bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Spin Dynamics of Elongated Minor Bodies with Applications to a Possible Solar System Analogue Composition for ‘Oumuamua
Authors: Seligman Darryl Z. , Levine W. Garrett , Cabot Samuel H. C. , Laughlin Gregory , Meech Karen
Published: October 2021

The first interstellar object, 1I/2017 U1 (‘Oumuamua), exhibited several unique properties, including an extreme aspect ratio, a lack of typical cometary volatiles, and a deviation from a Keplerian trajectory. Several authors have hypothesized that the non-gravitational acceleration was caused by either cometary outgassing or radiation pressure. Here, we investigate the spin dynamics of ‘Oumuamua under the action of high-surface-area fractional activity and radiation pressure. We demonstrate that a series of transient jets that migrate across the illuminated surface will not produce a secular increase in the spin rate. We produce 3D tumbling simulations that approximate the dynamics of a surface-covering jet and show that the resulting synthetic light curve and periodogram are reasonably consistent with the observations. Moreover, we demonstrate that radiation pressure also produces a steady spin state. While carbon monoxide (CO) has been dismissed as a possible accelerant because of its non-detection in emission by Spitzer, we show that outgassing from a surface characterized by a modest covering fraction of CO ice can satisfy the non-ballistic dynamics for a plausible range of assumed bulk densities and surface albedos. Spitzer upper limits on CO emission are, however, inconsistent with the CO production necessary to provide the acceleration. Nonetheless, an ad hoc but physically plausible explanation is that the activity level varied greatly during the time that the trajectory was monitored. We reproduce the astrometric analysis presented in Micheli et al., and verify that the non-gravitational acceleration was consistent with stochastic changes in outgassing.
Breaking the Degeneracy in Magnetic Cataclysmic Variable X-Ray Spectral Modeling Using X-Ray Light Curves
Authors: Belloni Diogo , Rodrigues Claudia V. , Schreiber Matthias R. , Castro Manuel , Costa Joaquim E. R. , Hayashi Takayuki , Lima Isabel J. , Luna Gerardo J. M. , Martins Murilo , Oliveira Alexandre S. , Parsons Steven G. , Silva Karleyne M. G. , Stecchini Paulo E. , Stuchi Teresa J. , Zorotovic Monica
Published: October 2021

We present an analysis of mock X-ray spectra and light curves of magnetic cataclysmic variables using an upgraded version of the 3D cyclops code. This 3D representation of the accretion flow allows us to properly model total and partial occultation of the postshock region by the white dwarf as well as the modulation of the X-ray light curves due to the phase-dependent extinction of the preshock region. We carried out detailed postshock region modeling in a four-dimensional parameter space by varying the white dwarf mass and magnetic field strength as well as the magnetosphere radius and the specific accretion rate. To calculate the postshock region temperature and density profiles, we assumed equipartition between ions and electrons; took into account the white dwarf gravitational potential, the finite size of the magnetosphere, and a dipole-like magnetic field geometry; and considered cooling by both bremsstrahlung and cyclotron radiative processes. By investigating the impact of the parameters on the resulting X-ray continuum spectra, we show that there is an inevitable degeneracy in the four-dimensional parameter space investigated here, which compromises X-ray continuum spectral fitting strategies and can lead to incorrect parameter estimates. However, the inclusion of X-ray light curves in different energy ranges can break this degeneracy, and it therefore remains, in principle, possible to use X-ray data to derive fundamental parameters of magnetic cataclysmic variables, which represents an essential step toward understanding their formation and evolution.
Multiwavelength View of the M87 Black Hole Captured by the Event Horizon Telescope
Authors: Principe G. , Lucchini M. ,   on behalf of Event Horizon Telescope (EHT) Multi-Wavelength Science Working Group, EHT Collaboration,   Fermi-LAT Collaboration, H.E.S.S. Collaboration, MAGIC Collaboration, VERITAS Collaboration, EAVN Collaboration
Published: October 2021

In 2017, the first image of the center of the M87 galaxy was captured by the Event Horizon Telescope (EHT). It revealed a ring morphology and a size consistent with theoretical expectations for the light pattern around a weakly accreting supermassive black hole of ∼6.5 billion solar masses. In parallel to the EHT measurements, an extensive multi-wavelength (MWL) campaign with ground- and space-based facilities from radio all the way up to the TeV energy range was organized. In this note we will give an overview of the results from this campaign. M87 was found to be in a historically low state. At X-ray energies the emission from the core dominates over HST-1. We present the most complete simultaneous, MWL spectrum of the active nucleus to date.
Nurse Support on Health Cadre Empowerment and the Influence on the Ability of Women’s Mentoring Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome
Authors: Ernawati Ernawati , Nursalam Nursalam , Devy Shimarti Rukmini , Soesanto Edy , Rejeki Sri
Published: October 2021

BACKGROUND: In the context of community empowerment, the role of nurses as health workers is very important to transform the knowledge and skills of cadres. However, the support of nurses in empowering human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) health cadres has not been widely explained.

AIM: This study examines the effect of nurse support and empowerment on the ability of HIV/AIDS cadres to assist mothers with HIV/AIDS.

METHODS: This study used a cross-sectional approach. We involved 119 HIV/AIDS cadres including local residents who care about AIDS (WPA, n = 90), facilitators of families of hope (PKH, n = 17), and peer support groups (KDS, n = 12). Data collection was carried out from February to April 2020, the sample was selected using multistage cluster sampling in Kudus Regency, Central Java, Indonesia. Multiple linear regression analysis was conducted to determine the support of nurses, empowerment of HIV/AIDS cadres, and its effect on the ability of cadres in assisting women with HIV/AIDS.

RESULTS: We found that nurses’ support for the empowerment of HIV/AIDS cadres was low in almost all aspects (instrumental, informational, emotional, and affiliation). Nurse support and cadre empowerment affect the ability of HIV/AIDS cadres by 28%. Regression test formula Y = −97.080 + 0.738X1 + 1.944X2.

CONCLUSION: The results showed that the four types of nurse social support may be interrelated and are generally still low in the process of empowering HIV/AIDS cadres. There is an effect of nurse support and empowerment of HIV/AIDS cadres on the ability of cadres to assist women with HIV/AIDS.
Le contrôle de gestion en cycle de production inversé, quelles spécificités ? Le cas du secteur assurantiel
Authors: Dufour Nicolas
Published: October 2021

L'objet de cet article est d’aborder la particularité du contrôle de gestion en cycle de production inversé. Dans ce cadre, nous proposons une étude autour du secteur assurantiel français afin de mieux comprendre cette notion et son contexte de survenance. Les principaux résultats amènent à questionner les spécificités de ce mode de contrôle de gestion en dualité et démontrant qu’il intègre une vision prospective du risque inhérente à ce mode de contrôle de gestion.
Articuler connaissances en psychologie cognitive et ingénierie pédagogique
Authors: Tricot André
Published: October 2021

Quand elle s’intéresse à l’apprentissage, la psychologie cognitive a pour objectif de comprendre comment les humains apprennent. L’ingénierie pédagogique a pour objectif de fournir des connaissances et des méthodes utiles lors de la conception de situations d’enseignement. Les deux disciplines n’ont donc ni le même objet (apprentissage vs . enseignement), ni le même statut (science vs . ingénierie). L’objectif de cet article est de montrer comment on peut articuler connaissances en psychologie cognitive et ingénierie pédagogique. La théorie de la charge cognitive est utilisée comme exemple pour montrer comment on peut produire des connaissances pour l’ingénierie pédagogique à partir d’hypothèses fondées sur une description précise des structures et des fonctions cognitives impliquées dans les apprentissages. Cette théorie illustre que les connaissances pour l’ingénierie sont conditionnelles : leur mise en œuvre dépend de la situation à concevoir et notamment des connaissances antérieures des élèves.
Des sciences interventionnelles ancrées sur des alliances entre recherche et terrain ? Le cas des ingénieries coopératives
Authors: Sensevy Gérard
Published: October 2021

Cet article présente théoriquement et empiriquement la notion d’ingénierie coopérative. Après une première description de cette notion, il précise ses filiations, le fonctionnement de ces ingénieries, et leurs principes organisateurs. Ces éléments sont ensuite concrétisés sur un exemple à vocation emblématique, celui de l’ingénierie coopérative ACE (Arithmétique et Compréhension à l’École élémentaire). En appui sur cette concrétisation, l’article montre d’abord comment les recherches accomplies dans le cadre des ingénieries coopératives peuvent être considérées en tant que sciences interventionnelles, à la fois comme fondamentales au sein des sciences de la culture, et comme des sciences ingénieriques. Il se conclut en insistant sur la double nécessité, pour de telles sciences, i) d’une élaboration conceptuelle qui fasse reconnaitre des preuves culturelles d’efficacité, et ii) d’une mise en combinaison des preuves culturelles et des preuves statistiques.
Pourquoi et comment soutenir le développement des compétences émotionnelles chez les élèves âgés de 4 à 7 ans et chez leur enseignant.e ? Apports des sciences cognitives
Authors: Richard Sylvie , Gay Philippe , Gentaz Édouard
Published: October 2021

Apprendre à identifier, exprimer, comprendre, utiliser et réguler ses émotions et celles d’autrui fait partie intégrante des apprentissages fondateurs d’une scolarité réussie. De nombreuses études en sciences cognitives ont montré que ces compétences jouent un rôle crucial dans la réussite des élèves à l’école et favorisent leurs relations interpersonnelles. Dans un premier temps, nous allons examiner dans quelle mesure le développement de ces compétences émotionnelles est tout particulièrement central chez les élèves qui débutent leur scolarité. Dans un second temps, nous allons proposer deux grands axes d’intervention en classe afin de soutenir leur développement. Nous allons présenter notamment les pratiques d’enseignement « indirectes » (à savoir, être en tant qu’enseignant.e « émotionnellement compétent ») qui visent à les favoriser et nous allons voir qu’il est également possible de mettre ces compétences émotionnelles au défi directement à travers la « labellisation » des émotions, des conversations portant sur les émotions et par le biais des jeux de faire semblant.
Cognition, métacognition, éducation : l’approche intégrative de l’Atelier d’Apprentissage
Authors: Hessels-Schlatter Christine , Hessels Marco , Brandon Sophie
Published: October 2021

L’Atelier d’Apprentissage est un service spécialisé dans la remédiation des problèmes d’apprentissage. L’approche développée est un exemple d’intégration des apports des sciences cognitives aux questions éducatives. Cette contribution décrit notre approche globale et intégrative d’intervention ainsi que ses caractéristiques principales : 1) une perspective résolument métacognitive tant dans ses objectifs que dans ses méthodes d’intervention pour la remédiation des processus de pensée et d’apprentissage ; 2) l’accent mis sur la promotion du transfert des compétences acquises au contexte de vie propre à l’apprenant (école, travail, vie quotidienne). Les apports d’une analyse cognitive des tâches pour optimiser le transfert des apprentissages, ainsi que pour développer de manière efficace les compétences en lecture des personnes avec déficience intellectuelle seront illustrés.
Comportamiento al desgaste y propiedades de corrosión de la aleación de aluminio AA2010 endurecida por envejecimiento
Authors: Çömez Nilay
Published: October 2021

El presente estudio tiene como objetivo investigar la resistencia al desgaste y las propiedades de corrosión de la aleación AA2010 tratada térmicamente. La aleación se disolvió a 500 ºC durante 1 h y luego se inactivó en agua a temperatura ambiente. El tratamiento en solución fue seguido por un tratamiento de envejecimiento a 160 °C durante 16, 18 y 22 h. La dureza máxima se alcanzó a las 18 h. La prueba de desgaste utilizando un disco de bola provocó una deformación en frío y, por tanto, aumentó localmente la dureza de la superficie desgastada. La velocidad de corrosión de la aleación AA2010 tratada térmicamente se determinó mediante el método de extrapolación de Tafel. Los ensayos de corrosión se llevaron a cabo en NaCl al 3,5% a temperatura ambiente. La velocidad mínima de corrosión se obtuvo con la aleación envejecida 18 h. Así, para una resistencia moderada al desgaste y buenas propiedades frente a la corrosión, se recomienda un envejecimiento de 18 h. Finalmente, se observó corrosión intergranular y corrosión por picadura en la superficie de la aleación.
The Influence of Shrinkage-Reducing Additives on Volume Changes and Mechanical Parameters of a Concrete Composite
Authors: Merunka Milan , Ťažká Lucia , Hela Rudolf
Published: October 2021

Cement hydration is a process during which the setting and hardening of cement stone occur. This process is linked to the significant development of heat of hydration, which is accompanied by volume changes of concrete composite (i.e. shrinkage). Due to this, cracks in a concrete composite can arise and influence not only its durability, mechanical parameters or aesthetics but, in the case of water-tight concretes (e.g. the so-called white boxes), also its function. The extent of volume changes can be influenced not only by the composite structure itself or the selection and amount of cement but also by using suitable active additions, e.g. high-temperature fly ash. As a result, it is possible to reduce the amount of cement required while maintaining identical mechanical parameters of concrete and, at the same time, slow down the progress of heat of hydration during cement hydration. One of the other options to eliminate volume changes in concrete composites is the use of shrinkage-reducing additives (SRA). This article focuses on the SRA influence on volume changes of high-performance concretes and their impact on the development of hydration temperatures and mechanical parameters of composites.
Study on Permeability of Concrete Fortifications from WW2 Based on Mercury Intrusion Porosimetry
Authors: Zatloukalová Jaroslava , Pazderka Jiří , Lukáš Petr , Reiterman Pavel
Published: October 2021

Quantification of water transport properties of concrete is crucial for prediction of the material degradation processes. In case of 80 years ́ old concrete of fortification structures of former Czechoslovakia, its permeability is the determining factor of the scale of degradation. Mercury intrusion porosimetry was used to characterize the porous system of seven existing bunkers from the defence line ”Pražská čára” and to calculate the permeability using model of Bágel and Živica. Results showed the altered structure of the old concrete, characterized by no notable peaks, which mark the critical pore radius most responsible for water intake. The majority of pores are small micropores, which does not contribute much in the water transport. However, calculated permeability is high enough to be the cause of several degradation processes. The performed program also confirmed high variability of permeability properties between individual structures.
The Influence of Phosphogypsum Microstructure on the Main Properties of Press-Formed Samples
Authors: Fornes Ignacio Villalon , Vaičiukynienė Danutė , Doroševas Viktoras , Nizevičienė Dalia
Published: October 2021

The storage of the phosphogypsum in stockpiles causes serious environmental problems. In order to avoid them, this by-product should be utilised. Hence, one solution is to employ it as a binding material, so that its structural and binding properties must be satisfactory. Depending on the type of original phosphate rock, the microstructure of phosphogypsum may differ, determining its main physical-mechanical properties. However, research with comparative analyses of the properties of phosphogypsum from different origins is almost inexistent. Therefore, in this study, the microstructure of phosphogypsum from two different sources is analysed: the first type is from Kovdor mine (Russia); the second is a mixture between material from Kirov (Russia) and Casablanca (Morocco) mines. The microstructure of both phosphogypsum types was analysed and compared by applying SEM-DES analysis and by measuring the loss on ignition. In order to obtain high mechanical properties, the material was processed by press-forming. Eventually, the mechanical properties of hardened phosphogypsum of both types were obtained by compression test and then compared.
Decomposition of Crystalline Limestones during the Burning Process
Authors: Sklenářová Dorothea , Dvořák Karel , Dolák Dušan
Published: October 2021

The decomposition of limestone during the firing process is mainly based on the decarbonation of CaCO3. In the case of crystalline limestone, it is the decomposition of calcite crystals. In this study, different limestone properties on the course of decarbonation are studied. Therefore, the samples are determined from a geological and physicochemical point of view (geological age and origin, total porosity, limestone category, chemical analyses and insoluble residue). After thorough identification of the samples, various analyses focused on limestone and lime microstructure are performed, such as SEM image analysis or lime reactivity. For these analyses, the samples are burned at different temperatures. The decrepitation amount of limestones during burning process is determined.
Pre-defined competency level based instructional design model for learning Anatomy in an undergraduate medical curriculum
Authors: Abeykoon I. , Fernando L. , Fernando A. , Weerasooriya T. , Chandratilake M.
Published: October 2021

The paper presents a competency based instructional design model to teach gross Anatomy in an undergraduate medical course. The main objectives of the presented instructional design model is to allow space for identification of finer demarcations for expected competencies while allowing the students to possess a broader understanding of the discussed areas under each competency level. Here the traditional semester will be split into three competency levels and within each competency level the entire region expected to be discussed will be presented. However, the first competency level will discuss the given area superficially with details being introduced during second and third competency levels. The center of focus as well as teaching learning modalities will also evolve with increasing competency levels making the presented instructional design model a more dynamic than a static approach.
Hybrid conferences in the new normal: reality in a resource restricted context
Authors: Karunathilake I. M. , Perera B. J. C. , Amarakoon P. M. , Ihsan F. R. , Mudiyanse R. M. , Manawadu M. C. K. , Chandrasena U. , Wijewickrama A. , Silva L. H. S. C. , Peiris J. S. M. , Low W. Y. , De Abrew A.
Published: October 2021

No abstract available
The autopsy in medical education
Authors: Edussuriya D. H. , Paranitharan P. , Perera W. N. S. , Thilakarathne M. G. N. I. , Wijesiriwardena W. M. S. Y. , Nanayakkara C.
Published: October 2021

No abstract available
Transcatheter Mitral Valve Repair Using MitraClip in Secondary Mitral Valve Regurgitation Guided by Real-Time Pressure–Volume Loops
Authors: Espinosa Samantha , El Sabbagh Abdallah , Behfar Atta , Patel Parag
Published: October 2021

Worsening of left ventricular (LV) function is a potential complication after repair of secondary mitral valve regurgitation, and one which has limited methods for predicting its risk of occurrence. We present a case utilizing real-time pressure–volume loops intraprocedurally to monitor hemodynamic changes before and after application of a trancatheter MitraClip device in a patient with severe symptomatic secondary mitral regurgitation (MR). Worsening of LV function is a potential complication after repair of secondary mitral valve regurgitation. We present a case utilizing real-time pressure–volume loops intraprocedurally to monitor hemodynamic changes before and after application of a transcatheter MitraClip device in a patient with severe symptomatic secondary MR.
First Case of Tricuspid Valve Surgery in a Neurofibromatosis Type 1 Patient
Authors: Saccocci Matteo , Ferraro Francesco , Blasi Stefania , Del Zanna Niccolò , Villa Emmanuel , Messina Antonio , Cirillo Marco , Mhagna Zean , Tomba Margherita Dalla , Troise Giovanni
Published: October 2021

The neurofibromatosis is a large class of different genetic disorders: Neurofibromatosis type 1, type 2, type 3 (or Schwannomatosys), which have different clinical characterization. Neurofibromatosis type 1 (NF1), also known as Von Recklinghausen disease, represents 95% of the total cases. It is a complex autosomal dominant disorder with multisystem involvement, frequently associated to cardiac malformation. We present the case of a 52-years-old male affected by NF-1 with severe tricuspid regurgitation and atrial septal defect (ASD). No previous report about tricuspid valve surgery in NF-1 are available in the literature. A complete perioperative assessment was performed, including dermatologist evaluation, angio-CT scan and transesophageal echocardiography. The patient underwent uneventfully tricuspid valve replacement and ASD closure, with no wound complication even at 6-months follow-up. Treating congenital malformation in patient with complex genetic disorders like NF-1 is safe and can be resolutive, permitting to reduce long-term risk of complications for the patients. Preoperative assessments are fundamental, as well as in-hospital care and expertise on congenital heart defects.
The Effect of Ivabradine on Hospitalization of Heart Failure Patients
Authors: Al-Balushi Sara , Alam Mohammed Fasihul , Abid Abdul Rehman , Sharfi Amal
Published: October 2021

Background:

Ivabradine is recommended in heart failure (HF) patients to reduce cardiovascular death and hospitalization due to worsening of HF symptoms.

Aims and Objectives:

To study the effect of Ivabradine in addition to guideline-directed medical therapy (GDMT) in a group of HF patients with HR more than 70 bpm, HF with reduced ejection fraction (HFrEF) left ventricular ejection fraction (LVEF ≤ 40%), and New York Heart Association class II-IV.

Methods:

The study was conducted at Heart Hospital, Hamad Medical Corporation, Qatar. HF patients with age > 18 years, LVEF ≤40%, on GDMT, and HR of ≥70 bpm were included. The study population was divided into two groups: ivabradine group and non-ivabradine group. The primary outcomes were risk, number and length of hospitalizations due to worsening HF, and cardiovascular mortality. The secondary outcome was all-cause mortality. Baseline characteristics were collected at enrollment. Study outcomes were compared in the two groups by applying Chi-square and Fisher's exact tests. Logistic regression model was applied to assess both hospitalizations and cardiovascular mortality.

Results:

A total of 111 patients were studied, 37 (33.94%) ivabradine group and 74 (66.67%) non-ivabradine group. Risk of hospitalization was lower in Ivabradine group compared to non-Ivabradine group (odds ratio: 0.43, 95% confidence interval [CI]: 0.16–1.015, P = 0.094). Average length of hospitalization in ivabradine and non-ivabradine groups was 12.54 and 8.91 days, respectively (incidence rate ratio [IRR]: 1.63, 95% CI: 0.79–3.38, P = 0.187). Compared to non-ivabradine, ivabradine patients had lower number of hospitalizations (IRR: 1.13, 95% CI: 0.61–2.11, P = 0.694). Death rate in both ivabradine and non-ivabradine groups was 3.

Conclusions:

Ivabradine along with GDMT reduces the risk of hospitalization due to worsening HF symptoms. Ivabradine had no significant effect on cardiovascular mortality and all-cause mortality. HFrEF non-Arabs patients have lower risk, number and length of hospitalization, and mortality compared to Arabs.
Training nonspecialists in clinical evaluation for telepsychiatry using videoconferencing
Authors: Malhotra Savita , Chakrabarti Subho , Gupta Aarzoo , Sharma Kanupriya , Sharma Minali
Published: October 2021

Aims:

Videoconferencing-based telepsychiatry has been used successfully for the assessment and management of psychiatric disorders. However, training mental health professionals through videoconferencing has seldom been attempted. Online decision support systems for diagnosing psychiatric disorders had been developed earlier at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, as a part of a project for delivering telepsychiatric services to remote areas. The feasibility of videoconferencing for training nonspecialist staff in the use of the online tool to diagnose psychiatric disorders was examined. The effectiveness of training was evaluated using ratings of diagnostic agreement between trainees and trainers and estimations of training costs.

Methods:

The Skype platform was used for videoconferences (VCs). Broadband internet connections had bandwidths of 4 mbps and speeds of 512 kbps. A total of 62 training sessions were conducted by the PGIMER team for remote-site teams using role-play techniques and actual patient interviews.

Results:

Videoconferencing-based training was considered to be convenient, satisfactory, and useful by all the participants. Diagnostic agreement between trainees and trainers was 89%–100%. Such training also appeared to be cost-effective. The main problems encountered were poor connectivity and poor audiovisual quality of the VCs.

Conclusions:

Videoconferencing can be feasible and effective for training nonspecialists to diagnose psychiatric disorders.
Coronary Collateral Circulation in Acute, Subacute, and Chronic Total Occlusions
Authors: Sarojadevi Ashida Thulaseedharan , Venugopal Vinayagamoorthy
Published: October 2021

Context:

A study on the pattern of coronary collateral circulation is relevant in coronary artery disease (CAD) where despite advances in revascularization, the prevalence of heart failure is increasing.

Aims:

The aim was to study the pattern of coronary collateral circulation in acute, subacute, and chronic coronary total occlusions and to find out the association between collateral grade with the severity of CAD.

Settings and Design:

This was a hospital-based retrospective cross-sectional study of 141 patients with acute, subacute, or chronic total occlusion of coronaries detected by coronary angiography.

Subjects and Methods:

Data of 141 patients with total occlusion of coronaries detected by coronary angiography were analyzed. Collateral grading was done according to the Rentrop classification and Werner classification. The severity of CAD was assessed using Gensini score and Syntax score. Pattern of collateral circulation in different types of coronary occlusions and the association between collateral grade and severity of CAD were assessed.

Statistical Analysis Used:

The association of categorical clinical and angiographic features with type of occlusion was tested using Chi-square test and that of continuous variable with student t-test. All tests were two tailed and P < 0.05 was considered statistically significant.

Results:

Young patients presented predominantly with acute coronary occlusions (82.6%). About 73% of the patients with left ventricle (LV) dysfunction had acute coronary occlusions. Nearly 68.8% of patients with poor Rentrop collateral grades had LV dysfunction. Patients with acute occlusion had low atherosclerotic burden as evidenced by lower Gensini and Syntax scores and had poor coronary collaterals. No significant correlation was seen between Gensini and Syntax scores and collateral grade. Patients who presented with ST-elevation myocardial infarction (STEMI) had poor Rentrop collaterals and higher prevalence of single-vessel disease and double-vessel diseases when compared to those with non-ST-segment elevation acute coronary syndrome and chronic stable angina.

Conclusions:

Young male patients with low atherosclerotic burden tend to present with acute coronary occlusions. This subgroup has poor collateral circulation and LV dysfunction. No statistically significant difference was seen in the presence of diabetes, hypertension, number of epicardial coronary artery involvement, or the severity of CAD in the STEMI patients with good or poor Rentrop collaterals.
Comparative Study of Implant Site Assessment Using CBCT, Tomography and Panoramic Radiography
Authors: Choudhary Anand , Kesarwani Pallavi , Verma Saumya , Srikrishna K. , Nandi Devarshi , Srishti
Published: October 2021

Aim:

The present study was done to evaluate the accuracy of panoramic radiography (OPG), conventional cross sectional tomography (CCST) and cone beam computed tomography (CBCT) to precisely portray structures in the posterior mandible.

Materials and Methods:

The present in-vitro study was performed on 42 edentulous human mandibles. A region 2cm behind the mental foramen was imaged using an OPG machine followed by imaging the same region using CCST function of the same OPG machine and CBCT. The distances from the alveolar crest to superior margin of the mandibular canal and alveolar crest to the lower border of mandible were measured in radiographs obtained by the three modalities. This step was followed by the comparison of the measurements performed in the cut-section of the mandible considered as Gold Standard.

Results:

The measurements done in the images obtained by OPG machine exceeded the values of gold standard by a mean of 2.69 mm ± 2.27 mm and 5.84 mm± 0.89 mm respectively. Similarly in CCST function and CBCT images, the measurements exceeded by 4.95 mm ± 2.35mm, 9.55mm ±1.25mm and 0.24mm ±0.20mm, 0.20mm ± 0.13mm respectively. The differences between the measurements made in radiographs and cut section were statistically significant.

Conclusions:

It was concluded that the measurements made by CBCT images were more precise, in addition CBCT images were also helpful in accurate three dimensional localization of the mandibular canal.
Comparison of Efficacy of Combination Therapy (Low Level Laser Therapy (LLLT) and Topical Steroid) with Topical Steroid Therapy only in Patients with Symptomatic Oral Lichen Planus – In vivo Study
Authors: Jain Richa , Mhapuskar Amit Anil , Prasad Hiremutt Darshan R , Kale Isha , Kalyanpur Kedarnath , Bhadani Harshit
Published: October 2021

Aim:

To compare the efficacy of combination therapy (low level laser therapy [LLLT] and topical steroids) with topical steroid therapy alone in individuals with symptomatic oral lichen planus.

Materials and Methods:

The study was conducted on 30 patients who reported to our department with clinically and histologically proven symptomatic oral lichen planus (OLP). All the patients were assessed for the criteria of outcome—pain, burning sensation, size of the lesion, clinical resolution, and recurrence. The patients were randomly assigned into two groups each comprising of 15 patients. Group I (study group) patients received a combination of topical steroid and LLLT while Group II (control group) patients received only topical steroid therapy.

Results:

A significant pain and burning sensation reduction were found in the patients who were given LLLT (P: 0.05). There was a decrease in the size of the lesion which was statistically significant. A complete clinical resolution was achieved and only 11% recurrence occurred in the study group. This therapy appears to be effective in patients with symptomatic OLP.

Conclusion:

The LLLT therapy appears to be useful in relieving pain and burning sensation, reduction in the size of the lesion, with complete clinical resolution and minimal recurrence, and hence, can be considered as a valuable aid in managing symptomatic OLP. Thus, the LLLT therapy serves as a potent and independent therapeutic modality in symptomatic OLP.
Diagnostic Reporting of Calcified Carotid Atheroma in Digital Panoramic Radiograph – A Retrospective Study
Authors: Sadaksharam Jayachandran , Kathiresan Iswarya
Published: October 2021

Context:

Cerebrovascular disease remains one of the leading causes of death in many countries.

Aim:

To evaluate the presence of calcified carotid atheroma in digital panoramic radiographs, thereby referring the patients to cardiology for early management and prevention of stroke.

Settings and Design:

Hospital- based, cross- sectional retrospective study.

Materials and Methods:

The study design included 1000 digital panoramic radiographs taken for the needful patients in the Department of Oral Medicine and Radiology for a period of one year from November 2018 to October 2019. Two examiners (experienced maxillofacial radiologists) evaluated the presence of calcified carotid atheroma in panoramic radiographs.

Results:

Out of 1000 digital panoramic radiographs, 39 panoramic radiographs were found to have the presence of calcified carotid atheroma, of which 9 were male and 30 were female panoramic radiographs. The prevalence was found to be higher in the age group between 45 to 54 years.

Conclusion:

Panoramic radiographs help to assess the presence of calcified carotid atheromas. Careful evaluation of panoramic radiographs by maxillofacial radiologists for carotid atheromas could be life-saving in the prevention of stroke.
Association of Pulp Stones among Patients with Addictive Habits – A Descriptive Cross-Sectional Study
Authors: Karemore Tapasya , Banubakode Trushita , Motwani Mukta , Dhole Apeksha , Muneshwar Rutuja
Published: October 2021

Aim:

The study aimed to determine the association of pulp stones among patients with addictive habits in comparison with healthy individuals without any addictive habits.

Materials and Methods:

A total of 240 patients were included in the study, i.e., 120 patients with addictive habits and 120 healthy individuals without addictive habits. Bite-wing projection of the intact or sound teeth of one side, i.e., either right or left side of the first and second molars of the upper and lower arch was obtained. The presence or absence of pulp stones was observed for the selected teeth. The Chi-square analysis was used to evaluate and compare the occurrence of pulp stones among patients with addictive habits and healthy individuals of a similar age group.

Results:

Of the 960 teeth examined from both groups, 111 (11.56%) teeth had pulp stones. Pulp stones were observed among 43 patients with addictive habits and in 30 healthy individuals. The occurrence of pulp stones was higher in the first molar followed by the second molar and in the maxillary than in the mandibular arch.

Conclusions:

No significant association was observed with the occurrence of pulp stones among patients with addictive habits, but a significant association was noted with respect to duration of habit.
Vitamin D and Liver Enzymes' Levels in Libyans with Type 2 Diabetes
Authors: ElJilani Mouna Mohamed , Alemam Hafsa A. , Bashein Abdulla
Published: October 2021

Background:

Many epidemiological studies reported the association of Vitamin D deficiency and abnormal liver enzymes' levels with type 2 diabetes (T2D) and their findings remain inconsistent.

Aim:

The study investigated the status of both Vitamin D levels and liver enzymes' activity in a Libyan population with T2D.

Materials and Methods:

A total of 180 individuals of both genders whose ages ranged between 25 and 62 years were enrolled. Fasting blood sugar, (FBS), Vitamin D, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) were measured in patients' serum. The association of both Vitamin D and liver enzymes levels with T2D was evaluated by Chi-square analyses.

Results:

55.6% of the study subjects were diabetics and 44.4% were healthy controls. 100% of T2D patients had deficient Vitamin D level (<20 ng/ml) (P = 0.000). The mean Vitamin D level was higher in nondiabetics (39.1 ± 4.0) ng/ml than in T2D patients (7.4 ± 1.8) ng/ml. 98% (P = 0.068), 97% (P = 0.118), and 100% of T2D patients had normal levels of AST, ALP, and ALT enzymes, respectively. The mean AST, ALP, and ALT enzymes levels for nondiabetics were 30.3 ± 4.1, 58.7 ± 8.0, and 24.8 ± 4.9 U/L, respectively. The mean AST, ALP, and ALT enzymes levels for T2D patients were 11.3 ± 2.9, 125.0 ± 11.5, and 10.3 ± 1.7 U/L, respectively.

Conclusions:

Vitamin D deficiency may be related to T2D in the Libyan population, while the liver enzymes showed no significant differences between diabetics and nondiabetics.
Neuropsychopathology of gambling disorder
Authors: Okechukwu Chidiebere E.
Published: October 2021

Gambling disorder (GD) is characterized by a pattern of continual or persistent gambling behavior, which may be online or offline, demonstrated by impaired control over gambling (e.g., inception, rate, passion, duration, cessation, and perspective). GD entails growing precedence given to gambling activities to the point that gambling takes priority over other daily activities and continuation and intensification of gambling despite the rate of negative consequences. The pattern of gambling behavior may be constant or episodic and recurrent. With regard to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, gambling behavior and associated characteristics are usually apparent over at least 12 months for a diagnosis to be assigned, although the required period may be reduced if all the diagnostic criteria are met and the symptoms are severe.
Grassroots sexual and reproductive rights interventions on sexual risk behavior among female sex workers in Nigeria
Authors: Ochonye Bartholomew B. , Abiodun Paul O. , Sanni Felix O. , Tewobola Olufunke , Alamu Tolu A. , Ogbonna Ngozika
Published: October 2021

Introduction:

Sexual reproductive health and rights (SRHR) involve access to accurate information, rights-based quality, safe, effective, affordable, and acceptable health-care services at all levels that cover the sexual and reproductive needs of the individual and community irrespective of social, sex, gender, and other differences.

Objective:

This study aims at assessing the grassroots interventions on the knowledge of rights, access, and uptake of sexual reproductive health (SRH) services among female sex workers (FSWs) in Benue State, Nigeria.

Materials and Methods:

This cross-sectional survey is a randomized cluster sampling among FSWs in Benue State, Nigeria. A structured questionnaire was used to collect data from the respondents, and the data collected were analyzed using IBM-SPSS Corp., Armonk, NY, version 25.0. The statistical significance level was set at P < 0.05.

Results:

Respondents were 446 FSWs aged 15–45 years, comprising 223 FSWs at baseline and post-intervention. Significantly higher intervention respondents (84.4%) use condoms while drunk compared with 56.1% at the baseline (P < 0.0001). Overall, 70.0% used lubricants in the past 12 months in the post-intervention study, whereas only 47.5% used them in the baseline study (P < 0.0001). Generally, 21.1% indulged in anal sex, and there was no significant difference between the baseline and intervention (P > 0.05). Virtually all respondents (96.0%) used any contraceptive methods in the intervention period compared with 68.6% at the baseline (P < 0.001). The intervention respondents were 11.84 (95% CI: 4.98–28.16; P < 0.0001) times more likely to use any contraceptive method than their baseline counterparts. The intervention respondents were 2.22 (95% CI: 1.51–3.27; P < 0.0001) times more likely to use emergency contraceptives than their baseline counterparts.

Conclusion:

This study showed the positive outcomes of grassroots interventions involving FSWs in Benue State, Nigeria. Such interventions should be extended to other key populations in Nigeria.
A comparative evaluation of Typhidot and Widal tests for the detection of agglutinins against typhoid and paratyphoid bacilli in patients’ sera
Authors: Singh Raksha , Singh Gurjeet
Published: October 2021

Background:

The term enteric fever includes typhoid fever caused by Salmonella typhi and paratyphoid fever caused by Salmonella paratyphi A, B, and C. Typhoid fever has been virtually eliminated in the developed countries during the past several decades, mainly as a result of improvement in water supply and sanitation, but it continues to be endemic in the resource-limited nations of the world. The control of paratyphoid fever has not been so successful. Bacteriological diagnosis of enteric fever consists of isolation of the bacilli from the patients and the demonstration of antibodies in their sera. Widal testing is cost-effective and gives reports quickly. The Typhidot test is based on the method of immunochromatography test. It is easy to perform, and the results can be preserved for a long time. This study aims to compare the sensitivity and specificity of the Widal test and Typhidot test for the diagnosis of enteric fever.

Materials and Methods:

This prospective study was carried out at the Department of Microbiology, N.C. Medical College and Hospital, Panipat, Haryana, India, over 6 months from September 2020 to February 2021. In our study, a total of 150 clinically suspected patients were included. First of all, the area for blood collection was cleaned with spirit-soaked cotton and 10 mL of blood was collected with a sterile disposable needle and syringe from a median cubital vein (antecubital vein) of each patient after obtaining informed consent from the patient (from parents in case of age below 18 years). Seven milliliters of blood was immediately transferred to a blood culture bottle by cleaning the cap of the bottle for isolation and identification of causative organisms and 3 mL was transferred to a sterile plain vial for serum separation. Then the qualitative Widal slide agglutination test and Typhidot test were performed on each sample.

Results:

In the present study, out of the 150 clinically suspected enteric fever cases, maximum positivity 53 (35.33%) was given by the Typhidot test, followed by 36 (24%) given by the qualitative Widal slide agglutination test and 44 (29.33%) given by blood culture for S. typhi and S. paratyphi.

Conclusion:

Our study highlights the use of Typhidot for early diagnosis of enteric fever and also cross-checks with Widal test and blood culture for the diagnosis of enteric fever. Typhidot tests are easy to perform and less-trained personnel can also perform the test; they have been designed to detect IgM and IgG antibodies to lipopolysaccharide or outer membrane protein antigens of S. typhi and S. paratyphi. It can be useful in the early diagnosis of infection in the initial weeks of primary infection when a single serum sample is available, with a sensitivity and specificity of 90% and 80%, respectively, considering blood culture as a gold standard.
Impact of under-five mortality on economic growth and health-care expenditures in India
Authors: Chinnaiyan Saravanan , Babu Bhavya , Ghimire Ananta
Published: October 2021

Introduction:

Under-five mortalities are the significant vital indicators of the population health condition and the social development of the country. Child survival is measured by the under-five mortality rate (U5MR). It also reflects the social, economic, and environmental circumstances, as well as their health care. Our main objective is to determine the impact of the U5MR on economic growth changes and health-care expenditure and examine the sex difference trend of under-five mortalities.

Materials and Methods:

We have retrieved data from World Bank Indicators from 2005 to 2017, with under-five mortality as the independent variable and health expenditure as a dependent variable. We used correlation analysis to assess the impact of under-five mortalities on economic growth and health-care expenditure in Rstudio (open-source software).

Results:

The U5MR was higher in females than in males. The correlation of mortality rate, under-five (per 1000 live births) with current health expenditure per capita, domestic general government health expenditure per capita, and domestic private health expenditure per capita was found to be statistically significant (P < 0.05).

Conclusion:

Accordingly, political stability, effective social sector policies, and government interventions are essential for reducing under-five mortality. The human health force’s participation in macro and micro policy-making is also necessary, and other determinants of health-care expenses should be critically examined.
Knowledge and Awareness of Pregnancy-Related Hypertension and Utilization of Exercises as its Preventive Strategies
Authors: Ojukwu Chidiebele Petronilla , Ezeigwe Anne Uruchi , Madu Obiageli Theresa , Mba Chidinma Goodness , Nseka Elizabeth Godwin
Published: October 2021

Introduction:

Pregnancy-related hypertension (PRH) is the leading cause of maternal and fetal morbidity and mortality. Knowledge and prevention strategy of PRH among pregnant women is imperative to promote favourable outcomes. This study examined the knowledge and awareness of PRH, including exercises as a preventive strategy and factors related to it, among pregnant women in Enugu, Nigeria.

Materials and Methods:

The study utilized a cross-sectional design. A structured questionnaire guided the collection of data from a sample of 296 women aged 18 years and above in multiple centres across the state.

Results:

68.6% of respondents know PRH, while 52.36% know antenatal exercises as a preventive strategy for PRH. The level of education and maternal age were factors significantly associated with knowledge of PRH and exercises as a preventive strategy, respectively.

Conclusion:

The study concluded that knowledge of PRH is high, while the knowledge and use of exercises to prevent the condition is average among expectant mothers.
Reflective Practice and Resident Doctors
Authors: Omosule Babaniji , Muhammed Abdul-Azeez , Somiari Abiye , Agiri Utchay , Worgu Glory Ovunda , Ezeme Constantine , Obazenu Lawson Ohwofasa , Uyilawa Okhuaihesuyi , Adebayo Oladimeji , Williams Adedayo , Ishaya Dare Godiya
Published: October 2021

Reflective practice has evolved over the years from being an informal subconscious process to a deliberate and formal one. Residency training programs are avenues for preparing residents for a lifetime of specialist practice, and reflective practice is being incorporated into the curriculum of the program in many parts of the world. There is no universal template for carrying out reflective practice; however, there appear to be accruable benefits to residents who can surmount the barriers and undergo some form of reflection using any of the available models. This article seeks to appraise reflective practice and the inherent benefits to the resident doctor and his practice. Thus, it makes a case for incorporating reflection into the curriculum of residency training programs in Sub-Saharan Africa. It also demonstrates the need to ensure standardized, reproducible methods of reflection globally.