiver operating characteristic (ROC) curve for pre-eclampsia showed that area under the curve was 0.68 (95% confidence interval: 0.63-0.73); P<0.001.

Interpretation & conclusions:

The findings of this study suggested that pregnant women with diabetes were at a higher risk for pre-eclampsia. SES, history of pre-eclampsia in previous pregnancy and pre-GDM were found to be the risk factors.
Radiological evaluation of metastatic lymph nodes in carcinoma cervix with emphasis on their infiltrative pattern
Authors: Dhamija Ekta , Baby Akhil , Bhatla Neerja , Pulappadi Vishnu Prasad , Kumar Mukesh , Kumar Sunesh , Kumar Lalit , Sharma Dayanand
Published: April 2024

Background & objectives:

Imaging has been added to the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system of cervical carcinoma. This study was performed to assess the impact of imaging in staging and to ascertain the prevalence and pattern of nodal metastasis on contrast-enhanced computed tomography (CECT) in patients with cervical carcinoma who were treated based on FIGO 2009 staging system.

Methods:

This retrospective study was conducted to evaluate all patients with biopsy-proven cervical carcinoma who underwent CECT of abdomen at a tertiary cancer centre in north India from April 2017 to April 2019 and for whom either baseline or follow up scans were available. In patients with enlarged or necrotic lymph nodes, the location, size and pattern of infiltration of adjacent organs were recorded.

Results:

A total of 602 patients of cervical carcinoma had undergone CT during the study period, of whom 138 (22.9%) underwent CT at baseline and 464 (77.1%) patients during follow up. The FIGO (2009) stage distribution at the time of presentation was stage IB: 109 (18.1%); stage IIA: 14 (2.3%), stage IIB: 118 (19.6%), stage IIIA: 12 (2%), stage IIIB: 277 (46%), stage IVA: 20 (3.3%) and stage IVB: 52 (8.6%). Ninety of the 138 (65.22%) patients underwent a stage shift according to the FIGO 2018 because of the presence of enlarged lymph nodes at baseline scan. Sixteen (2.7%) patients had infiltrative nodal masses most commonly involving the blood vessels (n=14) followed by ureter (n=8), bones (n=5), muscle and bowel (n=3, each). The majority (14/16) of these patients presented with vague abdominal pain, discomfort and vomiting, while two had bone pain.

Interpretation & conclusions:

CECT at baseline helps in accurately assessing the stage in cervical carcinoma. It helps in the identification of lymph node metastasis in cervical carcinoma, which is crucial for guiding accurate management.
Association of hyperglycaemia at-admission & diabetes mellitus with 28 day mortality in patients admitted with moderate-severe SARS-CoV-2 infection: A retrospective study
Authors: Kurian Navya Mary , Yadav Subhash Chandra B. , Gurjar Mohan , Mishra Prabhakar , Sanjeev Om P. , Azim Afzal , Gupta Devendra , Hashim Zia , Verma Alka , Bhatia Eesh , Ghatak Tanmoy , Singh Ratender Kumar , Nath Alok , Sahoo Saroj Kumar , Dabadghao Preeti , Gupta Sushil
Published: April 2024

Background & objectives:

The association between hyperglycaemia at admission, diabetes mellitus (DM) status and mortality in hospitalized SARS-CoV-2 infected patients is not clear. The purpose of this study was to determine the relationship between DM, at-admission hyperglycaemia and 28 day mortality in patients admitted with moderate-severe SARS-CoV-2 infection requiring intensive care.

Methods:

All consecutive moderate-to-severe patients with SARS-CoV-2 infection admitted to the intensive care units (ICUs) over six months were enrolled in this single-centre, retrospective study. The predicators for 28 day mortality were analysed from the independent variables including DM status and hyperglycaemia at-admission.

Results:

Four hundred and fifty two patients with SARS-CoV-2 were admitted to the ICU, with a mean age of 58.5±13.4 yr, 78.5 per cent being male, HbA1c of 7.2 per cent (6.3-8.8) and 63.7 per cent having DM. Overall, 28 day mortality was 48.9 per cent. In univariate analysis, mortality in diabetes patients was comparable with non-diabetes (47.9 vs. 50.6%, P=0.58), while it was significantly higher in hyperglycaemic group (60.4 vs. 35.8%, P<0.001). In multivariate Cox regression analysis, after adjusting for age, sex and comorbidities, hyperglycaemia at-admission was an independent risk factor of mortality [hazard ratio (HR) 1.45, 95% confidence interval (CI) (1.06-1.99), P<0.05].

Interpretation & conclusions:

This study showed that the presence of hyperglycaemia at-admission in critically ill SARS-CoV-2 patients was an independent predictor of 28 day mortality. However, the findings may be susceptible to unmeasured confounding, and more research from prospective studies is required.
Evaluation of Madras Diabetes Research Foundation-Indian Diabetes Risk Score in detecting undiagnosed diabetes in the Indian population: Results from the Indian Council of Medical Research-INdia DIABetes population-based study (INDIAB-15)
Authors: Deepa Mohan , Elangovan Nirmal , Venkatesan Ulagamathesan , Das Hiranya Kumar , Jampa Lobsang , Adhikari Prabha , Joshi Prashant P. , Budnah Richard O. , Suokhrie Vizolie , John Mary , Tobgay Karma Jigme , Subashini Radhakrishnan , Pradeepa Rajendra , Anjana Ranjit Mohan , Mohan Viswanathan , Kaur Tanvir , Dhaliwal Rupinder Singh ,   for the ICMR-INDIAB Collaborative Study Group
Published: April 2024

Background & objectives:

Screening of individuals for early detection and identification of undiagnosed diabetes can help in reducing the burden of diabetic complications. This study aimed to evaluate the performance of Madras Diabetes Research Foundation (MDRF)-Indian Diabetes Risk Score (IDRS) to screen for undiagnosed type 2 diabetes in a large representative population in India.

Methods:

Data were acquired from the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study, a large national survey that included both urban and rural populations from 30 states/union territories in India. Stratified multistage design was followed to obtain a sample of 113,043 individuals (94.2% response rate). MDRF-IDRS used four simple parameters, viz. age, waist circumference, family history of diabetes and physical activity to detect undiagnosed diabetes. Receiver operating characteristic (ROC) with area under the curve (AUC) was used to assess the performance of MDRF-IDRS.

Results:

We identified that 32.4, 52.7 and 14.9 per cent of the general population were under high-, moderate- and low-risk category of diabetes. Among the newly diagnosed individuals with diabetes [diagnosed by oral glucose tolerance test (OGTT)], 60.2, 35.9 and 3.9 per cent were identified under high-, moderate- and low-risk categories of IDRS. The ROC-AUC for the identification of diabetes was 0.697 (95% confidence interval: 0.684-0.709) for urban population and 0.694 (0.684-0.704) for rural, as well as 0.693 (0.682-0.705) for males and 0.707 (0.697-0.718) for females. MDRF-IDRS performed well when the population were sub-categorized by state or by regions.

Interpretation & conclusions:

Performance of MDRF-IDRS is evaluated across the nation and is found to be suitable for easy and effective screening of diabetes in Asian Indians.
Nutritional requirements for the elderly in India: A status paper
Authors: Tattari Shalini , Gavaravarapu SubbaRao M. , Pullakhandam Raghu , Bhatia Neena , Kaur Supreet , Sarwal Rakesh , Rajkumar Hemalatha , Reddy G. Bhanuprakash
Published: April 2024

Advances in the medical field and healthcare sector during the last few decades have resulted in increased longevity. Increased lifespans have in turn led to a rapid global rise of the elderly population. However, ensuring the health and quality of life, especially in the context of chronic age-related ailments, among the growing geriatric population is a challenge. Ageing is associated with several changes in body composition including a decline in the lean body mass usually accompanied by an increase in body fat content which have a bearing on the nutrient requirements for the elderly. The nutrient requirements currently recommended for Indian adults are primarily computed using a factorial approach, that considers the cumulative loss of nutrients and is adjusted for optimal body weights and bioavailability. It is logical that physiological and metabolic changes associated with ageing influence several of these factors: body weight, lean mass, energy expenditure, nutrient retention and bioavailability and thus alter nutrient requirements compared to the adult population. Acknowledging these age-related changes, some international organizations have suggested nutrient requirements specific to the elderly. Given the contextual differences in physiology, caution needs to be exercised in adopting these guidelines for the Indian elderly. In addition, in the Indian context, there is sparse information on the diet and nutrient intakes vis-à-vis nutritional status and physiology of the elderly. This status paper highlights some of the pertinent issues related to nutritional requirements for the elderly that advocate a need for deriving nutritional requirements for the elderly in India.
Diagnostic performance of combined use of automated breast volume scanning & hand-held ultrasound for breast lesions
Authors: Liu Jialin , Zhou Yang , Wu Jialing , Li Peng , Liang Xinyu , Duan Haonan , Wu Xueqing , Hou Xiukun , Li Xiaofeng
Published: April 2024

Background & objectives:

Breast cancer being one of the most common malignant tumours among women, diagnostic modalities for early detection of the same become of paramount importance. In this context, the hand-held ultrasound (HHUS) and automated breast volume scanner (ABVS) could provide valuable information for clinicians to diagnose breast diseases. This study aimed to compare and evaluate the diagnostic performance of combined use of HHUS and ABVS for the differentiation of benign and malignant breast lesions.

Methods:

A total of 361 female patients, who underwent both HHUS and ABVS examinations were included in this study. ABVS and HHUS images were interpreted using the American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS). The distributions of the BI-RADS categories and pathology results were shown as specific numbers. Kappa coefficients test (κ) was calculated to compare the diagnostic results amongst the ABVS, HHUS and ABVS combined with HHUS. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the three diagnostic methods were calculated and their respective diagnostic performance was analyzed by receiver operator characteristic curve.

Results:

Of a total of 431 lesions, 153 (35.5%) were malignant and 278 (64.5%) were benign. With respect to the pathology results, the value of κ was 0.713 (P<0.001) for HHUS, κ=0.765 (P<0.001) for ABVS and κ=0.815 (P<0.001) for HHUS+ABVS. The sensitivity, specificity, accuracy, PPV and NPV for HHUS combined with ABVS were 96.08 (147/153), 88.49 (246/278), 91.18 (393/431), 82.12 (147/179) and 97.62 per cent (246/252) respectively. For HHUS, these were 90.20 (138/153), 84.17 (234/278), 86.31 (372/431), 75.82 (138/182) and 93.98 per cent (234/249) respectively; and for ABVS these were 92.16 (141/153), 87.05 (242/278), 88.86 (383/431), 79.66 (141/177) and 95.28 per cent (242/254), respectively. There was no significant difference amongst these three methods, but the diagnostic performance of HHUS combined with ABVS was better than, or at least equal to, that of HHUS or ABVS alone.

Interpretation & conclusions:

The results of this study suggest that ABVS is a promising and advantageous modality for breast cancer detection. Furthermore, the combination of HHUS and ABVS showed a more comparable diagnostic performance than HHUS or ABVS alone for distinguishing between benign and malignant breast lesions.
Assessment of prevalence and need for screening of diabetic retinopathy using non-mydriatic fundus camera in rural and tribal diabetic populations in Maharashtra
Authors: Jain Pranjal , Shukla Ajay K , Singh Smita , Sheikh Azhar M , Malwe Gaurav
Published: April 2024

Purpose:

To assess the prevalence of DR and the need for screening and management of DR with medical management of diabetes in rural and tribal population in Maharashtra.

Methods:

The known diabetics of rural area and tribal area were screened at corresponding primary health centers, subcenters, and village level with the help of local healthcare workers using a portable non-mydriatic fundus camera. The prevalence of blindness among known diabetics in rural area was 1.29%, and 0.84% in tribal area.

Results:

In the rural area, the prevalence of diabetic retinopathy (DR) was 5.67% (n = 776), out of those 18.18% had sight threatening diabetic retinopathy (STDR). The prevalence of DR was 7.73% (n = 711) in tribal areas, out of those, 30.90% had STDR.

Conclusions:

The significant risk factors were identified to be the duration of diabetes and poor glycemic control. Implementation of targeted interventions for screening and management are required to reduce the risk of blindness among known diabetics in rural and tribal areas.