bluuebunny/crossref_metadata_2025 huggingface dataset:
An unusual foreign body into the pericardium after a penetrating thoracic injury: a case report
Authors: Alshammari Dalal S. , Alhelali Maisa F. , Amana Nizam A. , Girgis Basem S.
Published: February 2025

Thoracic trauma remains a major contributor to global morbidity and mortality, particularly through penetrating injuries. This case report discusses a 16-year-old female patient who presented with a penetrating injury following a fall involving a heavy object, resulting in three sewing needles embedded in her chest. Two needles were removed in the emergency department, while a third needle was retained and found to be in contact with the pericardium. Imaging, including chest X-ray and CT scans, facilitated the diagnosis and localization of the foreign body. Surgical intervention was performed successfully under local anesthesia, resulting in the complete removal of the needle without complications. The patient recovered well and was discharged two days post- surgery. This case underscores the importance of prompt imaging and surgical management in cases of penetrating thoracic trauma.
Exploring the practicality of transition care guidance for paediatric CHD patients: a case series
Authors: Panda Shramana Ray , Shetty Asha P. , Dwibedi Bhagirathi
Published: February 2025

This pilot study evaluates the feasibility of implementing a nurse-led transition care program among caregivers of CHD children admitted to a pediatric medicine ward. A quantitative approach was used to collect the data from eight caregivers and children distributed equally among control and experimental group. The study has used data collection instruments including demographic proforma, caregiver's knowledge and self-efficacy format as well as satisfaction form. Results highlighted the feasibility of implementing a nurse-led transition care program in pediatric patients and showed the potential benefit of a nurse-led program in terms of improved caregiver readiness for discharge. Study findings provide a base for implementing structures and transition care models to improve post-transition healthcare outcomes.
Mandibular chondroblastic type osteosarcoma primarily diagnosed as chondrosarcoma as a result of radiation therapy: a case report
Authors: Rone Alise Elizabete , Bāgante Ieva , Vasiļčenko Irina , Zariņš Jānis , Deksnis Renārs , Hasnere Sigita
Published: February 2025

Radiation therapy is a recognized etiological factor for osteomyelitis, osteoradionecrosis and multiple sarcomas such as chondrosarcoma and osteosarcoma. Here we present a case of mandibular chondroblastic type osteosarcoma induced by radiotherapy which was primarily misdiagnosed as chondrosarcoma. A female presented with main complaint of pain at the extraction site following multiple teeth extraction and sequestrectomy on the right lower jaw. Medical history revealed stage IV squamous cell carcinoma of the base of the tongue which was treated by surgical excision, chemotherapy and radiotherapy ten years ago. Four recurring sequestrectomies were performed, but only histological material from the fourth sequestrectomy revealed grade 2 chondrosarcoma. This was followed by resection of the tumour and floor of the mouth, mandibular, lip and facial skin reconstruction and operation material through histology was again confirmed to be grade 2 chondrosarcomas. In a year’s time, pathological nodule in thyroid gland was found on CT, surgery was performed. Operation material now revealed high grade chondroblastic type osteosarcoma and additional radiotherapy and chemotherapy was prescribed. This case illustrated chondrosarcoma and chondroblastic type osteosarcoma as a rare malignant incidence, with diagnostical difficulties and treatment. Differential diagnosis should be considered if no positive changes are observed after the designated therapy as well as importance of immuno histological evaluation. One treated malignancy does not exclude development of another unrelated malignancy.
Congenital arhinia: a highly unexpected presentation
Authors: Elizabeth Mathai Anju , Shekhawat Pushpendra , Tamami Nasser Al , Shekhawat Dimple
Published: February 2025

Congenital nasal absence (arhinia) is an extremely rare malformation. Arhinia causes severe airway obstruction and poor feeding in the affected neonate. There is an association with other facial anomalies, especially defects of the eyes, ears, palate, and midline defects. In this article, we present a 16-month-old child born with absent nose, microphthalmia and cleft palate. Such patients require multidisciplinary team approach for appropriate care and management.
Clinico-epidemiological study of dermatological disorders in pediatric population at tertiary care centre
Authors: C Lalitha , Reddy Chandan Kumar , Prasad Anupama Manohar , Salahuddin Syed
Published: February 2025

Children in India constitute a substantial portion of the population, with nearly half a billion children, about 40% of the total population. Skin diseases are prevalent among them, accounting for 30% of dermatologist and pediatrician visits and conditions vary widely across regions due to factors like poverty, malnutrition, hygiene, and climatic influences. Pediatric dermatology addresses unique challenges in managing skin diseases from infancy to adolescence, necessitating tailored approaches distinct from adult care. Understanding these variations is crucial for effective diagnosis and treatment, ensuring optimal childhood health outcomes.

A hospital-based clinical descriptive study was conducted, involving 600 children under the age of 16, clinically diagnosed with skin diseases over a period of one and half year after ethical committee approval.

In this study, 600 pediatric patients (316 males, 284 females; mean age 8.06 ± 5.10 years) were analyzed for dermatoses. The majority of patients were aged 11-16 years (36.33%). A total of 642 skin disorders were recorded, with infections and infestations being the most common (39.41%), followed by eczematous diseases (21.49%). Among infections, bacterial infections were most prevalent (36.76%), with impetigo being the most common bacterial infection (52.7%). Viral infections were led by verruca vulgaris (43.4%), while Tinea was the predominant fungal infection (58.49%). The study highlights significant variations in dermatoses across different age groups, with a higher incidence of bacterial infections in younger children and fungal and viral infections in older children.

Pediatric dermatoses present varied challenges in diagnosis and treatment globally, affecting rural and urban populations differently. Our study categorized these conditions into fewer than eight groups, highlighting infections as most prevalent, followed by eczematous and pigmentary disorders. Disease distribution is influenced by age, gender, socioeconomic factors, family history, and seasonal variations. Effective strategies require enhancing public awareness, improving hygiene practices, and implementing targeted interventions based on regional epidemiology to reduce the burden and improve pediatric health outcomes.
Evaluation of lipid profile in young adults (18-50 years) with psoriasis vulgaris in Chennai
Authors: Kuberan Abinaya , MP Sankeerthana , Thomas Jayakar , Sharma Shea , K Gopalakrishnan
Published: February 2025

Psoriasis is a chronic inflammatory and proliferative skin condition influenced by both genetic and environmental factors. Its typical manifestations include red, scaly, well-defined plaques that often appear on the extensor surfaces of the body and the scalp. The disease can vary significantly in terms of duration, frequency of flare-ups, and affected areas, and it often presents with various morphological variations.

My study aims to primarily ascertain the frequency of lipid disturbances in patients with psoriasis vulgaris and their extent of derangement correlated with severity of psoriasis.

After obtaining ethical committee clearance, and consent from patients, 130 psoriatic patients were studied. Their lipid profiles were investigated. PASI was assessed against derangements in fasting lipid profiles using statistical analysis ANOVA.

Most common age group affected was between 26 to 35 years. 55% males and 45% females were affected. NCEP ATP III guidelines was followed for fasting lipid evaluation. 19% cases had elevated triglycerides levels. 65% had elevated HDL cholesterol levels. 33% cases had elevated serum cholesterol levels.45% cases had elevated LDL, 28% had elevated VLDL. 79% had elevated waist circumference. 3% had increased albumin levels, 45% had increased serum globulin levels, 0.8% had increased albumin globulin ratio, 8% had increased total bilirubin levels, 3% had increased direct bilirubin levels, 7% had increased serum AST, 1.5% had increased serum alkaline phosphatase and 8% had increased Gamma glutamyl transferase.

After statistically evaluating PASI with cholesterol levels and waist circumference, PASI and Cholesterol & Waist circumference was statistically significant with P values showing 0.01 and 0.021 respectively. No statistical difference was noted between PASI and Liver function test values. Hence, PASI and cholesterol levels and waist circumference can be taken as an indicator to assess the severity of psoriasis and cardiac involvement by periodically screening the patient .
Evaluation of dermatoses in pediatric age group (3-15 yrs) in accordance with seasonal variation
Authors: T U Pooja , Jayakrishnan Roma , Thomas Jayakar , Kunjaram Gopalakrishnan
Published: February 2025

This study aimed to evaluate pediatric dermatoses based on clinical diagnosis and seasonal variation at a tertiary care hospital in Chennai. Informed consent was obtained, and histories recorded; diagnoses were based on physical examination. It included 271 patients aged 3–15 years, with a mean age of 7.93 ± 3.52 years (range: 3–15) and a median of 8 years (IQR: 5–10). The highest prevalence was in children aged 3–6 years, with a balanced gender distribution. Cases peaked during monsoon and summer. Infections, especially viral, were most common, with scabies being the leading diagnosis.

Patients aged 3-15 years who visited the dermatology OPD were selected. Informed consent was obtained from parents or guardians, and their medical, family, and treatment histories were recorded. A thorough physical examination was conducted to reach a diagnosis.

The study included 271 patients, mostly younger children (mean age: 7.93 ± 3.52 years; range: 3–15; median: 8 years; IQR: 5–10).Participants included 51.5% males and 48.5% females, showing a balanced gender distribution. Distribution of participants by season, cases were highest in monsoon (32.6%) and summer (31.9%), with fewer in winter (24.4%) and post-monsoon (11.1%). Distribution of participants by disease group shows, Viral infections as the most common (21.1%), followed by parasitic infestations (13.0%), eczema (11.1%), and fungal infections (10.0%), with other disorders also observed.

The study found higher cases of pediatric dermatoses in children aged 3-6 years, with a balanced gender distribution. More cases occurred in monsoon and summer. Viral infections were most common, with scabies as the leading diagnosis, followed by chicken pox, insect bite hypersensitivity, atopic dermatitis, hand-foot-mouth disease, and verruca vulgaris.
Unlocking the healing potential: Agada tantra principles in pyoderma gangrenosum management
Authors: Savalagimath Mahesh P , Walia Arpit , Devaraddiyavar Vinuta H
Published: February 2025

Due to their rising prevalence and growing awareness of the associated morbidity and socioeconomic burden, chronic ulcers, defined by their inability to heal within a reasonable amount of time, have become a more significant clinical issue. In Ayurveda, Agada Tantra principles provide a comprehensive approach to treating chronic wounds.

We present a case report of a 60-year-old female patient with a non-healing ulcer on the lateral aspect of her right leg that had been present for one year and associated with Itching and burning sensation, as well as serosanguineous discharge from the wound.

Hence Pyoderma gangrenosum was successfully managed using Ayurveda intervention, highlighting the potential of Agadas in managing chronic ulcers.
Comparing clear aligner treatments with multi-bracket systems: Advantages and disadvantages
Authors: Uzunçıbuk Hande , Russo Diana , Marrapodi Maria Maddalena , Cicciù Marco , Minervini Giuseppe
Published: February 2025

This editorial presents a comparative analysis of two widely used orthodontic treatment modalities: Clear Aligner Therapy (CAT) and Multi-Bracket Systems (MBS). Both approaches offer distinct advantages and disadvantages based on aesthetics, comfort, patient compliance, and treatment complexity. Clear aligners are favored for their discreet appearance, patient comfort, and ease of maintaining oral hygiene, making them especially appealing to adults and adolescents. However, their effectiveness is closely tied to patient compliance, and more complicated orthodontic cases might not be a good fit for them. However, multi-bracket systems provide superior control for treating complex malocclusions and do not depend on patient adherence for success, though they pose challenges regarding aesthetics, oral hygiene, and comfort. This editorial examines the current literature, highlighting both the strengths and limitations of these two systems. In conclusion, the choice of orthodontic treatment should be personalized, considering each patient’s unique needs and compliance levels, to achieve optimal results.
Geometric morphometric analysis of palatal form in patients with maxillary anterior teeth impaction-A systematic review
Authors: Rana Shailendra Singh , Rajagopalan Anjana , Lal Babu , Chaudhari Prabhat Kumar
Published: February 2025

Morphometrics is a rising technology being employed for describing biological structures in terms of quantifying their shape and form. This review explores maxillary palatal vault shape and arch dimensions which are proposed to have a role in the aetiology of maxillary buccal and canine impactions.

To analyse the morphological variations in palatal shape in subjects with maxillary anterior teeth impaction using Geometric Morphometric Analysis.

Two independent reviewers searched six databases (PubMed, Web of Science, Embase, Google Scholar, Scopus, and Open Grey). The searches were carried out in November 2023 with no restrictions on publication date. Observational studies and Randomised controlled trials (Study design) were included wherein the morphological variations in palatal shape (outcome) in subjects with maxillary anterior teeth impaction (population) studied using Geometric Morphometric Analysis (intervention). The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were applied, and the protocol was registered in PROSPERO (CRD42023449757). The risk of bias was determined using the Anatomical Quality Assessment (AQUA) tool.

Patients with unilateral or bilateral buccal displaced permanent canine showed a vertical extension and a horizontal compression in the lateral area of the palate. Palatal canine impactions had minimal relationship with palatal shape and morphology.

Morphometric variations of the palatal vault can be considered a factor in determining the probability of maxillary anterior teeth impactions.
Comparative evaluation of sequential maxillary molar distalization utilizing clear aligners in combination with micro-implants and Class II elastics for reinforcing the anchorage- A finite element model study
Authors: Trambadia Shikha , Gadhiya Nitin , Khamatkar Aparna , Sawant Veera , Shroff Keval , Jadhav Pranita
Published: February 2025

This study aims to perform a comparative evaluation of sequential maxillary molar distalization using clear aligners in combination with micro-implants and Class II elastics for reinforcing anchorage. The goal is to assess the biomechanical effectiveness and outcomes of these methods in achieving distalization without unwanted tooth movements.

A finite element model (FEM) study was conducted using the CBCT data of a 21-year-old female patient with Class II malocclusion. The 3D model of the maxilla and maxillary dentition was created and meshed for simulation. Five sub-models were developed to represent different treatment scenarios: clear aligners alone (control), aligners with Class II elastics using buttons or precision cuts, and aligners with micro-implants combined with elastics. Each model simulated sequential molar distalization with static loading forces. Displacement and stress responses were analyzed to determine the effectiveness and control of tooth movements.

The FEM simulations revealed that the use of clear aligners with Class II elastics and micro-implants enhanced molar distalization efficiency while minimizing mesial displacement of anchorage teeth. Models with precision cuts and micro-implants showed superior anchorage control, reducing unwanted tipping and rotation. The greatest displacement was observed in models using precision cuts with Class II elastics, while the least displacement occurred in the control models.

The study concluded that Class II elastics provide superior control over molar movement compared to micro-implants when used with clear aligners for sequential maxillary molar distalization. Precision cuts on aligners offer better anchorage reinforcement than buttons.
Radiographic assessment of apical root resorption in the mandibular molars following the usage of resin bite turbos in orthodontic patients– A retrospective study
Authors: Maddalena Marrapodi Maria , Raju Rebekah , Navaneethan Ramasamy , Subramanian Aravind Kumar , Ramalingam Karthikeyan , Uzunçıbuk Hande , Russo Diana , Cicciù Marco , Minervini Giuseppe
Published: February 2025

Orthodontic treatment involves the use of bite turbos that are frequently utilized in orthodontic therapy to disocclude the lower and upper teeth to achieve adequate alignment and leveling. This occurs due to excessive intrusive forces which led to resorption of roots. This study aimed to quantify the amount of apical root resorption in molar region caused by bite turbos using orthopantomograms (OPGs).

The study involved 30 OPGs pertaining to orthodontic patients, each before and after orthodontic therapy. The study group involved patients for whom bite turbos were placed in the mandibular molar region for a minimum of 4 months during treatment. The control group involved the OPGs of patients without the use of bite turbos. The molar root and crown lengths were assessed using modified Lind approach. Root crown ratio was measured for each molar, and the relative root crown (rRCR) ratio was determined.

The placement of biting turbos on the mandibular molars resulted in a decline in rRCR, which suggested a decrease in the root length. The ratios for the study and control groups differed significantly (p=0.014). Additionally, significant variations were detected between the study groups' pre and post ratios based on statistical analysis (p=0.00 ).

C Bite turbos can be considered as a factor that could cause root resorption if used for a prolonged period during orthodontic therapy.
Acceptance or rejection of the COVID-19 Vaccine: A cross-sectional study among Orthodontists
Authors: Minervini Giuseppe , Kadhom Zainab Mousa , Faleh Albo Hassan Alaa , Ali Abdul Ameer Suha , Nahidh Mohammed , Maddalena Marrapodi Maria , Cicciù Marco
Published: February 2025

Close contact with the infected patient is one reason for the spread of infection. COVID-19 can easily infect orthodontists; it may be found in saliva droplets during the removal or insertion of the orthodontic fixed appliance components or even during the removal of the removable appliance.

This study aims to assess the acceptance or rejection of the COVID-19 vaccine among Iraqi orthodontists.

A web-based cross-sectional survey among orthodontists in Iraq was conducted. Thirteen pre-structured questions were sent in a Google Form via their WhatsApp and Telegram groups.

There were 123 orthodontists participating in this survey. The majority of the participants (96.75%) were aware of COVID-19, and 62.60% suggested that coronavirus poses a significant risk. Orthodontists who took the vaccine accounted for 93.50%; among them, those who preferred the Pfizer vaccine accounted for 57.39%. The side effects associated with the vaccine were the leading reasons for vaccine refusal.

Although there is a high level of awareness about COVID-19 viruses among orthodontists, some abstained from the vaccine because of fear. The acceptance of COVID-19 vaccines and the number of participants who got the vaccine were high to achieve precise infection control in orthodontic clinics and decrease viral infection spread.
Assessment of cortical plate thickness and bone density of mandibular symphyseal region in subjects having skeletal Class III malocclusion with different facial types – A CBCT study
Authors: Churiwal Devanshi , Bhagchandani Jitendra , Vashishta Vaibhav , Singh Ayushi , Raj Stuti , Rastogi Tushant
Published: February 2025

The study used CBCT to analyze mandibular symphyseal bone thickness and density in Skeletal Class III subjects with different vertical facial patterns. It found higher cortical bone thickness in Normodivergent and higher bone density in Hypodivergent subjects, emphasizing the importance of careful orthodontic treatment to avoid complications related to reduced bone density and cortical thickness.

CBCT images of 30 skeletal Class III subjects were evaluated. Class III subjects were divided by mandibular plane angle: Hyperdivergent (SN–MP > 34o), Normodivergent (SN–MP – 32o), and Hypodivergent (SN–MP < 30o) groups. Buccolingual cortical bone thickness and bone density was measured using CBCT images of mandibular incisors at alveolar crest and 3, 6 and 9 mm apical levels. Shapiro Wilk test, Bonferroni post-hoc test, and Pearson correlation analysis were used for statistical significance.

The mean cortical bone thickness of the mandibular symphyseal region was highest in Normodivergent subjects (Group I) and lowest in Hyperdivergent subjects (Group III). Group II subjects with a Hypodivergent growth pattern had the highest mean bone density, with the lowest reported in Normodivergent subjects on the labial side and Hyperdivergent subjects on the lingual side. However, differences in bone density among groups were statistically insignificant.

Careful orthodontic treatment in Skeletal Class III malocclusion, especially with Hyper-divergent facial types, is crucial to prevent root issues due to reduced bone density. Bracket adjustments are essential for optimal outcomes by ensuring proper root placement within cancellous bone.
Comparison of linear dimensional changes of mandibular symphyseal morphology in patients of various age groups with different growth patterns - A retrospective CBCT study
Authors: Pandian Srirengalakshmi Muthuswamy , Setvaji Nisshitha Rao
Published: February 2025

Mandibular symphyseal morphology is a significant aspect in orthodontic treatment planning. The current research aimed at comparing the linear dimensional variations of the mandibular symphysis seen in various age groups with different growth patterns using CBCT.

Ninety CBCTs were segregated into three groups based on their growth patterns as horizontal (HGP), average (AGP), and vertical (VGP). Each group was additionally categorised into age-based subgroups such as Pre-adolescent (<13 years), Adolescent (13-20 years), and Adult (>20 years). The symphyseal height and widths were measured along the midline and the lateral aspects. One-way analysis of variance (ANOVA) and the Bonferroni post hoc test were employed. The right and left sides were differentiated by applying the Independent-t test. Kendall Tau’s b correlation tests were performed to determine the relation between the measured parameters and age as well as the parameters with the growth patterns.

In the pre-adolescent age group, a significant increase in symphyseal height and upper width was seen along the midline (P < 0.05). In the adolescent age, a significant difference was observed in the height and upper width on the lateral aspects (P < 0.05). In the adult age group, a significant increase in the lower width along the midline and lateral aspects was seen (P < 0.05). Patients with HGP showed increased width whereas VGP showed increased height in all age groups.

The quantitative dimensions of the symphysis varied with increasing age in different growth patterns which is essential for preoperative surgical planning.
A Comparative evaluation of the Shear bond strength of brackets bonded to pre-treated demineralised enamel treated with two different remineralising agents – An In-vitro study
Authors: Revathi P. , Shaik Shafeen Naqheeb , Mallavarapu Kalyani , Lanka Devikanth , Dokku Aruna , Pichai Saravanan
Published: February 2025

Remineralising agents are suggested on sound enamel and on demineralised enamel during fixed appliance therapy as they increase the risk of enamel demineralization; but their influence on bond strength is questionable. Toothmin has been recently introduced and showed promising results in preventing demineralization and promoting remineralization similar to CPP-ACP.Therefore, the rationale of doing this study is to evaluate Toothmin efficacy on shear bond strength (SBS) of pre-treated demineralized enamel.

To measure the SBS of brackets bonded to pretreated demineralised enamel treated with Toothmin and CPP-ACP.

Settings and Design: Teeth were divided into four groups prior to bonding. Group I with No enamel pre-treatment, Group II, demineralized enamel, Group III, CPP-ACP was applied on demineralized enamel whereas in Group IV, Tooth min was applied on demineralised enamel.

Intact enamel group, demineralised group and remineralised groups were evaluated for SBS and (Adhesive Remnant Index ) ARI scores.

Statistical analysis: Data were analyzed using IBM SPSS version 20 software and subjedted to one way analysis of variance with Tukey’s post hoc tests.

 Toothmin group had highest mean SBS (10.37±3.08) followed by CPP-ACP (9.6±2.43), control (8.67±2.31), and the demineralization (2.42±1.21) groups. Highest mean ARI scores were observed in Toothmin group (2.33±0.48) and the least in the demineralization group (0.4±0.507).Demineralization of enamel significantly reduces the SBS of orthodontic brackets. Remineralization of enamel with Toothmin or CPP-ACP after demineralisation improved bond strength. Highest mean ARI scores were observed in Toothmin group and lowest in demineralized group.
Perceptions of patients regarding the cost of orthodontic treatment: Questionnaire based study
Authors: Chugh Tina , Ahluwalia Rajiv , Mathew Mary , Mailk Robin , Katara Pradhumn
Published: February 2025

Ensuring affordable orthodontic treatment is essential for promoting equitable access to dental care, emphasizing the significance of justice in addressing socio-economic disparities and fostering equal opportunities for individuals seeking orthodontic interventions. This study aims to investigate the perceptions of patients regarding the cost of orthodontic treatment and the factors influencing their views on affordability.

A semi-structured questionnaire was distributed to 116 participants undergoing orthodontic treatment to gather data on demographic information, personal experiences with orthodontic treatment, and attitudes toward the perceived cost of such treatment. The questionnaire was developed with input from orthodontic professionals and validated through pilot testing. Descriptive statistics including frequencies and percentages were calculated for all quantitative and categorical variables. Bivariate inferential analyses using chi-square tests were conducted to assess associations between categorical variables. Statistical significance was determined using a p-value cut-off of 0.05. P-values below 0.05 were considered statistically significant.

The study showed that 96% of the participants were satisfied with the treatment. 94.0% felt that the treatment cost was justified by the duration of the treatment and the type of appliance. However, 49.1% of participants still felt the need for cost reduction. Patients with higher monthly income felt less need for cost reduction (p value < 0.001). There was an association between monthly income and the payment plan (p - 0.045), and between education and treatment satisfaction. (p-value = 0.018)

This questionnaire-based study sheds light on the diverse perceptions surrounding the cost of orthodontic treatment. Understanding these perspectives is crucial for healthcare professionals, policymakers, and stakeholders to develop strategies that enhance accessibility and affordability while addressing the broader implications of orthodontic care on individuals' well-being.
3D printed simplified guide design for Infra-zygomatic screws
Authors: Prabha Rahul D , Madhu Sandhra T , Ajith V V
Published: February 2025

Placement of infra-zygomatic crest screw (IZC) in patients with missing posterior teeth or low set sinus floor often presents as a clinical challenge. The ideal position of the bone screw was identified and pre-planned using CBCT images. The critical factors in placement position like the available bone thickness, proximity of sinus floor and adjacent root structures were evaluated. The 3D printed guide was designed for the precise insertion of the bone screw. A detailed protocol for designing and printing the implant guide along with additional features for accuracy of placement has been elaborated in this article.
Stressors, religiosity, and job performance: The lenses of conservation of resource theory and attachment theory
Authors: Lina Lina
Published: February 2025

This research aims to examine the influence of challenge stressors on job performance and to empirically prove intrinsic and extrinsic religiosity as a moderating variable in the influence of challenge stressors on job performance. Data was collected using a questionnaire survey method. One hundred fifty-three respondents from various organizations in Indonesia participated in this study. Data analysis uses variance-based structural equation modeling. This study successfully proves a new moderator, extrinsic religiosity in the relationship between challenge stressors and job performance. This finding is grounded in attachment theory particularly the anxious attachment style. The study supports the following hypotheses: Challenging stressors improve work performance and external religiosity increases this impact whereas intrinsic religiosity decreases it. The study’s result can help company management to understand the impact of challenge stressors on job performance. In addition, management can also understand the important role of intrinsic and extrinsic religiosity in this relationship.
Trust and satisfaction towards loyalty business mediated with relationship quality with a turbulent environment in East Java sugar cane farmers B2B sector
Authors: Utami Budi , Sudarmiatin  , Mukhlis Imam , Rahayu Wening Patmi
Published: February 2025

This paper discusses the effects of trustworthiness, business loyalty (BL), perseverance, and relationship quality (RQ) on environmental volatility (ET). Assessment of a Likert-scale survey questionnaire was conducted to analyze the average value for each item, indicator, and variable in a descriptive manner. Data collection was done via a manual sample survey. Analyzed data using Structural Equation Modeling (SEM) on Smart PLS (partial least squares) 3.0. The study's findings indicate that while it has both a short- and long-term impact on loyalist business operations, it has a greater impact on long-term business operations with high-quality connections and short-term business operations with a fluctuating environment. The research findings demonstrate a direct correlation between trustworthiness and the quality of business-to-business and loyalty relationships. This is a result of the sugarcane farmer's relatively low level of trustworthiness when it comes to consistently reporting the results to the sugar plant; this is caused by the relatively low quality of the partnership.
Enhancing pre-service teachers' well-being during long-term internships: The roles of self-efficacy, mentoring, and task-related sense of coherence
Authors: Homann Hanna-Sophie , Beckmann Timo , Ehmke Timo
Published: February 2025

This study investigates the protective influence of different resources on the occupational well-being of pre-service teachers during their long-term internship. This research grounded in the theoretical framework of the JD-R model seeks to comprehend how internal resources such as self-efficacy and task-related sense of coherence (SoC) in pre-service teachers along with external resources such as different mentoring styles can foster engagement and mitigate emotional exhaustion. This study introduces the task-related SoC as a novel internal resource in the context of long-term internships to determine its value alongside other resources. The study used a sample of 213 pre-service teachers who answered self-questionnaires at the beginning and end of their four-month-long internship. Structural equation modeling explored the relationships between self-efficacy beliefs, task-related SoC, mentoring approaches, engagement and emotional exhaustion. Results indicate that self-efficacy and task-related SoC significantly predict pre-service teachers’ occupational well-being. Among mentoring approaches, emotional mentoring emerged as the most influential in fostering well-being. The findings confirm the health-promoting effects of self-efficacy and emotional mentoring.  This is the first study to apply the general construct of a sense of coherence to the specific context of a long-term internship. It demonstrates that strengthening pre-service teachers’ SoC about particular tasks can be an additional resource for mental health promotion during this period. The results suggest that supporting pre-service teachers in perceiving their internship activities as comprehensible, meaningful and manageable can be beneficial and should be externally promoted by the university.
The determinants of perceived risk: A moderating role of investor sophistication
Authors: Colline Fredella , Rusmanto Toto , Warganegara Dezie Leonarda , Hutagaol Yanthi R I
Published: February 2025

This study investigates the factors affecting perceived risk and the moderating effects of investor sophistication. Young investors are known to possess low financial literacy, exhibit herding behavior, and rely heavily on social media for information. A cross-sectional method was used to collect data through online questionnaires developed with Google Forms. At the same time, partial least squares structural equation modeling was adopted for data analysis using SmartPLS version 4. Purposive sampling was applied using a sample size of 344 young Indonesian investors aged 30 years and below with one year of experience in stock investing. Herding behavior and investor sophistication were adopted as mediating and moderating variables, respectively. The results show that social media influence significantly affects the perceived risk and herding behavior of young investors. Additionally, social media has an indirect impact on perceived risk through herding behavior. In this context, investor sophistication is a critical moderating factor amplifying the effects of social media and herding on perceived risk. This study contributes to prospect theory, behavioral finance, and social influence theory.
Developing an active learning model using problem-based learning to enhance the 21st century skills
Authors: Klaharn Rungrudee , Chaleoykitti Saisamorn , Chakchaichon Chukiat
Published: February 2025

This research aimed to develop and implement the Problem-Based Learning (PBL) model for 21st-century skills and evaluate the outcomes. The model went through three phases of research and development and was conducted with two groups of 55 third-year students selected using a clustered random sampling method. The research instruments used included a structured interview form, the PBL model, the 21st-century skill scales, and the satisfaction questionnaire. The instruments had quality and were assessed with the content validity and reliability. The data analysis involved the use of descriptive statistics, dependent t-tests, and content analysis. The results showed that the PBL model developed consisted of four components and was highly appropriate. Process of the PBL instruction included six steps: problem statement, problem analysis, research, synthesis, summary and evaluation, and presentation and discussion; students’ critical thinking skills, collaboration, teamwork, and leadership skills significantly improved after the implementation of the model, and students expressed high satisfaction. This model can help foster learners to achieve and should also be used with other groups.
External audit importance toward efficiency of public funds and the economic growth-a study case of Kosovo
Authors: Hashani Medain , Bajrami Roberta , Ziberi Besime
Published: February 2025

The purpose of this study is to shed light on the importance of the external audit towards the efficiency of public funds and to estimate further the impact of related macroeconomic determinants such as government expenditures, government debt to GDP, government revenue, and fiscal expenditure in economic growth in the case of Kosovo. The study employs a quantitative research method utilizing secondary data from 2012-2021 sourced from World Bank indicators. The econometric models employed in this study are the OLS and VAR models. The study finds that a point increase in public debt will decrease the GDP growth in the case of Kosovo. The empirical findings suggest further that an increase in government spending leads to a rise in GDP growth, whereas government revenues and fiscal expenditures are statistically not significant in the study circumstances. Budgetary expenditure is negatively signed, indicating that an increase in fiscal expenditure leads to a decrease in GDP growth, and it is statistically not significant. The study concludes that external audits play a crucial role in the efficiency of public funds and sheds light on macroeconomic determinants related to external audits that have an impact on economic growth in the case of Kosovo.
Effect of intercropping on growth and yield of okra (Abelmoschus esculentus L.) with leafy vegetables
Authors: Shishir Sharoar Jahan , Rahman Md Masudur , Moonmoon Sharifunnessa
Published: February 2025

A study was carried out to assess the impact of intercropping on growth, yield and yield attributes of Okra with leafy vegetables. Okra was used as the main crop; Indian spinach (Basella alba) (T2), Stem amaranth (Amaranthus viridis) (T3) and Coriander (Coriandrum sativum) (T4) were used as intercrops and were planted in between Okra rows in separate plots. Morphological growth data were recorded during 15, 30, 45, 60, 75, 90 and 105 days after sowing (DAS). Significant effect was found at different intercropping systems on the growth, yield and yield attributes compared with sole cropping (Okra). Plant height (cm), plant diameter (cm), no. of leaves plant-1, petiole length (cm), leaf length (cm), fruit length (cm), fruit diameter (cm), fresh weight of fruit (g), dry weight of fruit (g) and total weight (g) of okra were negatively affected by the intercropping at an early stage with Stem amaranth. Stem amaranth affected adversely the yield and yield attributes of Okra. Intercropping with Coriander as well as Indian spinach at the early stage of Okra plant growth does not reduce the yield significantly, thus Coriander and Indian spinach may be intercropped in the Okra field for increasing yield and economic benefits.
An online intervention relationship enhancement couple therapy program versus systematic desensitization on sexual performance anxiety in women undergoing infertility treatment with timed intercourse: An RCT
Authors: Afzal Dehkordi Maryam , Farajkhoda Tahmineh , Khanabadi Mahdi , Shamsi Farimah
Published: February 2025

Background: Sexual performance anxiety is common among infertility treatments. Psychological interventions are options for couples who do not tolerate psychiatric medications or like psychotherapy with pharmacotherapy.
Objective: This study aimed to compare the effectiveness of relationship enhancement couple therapy program (RECT) vs. systematic desensitization (SD) on sexual anxiety.
Materials and Methods: A parallel randomized clinical trial was conducted on 68 women with infertility in Shahrekord, Iran, in January 2022. They were randomly allocated to 8 weekly online interventions RECT or SD (control). The main outcome variable, sexual performance anxiety, was assessed via Davis’s questionnaire at baseline, completion of the intervention (week 8), and follow-up (week 12). The secondary outcome variable spouse’s satisfaction was assessed (weeks 8 and 12, via visual analog scale). Data from 29 women were analyzed in each group.
Results: Intra-group comparison RECT and SD showed a significant decrease of sexual anxiety baseline compared to week 12 (p = 0.001, 0.001 for RECT and SD, respectively). No significant difference was observed between the 2 groups in baseline compared to week 12 (RECT vs. SD, p = 0.149). Time-group interaction of spouse’s satisfaction showed a significant difference between RECT and SD (p = 0.010).
Conclusion: Both RECT and SD were almost equally effective in decreasing sexual anxiety. RECT (couple relationship-centered) by empowering 10 interpersonal skills, and SD (personal-oriented) by learning step-by-step how fight-or-flight response is replaced by relaxation response, helping women perform more adaptive behaviors regarding sexual anxiety. RECT increased spouse satisfaction significantly compared to SD, indicating that males need to participate in positive relationship changes. The results may be applied by therapists and health policymakers.
The effect of dienogest and gonadotropin-releasing hormone agonist on pelvic pain after laparoscopic surgery for endometriosis: An RCT
Authors: Davari Tanha Fatemeh , Rasti Azam , Pakniat Hamideh , Salimi Setudeh Shohreh
Published: February 2025

Background: Endometriosis is a chronic inflammatory condition associated with debilitating chronic pelvic pain that affects women’s quality of life. Several drugs have been used to reduce pain and psychological distress associated with this disease. Currently, gonadotropin-releasing hormone (GnRH) agonists and dienogest are the most widely used medical therapies for endometriosis.Objective: This study aimed to investigate the efficacy of dienogest and GnRH agonists in improving pelvic pain after laparoscopic surgery for endometriosis.Materials and Methods: In this randomized clinical trial study, 104 women with endometriosis who were referred to the Department of Reproductive Medicine of Yas hospital, Tehran, Iran, between April 2022 and March 2023 were studied. After laparoscopic surgery, individuals were randomly assigned into 2 groups (n = 52/each): the dienogest-administered group and the GnRH agonist-administered group. Participants were followed up at 3 months and pelvic pain was measured using the visual analog scale. Pelvic pain and adverse effects of drugs were compared between the groups.Results: Pelvic pain significantly improved in both treatment groups (p < 0.0001). No significant difference was observed in hot flashes and joint pain between the dienogest and GnRH agonist groups. However, a significant difference was found in vaginal dryness (p = 0.03) and decreased libido (p = 0.02). GnRH agonists and dienogest reduced irregular vaginal bleeding.Conclusion: Our results suggested that the effect of GnRH agonists and dienogest in improving pelvic pain for endometriosis is the same after a 3-month treatment period. However, these 2 drugs caused different adverse effects.
Influences of the Work Environment on Nurses’ Psychological Wellbeing at Selected Teaching Hospitals in Lusaka, Zambia: A Focus on Secondary Traumatic Stress and Burnout
Authors: Kanyanta Michael Mumba , Kabinga-Makukula Marjorie , Wahila Ruth
Published: February 2025

Introduction: The current study sought to establish associations of the nurse work environment, with Secondary Traumatic Stress and Burnout among nurses at selected Teaching Hospitals in Lusaka, Zambia.
Methods: A correlational study was conducted at three Teaching Hospitals in Lusaka, Zambia using a stratified sample of 250 nurses. Spearman rank order correlations and hierarchical linear regression were employed to determine correlations among variables at 95% confidence level and 0.05 level of significance.
Results:  Secondary Traumatic Stress was positively correlated with levels of nursing workload (rs = .18, p<.004) and level of stress reported between respondents and their supervisors (rs = .20, p = .001). Taken together, quality of the respondent’s relationship with the supervisor and the reported level of nursing workload explained 23.7% of the variance in Secondary Traumatic Stress [F (5, 244) = 4.793, p < 0.001, R2 = 0.237]. Reported quality of relationship with the supervisor and reported level of nursing workload also explained 12.1% of the variance in Burnout [F (5, 244) = 6.748, p < 0.001, R2 = 0.121].
Conclusion: Findings of this study suggest a need to develop measures that can enhance good relationships between nurses and their supervisors, reduce nursing workloads and regulate frequency of exposure to severe patient suffering.
Deep Learning Techniques for Enhancing Data Reliability and Failure Mitigation in Large-Scale Cloud Infrastructures
Authors: Pentyala Dillep kumar
Published: February 2025

Ensuring data reliability and mitigating failures are critical challenges in large-scale cloud infrastructures, given their complexity, dynamic nature, and the increasing demand for real-time data processing. Traditional approaches often struggle with scalability, adaptability, and predictive accuracy, necessitating innovative solutions. Deep learning, with its ability to model complex patterns and predict outcomes, has emerged as a transformative tool for addressing these challenges.
This article explores the application of deep learning techniques to enhance data reliability and failure mitigation in large-scale cloud systems. It examines methods such as anomaly detection using auto-encoders and convolutional neural networks (CNNs), predictive maintenance through recurrent neural networks (RNNs) and long short-term memory (LSTM) models, and fault localization enabled by deep reinforcement learning. Additionally, intelligent resource allocation, adaptive scaling, and data recovery processes are highlighted as critical areas where deep learning delivers significant advancements.
Through real-world case studies and experimental evaluations, the research demonstrates the superiority of deep learning approaches over traditional methods in terms of accuracy, scalability, and efficiency. While the findings underscore deep learning's potential, the discussion also addresses limitations, ethical considerations, and integration challenges. This study not only establishes a framework for leveraging deep learning in cloud reliability and resilience but also outlines future directions for research, emphasizing model interpret-ability, federated learning, and sustainable AI practices.