bluuebunny/crossref_metadata_2025 huggingface dataset:
Test Item Analysis: A Catalyst for Quality Assurance of Assessment in Outcome-Based Education
Authors:   Department of Electronics and Telecommunication Engineering, Rajarambapu Institute of Technology, Shivaji University, Sakharale, MS-415414, India., Pujari Arati A. , Sawashe Ketaki S. ,   Department of Electronics and Telecommunication Engineering, Rajarambapu Institute of Technology, Shivaji University, Sakharale, MS-415414, India., Watharkar Snehal R. ,   Department of Electronics and Telecommunication Engineering, Rajarambapu Institute of Technology, Shivaji University, Sakharale, MS-415414, India., Nishandar Siddhanath V. ,   Department of Mechanical Engineering, Annasaheb Dange College of Engineering and Technology, Shivaji University, Ashta, MS-416301, India
Published: April 2024

Due to the evolving demands of the educational system, where a greater focus is placed on learning outcomes for students rather than merely degrees, outcome-based education (OBE) has grown in favor. An OBE system involves a clear picture of what is important for students to be able to do, organizing the curriculum, instruction and assessment to make sure this learning ultimately happens. Assessment and evolution is one of the important steps in Outcome based education. Purpose of the assessment and evolution is to final the lacuna and loopholes of teaching learning process and intended outcome that are finalized for particular course. Test item analysis is one of the prime components of assessment, which is the process of statistically analyzing student responses to individual exam questions. Facilitation value, discriminative index, and effectiveness of the distraction are the components of test item analysis. Item analysis helps in analyzing the difficulty level of items; whether the items are challenging, easy, comparatively difficult, or relatively easy, to discriminate amongst pupils who have different performance levels and identifies the effectiveness of the distractions in the multiple choice items. Keywords—Item Analysis, Facilitation value, Discrimination Index, Effectiveness of the Distractors’
Fostering Student Engagement and Success in STEM Education: An AI-Driven Exploration of High Impact Practices from Cross-Disciplinary General Education Courses
Authors:   University of Wisconsin-Parkside, Wisconsin, USA, Ramasamy Vijayalakshmi , Singsen Doug ,   University of Wisconsin-Parkside, Wisconsin, USA, Walia Gursimran S. ,   Augusta University, Georgia, USA
Published: April 2024

Due to the increase in data and software tools, the need for programmers and data analysts has risen in the United States during the 21st century. As a result, more students are enrolling in Computer Science, Information Technology, and Data Science programs nationwide. However, switching to online and blended learning and using cyberlearning tools have presented new challenges for student learning, retention, and program success. One way to overcome these challenges and improve student achievement is to implement evidence-based pedagogical strategies and innovative technologies within clear theoretical frameworks. Recent studies have shown that various Learning Engagement Strategies (LESs) in STEM education, such as gamification, active learning, feedback and assessment, and interactive multimedia, significantly increase student engagement and course completion rates. High-Impact Practices (HIPs), identified as crucial by Kuh in 2008, have become powerful tools for enhancing student involvement, retention, and completion in higher education. This article explores practices that can enhance student learning and success that have many benefits, including more robust relationships between students and faculty, cooperative learning, quick feedback, inclusive environments, and conflict resolution. The study uses NLP-based text analytics to investigate the application and impact of these High-Impact Practices (HIPs) across different disciplines. Firstly, it identifies the most prevalent HIPs in various General Education (Gen Ed) disciplines that impact student success. Secondly, it formulates AIdriven recommendations for cultivating a student-centric learning environment through HIPs within STEM education. The results of empirical analyses using course materials, survey data, syllabi, and pre/post-workshop surveys sourced from around 65 Gen Ed course at a small public university provides valuable insights into successful HIPs for STEM courses that can help instructors improve their online and blended course designs. By implementing these practices, educators can increase student engagement, retention, and completion rates across diverse student populations in Gen Ed STEM courses. Keywords— High-Impact Practices; General Education, STEM education; Natural Language Processing.
AI-Enhanced Personalized Learning Practices in Higher Engineering Institutes
Authors:   Asso.Prof., Dept. of EEE, Kalasalingam Academy of Research and Education, Krishnankoil, Tamil Nadu, India, Rajesh K. , Sivapragasam C. ,   Sr.Prof.,Dept. of Civil, Kalasalingam Academy of Research and Education, Krishnankoil, Tamil Nadu, India, Dargar Shashi Kant ,   Asso.Prof., Dept. of ECE, Kalasalingam Academy of Research and Education, Krishnankoil, Tamil Nadu, India
Published: April 2024

The main task of engaging the students with an interesting classroom environment is challenging in nature. The better way of teaching the students with effective learning pedagogy seems to be more effective. In this technological era, every student requires some technological involvement in their day-to-day process. So, with a broadcasted mindset, an active learning pedagogy has been initialized in this manuscript which gives more and more active methods of learning especially for engineering students. This research mainly focuses on a widely available learning process that is more effective in context with an easy understanding of the concepts. The AI – Enhanced Personalized learning methodology has been utilized in this manuscript. A deep understanding of the concept lies in the visual representation of the concept. In context to this, the simulation-based active learning pedagogy has been implemented for the Electrical Engineering graduates of the third year. The pedagogy related cource outcome (CO) has been framed. The effectiveness of the implemented method has been evaluated with various feedback responses and their scores in the end-semester with and without AI methodology help to view the performance metrics of the implemented AI – based learning learning pedagogy. Surely, this method yields good results in the performance of every student. Keywords – Active learning methodology, Teaching pedagogy, AI-based learning methodology, Program Outcome, Renewable energy sources.
Physical Education and Sports for enhancing professional life of engineering students – An initiative towards implementing National Education Policy in Engineering Education
Authors:   Department of Physical Education, Anurag University, Hyderabad, Telangana- 500088, India, Thakur Tara Singh , Srivastava Divya ,   Department of Physical Education, Anurag University, Hyderabad, Telangana- 500088, India, Chanda Mahesh ,   Department of Physical Education, Anurag University, Hyderabad, Telangana- 500088, India
Published: April 2024

Engineers today need not only intellectual abilities but also physical fitness and proper health which is defined by World Health Organization as the combination of Physical, Mental and Social Wellbeing. In this connection, we made an initiative of introducing Sports and Games as a mandatory course for students. The students of 3rd B.Tech have undergone the course for duration of 3 months and the outcomes of the course were assessed through a customized questionnaire which also accepted suggestions from the students for students pursuing engineering education. The experiment revealed fruitful outcomes in the form of benefits which the students gained by active participation in theory and practical classes. Qualities such as motivation, leadership, concentration, teamwork, relaxation, stress management etc. were found to be developed among the students and the students have expressed the support gained for their professional growth through this course. The academics of students were also taken into consideration which explained that the academics were nowhere disturbed due to participation in physical education and sports activities. Key Words: Life skills, Virtues, extra-curricular, cocurricular.
Nurturing future Engineers through Industry- Oriented Training: The imperative of Core Competencies
Authors:   Department of Electronics and Communication, St Joseph Engineering College, Mangaluru, Karnataka, India, Toney Glenson , . Roopesh ,   Department of Business administration, St Joseph Engineering College, Mangaluru, Karnataka, India, Bhat Sathyendra ,   Department of Computer Applications, St Joseph Engineering College, Mangaluru, Karnataka, India, Kaliveer Vinoothan ,   Department of Mechanical Engineering, St Joseph Engineering College, Mangaluru, Karnataka, India, K G Binu ,   Department of Mechanical Engineering, St Joseph Engineering College, Mangaluru, Karnataka, India, D’Silva Rolvin ,   Department of Mechanical Engineering, St Joseph Engineering College, Mangaluru, Karnataka, India, K Yathish Kumar ,   Department of Mechanical Engineering, St Joseph Engineering College, Mangaluru, Karnataka, India, Shetty Ashwin ,   Department of Mechanical Engineering, St Joseph Engineering College, Mangaluru, Karnataka, India, Singh Athokpam Bikramjit ,   Department of Computer Applications, St Joseph Engineering College, Mangaluru, Karnataka, India
Published: April 2024

This research paper investigates the transformative effects of Industry-Oriented Training (IOT) at St Joseph Engineering College both on engineering and management graduates. The IOT course under evaluation emphasizes five essential skill sets: communication, self-evaluation, leadership, team building, and problem-solving. The study analyzes the impact of this comprehensive training endeavor on students' academic performance, employment, and career paths. The findings demonstrate the tangible benefits of the well-planned and structured IOT curriculum. The program's participants graduate with the critical problem-solving abilities essential for success in challenging work environments. The investigation extends beyond traditional academic metrics to demonstrate the substantial impact of IOT on professional and personal development. This study emphasizes the critical significance of effective communication, the potency of self-evaluation in fostering adaptability, the transformative potential of leadership skills, the value of teamwork in achieving common goals, and the critical significance of problem-solving prowess in addressing contemporary challenges. This study indicates how industryoriented training acts as a catalyst for holistic growth, enabling students to not only meet but also exceed the expectations of the engineering and management landscape's constantly evolving expectations. For educators, organizations, and corporations committed to fostering the next generation of dynamic and competent professionals, the paper offers insights that will be invaluable. Keywords—Communication, Industry Oriented Training, Leadership, Problem-Solving Skills, Self-Evaluation, Teamwork.
Awareness of Divyanga Seva Kendra among physically impaired in Hubli-Dharwad region
Authors:   Student KLE Technological University, Hubballi., Salunke Reacha , Goudar Nikhil ,   Student KLE Technological University, Hubballi., Kurbet Ramesh ,   Assistant Professor, CEER, KLE Technological University, Hubballi., Goggal Praveen V ,   Assistant Professor, CEER, KLE Technological University, Hubballi., Ghokhale Dr. Sunil ,   Department of Physiology, KIMS, Hubballi.
Published: April 2024

The current research outlines the social challenge of raising mindfulness about Divyanga Seva Kendra (DSK), a platform that offers benefits and support services to impaired individuals, aiming to ameliorate their quality of life and independence. For our social challenge, our team visited Divyanga seva Kendra (DSK). Team got information on Divyanga seva Kendra (DSK), it was lately organized and is particularly for impaired people, but numerous people aren't apprehensive of this. The point of view (POV) statement emphasizes the significance of creating mindfulness about Divyanga Seva Kendra to ease access to information and reduce burdens faced by impaired individuals. The lack of sanctioned recognition frequently hinders them from serving specific benefits and lodgments designed for their requirements. The prototype developed to address this challenge is a 3-minute and 10-second animated videotape teaser. The videotape incorporates a content strategy fastening on the simplicity of language and limpidness, icing availability for all observers. Its responsive design aims to engage the target followership effectively. The videotape aims to make people apprehensive of the instructions handed by Divyanga Seva Kendra, enabling them to save time. The abstract highlights the successful dispersion of the prototype through hospitals and social media, garnering positive responses and feedback. In simple terms, the prototype is designed to help people with disabilities feel included and have access to things easily. It also wants to make society more aware and understanding of these individuals. By telling people about Divyanga Seva Kendra which makes disabled people feel better overall. By learning the Design Thinking for Social Innovation course, we empathetically connected to a society who were facing lot many problems, We identified a solution through a process and developed a prototype which was tested in the community itself and the results were greatly appreciated and we understood the teamwork and the empathy clearly through the Design Thinking for Social Innovation course. Keywords—Disability awareness campaigns, Disability organizations, physically impaired individuals, Healthcare for the disabled, Disability awareness surveys.
The role of mediastinoscopy in the diagnosis of thoracic disease: 107-case analysis
Authors: Oğuz Kapicibaşi Hasan
Published: April 2024

Aim
 To evaluate the efficacy, safety and feasibility of mediastinoscopy in 107 cases with mediastinal lesions that could not be diagnosed histopathologically with other methods.
Methods
 A total of 107 cases (73 males, 34 females; mean age 57.4, range 30-88 years) with mediastinal lymphadenopathy, who underwent mediastinoscopy between 12 September 2012 and 29 November 2018 were examined retrospectively. The cases were evaluated in terms of age, gender, complaint, operation time, histopathological diagnosis, postoperative morbidity and mortality parameters.
Results
 Upon histopathological examination 32 (30%) patients were diagnosed with lung cancer metastasis (N2 stage), which was the most common diagnosis. With this diagnosis unnecessary thoracotomy was prevented. In patients with pathological lymphadenopathy found by imaging histopathological results were examined to evaluate the presence of N2 stage. In 25 (23.5%) cases biopsy results were reported as reactive lymph nodes. In addition, 23 (21.4%) patients had sarcoidosis, 16 (15%) had tuberculosis lymphadenitis, seven (6.5%) had lymphoma, one of each (0.9%) had benign epithelial cyst (0.9%), malign epithelial tumour (invasive ductal carcinoma of breast), chronic lymphocytic leukaemia (CLL), and adenocarcinoma metastasis (renal cell cancer).
Conclusion
 When other non-invasive procedures are ineffective, mediastinoscopy is an efficient diagnostic method with high diagnostic value, which is applicable also in places other than advanced centres, with low morbidity and mortality.
Changes in bone density measured by ultrasound of calcaneus in sedentary workers
Authors: Bišćević-Tokić Jasmina , Brekalo-Lazarević Sanja , Tokić Nedim , Bećirović Sabina , Sarajlić Spahić Selvedina
Published: April 2024

Aim
 To determine a degree of change in the bones of workers who spend their full time job in sitting position and to find a correlation between smoking and changes in bone structure.
Methods
Examinees were 213 female workers who worked full time sedentary work in front of computer. Each worker was subjected to physical examination and ultrasonic osteodensitometry of calcaneus.
Results
 The average age of patients was 45.4 years. Changes in bone density were found in 110 (51.64%) workers. Correlation between smoker and non-smoker groups was positive, but "r" was higher in smokers than in non-smokers. It is worrying that 10 out of 22 persons in the group up to 30 years of age have osteopenia.
Conclusion
 Recommendation for regular annual control of bone density of the working group at risk regardless of age should be followed. Prescribing exercise for the working group at risk should be a significant part of preventive work in clinics of occupational medicine and sports.
Cardiovascular remodelling in patients with pre-dialysis chronic kidney disease and renal transplant recipients
Authors: Temimović Ramajana , Rašić Senija , Džubur Alen
Published: April 2024

Aim
To evaluate the relationship between cardiovascular remodelling and glomerular filtration rate (eGFR) in pre-dialysis chronic kidney disease (CKD) patients without cardiovascular diseases (CVD) and in renal transplant recipients (RTR).
Methods
 The cross-sectional study included 83 patients with eGFR<60 mL/min/1.73m 2 (45 with CKD 3 stage and 38 with CKD 4 stage). Thirty six RTR had eGFR 67.8 (57.3-73.7) mL/ min/1.73m 2 and control group consisted of 44 patients with eGFR>60 mL/min/1.73m 2. All patients were evaluated by echocardiography and X-ray.
Results
 Left ventricular hypertrophy (LVH) was present in 74.7% CKD patients, most frequently in CKD 4 stage and in RTR. Calcifications of abdominal aorta (CAA) were present in 87% CKD 4, 60% RTR and in 44% CKD 3 patients. Calcifications of the mitral valve were found in 34.2% CKD 4, 25.0% RTR and in 6.7% CKD 3 stage patients. Aortic valve calcifications were most frequently present in CKD 4 stage (26.3%). The LV mass index negatively correlated with eGFR (p<0.001), and positively with parathyroid hormone (p<0.001), phosphorus (p=0.043), age (p<0.001) and diabetes (p=0.043). In multivariate regression analysis the risk factor for calcifications of the mitral and aortic valve, as well as for CAA was the decline in eGFR (p<0.001).
Conclusion
 Renal transplant recipients have a higher incidence of CV remodelling than patients with CKD 3 and less than patients with CKD 4 stage, indicating incomplete regression of CV calcifications and LVH after kidney transplantation. A decrease of renal function represents a significant risk factor for valvular and vascular calcifications occurrence in CKD patients.
Morphometric study of the anatomic relationship between large retroperitoneal blood vessels and intervertebral discs of the distal segment of the lumbar spine: a clinical significance
Authors: Bečulić Hakija , Sladojević Igor , Jusić Aldin , Skomorac Rasim , Imamović Melica , Efendić Alma
Published: April 2024

Aim
 To analyse potential clinical implications of the distance between large retroperitoneal vessels and lower segment of the lumbar spine in the supine and prone position.
Methods
Prospective, non-randomised study included 40 patients of different age and gender. For all patients magnetic resonance imaging of the lumbar spine was performed in supine and prone position. The level of aortal bifurcation, common iliac vein confluence, the distance from the anterior and posterior aspect of the annulus to the posterior wall of the large retroperitoneal vessels were analysed.
Results
 The study included 40 patients, 22 (55%) males and 18 (45%) females. The level of aortal bifurcation was higher in prone compared to supine position (χ2 = 29.88571; p˂0.05). In supine and prone positions, the common iliac veins confluence was most commonly at the level of the lower third of the L4 vertebra (p˃0.05). There was a statistically significant difference between the distance from the left common iliac artery to the anterior contour of L4/L5 intervertebral disc (p˂0.05). Conclusion
 Knowledge of the anatomic relationship between iliac vessels and structures of the lower segment of the lumbar spine is very important in the prevention of a potentially severe complication, such as artificial common iliac vessels rupture. Our study showed that the risk of lesions of the common left iliac artery was lesser in the prone position.
Risk factors associated with anastomotic leakage in patients operated due to colorectal tumour
Authors: Altın Onder , Alkan Murat
Published: April 2024

Aim
 To evaluate risk factors that may cause anastomotic leakage (AL) in patients who underwent resection and anastomosis due to colorectal cancer.
Methods
 Patients who underwent resection and anastomosis due to colorectal cancer between January 2014 and July 2018 in our clinic were included into the study. The patients were divided into two groups as ones with AL being Group 1, ones without AL being Group 2. Parameters related to the clinical characteristics, surgical and pathologic results in both groups were evaluated with univariate and multivariate analyses.
Results
A total of 302 patients were included in the study. The AL was observed in 24 (7.9%) patients. Mortality was observed in five (20.8%) and six (2.2%) patients in Group 1 and Group 2, respectively (p=0.001). Significant risk factors for AL in the univariate analysis were coronary artery disease (CAD), chronic obstructive pulmonary disease, high American Society of Anesthesiologists (ASA) score, emergency surgical intervention, absence of preoperative intestine preparation, performed perioperative blood transfusion, tumour T stage, and neoadjuvant chemo-radiotherapy application. Only CAD and neoadjuvant CRT were determined as the independent risk factors for AL in the multivariate analysis.
 Conclusion
 The AL developing after colorectal surgery continues to be an important problem thereby increasing mortality and morbidity along with its negative effect on hospitalization time and functional and oncologic results. Despite several studies on the topic, it is still very difficult to estimate the AL possibility in advance. Therefore, avoiding anastomosis in high risk patients may perhaps be the best option.
Complications in ascending aortic aneurysm surgery: a single centre experience of 81 patients
Authors: Khalil Emced
Published: April 2024

Aim:
 To investigate major in-hospital complications of ascending aorta reconstruction and to identify factors associated with these complications.
Methods
All consecutive patients admitted to our clinic for aortic aneurysm repair from June 2005 to June 2009 were enrolled in this retrospective study. Demographic data, details of the surgical procedures and major in-hospital complications were assessed and recorded from the institutional electronic database. Patients were divided into two groups according to the development of major in-hospital complications.
Results
 The New York Heart Association (NYHA) Class of patients with major in-hospital complications was higher than those without complications. In addition, the number of patients with coronary artery disease (CAD), diabetes, chronic renal disease (CRD), chronic obstructive pulmonary disease (COPD), and previous cardiac surgery was significantly higher in those with major in-hospital complications. Moreover, the requirement for inotropic agents and intra-aortic balloon pump was higher in these patients. Cross-clamp time was significantly higher in patients with major in-hospital complications (107±34 vs. 79±26 (p<0.001). Presence of CRD (r=0.308; p=0.005) and CAD (r=0.244; p=0.028), previous cardiac surgery (r=0.266; p=0.022), cross-clamp time (r=0.349; p=0.001) and IABP requirement (r=0.308; p=0.005) were significantly correlated with the development of major in-hospital complications.
Conclusion
 Our results show that presence of underlying CRD and CAD, previous cardiac surgery, length of cross-clamp time and IABP requirement were significantly associated with the development of in-hospital complications in patients undergoing surgical reconstruction for ascending aortic aneurysm.
Analysis of data on breastfeeding in Croatia from 2005 to 2016
Authors: Miloš Maja , Rodin Urelija , Tješić-Drinković Duška , Mujkić Aida
Published: April 2024

Aim
To analyse available breastfeeding data in Croatia and to describe the process of gathering, collecting, recording and reporting on them to the official institutions.
Methods
 Infant nutrition data collected at maternity wards and infant nutrition data from primary health care units during the period 2005 to 2016 have been used. Descriptive statistics was used to analyse the data and to show the trends in breastfeeding. Results
More than 85% of newborns were exclusively breastfed in the maternity wards. Data on breastfeeding from primary health care showed growth in exclusive breastfeeding up to 2011, followed by a fall in 2013. From 2012, paediatric teams had the obligation to join information system (CEZIH), but electronic forms did not contain infant nutrition information. Similarly in the E-Newborn project (E-novorođenče) the question on the feeding method in the application was not designated as mandatory. Conclusion
 The routinely collected data on breastfeeding did not allow us to draw any conclusion regarding breastfeeding trends in Croatia. In order to improve the process of gathering, recording and reporting data on breastfeeding to the proper authorities, it would be necessary to clearly align definitions, employ a uniform methodology, and upgrade the computer applications in primary health-care. Only then may the reports required for compulsory health insurance be obtained via the CEZIH, as well as the public health reports necessary to monitor preventive work in care of children's health, and monitoring public health indicators.
Antidepressant treatment outcomes in family medicine
Authors: Prasko Subhija , Pranjić Nurka , Gavran Larisa , Alić Alma , Gledo Ibrahim , Ramić Enisa , Spahić Emina , Prasko Erna , Ramić Irma
Published: April 2024

Aim
To determine the prevalence of depressive episodes and recurrent depressive disorders despite of the length of therapy and type of antidepressants.
Methods
 The study was conducted among 508 patients aged 19-65 years who were treated for depression for at least 3 months (mild and moderate episodes were controlled and the effects of treatment monitored by family physicians, while severe episodes were controlled by a psychiatrist) during 2013- 2015 in Zenica-Doboj Canton using the Hamilton Depression Rating Scale (HDRS).
Results
 The average age of the patients was 48.98±11.585 years. Depressive disorder was most commonly represented in patients with high-level education, 22%, more frequently in non-productive workers (non-productive vs. manufacturing 58%:35%). A significant number of patients who were treated for depression were unemployed (57%). All respondents were suffering from the most serious episode of depression with an average depression rate at the Hamilton scale 18.49±8.603, with a very serious depression level of 32%, severe 17%, moderate 21%, and mild 20%. Most patients were treated with paroxetine, 27%, fluoxetine 22% and sertraline 17%. Efficacy of depression treatment with different types
of selective serotonin reuptake inhibitors antidepressants (SSRIs)
was not significantly different (p=0.502).
Conclusion
Success of the treatment with the absence of symptoms of depression was achieved in 10% and the maintenance of
depressive episodes occurred in 90% of cases. Adverse reactions with the most commonly prescribed SSRI in our country should be important in creating procedures and strategies for the future treatment of depression in family medicine.
Short-term changes in renal function in children and adolescents undergoing extracorporeal shock wave lithotripsy
Authors: Milišić Emir , Zvizdić Zlatan , Jonuzi Asmir , Begić Edin , Milišić Lejla , Mešić Amira
Published: April 2024

Aim
To identify short-term effects of extracorporeal shock wave lithotripsy (ESWL) on renal function in children and adolescents with single kidney stones.
Methods
 In a 4-year period 30 children (15 boys and 15 girls) from 10 to 18 years of age were treated for unilateral renal stones with ESWL. Inclusion criteria were: up to 18 years of age, kidney stone (from 4 to 20 mm in diameter) visible on X-ray, first ESWL treatment, unilateral lithotripsy treatment without previous kidney surgery, patients without infravesical obstruction, patients without proven urinary infection, repeated use of one (the same) analgesic, patients without anticoagulant and antihypertensive therapy, patients without use of nephrotoxic drugs prior to and during the treatment, normal blood pressure, non-pregnancy patients with normal renal function. Serum enzymes (alkaline phosphatase, lactate dehydrogenase), cystatin C, serum and urine electrolytes (sodium, potassium, chloride), and urine neutrophil gelatinase-associated lipocalin (uNGAL) were tested before, on the first and fifth day after the treatment.
Results
 An increase of alkaline phosphatase and lactate dehydrogenase was statistically significant on day 1 (p<0.05) and values returned to normal on day 5. Serum cystatin C level was also significantly increased during the first four days after ESWL treatment (p<0.05) and returned to baseline on post-treatment day 5. There was a statistically significant difference in the level of uNGAL in urine before and 24 hours after ESWL treatment (p<0.05).
Conclusion
The ESWL is a safe and curative procedure for the treatment of kidney stones in children and adolescents with no evidence of serious adverse effects on renal function.
Evaluation of biochemical markers effectiveness in elderly malnutrition assessment
Authors: Gavran Larisa , Pavlović Jelena , Račić Maja , Ivković Nedeljka , Tušek Bunc Ksenija
Published: April 2024

Aim
 To systematically review the scientific evidence of biomarker validity, reliability, specificity and sensitivity in identifying malnutrition in the elderly.
Methods
Peer-reviewed journals were searched using PUBMED and EBSCO from January 1998 to April 2018. The articles included description of the association between malnutrition blood biomarkers and validated nutritional status assessment instruments and studies were conducted among community-dwelling elderly or nursing home residents.
Results
The research strategy identified a total of 293 studies. This literature review picked out seven articles for follow-up evaluation. A total of sixteen blood biomarkers were identified. Six studies found a significant association between the nutritional assessment score and albumin level.
 Conclusion
 Combining serum concentrations of malnutrition biomarkers with nutritional status assessment tools has a great potential in identifying the risk of malnutrition in the elderly, while also increasing sensitivity and specificity.
Experience of nurses in assessing postoperative pain in hip fracture patients suffering from dementia in nursing homes
Authors: Krupić Ferid , Bišćević Mirza , Spahić Emina , Jašarević Amila , Jašarević Mahir , Grbić Kemal , Hamrin-Senorski Eric , Svantesson Eleonor , Čustović Svemir , Westin Olof
Published: April 2024

Aim
 To explore the experiences of registered nurses in assessing postoperative pain in hip fracture patients suffering from dementia in nursing homes.
Methods
 The study was designed as a qualitative study using data from a self-reported questionnaire form. Data were collected through the self-administered questionnaire with 23 questions, mainly addressing demographic and social data, information about communication and pain assessment.
Results
All nurses reported that large part of verbal communication with dementia patients was lost, and non-verbal communication was very important to optimize the care of these patients in postoperative situations. An assessment of pain in patients with dementia and hip fractures was a complex process because cognitive ability of these patients was reduced.
Conclusion
 Registered nurses need to know various and different forms of evaluation and tools to assess the experience of pain in patients with dementia who had undergone surgery for hip fractures. This is a complicated task, which requires a great deal of time, and means that nurses must work together with other medical staff, using a holistic approach.
Comparison of intubation condition and the quality of muscle relaxation between rocuronium and vecuronium using „timing principle“
Authors: Čaušević Senada , Rizvanović Nermina , Pojskić Belma
Published: April 2024

Aim
To compare the quality of the conditions for endotracheal intubation and muscle relaxation between rocuronium bromide and vecuronium bromide using the ''timing principle'' method for induction in anaesthesia. The "timing principle" includes the administration of muscle relaxants before the hypnotic agent during induction in anaesthesia.
Method
 Sixty patients who had undergone elective surgery were randomly allocated into two equal groups using muscle relaxants: rocuronium (group R) and vecuronium (group V). The intubation conditions were asse ssed using Cooper's scoring system, based on jaw relaxation, vocal cords position and response to intubation. The quality of muscle relaxation was evaluated by recording the time of clinical weakness, a count of ''train of four'' (TOF) twitches at intubation, the time of loss TOF response and duration of direct laryngoscopy.
Results
 The intubation conditions were excellent in 100% of patients in the group R versus excellent in 80% and good in 20% of patients in the group V (p<0.05). The time of clinical weakness was statistically significantly shorter in the group R than in the group V (p<0.000). The time of loss of TOF response was statistically significantly shorter in the group R (p<0.000). The absence of TOF twitches (the level of muscle relaxation of 100%) at intubation recorded in 25 (83.3%) patients in the group R versus five (16.7%) patients in the group V (p<0.000). Duration of direct laryngoscopy did not significantly differ between the groups.
Conclusion
 Rocuronium bromide provides better intubation conditions and greater quality of muscle relaxation than vecuronium bromide using ''timing principle'' technique.
Inter-professional ethical values in Iranian aged care: a qualitative study
Authors: Hosseinabadi Reza , Abolfathi Momtaz Yadollah , Mohammdi Shahboulaghi Farahnaz , Abbaszadeh Abbas , Akbari Kamrani Ahmad Ali , Pournia Yadollah
Published: April 2024

Aim
 Ethical values are the basis of the behaviour and performance of professional care staff. This study aimed to identify inter-professional ethical values in aged care.
Methods
 This qualitative thematic content analysis study was conducted in Khorramabad, Iran, from September 2018 to June 2109, and 36 core members of the aged care team (including 24 nurses, 5 physicians, 3 physiotherapists, and 4 social workers) were selected through the purposive sampling method and interviewed in depth. The data were analysed using the directed content analysis and the method of Zhang and Wildemuth.
Results
 Four main themes of providing professional care, preserving the integrity of the aged, observing the dignity of the aged, establishing human relationship, along with 21 subthemes were extracted as ethical values in aged care.
Conclusion
The results of this study indicate that providing ethical aged care is influenced by the specific conditions of this age group. In addition to general ethical values such as providing professional care, providing ethical aged care is based on ethical values such as promoting social interaction, promoting peace and comfort, preserving and promoting independence, and autonomy in aged care. Promoting collaborative care and paying more attention to the human dimensions of communication and interaction were other emphasized values.
Stereological analysis of terminal villi, intervillous space and fibrinoid of adolescent placentas and birth weight of newborns
Authors: Marković Sergije , Cerovac Anis , Kunosić Suad , Ramić Suada , Bećirović Emir
Published: April 2024

Aim
 To determine stereological structural parameters of the parenchymal part of the placenta, placental weight and volume of adolescent pregnant women and their correlation with newborns' birth weight.
Methods
This prospective study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. Experimental group consisted of 30 placentas of pregnant women aged 13-19 years. Control group consisted of 30 placentas of pregnant women aged 20-35 years. Stereological analysis was performed. Results
Volumetric density of terminal villi of adolescent placentas was significantly higher than the one of control group (p <0.0001). The volumetric density of fibrinoid of adolescent placentas was significantly lower than of the control group (p <0.0001). Total volume of terminal villi of adolescent placentas was significantly higher than of the control group (p<0.0001). The total volume of fibrinoid of adolescent placentas was significantly lower than of the control group (p<0.0001). Newborns of adolescent pregnancies had in average lower birth weight of 439.01 g compared to the newborns of the control group (p <0.00001).
Conclusion
 Adolescent pregnancy affects placental structure, weight and volume. Newborns of adolescent pregnancy have optimal body weight.
Influence of thyroid hormones on bone density
Authors: Begić Alden , Begić Amela , Arnautović-Halimić Ajla
Published: April 2024

Aim
 To investigate the relations between hormonal status of the thyroid gland and mineral bone density in women in menopause with or without osteoporosis.
Methods
The study included 120 postmenopausal women, who were divided into two groups. Group I included postmenopausal patients with osteoporosis, of whom 30 were in the early stages of postmenopause, and 30 of them where in the late postmenopausal phase. The second group included patients with preserved bone mass, of which 30 were in the early stage of postmenopause, and 30 were in the late postmenopausal phase. Bone densitometry (DEXA) was performed for all patients, along with analysis of the level of follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3).
 Results
A statistically significant correlation between TSH level and mineral bone density in the lumbar spine level (r=0.27) was found in early postmenopausal women (r <0.05), TSH and T-score at the level of the lumbar spine (r=0.31) (p<0.05), as well as between TSH and mineral content of the femur bone (r=0.29; <0.05). There was statistically significant independent association between thyroxine and mineral bone density at the lumbar spine level in the late postmenopausal women (ß=0.29; p=0.025).
Conclusion
In the early postmenopausal phase, TSH was associated with mineral bone density in the lumbar spine and in the area of the femur.
Use of chest CT scan scoring system for diagnostic and therapeutic decision making in pleural effusion
Authors: Burnazović-Ristić Lejla , Prnjavorac Besim , Bego Tamer , Rakanović-Todić Maida , Prnjavorac Lejla
Published: April 2024

Aim
To investigate the usage of chest computed tomography (CT) scan score for improvement in diagnostic and treatment efficacy of repetitive pleural effusion.
Methods
CT scan scoring system was used as a part of diagnostic procedures in patients with repetitive pleural effusion. Patients with at least two pleurocentesis were included in the study. Chest and abdominal ultrasound, chest x-ray, bronchoscopy, biochemical, microbiological and cytological analysis of pleural fluid specimen were performed for all patients.
Results
In a two-year period (during 2017-2018) 79 patients were analysed, 27 (34.17%) female and 52 (65.82%) male patients. Malignant pleural diseases were confirmed in 32 cases (40.5%), nonmalignant pleural effusions in 38 (48.1 %) cases, and nine (11.4%) patients rested without exact cause of pleural effusion after two pleurocenteses. Binary regression model showed odds ratio of 1.314; CI 95% 1.119-1.543) (p=0.00088). Confirmed malignancies with pleural effusion were in high correlation with the number of points in CT scan score.
Conclusion
CT scan scoring system was helpful for diagnostic and treatment decision making in patients with repetitive pleural effusion.
Maintaining professional integrity in Iranian nurses
Authors: Jesmi Ali Asghar , Yazdi Khadijeh , Sabzi Zahra
Published: April 2024

Aim
 To determine obstacles in maintaining professional integrity of nurses and their strategy to overcome them.
Methods
 A conventional content analysis was conducted by 16 interviews. The data collection instruments were semi-structured interviews, observation and field notes. The interviews were recorded and transcribed verbatim, then analysed by Grandhime and Landman approach. For the validity and reliability of the study Guba and Lincoln criteria were used.
Results
 Latent meanings were formulated into "passive management", "inefficient organization", and "solid spirituality" themes. Passive management consisted of "lack of support from managers", "not understanding the nurses" and "improper supervision system". Inefficient organization was composed of "nursing staff shortages", "underestimation of nurses' roles" and "high workload". "Religious beliefs" and "personal beliefs" constituted the "solid spirituality" theme.
 Conclusion
There are factors that decline motivations in Iranian nurses; nevertheless, it is still possible to be a professionally integrated nurse. Among many factors contributing to internalization of professional integrity of nurses, spirituality is one of the most prominent factors.
Fetuin-A Thr256Ser gene polymorphism as a mortality predictor in patients with chronic kidney disease on maintenance haemodialysis in Medan, Indonesia
Authors: Muzasti Riri Andri , Suhardjono Dr , Purwanto Bambang , Sembiring Rosita Juwita
Published: April 2024

Aim
To investigate an impact of Fetuin-A Thr256Ser gene polymorphism on the mortality rate of chronic kidney disease on maintenance haemodialysis patients in Indonesia.
Methods
This is an analytic-longitudinal observational study using survival analysis with nine-month follow up on 106 maintenance haemodialysis patients. The PCR-RFLP is used to determine Fetuin-A Thr256Ser gene polymorphism and Fetuin-A serum level measured by using ELISA methods. We use time-independent cox regression analysis to investigate factors that contribute to patient survival.
Results
The mean survival time of this study is 8.49±1.53 months, with a median survival of 9 months (range 1-9 months). Among 12 (11.3%) deceased patients, most of them carried GG genotype with 8.87 times risk of mortality compared to those with CC+CG genotype (p=0.005). The group of patients with IL-6 level ≥86.9 pg/mL had higher mortality with 3.64 times greater risk compared to those with IL-6 level, <86.9 pg/mL (p=0.03).
Conclusion
This study revealed a significant dominance independent impact of the Fetuin-A Thr256Ser gene polymorphism on the survival rate of maintenance haemodialysis patients. These results suggest that genotype variation of Fetuin-A gene could be a potential marker to identify high mortality risk in Indonesia's maintenance haemodialysis patients, especially in Medan.
The relation between BRAFV600E mutation and clinicopathological characteristics of papillary thyroid cancer
Authors: Celik Mehmet , Bulbul Buket Yılmaz , Ayturk Semra , Durmus Yusuf , Gurkan Hakan , Can Nuray , Tastekin Ebru , Ustun Funda , Sezer Atakan , Guldiken Sibel
Published: April 2024

Aim
BRAF mutation inhibits many tumour suppressor genes, increases pro-angiogenic molecules and reduces radioactive iodine uptake of tumour in papillary thyroid cancer (PTC), giving it more aggressive clinical characteristics. In this study, we aimed to evaluate the effect of BRAF V600E mutation on the clinicopathological features in patients with PTC.
Methods
 The laboratory and clinical findings of 256 PTC patients who were referred to our clinic between 2007 and 2017 were assessed. Subjects involved in the study were divided into two groups depending on the presence of BRAF V600E mutation. Results
 BRAF V600E mutation testing gave positive results for 65 (25.4%) out of 256 patients. No significant correlation between BRAF V600E mutation, age and gender was detected. There was no difference between the groups in terms of tumour variant, tumour localization, tumour focality, and perineural invasion. In terms of histopathologic characteristics, presence of tumour capsular invasion (p=0.027), extrathyroidal extension (ETE) (p=0.002), absence of pathologically detected lymphocytic thyroiditis (p=0.006) and radio iodine I-131 treatment (p=0.001) were significantly higher in BRAF V600E (+) patients. During a followup period, four patients with BRAF V600E (+) and two patients with BRAF V600E (-) status underwent lateral neck dissection due to lymph node metastasis (p=0.01).
Conclusion
 The presence of BRAF V600E mutation was proved to be a poor prognostic factor. However, in order to further assess the prognostic effect of BRAF V600E mutation in this group of patients and particularly its effect on mortality, long term followup results must be evaluated.
Epidemiological characteristics of accidental needle-stick injury among health care professionals in primary healthcare in Zenica
Authors: Sivić Suad , Gavran Larisa , Baručija Aida , Alić Alma
Published: April 2024

Aim
To determine the extent and characteristics of incidental injuries, primarily by needles and other medically sharp instruments and to recommend preventative activities to health care professionals.
Methods
The survey was conducted among 200 healthcare and non-healthcare employees of the Primary Health Care Centre Zenica (48% of the total number of employees). Care workers were surveyed, and the sample was randomly selected in proportion to the number of employees in institutional departments. Respondents answered questions about gender and age, work experience and qualifications; the number and type of exposure to incidents in the past year, number of career incidents, number of reported incidents; information on the manner and cause of the incident.
Results
 The sample consisted mainly of females, 153 (83.2%). An exposure to incident during their work was experienced by 128 (69.6%) respondents: needle-stick injury, 79 (42.9%), unforeseen patient response, 42 (22.8%), rush to perform the procedure, 34 (18,5%), and negligence, 18 (9.8%). The incidents most frequently occurred in gynaecology department (all respondents experienced an incident event), followed by department of family medicine, 47 (67%). The main reason for these incidents was rush to perform procedures, in 9 (12.5%). Of 128 experienced incident events, 21 (16.4%) were reported.
Conclusion
The low rate of reporting of exposure to incidents does not provide a realistic basis for risk assessment and preventive action. Primary task for improving safety of work processes at our setting will be to raise employee's awareness of the need to report exposure incidents.