bluuebunny/crossref_metadata_2025 huggingface dataset:
Stop the Thief?
Authors: El-Gamal Sarah Yousry , Ayaad Hany , Rowan Hamdy Abd El-bary
Published: February 2023

Reaching a sustainable industry is now possible through digitisation. The current era witnessed an increase in the impact of digital transformation on the economy; this encouraged various sectors to adopt Industry 4.0. Digital supply chain and Industry 4.0 are current buzzwords in all industries that can solve common drawbacks. The logistics sector in particular suffers from numerous weaknesses, one of which is cargo theft. Logistics companies started adopting technology in operations aiming to mitigate cargo thefts and reach a sustainable work environment through their digital supply chains. The Egyptian government intends to participate in the transition into a digital society. This case aims to demonstrate a best practice of digitisation in the logistics sector in the Egyptian market. Global Chains Company was one of the first logistics companies to apply a digital solution through ERP systems. Through the interviews conducted, cargo theft problems and consequences are demonstrated along with the results of applying digitisation to operations and the lessons learned.
Effect of COVID-19 on the Freight Forwarding Industry in Egypt
Authors: El Haddad Rawan Hisham , El-Gazzar Sara Hassan , Mohamed May Salah El-Dine , Rosi Bojan
Published: February 2023

The freight forwarding industry is an important player in the maritime transport industry that facilitates shipping processes by providing various value-added services such as securing bookings, transporting cargo, and preparing shipping documents. However, due to COVID-19 outbreak, the freight forwarding industry faced many challenges like port congestion, container shortages, and blank sailings. Therefore, this study examines COVID-19 effect on the freight forwarding industry and the challenges that the freight forwarders faced especially in Egypt, which is a logistics hub due to its strategic location. The case provides researchers and practitioners with an overview of the challenges that affected both maritime transport and freight forwarding industries in Egypt and investigates the challenges that Agility Egypt encountered due to COVID-19 restrictive safety measures. Also, it presents the solutions undertaken to deal with those challenges. Data were collected through interviews with various operation managers, executives, and specialists in Agility Egypt for shipping and freight.
Leading Global Digitalization in Higher Education
Authors: Ghavifekr Simin , Pei Xiaozhu
Published: February 2023

Higher education institutions, as the complex organizations that create and deliver knowledge through teaching, learning, and research have naturally become a part of the current globalization and digitalization. Due to the rapid change in the external environment of higher education, it has met lots of difficulties and challenges from the management to the finance system. One of the key challenges for higher education institutions is adapting to global digitalization—a key to internationalization. Internationalization of higher education is one of the critical trends of development that has an effective influence to achieve competitiveness and create opportunities for high performance and quality education in universities. To handle the challenge of global digitalization and digital transformation, the notion of digital leadership has been put forward. This chapter aims to elaborate on digital gaps and higher education leadership policies to close the gaps through the global digitalization process and the strategies to overcome the inherent challenges.
Online Education Directors' Perceptions of Leadership, Management and Administrative Roles
Authors: Altun Sadegül Akbaba , Johnson Tristan
Published: February 2023

The purpose of this study was to find out how online education directors perceive their administrative, management, and leadership roles, and how those roles interact each other's. It was found that participants perform all three roles depending on the nature of tasks. These roles also depended on the level at which they were working and what they were doing. Leadership roles among others comes first. In this research, it was found that although there is no clear-cut distinction among those roles, it seemed that those roles evolved with each other in such a way that a leader can also play an administrator role or/ and managerial role. To perform the duties effectively, directors need to blend those roles in practice, and it seems that there are transitions among those roles.
A Case-Based Reasoning System-Based Random Forest for Classification
Authors: Tarchoune Ilhem , Djebbar Akila , Merouani Hayet Farida
Published: February 2023

The huge amount of health data attracts machine learning (ML) techniques to medical classification, and, through learning strategies, obtain remarkable results. Some techniques are used to classify and predict data to make accurate decisions, especially case-based reasoning (CBR), which is considered a reasonable technique in medicine, based on past experiences for problem solving. This chapter studies the case-based reasoning approach and its use in the medical field. In the analysis, the authors identify hybridization as a major trend in CBR. Secondly, random forests (RF) as a very popular tool in machine learning is also suggested and is presented as a new way to improve the recall phase of CBR in order to further improve it for medical data. Thus, the authors present hybrid systems between case-based reasoning and random forests. The authors show that combining ideas from some classifiers can lead to better performance.
Cultivating and Nurturing an Empathy-Ready Mindset Through Value-Based Innovation
Authors: Banyan Serit , Abu Bakar Zaim Azizi Bin , Lokman Fadhilah Raihan Binti
Published: February 2023

The Social Innovation Project focuses on developing and implementing innovative solutions to impact students and the community positively. In this module, students are engaged in an interdisciplinary and collaborative setting to identify opportunities in today's global and local environments that create and capture values. The project-based learning activities for this module emphasize situated learning, which deals with authentic and unique real-world issues. Students will be involved in collaborative decision-making and problem-solving as they have to discuss, consult, collaborate, and solve the problem to provide services or create a product for the desired community. After taking this module, students are able to enhance their creativity and instill values, such as leadership, teamwork, communication, and interpersonal skills, among students through the completion of the group's project.
Multiple-Multimodal Skills Through Responsive and Responsible Learning
Authors: Nicolaou Constantinos
Published: February 2023

This chapter investigates and highlights the multiple-multimodal skills from and through literature review that can be acquired in the educational path using audiovisual media technologies and audiovisual content (henceforth, audiovisual media communications) through technology-enhanced learning perspective. Specifically, an attempt is made to present how audiovisual media communications help both learners and educators to achieve these multiple-multimodal skills under the lens of responsive and responsible learning. The chapter also presents and comments indicative ways in which audiovisual media communications can be used in technology-supported learning environments to support teaching, professional learning, and effective educator-learner communication. Nowadays society is highly visualized and requires all of us, in addition to being receptive to the continual use of audiovisual media communications, to somehow maintain a positive outlook for every emerging cutting-edge innovation, and to possess a plethora of skills in order to survive in this digital technological world.
User Intent-Based Segmentation Analysis for Internet Access Services
Authors: Nishimatsu Ken , Inoue Akiya
Published: February 2023

The Internet is available for almost all homes in Japan. During the diffusion stage of Internet access services, it was important to construct a model to evaluate the sensitivity for Internet access service attributes and estimate user service choice behavior to consider service sale strategies. However, as the demand for Internet access services reached saturation, the differences in service attributes among service providers became smaller, making it difficult to decide service sale strategies using conventional choice behavior models. Therefore, the purpose of this paper is to establish a method for extracting effective information for service sale strategies by focusing on user intentions and clarifying the differences in future intentions for current carriers or services with observable and unobservable factors concerned with user intention. The authors propose a framework for user intent-based segmentation to understand the current market structure and develop appropriate service sales strategies for each segment.
Security of Medical Images Using a Key-Based Encryption Algorithm in the RDWT-RSVD Domain
Authors: Singh Monu , Singh Amit Kumar
Published: February 2023

Today, in the era of big data, an increasingly serious problem is the security of digital media in the healthcare domain. Encryption is a popular technique to resolve the security concern of medical data. In the paper, the authors propose a key-based encryption algorithm – namely, SeMIE, designed by RDWT and RSVD for healthcare applications – which can guarantee the security of the medical images. Initially, the image normalisation procedure along with RDWT-RSVD is followed to generate hash value. Here, image normalisation is used to ensure the high resistance against the geometric modifications. Then, a key expansion process is utilised with the hash value for generating the secure keys. Finally, the encryption process uses Feistel structure along with constant substitution-permutation functions to provide sufficient confusion and diffusion of cipher data. Experimental evaluation indicates that the SeMIE algorithm is secure against several attacks. From the simulation findings, it is inferred that the algorithm exhibits improved security compared to existing methods.
Frequent Itemset Mining Algorithm Based on Linear Table
Authors: Lu Jun , Xu Wenhe , Zhou Kailong , Guo Zhicong
Published: February 2023

Aiming at the speed of frequent itemset mining, a new frequent itemset mining algorithm based on a linear table is proposed. The linear table can store more shared information and reduce the number of scans to the original dataset. Furthermore, operations such as pruning and grouping are also used to optimize the algorithm. For different datasets, the algorithm shows different mining speeds. (1) In sparse datasets, the algorithm achieves an average 45% improvement in mining speed over the bit combination algorithm, and a 2-3 times improvement for the classic FP-growth algorithm. (2) In dense datasets, the average improvement over the classic FP-growth algorithm is 50-70%. For the bit combination algorithm, there are dozens of times of improvement. In fact, the algorithm that integrates bit combinations with bitwise AND operation can effectively avoid recursive operations and it is beneficial to the parallelization. Further analysis shows that the linear table is easy to split to facilitate the data batch mining processing.
Semantic Technology and Anthropomorphism
Authors: Hsu Wen-Chin , Lee Mu-Heng
Published: February 2023

A long-standing debate exists on whether robots need personality. With voice assistants (VAs) (i.e., Google Assistant and Apple's Siri) as the research context, this study employed the stimulus-organism-response (SOR) model and the theory of reasoned action to investigate how the personalities that VAs display (i.e., humanlike traits and behavior traits) influence perceived risk, perceived enjoyment, trust, attitude to use, and continued usage intention. The results show that when VAs have more humanlike linguistic traits, such as tone and phrasing, and more positive behavior traits, such as politeness and helpfulness, users enjoy using VAs more, have more trust in VAs, and display a greater willingness to continue using VAs. Unlike past studies focusing on technical aspects, the results of this study provide decision-makers with a new perspective, showing that using more humanlike designs and giving VAs unique personalities can build user trust and increase willingness to use VAs.
The Optimization of Supply Chain Financing for Bank Green Credit Using Stackelberg Game Theory in Digital Economy Under Internet of Things
Authors: Zhang Hui , Zhang Fengrui , Gong Bing , Zhang Xuan , Zhu Yifan
Published: February 2023

The aim is to improve small and medium-sized enterprises (SMEs)' core competitiveness and financing attainability using deep learning (DL) under economic globalization. Accordingly, this work constructs a supply chain symbiosis system based on DL, economics, and Stackelberg game theory following a status quo analysis of the financing status of SMEs. Afterward, a structural framework of supply chain financing (SCF) is designed. Further, it verifies the effectiveness of the proposed back propagation neural network (BPNN) credit evaluation model through specific enterprise data. The results show that the proposed internet of things (IoT)-based SCF SMEs-oriented BPNN credit evaluation model reaches a prediction accuracy of 91.4%. It effectively eliminates information asymmetry between banks and various capitals. As a result, banks can guarantee operation funds for the supply chain SMEs and help them minimize project risks by lowering financing leverage and through information transparency.
Ataque pirata a La Serena de 1680: poder blando (soft power), enodiplomacia y patrimonio cultural y agroalimentario
Authors: Lacoste Pablo
Published: February 2023

En este artículo se examina el ataque del capitán Sharp a La Serena, ocurrido en 1680, a partir de cuatro cronistas piratas: Dick (1684), Anónimo (1684), Ringrose (1685) y Sharp (1699). Sin poder hacer frente a la agresión pirata con recursos militares ni de fuerza (hard power), la comunidad local centró su defensa en recursos de poder blando (soft power). Se detecta una notable defensa de la ciudad, con la activación del patrimonio cultural de los changos (con sus balsas de cuero de lobo) y los diaguitas (con sus redes de canales de riego). Estos elementos se articularon con la estrategia de las autoridades hispanocriollas (enodiplomacia) y, desde los tres frentes, se articuló una estrategia que logró expulsar a los piratas de la ciudad.
Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea
Authors: Oh Tak Kyu , Jo Hayoung , Song In-Ae
Published: February 2023

Background: The optimal anesthetic technique for cancer surgery remains a controversial issue. This study aimed to examine whether propofol-based total intravenous anesthesia (TIVA) was associated with survival outcomes after major cancer surgery in South Korea and compare its effectiveness with that of inhalation anesthesia.Methods: This nationwide population-based cohort study included adult patients who were admitted to the hospital and underwent major cancer surgery between January 1, 2016, and December 31, 2020. The major cancers included lung, gastric, colorectal, esophageal, small bowel, liver, pancreatic, and bile duct or gallbladder cancers.Results: A total of 253,003 patients who underwent major cancer surgery were included in the analysis. After propensity score (PS) matching, 115,370 patients (57,685 in each group) were included in the final analysis. In the PS-matched cohort, the TIVA group showed 9% (hazard ratio [HR]: 0.91, 95% CI [0.85, 0.98], P = 0.018) and 7% (HR: 0.93, 95% CI [0.89, 0.96], P < 0.001) lower 90-day and one-year mortality rates, respectively, than the inhalation group. In subgroup analyses, the TIVA group showed lower 90-day mortality than the inhalation group in the gastric (HR: 0.86, 95% CI [0.72, 0.97], P = 0.033), colorectal (HR: 0.64, 95% CI [0.56, 0.73], P < 0.001), and pancreatic (HR: 0.76, 95% CI [0.57, 0.94], P = 0.038) cancer surgery groups.Conclusions: Propofol-based TIVA is associated with better survival outcomes after major cancer surgeries. Moreover, propofol-based TIVA was beneficial in patients who underwent gastric, colorectal, and pancreatic cancer surgeries.
Antioxidant, antimicrobial, and α-glucosidase inhibitory activities of saponin extracts from walnut (Juglans regia L.) leaves
Authors: Elouafy Youssef , El Yadini Adil , Mortada Salma , Hnini Mohamed , Harhar Hicham , Khalid Asaad , Abdalla Ashraf N. , Bouyahya Abdelhakim , Goh Khang Wen , Ming Long Chiau , Faouzi My El Abbes , Tabyaoui Mohamed
Published: February 2023

Objective:

To investigate the relationship between triterpenoid saponin content and antioxidant, antimicrobial, and α-glucosidase inhibitory activities of 70% ethanolic, butanolic, aqueous, supernate and precipitate extracts of Juglans regia leaves.

Methods:

Triterpenoid saponins of different Juglans regia leaf extracts were measured by the vanillin method. Antioxidant activity was evaluated against DPPH and ABTS free radicals. We also assessed α-glucosidase inhibitory and antimicrobial activities of the leaf extracts. Pearson's correlation coefficient was evaluated to determine the correlation between the saponin content and biological activities.

Results:

The butanolic extract was most effective against DPPH with an IC50 of 6.63 μg/mL, while the aqueous extract showed the highest scavenging activity against ABTS free radical with an IC50 of 42.27 μg/mL. Pearson's correlation analysis indicated a strong negative correlation (r = -0.956) between DPPH radical scavenging activity (IC50) and the saponin content in the samples examined. In addition, the aqueous extract showed the best α-glucosidase inhibitory activity compared with other extracts. All the extracts had fair antibacterial activity against Bacillus subtilis, Escherichia coli, and Klebsiella pneumoniae except for the aqueous extract.

Conclusions:

Juglans regia extracts show potent antioxidant, antimicrobial, and α-glucosidase inhibitory activities. There is a correlation between saponin levels in Juglans regia leaf extracts and the studied activities. However, additional research is required to establish these relationships by identifying the specific saponin molecules responsible for these activities and elucidating their mechanisms of action.
Salidroside attenuates oxygen and glucose deprivation-induced neuronal injury by inhibiting ferroptosis
Authors: Li Ying-Zhi , Wu Ai-Ping , Wang Dan-Dan , Yang Pan-Pan , Sheng Bin
Published: February 2023

Objective:

To evaluate the effect of salidroside on oxygen and glucose deprivation (OGD)-treated NT2 cells and its underlying mechanisms of action.

Methods:

Retinoic acid was used to induce the differentiation of NT2 cells into neurons. The effects of salidroside on survival, apoptosis, inflammatory response, and oxidative stress of neurons undergoing OGD were evaluated. Using precursor cells as controls, the effect of salidroside on the differentiation progression of OGD-treated cells was evaluated. In addition, the effect of erastin, a ferroptosis inducer, on NT2 cells was examined to investigate the underlying mechanisms of neuroprotective action of salidroside.

Results:

Salidroside alleviated the effects of OGD on neuronal survival, apoptosis, inflammation, and oxidative stress, and promoted NT2 cell differentiation. Moreover, salidroside prevented ferroptosis of OGD-treated cells, which was abolished following erastin treatment, indicating that ferroptosis mediated the regulatory pathway of salidroside.

Conclusions:

Salidroside attenuates OGD-induced neuronal injury by inhibiting ferroptosis and promotes neuronal differentiation.
The effects of sensory modulation on patient’s distress and use of restrictive interventions in adult inpatient psychiatric settings
Authors: Alhaj Hamid A. , Trist Adam
Published: February 2023

Within a psychiatric inpatient setting, restrictive interventions may be used for managing disturbed behaviors. However, the restrictive practice can be traumatic and may carry risks to patients and staff. Evidence is growing for the use of sensory modulation in mental health, yet in a general adult psychiatric inpatient setting, the effect on reducing distress and restrictive practice is not fully ascertained. An electronic literature search was conducted to identify the impact of sensory modulation as a therapeutic measure to reduce the need for more restrictive interventions. Studies of varying designs were identified, with key relevant outcomes including seclusion events, seclusion duration, patient distress, and staff and patient feedback. Reduction in the percentage of patients needing seclusion, reduced patient distress levels, and favorable feedback from staff and patients were identified. However, conflicting results of seclusion events were demonstrated. The findings from this review are promising for the therapeutic benefits of sensory modulation in adult inpatient settings. Further studies are warranted, particularly to evaluate the multiple static and dynamic environmental factors that may influence restrictive practice in inpatient settings.
Accuracy of dental implant placement using chairside computer-aided surgery/computer-aided manufacturing-milled guides compared to three-dimensional printed guides
Authors: Moufti Mohamed Adel , Gangotra Karen , Zuendorf Gerhard , Seoudi Noha , Almasri Maher
Published: February 2023

Background:

In-office devices are increasingly used in dental practices to mill “chairside” restorations for increased turnover. New functions permit milling implant surgical guides, thus cutting the time and cost of treatment. This study compares the accuracy of chairside-milled surgical guides (CMG) with that of high-accuracy laboratory-based three-dimensional (3D)-printed guides (PGs).

Methods:

In this in vitro study, 10 bone-level cylindrical implants (4 mm × 13 mm) were placed using both guide types (five for each) in 10 similar prefabricated plastic models with the aid of a specially designed machine. The positions of the placed implant were compared to the planned positions by superimposing postsurgical cone-beam computed tomography scans over the preoperative scans and by measuring the horizontal, vertical, and angular deviations within each study group.

Results:

The horizontal deviation at the implant neck was 0.37 mm ± 0.16 for CMG and 0.84 mm ± 0.35 for PG (P < 0.05). The horizontal deviation at the apex was greater; 0.76 mm ± 0.49 for CMG and 1.70 mm ± 0.46 for PG (P < 0.05). The vertical deviations in both groups were smaller than the horizontal values and almost identical at the neck and apex within each group (0.26 mm ± 0.13) and (0.37 mm ± 0.25) for CMG and PG, respectively (P > 0.05). The angular deviation of the implant's long axis for PG (4.10° ± 1.96°) was twice as large as CMG (2.0° ± 1.37°), but the difference was not statistically significant (P = 0.08).

Conclusion:

Chairside milled guides demonstrated higher accuracy and predictability compared to laboratory-based 3D-PGs.
Effects on Glycemic Control by Combination Therapy of Gliclazide-Metformin and Insulin in Type 2 Diabetes Mellitus Patients
Authors: Rahaman Md. Arifur , Das Adhir Kumar , Ray Sharmistha , Islam Tazin , Akther Nazma , Ansari M. A. Jalil , Prasad Indrajit , Saifuddin Mohammad , Islam Moinul , Sharifuzzaman Mirza
Published: February 2023

Background:

Diabetes mellitus is one of the most common noncommunicable diseases worldwide, which requires management of the symptoms through lifestyle modification and antidiabetic pharmacotherapies. The purpose of this study was to observe the effects on glycemic control by combination therapy of gliclazide-metformin and insulin in type 2 diabetes mellitus patients according to baseline HbA1c, fasting blood glucose (FBG), and blood glucose 2 h after breakfast.

Methods:

An observational study was conducted at Endocrinology Outpatient Department of Dhaka Medical College Hospital, Dhaka, and Outpatient Department of Ibrahim General Hospital, Mirpur, Dhaka, for 1 year (July 2018–June 2019). In total, 110 type 2 diabetic patients were selected purposively. The patients were divided into two groups. In Group I, 55 patients treated with gliclazide (80 mg) and metformin (500 mg) combination therapy twice daily for consecutive 12 weeks, and in Group II, 55 patients treated with insulin (premixed 30/70) twice daily for consecutive 12 weeks.

Results:

After 12 weeks of treatment, HbA1c level reduced from (mean ± standard deviation) 8.94 ± 0.91 to 7.82 ± 1.86 in Group I and 10.07 ± 1.28 to 7.90 ± 1.01 in Group II. FBG level reduced from 10.05 ± 1.57 to 7.96 ± 1.62 in Group I and 11.61 ± 2.62 to 7.60 ± 1.23 in Group II. Blood glucose 2 h ABF level reduced from 14.00 ± 2.04 to 10.99 ± 1.41 in Group I and 16.70 ± 3.61 to 10.71 ± 1.52 in Group II. In Group I, 36.4% of patients achieved HbA1c target level, 40% of patients achieved FBG target level, and 25.5% of patients achieved blood glucose 2 h ABF target level. In Group II, 29.1% of patients achieved HbA1c target level, 56.4% of patients achieved FBG target level, and 29.1% of patients achieved blood glucose 2 h ABF target level.

Conclusions:

On the basis of the study findings, patients of both study groups showed an improvement in the overall glycemic control (HbA1c, FBG, and blood sugar 2 h ABF) during the study. Both groups of drugs are effective in controlling blood glucose, but individual group has a unique beneficial effect.
Frequency and Determinants of Hypogonadism and Erectile Dysfunction in Men with Newly Detected Type 2 Diabetes
Authors: Selim Shahjada , Lona Hafiza , Imran Shahed , Rahman Mahbubur , Mahjabeen Samira , Mustari Marufa
Published: February 2023

Introduction:

Hypogonadism in males is characterized by low serum testosterone (T) levels together with clinical symptoms and is more common in diabetes mellitus (DM). Association between DM and hypogonadism has been studied in different populations but is not clearly known in Bangladeshi population.

Objectives:

The objective of this study was to find out the frequency and determinants of hypogonadism and erectile dysfunction (ED) in men with newly detected type 2 DM diabetes (T2DM).

Materials and Methods:

A cross-sectional study encompassing 1940 newly T2DM male patients (age: 42.57 ± 7.4 years; body mass index [kg/m2]: 26 ± 5.1; mean ± standard deviation) was carried out in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, to see hypogonadism. Measurement of serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle stimulation hormone (FSH) was measured by chemiluminescent technology.

Results:

Among hypogonadal subjects, according to calculated Free Testosterone (cFT) and Androgen Deficiency in the Aging Male (ADAM) criteria, the frequency of hypogonadotropic hypogonadism was 80% which, on the basis of TT and ADAM criteria, was 92.5%. There was no significant difference for hypogonadism among either the hemoglobin A1c (HbA1c) categories (P = 0.23) or age groups (P = 0.9). Hypogonadal and eugonadal groups significantly differed both according to TT and ADAM (81.5% vs. 43.4%, P = 0.01) and cFT and ADAM (93.3% vs. 47.7%, P ≤ 0.001) criteria for ED. There was a significant difference between the groups for SHBG (21.7 ± 11.6 vs. 30.71 ± 22, P = 0.05) by TT and ADAM criteria. Similarly, cFT and ADAM criteria also revealed a statistically significant difference for SHBG (38.04 ± 19.90 vs. 25.28 ± 19.37 nmol/l, P = 0.03) and total cholesterol (211.40 ± 44.7 vs. 191.3 ± 32.64 mg/dl, P = 0.04). However, in both the groups, LH, follicle-stimulating hormone (FSH), HbA1c, fasting blood sugar, 2 h after 75 g glucose, triglyceride, high-density lipoprotein, and low-density lipoprotein did not differ significantly. cFT significantly correlated with age (r = [FIGURE DASH]0.3503, P = 001) and SHBG (r = [FIGURE DASH]0.37, P ≤ 0.01) whereas TT with SHBG (r = 0.58, P = 0.01). By multiple regression, ED and SHBG were significant predictors for hypogonadism (P = 0.01 and 0.03, respectively).

Conclusion:

It was concluded that a significant number of newly detected male T2DM subjects have symptoms of hypogonadism judged on the basis of TT, cFT, and ADAM scores. Poor glycemic control may affect gonadal and erectile functions. This aspect should be considered while diagnosing male subjects as T2DM.
Legal issues in end-of-life care
Authors: Gera Anjali , Sharma Bimla , Sood Jayashree
Published: February 2023

End-of-life (EOL) care is a multidisciplinary approach to provide 'whole person care' to individuals with advanced, progressive, incurable or life-limiting illnesses to prevent or relieve suffering with a goal to reduce suffering as much as possible while respecting the patient's wishes. The focus is on comfort, symptom control and quality of death (QOD) rather than actual treatment or prolonging life. It includes withholding or withdrawing life support treatments and initiating palliative care in terminally ill patients. However, lack of awareness amongst people and healthcare workers and inadequate legal framework are barriers to ensuring good QOD. All these issues result in a prolonged stay of terminally ill patients in intensive care units, high financial costs and emotional stress to the family, resulting in an excessive burden on the healthcare system. EOL care poses numerous legal and ethical problems for physicians. It is critical in therapeutic decision-making to protect the rights, dignity and vigour of all individuals concerned, including the patient's family members and the society. Physicians must comprehend the concepts of relevant legal and biomedical ethics to solve EOL care issues.
Intraperitoneal onlay mesh versus laparoscopy-assisted ventral hernia patch mesh repair in small primary ventral hernias
Authors: Kanuri Harish , Dey Ashish , Mittal Tarun , Tripathi Shikhar , Malik Vinod K.
Published: February 2023

Aims:

The aim of this study is to compare and evaluate short-term outcomes of laparoscopy-assisted composite patch mesh repair versus laparoscopic intraperitoneal onlay mesh in small primary midline ventral hernias.

Materials and Methods:

Eighty consecutive patients with small (<2 cm) midline ventral hernia admitted to the Department of General and Laparoscopic surgery at Sir Ganga Ram Hospital, New Delhi, from January 2017 to May 2019 were included in the study and randomised into two groups. Group A included patients who underwent laparoscopic intraperitoneal onlay mesh repair with the classical barrier flat mesh and Group B patients underwent laparoscopy-assisted ventral hernia patch-mesh repair. Parameters assessed at the follow-up were early post-operative pain by Visual Analogue Scale score, wound complications, early recurrence and hospital stay.

Results:

Early post-operative pain was more in the laparoscopic intraperitoneal onlay mesh group and the difference was statistically significant. Usage of additional analgesia in the post-operative period was required only in the laparoscopic intraperitoneal onlay mesh group. There was a statistically significant difference between the two groups in terms of hospital stay.

Conclusion:

For primary midline ventral hernia, with defect size <2 cm, laparoscopy-assisted composite patch mesh repair is feasible and safe. It causes less pain and necessitates less usage of additional analgesia enabling patients to be discharged earlier.
Stress, subjective well-being and its link to the academic performance amongst medical students of a tertiary care setting
Authors: Periasamy Panneerselvam , Vajiravelu Suganthi , Gunasekaran Sasikala
Published: February 2023

Background:

Understanding medical students' mental health using subjective well-being indicators is important because it will allow for the creation of positive psychology-based intervention techniques as well as the implementation of main and secondary psychiatric disorder prevention procedures for medical students. These indicators may help to improve the overall quality of health care provided by these future professionals to the general public.

Aims:

The aim of the present study was to assess the levels of stress and subjective well being as well as factors related to it and their link to the academic performance amongst medical students of a tertiary care setting.

Materials and Methods:

This is a 3-month cross-sectional survey that took place amongst medical students at a tertiary care medical college in Salem, India, between January and March 2022. Students from all academic years, from first year to internship, were included in this study. The study included all students who were willing to participate and gave their informed consent.

Results:

Of the total 492 respondents, 288 (58.5%) were females and 204 (41.5%) were males. 29.7% of the study participants belonged to the first year of the MBBS course. 43.9% of the study participants possess a very good academic performance and majority (86.6%) of the students have regular attendance towards classes.

Conclusion:

Taken together, the findings of studies like these could inform preventive interventions aimed at reducing medical students' distress and promoting future doctors' well-being.
Pigmented medulloepithelioma of the optic nerve: A challenging diagnostic entity
Authors: El Mehdi Tiabi , Siham Chariba , Imane Kamaoui , Noufissa Benajiba , Amal Bennani
Published: February 2023

Because of its rarity, the diagnosis of optic nerve medulloepithelioma poses a real diagnostic challenge. Medulloepithelioma is a congenital tumor that derives from the primitive medullary epithelium present in the neural tube and the optic vesicle. Its classical location is the ciliary body. Cases of retinal or optic nerve locations have been rarely reported in the literature. Only 11 cases have been published in the English literature. Herein, we report the case of a 2-year-old boy who underwent enucleation of the right eye for a presumed diagnosis of right-eye retinoblastoma, based on the presence of leukocoria on ophthalmological examination. Pathological examination showed an optic nerve medulloepithelioma. A review of the literature is also discussed in our work.
Prevalence of Keratoconus on Screening of Egyptian LASIK Candidates: A Retrospective Multicenter Study
Authors: Abd-Elaziz Khaled , Eissa Sherif , Salah Yehia , Azzam Sarah
Published: February 2023

PURPOSE:

This is a retrospective multicenter study to report the incidental discovery of keratoconus (clinical and subclinical) in a screening of laser vision correction (LVC) surgery candidates.

METHODS:

This retrospective multicenter study was conducted on patients presenting for LVC in four Egyptian governorates (Cairo-Giza-6th of October-Beni Suef) during the year 2018. The patients were examined using the Pentacam HR (OCULUS Optikgeräte GmbH, Wetzlar, Germany) or Sirius (Costruzione Strumenti Oftalmici, Italy). The following parameters were evaluated: the axial curvature map, keratometry (Kmax and K2 on the posterior surface), minimum corneal thickness, anterior elevation, posterior elevation, Baiocchi–Calossi –Versaci index (Sirius), index of height decentration, and BAD-D (Pentacam). The prevalence of keratoconus cases was reported and data were analyzed.

RESULTS:

A total of 46 out of 782 candidates presenting for LVC in 2018 were incidentally discovered as clinical or subclinical keratoconus cases and were excluded from performing the LVC procedure.

CONCLUSION:

Screening of LVC candidates for keratoconus is a crucial tool to detect the incidence of the disease in the Egyptian population.
Obstacles and Challenges Facing Iraqi Women Ophthalmologists
Authors: Rattan Suzan A. , Mutashar Mahir K. , AnNasseh Muhannad G. , Al-Attar Zaid
Published: February 2023

PURPOSE:

The purpose of this study was to address disparities between male and female Iraqi ophthalmologists in terms of personal circumstances, professional profiles, and attitudes toward work and family life.

METHODS:

A Google Form-based questionnaire was released on a social media platform including 500 ophthalmologists between September 1, and December 1, 2021. The survey included three domains: (1) demographic characteristics, (2) clinical practice profile, and (3) career satisfaction and work/family balance.

RESULTS:

The study included a total of 209 specialists, with a response rate of 45.5%. About 69.4% of them were 45 years and younger. The female-to-male ratio was 1:1.6, 188 (90%) were married and 186 (88.9%) had children. Women ophthalmologists worked fewer hours, days, and operations than male ophthalmologists (P = 0.091). Moreover, women ophthalmologists in private practice were considerably underrepresented. General ophthalmologists represented 77%. The number of women ophthalmologists with subspecialty degrees was far less 9 (11.5%) than males 38 (29.2%), P = 0.003, and they performed significantly fewer operations than male ophthalmologists (P = 0.001). Family duties were the biggest deterrent for female ophthalmologists. For males, the private clinic is an obstacle to acquiring a specialty degree in 45.6%, but for women, it is just 25.7%. Overall satisfaction was 65.1%. Women respondents were less satisfied with their practice (P = 0.009) and thought that they are facing more challenges (0.007). Men believed they had less time to spend with family, implying that women sacrifice working time/income to satisfy family obligations and expectations. Work-life balance is achieved by limiting work hours and including family members.

CONCLUSION:

Women ophthalmologists in Iraq might be facing greater obstacles to their professional advancement than their male counterparts. Female doctors were working fewer hours and doing fewer surgical procedures, and they were less likely to pursue subspecialty certification.
Ocular Sporotrichosis with Limbal Stem Cell Deficiency: An Impostor with Blinding Sequelae
Authors: Mohamad Shahidatul-Adha , Muhammed Julieana , Ibrahim Mohtar
Published: February 2023

Sporotrichosis is a chronic granulomatous fungal infection caused by Sporothrix schenckii. Inoculation of the fungus through breached skin or mucosa typically results in nodular ulceration of the cutaneous and subcutaneous tissue as well as its draining lymphatic nodules. However, reports on ocular involvement have recently increased. We describe a severe case of diffuse granulomatous conjunctivitis involving bulbar and palpebral conjunctiva, resulting in inevitable damage to the limbal stem cells. Isolation of S. schenckii from a conjunctival swab confirmed the diagnosis of sporotrichosis. A 6-month course of oral antifungal therapy was given through which the patient fully recovered. However, extensive corneal conjunctivalization secondary to total limbal stem cell deficiency has caused almost complete blindness in the affected eye. Clinical suspicion of this zoonotic disease is essential for early diagnosis and prompt treatment to prevent ocular surface complication and blindness.
Identification and Sequencing of ISAba2 of Acinetobacter baumannii Isolated from Baghdad Hospitals
Authors: Muhsin Salah Sabah , Bakir Wasan Abdul-Elah , Sabbah Majeed Arsheed
Published: February 2023

Background:

The ability of multidrug-resistant Acinetobacter baumannii to survive in any situation including the acquisition of many different kinds of virulence factors and antibiotic resistance genes is the primary source of worry in hospital settings. Despite their low hydrolysis capability, oxacillinase (OXA) types are often associated with genetic factors such as insertion sequences (ISs) in order to enhance carbapenemase production and mobilization. As a result, assessing the frequency of IS genes in A. baumannii is extremely essential in many hospitals and medical institutions.

Aims:

The goal of this work is to find the IS ISAba2, which may have a role in antibiotic resistance in extensively drug-resistant (XDR) A. baumannii.

Methods:

The polymerase chain reaction (PCR) was used to confirm the presence of A. baumannii by identifying the bla

OXA-51
gene. According to the current Clinical and Laboratory Standards Institute recommendations (2020), antimicrobials are determined using the Kirby–Bauer disc diffusion technique on Mueller-Hinton agar. The molecular research of ISAba2 includes PCR and Sanger sequencing of the PCR results.

Results:

Among 38 A. baumannii isolates, 23 (61%) and 25 (66%) were resistant to meropenem and imipenem, respectively. The bla

OXA-51
gene was detected in all 21 XDR strains tested; furthermore, ISAba2 was found in all 21 XDR-analyzed A. baumannii isolates.

Conclusions:

ISAba2 has a high predominance between extreme drug-resistant A. baumannii. The identification of these parameters can assist in the control of infection and decrease of the microorganism's prevalence rate.
The Role of Retinol-Binding Protein 4 in Women Infected with Toxoplasma gondii
Authors: Ali Rajaa Abd , Al-Kuraishi Azhar Hatif , Farhan Fatin Shallal
Published: February 2023

Background:

Ocular toxoplasmosis mainly affected people in the second to fifth decades, as a result of acute or reactivate congenital or postnatally acquired infection. Retinol binding protein 4 (RBP4) is a protein transporter for retinol (Vitamin A) from the liver to peripheral tissue. Because of its function in vision RBP4 has become a target for ophthalmology research.

Objectives:

Identification of the role of RBP4 parameter in women infected with acute toxoplasmosis.

Methodology:

One hundred and fifteen blood samples were collected from aborted women, who were suspected of having toxoplasmosis for the period October 2020 to March 2021; in addition, 25 samples were collected from apparently healthy women to use as a healthy control group. All sera were investigated for the presence of anti-Toxoplasma IgM, IgA and IgG antibodies, all IgG-positive samples (50 samples) were neglected. IgM and IgA-positive samples (40 serum samples) out of 115 samples were used as toxoplasmosis case group (acute toxoplasmosis), while the negative IgM, IgA, and IgG aborted women samples were used as aborted nontoxoplasmic control group (25 serum samples). The samples from healthy women that gave negative results for the three antibodies were used as the healthy control group.

Results:

The RBP4 serum level was reflected a significant decrease 1.84 ± 0.44 ng/ml in aborted toxoplasmic cases when compared with aborted nontoxoplasmic and healthy control groups; 2.85 ± 0.60, 3.90 ± 0.62 ng/ml, respectively.

Conclusion:

There was a highly significant decrease in RBP4 serum levels in acute toxoplasmosis-infected women. This decreasing may be one of the indirect effects of Toxoplasma gondii infection on their hosts. Furthermore, this level can be used as aid test for the detection for toxoplasmosis.
Interferon-Gamma
Authors: Hamza Sabreen Hamodi , Ashoor Zainab Fadhel , Rahmah Abbas Mahdi
Published: February 2023

Background:

Acromegaly is a rare endocrine disease, its incidence is 4-6 per million per years while its prevalence is 40-60 per million. The distinctive facial characteristics are prognathism prominent forehead, and large hands and feet. This happens after the fusion of growth plates; separating acromegaly from gigantism that occurs before growth plates are closed. Interferon-gamma was checked in (80) acromegalic patients (50% are diabetics and 50% are non-diabetics) while (40) persons were regareded as healthy control group being non-diabetic, non-acromegalic.

Aim of the study:

To find out impact lnterferon-gamma in diabetic acromegalic versus non-diabetic acromegalic patients.

Methods:

Eighty acromegalic subjects were enrolled in across sectional study by measuring the level of lnterferon-gamma in the sera of diabetics and non-diabetics as 39 are diabetics while the remaining 41 patients are non-diabetic.

Result:

lnterferon-gammais high among diabetic acromegalic patients when compared with non-diabetic acromegalic subjects.

Conclusion:

Interferon gamma is high in acromegalic diabetic patients, nondiabetic acromegalic patients, and controls (100%, 97.6%, and 97.5%, respectively). Interferon gamma is elevated in patients with acromegaly only in the age group of 30–39 years, but in those with diabetes, the elevation is noticed later within the age group of 40–49 years as if concomitant diabetes delays its elevation.
Microbiome of the Head-and-Neck Region
Authors: Swain Santosh Kumar , Jena Pragnya Paramita
Published: February 2023

The microbiome includes microbes that are both helpful and potentially harmful to the human body. The majority of the microbiome are symbiotic and few are pathogenic. The collaboration of microbial colonizers is thought to help in and regulate bodily function. The rapid development of sequencing techniques and analytical methods is increasing the ability to understand the human microbiome. The importance of the human microbiome in the detection and prevention of the disease has been well established in different anatomical parts; however, there is limited literature or research on the microbiome of the head-and-neck region. Proper understanding of the microbiome in the head-and-neck area can help to differentiate the disease-prone patients from normal persons and is helping to guide the treatment regimens and usage of antibiotics. This can help to control resistance and limit the adverse effects of antibiotic overuse. Understanding by clinicians about dysbiosis can help to treat and even protect from common clinical entities such as tonsillitis and rhinosinusitis. Novel genetic sequencing (16S/next-gen sequencing) is helpful for the accurate identification of bacterial taxa in samples collected from the head-and-neck region and a better understanding of the composition of the otolaryngologic microbiome. In this review article, we discuss details of the head-and-neck microbiome distinguished by all relevant subsites.
Definition of Developmental Dysplasia of the Hip
Authors: Doski Jagar Omar
Published: February 2023

Existing definitions of developmental dysplasia of the hip (DDH) lack uniformity. This study reviewed the main articles discussing DDH definition to make a uniform, feasible, and clinically relevant definition. Electronic databases with some orthopedic books were used to search for the relevant articles. The articles included were 26 (13 from journals and 13 from books). They were published in the last three decades, in the English language, and related to the human species. The retrieved descriptive data used to define DDH were summarized and sorted according to the concepts they contained (they were 12 concepts). Most of them gave more than one set of data to define DDH. From the summary of these data, it can be concluded that DDH can be defined as a developmental spectrum of abnormal formation and alignment of hip joint components that present in healthy infants.
An unusual Cause of Persistent Frontal Headache in a 9-Year-Old Boy
Authors: Swain Santosh Kumar
Published: February 2023

Headache is a common clinical experience of the patients and is found in all age groups. Intranasal mucosal contact with the absence of inflammation in the nasal cavity and paranasal sinuses may cause a secondary headache which is called a rhinogenic contact point headache (RCPH). RCPH is currently a topic of interest among clinicians and is accepted as a cause of headaches by the International Headache Society Classification. The diagnostic nasal endoscopy showed an S-shaped deviated nasal septum with intranasal mucosal contact in both nostrils. The headache of the child was disappeared after performing septoplasty and excision of the bilateral mucosal contact points. These anatomical variations in the nasal cavity in the pediatric age with bifrontal headache is a very rare clinical entity. Hence, clinicians and pediatricians should keep in mind RCPH during the evaluation of headaches in a pediatric patient. In this case report, a 9-year-old boy presented with a persistent bifrontal headache due to mucosal contact points in the nasal cavity.