bluuebunny/crossref_metadata_2025 huggingface dataset:
La fleur bleue : naissance d’un cliché romantique
Authors: Franco Bernard
Published: February 2024

De Goethe à Queneau en passant par Novalis et Mallarmé, la fleur bleue est un motif littéraire devenu cliché qui renvoie à la mémoire littéraire elle-même. Associée au genre lyrique dans une ballade de Goethe, elle en vient peu à peu à représenter et à incarner la création poétique et littéraire de façon générale, devenant un des symboles privilégiés de l’Art et de sa conception romantique. L’épopée parodique des Fleurs bleues de Raymond Queneau peut se lire comme un reflet de la quête du personnage d’Henri Ofterdingen de Novalis, proposant une réflexion sur le romantisme et l’histoire, en interrogeant le passé fondateur et mythique de l’entreprise littéraire. Plus qu’une idée reçue, le cliché doit se comprendre comme une métaphore éculée, reprise par l’opinion hors de sa signification et de son contexte d’origine. La notion partage avec celle de stéréotype une source commune, représentant une image liée à l’imprimerie et associée à une répétition infinie et dépourvue de signification. Or, s’il est un cliché que l’on associe au romantisme, c’est celui de la fleur bleue. Véritable réservoir de clichés, internet en fait apparaître un certain nombre, associés à la fleur bleue.
Entre dionysisme et décadence. Reflets du romantisme dans l’œuvre de Friedrich Nietzsche
Authors: Broillet Guillaume
Published: February 2024

Cet article explore l’ambivalence des liens unissant le geste littéraire nietzschéen aux différentes vagues successives du mouvement romantique qui l’ont précédé ou qui lui sont contemporaines. À la faveur de ces investigations, Nietzsche se révèle à la fois comme le détracteur des conceptions esthétiques colportées par certains auteurs influents de son temps se réclamant d’une vision conventionnelle du romantisme, et comme l’adepte d’un paradigme esthétique très similaire à celui développé par les premiers tenants du romantisme littéraire. En effet, nombre de traits caractéristiques de l’« écriture nietzschéenne », comme son style aphoristique, son recours privilégié à l’anecdote, ou sa prédilection pour la forme fragmentaire, laissent deviner une forme de réappropriation par Nietzsche du projet de la «  progressive Universalpoesie  » formulé par les membres du cercle d’Iéna dans le cadre de la théorisation du premier romantisme allemand.
Les structures de coordination des soins primaires en France
Authors: Lessi Jean
Published: February 2024

L’une des réponses aux multiples défis que rencontrent les soins primaires (enjeux de démographie professionnelle, médecine de parcours, territorialisation, place dans la gradation des soins, qualité des pratiques, etc.) au cours des deux dernières décennies a consisté à créer des structures ou cadres formalisés de coordination des intervenants. Ces nouvelles formes de coordination connaissent, pour certaines d’entre elles, une dynamique remarquable, et nourrissent une cinétique de coordination professionnelle aux implications plus vastes (délégation d’actes, etc.). Elles se sont toutefois ajoutées les unes aux autres, ou se sont succédé, à un rythme rapide, sans qu’un plan d’ensemble ait initialement présidé à leur développement, ce qui a pu soulever des interrogations sur leurs vocations respectives, et susciter une impression de chevauchement ou de concurrence. Un arrêt sur image est proposé pour en saisir l’architecture. Il est proposé schématiquement de distinguer les structures effectrices centrées sur une patientèle, les structures non effectrices centrées sur un territoire, et celles centrées sur les patients présentant des besoins particuliers.
Research on gesture recognition algorithm based on MME-P3D
Authors: Jin Hongmei , He Ning , Liu Boyu , Li Zhanli
Published: February 2024

A Multiscale-Motion Embedding Pseudo-3D (MME-P3D) gesture recognition algorithm has been proposed to tackle the issues of excessive parameters and high computational complexity encountered by existing gesture recognition algorithms deployed in mobile and embedded devices. The algorithm initially takes into account the characteristics of gesture motion information, integrating the channel attention (CE) mechanism into the pseudo-3D (P3D) module, thereby constructing a P3D-C feature extraction network that can efficiently extract spatio-temporal feature information while reducing the complexity of the algorithmic model. To further enhance the understanding and learning of the global gesture movement's dynamic information, a Multiscale Motion Embedding (MME) mechanism is subsequently designed. The experimental findings reveal that the MME-P3D model achieves recognition accuracies reaching up to 91.12% and 83.06% on the self-constructed conference gesture dataset and the publicly available Chalearn 2013 dataset, respectively. In comparison with the conventional 3D convolutional neural network, the MME-P3D model demonstrates a significant advantage in terms of parameter count and computational requirements, which are reduced by as much as 82% and 83%, respectively. This effectively addresses the limitations of the original algorithms, making them more suitable for deployment on embedded and mobile devices and providing a more effective means for the practical application of hand gesture recognition technology.
Traffic network analysis via multidimensional split variational inequality problem with multiple output sets
Authors: Alakoya Timilehin O. , Ghosh Bidisha , Moutari Salissou , Pakrashi Vikram , Ramachandra Ranganatha B.
Published: February 2024

In this study, we introduce and investigate a new class of split inverse problems, comprising a multidimensional parameter of evolution, which we call the multidimensional split variational inequality problem with multiple output sets. To demonstrate its applicability, we formulate the equilibrium flow of multidimensional traffic network models for an arbitrary number of locations. We define a multidimensional split Wardrop condition with multiple output sets and establish its equivalence with the formulated equilibrium flow of multidimensional traffic network models. We then establish the existence and uniqueness of equilibria for our proposed model. In addition, we propose a method for solving the introduced problem. We then validate our results using some numerical experiments.
A process for updating teaching evaluation criteria, for formative and summative purposes, at a primarily undergraduate Hispanic-Serving Institution
Authors: Cressman Jodi , Burns Kelly , Calin-Jageman Irina , King Denise E. , Krafnick Anthony J. , Li Yuanqing , Reavey Brooke , Silvers Penny , Kreher Scott A.
Published: February 2024

Teaching evaluation is a central process across institutions for faculty retention, promotion, and tenure. While there is a rich literature on methods for evaluating teaching, there is less scholarship on the goals and processes for reforming systems of teaching evaluation. Surprisingly, there is little to no information on teaching criteria at teaching-focused institutions, such as primarily undergraduate institutions. In this article we describe the process of reform of teaching evaluation criteria at our primarily undergraduate institution, which is also a Hispanic-Serving Institution. We present our newly adopted criteria for teaching evaluation for other institutions to build from and describe our process, along with predictable challenges.
Comparative Analysis of Structural Reinforcement with Viscoelastic Energy Dissipators, Friction and Metal Creep in Tall Buildings
Authors: Lipa Eddie J. , Pomasoncco Jhon O. , Casas Joan R. , Delgadillo Rick M.
Published: February 2024

Seismic risk is a challenging problem in tall buildings due to the possibility of loss of human life and economic caused by seismic events. Peru is located at the interaction of the South American plate and the Nazca plate, which is why various seismic events of moderate to large magnitude occur. Today there are many ways to solve these problems and it is a very challenging case to reinforce tall buildings. In addition, technological advances in software facilitate and help through programmed models in tall buildings that analyze their structure characteristics such as drift, shear and others. This article proposes a comparative analysis of three types of dissipators: viscous fluid, friction, and metal creep through a Time-History analysis in a 15-story high-rise building located in Peru. The proposed methodology considers three stages: (i) definition of the characteristics and properties of the structure in accordance with Peruvian Standard E.030, in addition three accelerograms are used for the dynamic time-history analysis and maximum displacements and drifts are determined by ETABS software. (ii) calculate the design drift of the tall building and the properties of the viscous fluid, friction, and creep dissipator. In addition, calculations are made for the design parameters of each dissipator, and it is modeled as required for the case study. (iii) the new drifts and the damping values that the building presents for each dissipator are analyzed. According to the results obtained, the dissipator with the best results is of the flow type, since it has better performance in drifts and manages to produce an average damping of 96.87% for tall buildings. While the viscous dissipators obtain a 57.85% damping and the friction ones are estimated at 81.57%.
Structure and Properties of Melt-Quenched Al4CoCrCuFeNi High-Entropy Alloy
Authors: Kushnerov Oleksandr I. , Bashev V.F. , Ryabtsev Serhii I.
Published: February 2024

The structure and mechanical properties of a multicomponent high-entropy Al4CoCrCuFeNi alloy in the as-cast and melt-quenched states were investigated. The alloy composition was analyzed based on the literature criteria for predicting the phase formation in high-entropy alloys, which considered the entropy and enthalpy of mixing, valence electron concentration as well as the atomic size difference of the components. The alloy films were synthesized by quenching from the melt using a splat-quenching technique. The cooling rate of the films was estimated to be ~ 106 K/s based on the film thickness. The X-ray diffraction analysis revealed that both as-cast and melt-quenched Al4CoCrCuFeNi alloy samples had an ordered B2 phase in their structure. The microhardness of the as-cast alloy was 6500 MPa, while the microhardness of the melt-quenched film was significantly higher and reached 9400 MPa.
The causes of wheat stem sawfly (Hymenoptera: Cephidae) larval mortality in the Canadian prairies
Authors: Sjolie Dylan M. , Willenborg Christian J. , Vankosky Meghan A.
Published: February 2024

Cephus cinctus Norton (Hymenoptera: Cephidae), the wheat stem sawfly, is a well-established and important pest of wheat, Triticum aestivum Linnaeus (Poaceae), and its relatives in North America. Crop losses are caused directly by C. cinctus feeding inside wheat stems during larval development and indirectly when weakened plants lodge before being harvested. Understanding the factors that affect population dynamics of C. cinctus can help farmers to better manage it. Our study therefore explored how C. cinctus and natural enemy densities vary in space (southern Alberta, Canada) and over time. Five fields were sampled using an established protocol in fall 2019 and resampled in spring 2020; six additional fields were sampled in fall 2020 and resampled in spring 2021. Wheat stubs were dissected to record numbers of cut stems, C. cinctus larvae, and sources of larval mortality (i.e., parasitism, fungal infection). Densities of wheat stem sawfly and the impact of natural enemies varied between the sampled fields. No C. cinctus mortality was observed during the winter, indicating that C. cinctus population dynamics are not susceptible to mortality (abiotic or biotic) between years. Results of our study will be incorporated into new models to predict wheat stem sawfly phenology and risk to crop production.
Clonal Hematopoiesis of Indeterminate Potential Is Associated with Current Smoking Status and History of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease
Authors: Lee Jung-Kyu , An Hongyul , Koh Youngil , Lee Chang-Hoon
Published: February 2024

Background: There is limited data regarding the clinical outcomes of clonal hematopoiesis of indeterminate potential (CHIP) in patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the clinical significance of CHIP as a COPD biomarker.Methods: This retrospective study was conducted on patients with COPD who were enrolled prospectively in the Seoul National University Hospital Airway Registry from January 2013 to December 2019 and underwent pulmonary function and blood tests. We evaluated the CHIP score according to smoking status and severity of airflow obstruction.Results: We analyzed next-generation sequencing data to detect CHIP in 125 patients with COPD. Current smokers had a higher prevalence of CHIP in combination of DNMT3A, TET2, and PPM1D (DTP), DNA methyltransferase 3 alpha (DNMT3A), and protein phosphatase, Mg2+/Mn2+ dependent 1D (PPM1D) genes than in never- or ex-smokers. CHIP of DTP and DNMT3A genes was significantly associated with current smokers (adjusted odds ratio [aOR], 2.80; 95% confidence interval [CI], 1.01 to 7.79) (aOR, 4.03; 95% CI, 1.09 to 14.0). Patients with moderate-to-severe airflow obstruction had a higher prevalence of CHIP in most of the explored genes than those with mild obstruction, although the difference was not statistically significant. CHIP in ASXL transcriptional regulator 1 (ASXL1) genes was significantly associated with history of mild, severe, and total acute exacerbation.Conclusion: Given that CHIP in specific genes was significantly associated with current smoking status and acute exacerbation, CHIP can be considered as a candidate biomarker for COPD patients.
Some fascinating Developments in Mathematics and Music
Authors: Amiot Emmanuel
Published: February 2024

The strength of the bonds between music and mathematics goes without saying. This popular belief hides a subtler misconception, that this relationship involves old school mathematics: arithmetics in the Greek School (Pythagoras), diophantine approximations in tuning theory (Euler, Rameau), Fourier series for the decomposi-tion of sound signal, and little else. However, there is much more than that and these two sciences still ad-vance hand in hand as of today. This paper will present by way of example three musical situations involving contemporary mathematical topics: Galois theory in a rhythmic canon problem in the field of minimalist mu-sic; a graph theory question raised by Ludwig van Beethoven which had to wait almost two centuries for an answer; and a neat word theory theorem discovered in a construction originating in combinations of mystical octaves and fifths in Plato’s Timaeus.
The ancient DNA of the N.E. Mediterranean/Euro-Asian Cultures and the Position of the Mycenaean Greeks among the first Cultures
Authors: Liritzis Ioannis
Published: February 2024

Alerted by a trio of papers that appear in the journal SCIENCE today (26th August 2022) I present briefly the essential findings with some extension on the hot subject of ancient DNA studies over all the World but mainly the SE Mediterranean and Euro-Asian neighborhood. These three papers summarize the results of a remarkable Ancient DNA project and involving 202 co-authors. These studies draw on published archaeogenetic records and new DNA analysis of 727 individuals who lived during the Copper and Bronze Ages. These people populated the “Southern Arc,” a swath of land connecting Europe to West Asia through Anatolia including coastal Levant. The findings are critically discussed in the wider frame of aDNA results, the migration and mobilities for the past about 8000 years ago and linked with the non-linear evolution processes of ancient cultures. Particular emphasis here is given to the 2016 expedition at the Late Helladic site of Kastrouli near Delphi in Greece, that contribute to these studies.
Symmetry and Symmetry Breaking in Science and Arts
Authors: Mainzer Klaus
Published: February 2024

In this review article, symmetry and symmetry breaking are considered as complementary principles in science and arts. It starts with symmetry and symmetry breaking in early world views of nature and art. Then, symmetries are definied as fundamental structures of mathematics. Mathematical models of symmetry and symmetry breaking are used to explain the emergence of space-time and matter in modern physics. Even molecular structures in chemistry are distinguished by mathematical symmetries. Their elegance and beauty seem to realize aesthetical categories in nature. In biological evolution, the question arises how symmetry breaking (e.g. molcular chirality) can be explained. In modern arts, symmetry and symmetry breaking are „hidden“ structures which can be found in music, painting, and architecture. In a philosophical outlook, symmetry and symmetry breaking are highlighted as regulative guiding ideas of research.
EASA Expert Group: Environment, Climate, and Energy -Toward Clean Energy production
Authors: Group Expert
Published: February 2024

Coordinator: Sergio Orlandi (Dean Sergio Orlandi class VI)Members of the Expert Group: Prof. Dr. Marco Aiello VI; Prof. Dr. Marco Amabili VI; Prof. Dr. Pierangelo Angelini VI; Prof. Dr. Mauro Cappelli VI; Prof. Dr. Martin Grambow VI; Prof. Dr. Krzysztof Kowalczyk VI; Prof. Dr. Ortwin Renn VI; Prof. Dr. Artur Pawlowski VI; Prof. Dr. Lucjan Pawlowski VI; Prof. Dr. Marcel VAN DE VOORDE VI; Prof. Dr. Peter Wilderer VI.
Disasters And Climatic Phenomena Today And In The Past
Authors: Liritzis Ioannis
Published: February 2024

The current interest and frenzy discussion and attribution of all the evils in climate change, the climate crisis, has led to skepticism about its right research direction, as well as its management and priority implementation actions, extended to its impacted effects on humans, the environment, and the economy. Rather than being the result of a simple mistake, an adequate dispute is based on diversity. I argue that many aspects of the scientific and ethical debate on climate change can be usefully viewed from a different more human-environment-centered perspective. This opinion article presents the topic recalling the historical past and discussing the current opinions and policy orientations followed by scientists, and decision-making centers. Emphasis is given to the prioritized sectors for mitigating the currently undesirable effects, in parallel to re-orientation and breakdown of research on the contemporary causes of climatic change from the non-human interventions.
Valutazione dell’efficacia del trattamento riabilitativo e della terapia comportamentale nell’incontinenza fecale e soiling in pazienti pediatrici con patologie congenite rare malformazioni anorettali (MAR) e morbo di Hirschsprung (HSCR): protocollo di studio e risultati preliminari
Authors: Cantone Enrica , Di Matteo Roberta , Camillo Silvia , Raffo Rossella , Grassi Elena , Bolgeo Tatiana , Maconi Antonio
Published: February 2024

Obiettivi: valutare l’efficacia del trattamento riabilitativo associato a terapia comportamentale nell’incontinenza fecale e soiling nei pazienti pediatrici affetti da patologie congenite rare MAR e HSCR. Materiali e Metodi: studio monocentrico interventistico prospettico con valutazione degli outcomes di soiling e incontinenza fecale attraverso la somministrazione di scale di valutazione (Scala di Wexner, Scala Rintala) a T0 (prima del trattamento), a T1 (al termine del trattamento) e a T2 (12 mesi dopo). Risultati: attualmente è ancora in corso la raccolta dati, è stata avviata l’analisi statistica sui risultati parziali inerenti all’arruolamento tra gennaio 2021 a dicembre 2021. Attualmente sono stati arruolati 15 pazienti e da una prima analisi sono emersi dei miglioramenti nei punteggi delle scale. Conclusioni: i risultati finora evidenziati mostrano l’efficacia del trattamento riabilitativo in associazione alla terapia comportamentale nella gestione dell’incontinenza fecale e del soiling nei pazienti pediatrici affetti da MAR e HSCR.
Compliance of thyroid nodules through ultrasound-guided trucut/core needle biopsy with Thyroid imaging, reporting, and data system score and surgical pathology
Authors: Hassan Ahmed M. , Ahmed Ahmed Abd Elrady , Abd El Wahab Radwa Nabawy Abd Allah , Nagla Noha M.
Published: February 2024

Background and Aim

The ultrasound-guided trucut/core needle biopsy (CNB) has been effectively used as a supplemental approach for the assessment of thyroid nodules.

We aimed to evaluate the diagnostic value of the ultrasound-guided trucut needle biopsy of thyroid nodules in correlation with Thyroid imaging, reporting, and data system (TIRADS score).

Patient and methods

Between November 2020 and November 2021, this prospective study had been carried out at Al-Azhar University Hospital, Assiut, in the department of general surgery and diagnostic and interventional radiology. There were 50 patients in this study, All of them had clinically suspected thyroid nodules.

Results

The mean age of patients involved in the current research was 43.9±11.7 years. Females represented 92% of the study groups, while males made up just 8%. There was no considerable variation in the prevalence of diabetes mellitus (DM) or hypertension among the study groups. The most prevalent diagnosis in the normocalcemic group (39.63%) was simple goiter, while in the hypocalcemic group was malignancy (44.44%). In terms of preoperative diagnosis, there was a substantial diversity among the 2 groups.

Conclusion

Thyroid CNB used as an alternative choice for cases with a previous non-diagnostic or indeterminate diagnosis, but is presently being recommended as a first-line method for identification of thyroid nodules in selected cases. Accuracy of CNB in thyroid nodules is high with low rate of drastic effects.
Microneedling with platelet-rich plasma versus microneedling with vitamin C in treatment of acne scars: comparative study
Authors: Tawfik Khaled M. , Makki Mahmoud A.E. , Mahmoud Fatma E.-Z.M.
Published: February 2024

Background and aim

Postacne scars may affect about 95% of patients with past history of acne that is related to its duration and severity of. Treatment of acne scarring is challenging. Microneedling with platelet-rich plasma (PRP) or vitamin C is a new, simple, and effective treatment modality for such scars. The authors aimed to compare between microneedling plus PRP versus microneedling plus vitamin C in treatment of postacne scars.

Patients and methods

This is a comparative study that was carried out on 20 patients (their ages ranged from 22 to 37 years). They are four males and 16 females, they presented with postacne scars. The patients were divided randomly to receive microneedling plus PRP on one side of the face, and microneedling plus vitamin C on the other side.

Results

The authors found a significant improvement of atrophic acne scars, with significant reduction in the number of acne scars as well as Goodman score after treatment by microneedling plus PRP as well as microneedling plus vitamin C, moreover, most of the patients were satisfied after treatment with no significant difference between both treatment methods. Microneedling with PRP and vitamin C was well-tolerated with no major adverse events that were observed.

Conclusion

PRP as well as vitamin C combined with microneedling is a safe, effective, and promising option in treatment of acne scars.
The effect of trifocal and extended-depth-of-focus intraocular lenses on optical coherence tomography parameters
Authors: Sezenöz Almila Sarıgül , Güngör Sirel Gür , Doğan İrem Kırcı , Çolak Meriç Yavuz , Gökgöz Gülşah , Altınörs Dilek Dursun
Published: February 2024

Purpose:

Optical properties of commonly used multifocal and extended-depth-of-focus (EDOF) intraocular lenses (IOLs) can induce artifacts or changes in optical coherence tomography (OCT) measurements. Our purpose was to investigate the possible effects of different IOLs on peripapillary and macular OCT parameters.

Methods:

The preoperative and postoperative third-month peripapillary OCT and ganglion cell analysis (GCA) parameters of patients having monofocal (Alcon IQ), multifocal (PanOptix), or EDOF (Vivity) IOL implanted during cataract surgery were compared.

Results:

Sixty-four eyes of 64 patients were included (21 monofocal, 24 multifocal, and 19 EDOF). Although all OCT image qualities increased postoperatively, only GCA image quality changes in the monofocal and multifocal groups reached statistical significance. Most peripapillary retinal nerve fiber layer (RNFL) and GCA parameters were similar preoperatively and postoperatively. The superior RNFL thickness in the monofocal group and the temporal RNFL thickness in the EDOF group were higher postoperatively (P = 0.04 and P = 0.02, respectively). Most GCA and RNFL value changes between preoperative and postoperative measurements were similar between groups. In the parameters that changed, postoperative values were higher in the monofocal group (P = 0.02 for minimum ganglion cell layer and inner plexiform layer, P = 0.04 for average RNFL).

Conclusion:

Trifocal and EDOF IOLs do not seem to have a negative effect on OCT parameters.
Quality-of-life index and its related factors during COVID-19 pandemic: A community-based study in Rashtian women/Iran
Authors: Namazi Asiyeh , Rafiey Hassan , Mousavi Mirtaher , Forouzan Ameneh Setareh , Harouni Gholamreza Ghaedamini
Published: February 2024

BACKGROUND:

The changes in everyday life, caused by the COVID-19 pandemic, were rapid and unprecedented. This pandemic affected not only physical health but also well-being and life satisfaction. This study was designed to assess the status of a quality-of-life index and some related factors during the coronavirus pandemic in the public population of Rashtian women.

MATERIALS AND METHODS:

This cross-sectional study was performed on 784 Rashtian women who were selected by cluster random sampling between 2020 and 2021. The data collection tool was the Ferrans and Powers Quality of Life questionnaire, which has two parts: satisfaction and importance of life. Each section consists of four subscales: health and performance, social and economic, psychological/spiritual, and family. Data analysis was done using descriptive and analytic statistics.

RESULTS:

The mean score of the quality-of-life index in this study was 21.39 (of 30), which is higher than the mean level. The scores obtained from the satisfaction section were inferior to the similar questions in the important section. The findings showed that there was no statistically significant difference between the quality-of-life scores of women living in different urban areas (P > 0.05).

CONCLUSION:

The feeling of satisfaction increases the ability to cope with problems and mental pressures and improves the level of mental and physical health of couples and ultimately of all members of society. So although the overall quality of life was above average, appropriate interventions should be designed to maintain and improve their satisfaction.
Determining the role of NT-proBNP levels in diabetic patients with heart failure: A study from North India
Authors: Siddiqui Merajul H. , Dixit Ritvija , Agarwal Shikha , Jha Subhash Chandra , Khanna Harshita , Agrawal Sonu Kumari
Published: February 2024

BACKGROUND:

Diabetic patients are at higher risk of cardiovascular morbidity and mortality. NT-proBNP levels measurements are useful for the assessment of risk in heart failure patients in emergency condition and give the faster result. Further, it also offers lower cost and unnecessary hospitalization and follow-up cost. The studies have shown that NT-proBNP levels are a direct predictor of outcome risk in diabetic patients with heart failure. The objective of this research was to study the role of NT-proBNP levels to determine the severity of heart failure in diabetic patients.

MATERIALS AND METHODS:

In this study 150 patients diagnosed with symptomatic heart failure admitted to the emergency department of a tertiary care center from January 2021 to January 2022 have been included in Saraswati Institute Of Medical Sciences, Hapur, India. N-terminal pro-B-type natriuretic peptide (NT-Pro-BNP) levels were measured using an automated analyzer ranging between 60 and 3000 pg/ml. According to the European society of cardiology (ESC) guidelines, it has been defined as NT-Pro-BNP level above 125 pg/ml indicates a high possibility of heart failure and NT-Pro-BNP level below 125 pg/ml excludes the high possibility of heart failure. All the patients underwent an echocardiographic study and ejection fraction was calculated and recorded.

RESULTS:

In diabetic patients ejection fraction was significantly lower in diabetic patients: 47.15 ± 8.75% vs. 43.24 ± 9.54%, P = 0.002). We have observed statistically significant lower HDL values (40.10 ± vs. 35.94 mg/dL, P = 0.0004), however, significant higher triglycerides values were found (101.43 ± 41.7 mg/dL vs. 151.37 ± 78.85, P = 0.001). No significant difference was observed in LDL level (97.8 ± 31.23 vs. 92.35 ± 314.2, P ≥ 0.05) and total cholesterol level (161.49 ± 41.38 vs. 159.97 ± 41.12, P ≥ 0.05).

CONCLUSION:

We concluded that the measurement of NT-proBNP in heart failure and diabetic patients could be an economic marker for the evaluation of morbidity and mortality, facilitating better management and follow-up.
Analysis of risk factor for pneumonia in children less than five years in Makassar
Authors: Sidabutar Evalina , Ansariadi  , Wahiduddin  , Bustan Nadjib , Stang  , Birawida Agus Bintara
Published: February 2024

BACKGROUND:

Pneumonia is one of the main causes of mortality in children less than five years worldwide and in Makassar City. The aim of this study was to investigate the risk factors for pneumonia in children less than five years in Makassar City.

MATERIALS AND METHODS:

A case–control study design was used in this research. A total of 210 children with consent from the parents were included in this study, which consisted of 70 children’s cases, and the data of the control group were taken by the random sampling method. All related data such as immunization record, nutritional status, birth body weight, vitamin A intake in the last six-month record, and parents’ education, occupation, and monthly income were registered as independent and control variables. Data analysis was performed by the Chi-square and logistic regression model with a P value of 0.005 and odds ratio (OR) with a 95% confidence interval (CI).

RESULTS:

Incomplete diphtheria–pertussis–tetanus–hepatitis B and Haemophilus influenzae type B (DPT-HB-Hib) immunization at the age of 2 months, 3 months, and 4 months, which had adjusted OR (AOR = 9,680; P = 0,001) and malnutrition condition (weight for age) (AOR = 5,486; P < 0,005), were associated with the incidence of pneumonia in children less than five years, whereas incomplete measles–rubella (P = 0,770), low birth weight history (P = 0,403), lack of vitamin A intake (P = 0,720), parents’ education (P = 0,163), and presence of smoker inside the household (P =) were not associated with the incidence of pneumonia in children less than five years (P > 0.005) in Makassar City.

CONCLUSIONS:

Incomplete DPT-HB-Hib immunization for three doses at the age of 2 months, 3 months, and 4 months and malnutrition were associated with pneumonia and the highest risk factors for developing pneumonia in children less than five years in Makassar City, Indonesia.
Concept mapping a potential pedagogical strategy to foster meaningful learning in physiology students
Authors: Sorte Smita R. , Sande Suvarna , Rathod Sachin B. , Vij Vinu A. , Gumashta Jyotsna , Muthiyan Gayatri , Patil Ashwini
Published: February 2024

BACKGROUND:

Understanding of human physiology is critical for clinical practice and disease management. Escalating the teaching-learning method to improve conceptual knowledge may help the students to apply their knowledge in clinical scenarios. The present study was conducted to teach the use of concept mapping as a learning strategy to foster meaningful learning in physiology, compare its impact as a learning tool with traditional methods on meaningful learning, assess the cognitive gain, and find student’s perception regarding concept mapping.

MATERIALS AND METHODS:

The interventional study was conducted on first-year MBBS students. Depending upon marks obtained in previous internal assessments, the students were classified into “rapid learners” (RL) and “potential learners” (PL). By simple random sampling technique, both groups were divided into interventional (concept mapping) and control groups (question-answer discussion). After a pretest, all students had a lecture on glomerular filtration. The assignment was given to the interventional group to prepare a concept map on glomerular filtration, and question-answer were discussed for control groups. A surprise posttest was conducted after 2-3 days.

RESULT:

In our study, all four groups showed significant differences in the pretest and posttest scores using a paired t-test (P < 0.05). The mean score of gain in learning, raw gain (G0), absolute learning gain, relative learning gain, and average normalized gain compared between the interventional group and controls group showed statistically significant performance improvement in both RL and PL groups.

CONCLUSION:

The concept mapping strategy was more efficacious than the question-answer discussion. Concept mapping is an impactful learning tool to improve cognitive gain and potential pedagogical strategy to foster meaningful learning in physiology students.
The role of adipokines and ghrelin in interactions and clinical implications in childhood obesity
Authors: Haddawi Karrar Haider , Al-Ziaydi Ahmed Ghdhban , Al-Khalidi Fatima Abd Al-Kathem
Published: February 2024

BACKGROUND:

Childhood obesity is a growing global health concern, especially prevalent in the Arabian Peninsula, and is known to contribute to metabolic syndrome and insulin resistance. This study aimed to investigate the interplay between adipokines (leptin and adiponectin), ghrelin, and insulin homeostasis in childhood obesity.

MATERIAL AND METHODS:

A case–control study was conducted in Babylon involving 120 children/adolescents (7–17 years). The participants were divided into two groups: 60 obese and 60 healthy controls. Anthropometric and biochemical measures were examined, applying World Health Organization (WHO) growth standards to categorize weight status. Data on blood lipids, glucose, adipokines, and ghrelin were collected in Babylon (Merjan Medical City), ensuring accuracy and providing insights into pediatric obesity’s metabolic and hormonal status.

RESULT:

Clinical, anthropometric, and laboratory attributes of children were evaluated, with classification as normal-weight or obese based on BMI/Z-score and Waist Circumference. The obese group exhibited elevated triglycerides and insulin levels, as well as reduced adiponectin levels (P ≤ 0.001). Leptin levels showed a positive correlation with BMI/Z-score (r = 0.352, P = 0.006). A diagnostic model demonstrated the significant diagnostic capacity of leptin (AUC > 99%) and its importance in predicting childhood obesity. Each unit increase in leptin elevated the probability of obesity by a factor of 1.197 (95% CI: 1.0507–1.3632, P = 0.0068).

CONCLUSION:

The study revealed significant differences in clinical, biochemical, and biological markers of obesity between the research groups and the control group. Leptin emerged as a significant predictor of obesity, demonstrating high diagnostic accuracy. The complex interactions among these adipokines underscore the necessity for comprehensive obesity management strategies.
Myasthenia Gravis with Toxic Goiter: Challenges with Management in a Low-Resource Setting in Africa; Review of Literature and Case Report
Authors: Akerele JM , Erameh C , Okomayin AA , Dongo A , Omosofe F , Ikponmonsa G , Osemobor KO , Akerele NN , Ngwu S
Published: February 2024

ABSTRACT

Myasthenia gravis (MG) is an antibody-mediated autoimmune disease with the cardinal feature being exertional voluntary skeletal muscle weakness and fatigability. It can be an isolated finding or in association with other autoimmune conditions such as Hashimoto’s thyroiditis, Graves’ disease, systemic lupus erythematosus (SLE), or rheumatoid arthritis. Thymectomy is recommended for most patients with MG whose symptoms begin before the age of 60 years. Patients with thymoma or thymic hyperplasia do respond to thymectomy compared to those without thymoma or enlarged thymus. Those with enlarged goiter would benefit from thyroidectomy. The management of these patients requires a multidisciplinary approach as performed in a low-resource setting. We are reporting the case of a 24-year-old who presented with MG with toxic goiter and had good control on medication. A computed tomography scan of the chest showed a superior mediastinal mass and a soft tissue scan of the neck was done which showed a diffusely enlarged thyroid gland. She subsequently had thymectomy and subtotal thyroidectomy with a satisfactory outcome. We highlight this case to show that MG with thymoma and goiter could coexist. Reports of such findings are infrequently reported in our environment.
A Comparative Evaluation of Three Methods of Disinfection of Gypsum Casts and the Changes in Surface Roughness and Dimensional Accuracy after Disinfection—An Ex Vivo Study
Authors: Lakshmi DM , Nandini VV , Raj SN , Albar NH , Alamoudi A , Bahammam SA , Zidane B , Bahammam HA , Patil S
Published: February 2024

ABSTRACT

Background:

One of the major problems of everyday dental practice is cross-contamination. It can place office personnel, dentists, and patients at risk of acquiring serious illness. Disinfection helps in controlling this cross-contamination to an extent. The evaluation was done to find the efficient disinfection method on gypsum casts.

Aims:

The aim of this study is to evaluate and compare the efficacy of three methods of disinfection of gypsum casts, namely, chemical disinfection by immersion, spray method, and microwave method, and also to evaluate and compare changes in surface roughness and dimensional accuracy between the three methods after disinfection.

Materials and Methods:

Ex vivo and experimental study. Thirty participants were selected, and impressions of the maxillary arch were made using polyvinyl siloxane impression material. Ninety type IV die stone gypsum casts were poured. It was divided into three groups and was subjected to chemical disinfection by immersion and spray methods, and microwave method. The disinfected casts were evaluated for microbial growth, surface roughness, and dimensional accuracy. It was performed by using the one-way analysis of variance test and paired t-test followed by the Kruskal − Wallis test and Wilcoxon signed rank test (α = 0.05).

Results:

Microwave disinfection was more effective than both immersion and spray chemical disinfection methods (P < 0.010 and <0.001). The surface roughness of the microwave-irradiated casts had significantly increased after disinfection. However, there were no significant dimensional changes by any of the methods of disinfection.

Conclusion:

Within the limitations of the study, the microwave method of disinfection is more effective in eradicating microorganisms when compared to chemical methods of disinfection by immersion and spray methods.
Identified Factors in COVID-19 Patients in Predicting Mortality
Authors: Yavuz S , Duksal F
Published: February 2024

ABSTRACT

Background:

The coronavirus disease 2019 (COVID-19) pandemic has led to a significant increase in global mortality rates. Numerous studies have been conducted to identify the factors associated with mortality in COVID-19 cases. In these studies, overall mortality was evaluated in patients, and no distinction was made as ward or intensive care mortality.

Aim:

This study aims to determine mortality-related factors in patients who died while in the ward. This could enable us to review the indications for intensive care hospitalization in possible pandemics.

Materials and Method:

This retrospective study was conducted on a cohort of 237 patients who applied to our institution between January 2020 and December 2021 with the diagnosis of COVID-19. Demographic characteristics, length of stay, type of admission (emergency ward or outpatient clinic), presence of comorbidities, thoracic computerized tomography (CT) findings, and laboratory findings were extracted from the hospital database. The demographic and laboratory results of both deceased and recovered patients were compared.

Results:

While many demographic and laboratory findings were statistically significant in the initial analysis, multiple logistic regression analysis showed that decreased albumin levels (adjusted OR = 0.23, 95% CI = 0.09 – 0.57), increased troponin (adjusted OR = 1.03, 95% CI = 1.02 – 1.05), and procalcitonin (adjusted OR = 3.46, 95% CI = 1.04 – 11.47) levels and higher partial thromboplastin time (PTT) (adjusted OR = 1.18, 95% CI = 1.09 – 1.28) values, presence of diabetes mellitus (DM) in patients (adjusted OR = 2.18, 95% CI = 1.01 – 4.69, P = 0.047), and admission to hospital from the emergency department (adjusted OR = 5.15, 95% CI = 1.45 – 18.27, P = 0.011) were significantly associated with mortality when adjusted for age. When a predictive model is constructed with these variables, this model predicted mortality statistically significant (AUC = 0.904, 95% CI = 0.856 – 0.938, P < 0.001), with a sensitivity of 77.2% (95% CI, 67.8 – 85), a specificity of 91.2% (95% CI, 85.1 – 95.4), a positive predictive value (PPV) of 86.7% (95% CI, 72 – 85.3), and an negative predictive value (NPV) of 84.4% (95% CI, 79.4 – 89.6).

Conclusion:

In this study, we may predict mortality among COVID-19-diagnosed patients admitted to the ward via this model which has the potential to provide guidance for reconsidering the indications for intensive care unit (ICU) admission.
Normalization of Cardiac Structural dimension and Function to Body Surface Area in South East Nigeria Children
Authors: Chinawa JM , Chinawa AT , Ujunwa FA , Odimegwu CL , Onyia JT , Chukwu K , Chukwu BF , Aronu AE , Ikefuna A
Published: February 2024

ABSTRACT

Background:

Standardizing cardiac valve structures and function to body surface area will help the clinician and surgeons in decision-making.

Aim:

To evaluate the z-scores of the sizes of cardiac structures and function and to present them in Gaussian curves and reference values.

Materials and Methods:

This was a cross-sectional study that involved 300 apparently healthy children. This study was performed among healthy children from birth to 18 years. Children with a normal echocardiogram, those with no chronic illness, no congenital heart defect, and no acquired heart defect were included in the study.

Result:

The majority fell within the normal limits, as shown in the Gaussian curves. For instance, 40 (13.3%) of atrioventricular (AV) valve diameters were +1 Z-score above the normal, and only 5 (1.7%) were +2 Z-score above the normal. About 9.3% (28/300) had below −2 Z-score below normal, while only 5% had −1 Z-score below normal. Similarly, the left ventricular function z-scores were also derived at −3 Z-scores to +3 Z-scores. The standard reference values were compared with the results obtained from our Z score values. There was no significant difference noted in the Z-scores. P values ranged from 0.07 to 0.84 for all the cardiac structures except for gender, where Z-scores of the mitral valve and left pulmonary artery varied significantly (P = 0.02).

Conclusion:

Reference values of cardiac structure and function were presented using Z scores, and we noted no significant difference when compared with the Western standard values except for the mitral valve and left pulmonary artery.
Identifying the Anatomical Variations of the Inferior Alveolar Nerve with Magnetic Resonance Imaging
Authors: Öçbe M , Borahan MO
Published: February 2024

ABSTRACT

Background:

The inferior alveolar nerve (IAN) is located in the mandibular canal (MC). It is critical to evaluate the position of the MC during treatment planning to prevent intra or postoperative complications.

Aims:

This retrospective study aimed to identify the anatomy and anatomical variations of the IAN using soft tissue imaging (pulse sequence magnetic resonance imaging [MRI]).

Materials and Methods:

This study was designed as a retrospective Consolidated Standards of Reporting Trials (CONSORT) study. In total, 220 MR images were obtained. Nutrient canals (NCs) were classified as intraosseous and dental NCs, while bifid MCs (BMCs) were classified as forward, retromolar, and buccolingual canals. IBM SPSS Statistics 22 was used. Kolmogorov–Smirnov and Shapiro–Wilk tests, descriptive statistical methods (means, standard deviations, and frequencies), and the Chi-square test were used. Statistical significance was set at P < 0.05.

Results:

In total, 220 patients (172 females and 48 males) were evaluated. NCs were present in 92.3% of all MCs and were significantly higher in patients aged <25 years. BMCs were observed in 106 patients (24.1%). The most common BMC of MC/IAN was in the forward canal (14.4%), followed by the retromolar canal (7.5%).

Conclusion:

Although previously, the dental canal was considered as an anatomical variation, this study revisited the classification and suggested that dental canals are anatomical structures.
Understanding Antenatal Care Service Quality for Malaria in Pregnancy through Supportive Supervision Data in Tanzania
Authors: Tesha Goodluck Elias , Makwaruzi Stella , Haws Rachel , Mostel Jadmin , Lusasi Abdallah , Lazaro Samwel , Mwaikambo Sijenunu , Chacky Frank , Reaves Erik , Kitojo Chonge , Serbantez Naomi , Tetteh Gladys , Wolf Katherine , Oseni Lolade
Published: February 2024

Malaria in pregnancy (MiP) is associated with maternal anemia, spontaneous abortion, and infant and maternal death. In Tanzania, MiP service data are collected through routine Malaria Services and Data Quality Improvement (MSDQI) supportive supervision rounds at antenatal care (ANC) facilities. Using structured assessment tools, the U.S. President’s Malaria Initiative Impact Malaria Project reviewed two annual rounds of MSDQI data (492 facilities in 2021 and 522 facilities in 2022), including ANC records and client satisfaction interviews. We assessed coverage of key MiP care components, used logistic regression to analyze uptake of the recommended three or more doses of intermittent preventive treatment in pregnancy (IPTp3+), and assessed client satisfaction. Coverage of most MiP care components exceeded 80%; however, only 38% of women received all components. Odds of receiving IPTp3+ were much lower among late ANC initiators than among those who initiated ANC during their first trimester (odds ratio [OR], 0.46; 95% CI, 0.38–0.57). Uptake of IPTp3+ increased almost exponentially by number of ANC visits. Women with seven visits were 30 times more likely than those with three visits to receive IPTp3+ (OR, 30.71; 95% CI, 11.33–83.22). Just 54% of clients had anemia screening and only 46% received IPTp3+. Client satisfaction with services and provider communication was high (98% and 97%, respectively); only 8% of client visits exceeded 3 hours. Increased ANC visits could boost IPTp3+ coverage. Routine MSDQI supportive supervision data are useful to assess quality of care, identify service delivery gaps, and guide policies to improve quality of MiP services.