bluuebunny/crossref_metadata_2025 huggingface dataset:
Fujitsu HIKARI, a Healthcare Decision Support System based on Biomedical Knowledge
Authors: Villazon-Terrazas Boris , Garcia-Santa Nuria , San Miguel Beatriz , del Rey-Mejías Angel , Muria Juan Carlos , Seara Germán , Reneses Blanca , de la Torre Victor
Published: June 2021

Fujitsu HIKARI is an artificial intelligence solution to assist clinicians in medical decision making, developed in the context of a joint collaboration project between Fujitsu Laboratories of Europe and Hospital Clínico San Carlos. This decision support system leverages on data analytics combined with healthcare semantic information to provide health estimations for patients, improving care quality and personalized treatment. Fujitsu HIKARI stands on the shoulders of biomedical knowledge, which includes (i) theoretical knowledge extracted from scientific literature, domain expert knowledge, and health standards; and (ii) empirical knowledge extracted from real patient electronic health records. The theoretical knowledge combines a theoretical knowledge graph (TKG) and a biomedical document repository (BDR). The empirical knowledge is encoded in an empirical knowledge graph (EKG). One of the main functionalities of Fujitsu HIKARI is the patient mental health risks assessment, which is based on the exploitation of its underlying Biomedical Knowledge.
Decision Models and Group Decision Support Systems for Emergency Management and City Resilience
Authors: Chen Yumei , Zhao Xiaoyi , Rich Eliot , Luna-Reyes Luis Felipe
Published: June 2021

This paper introduces the concept of Group Decision Support Systems (GDSS) as a tool to support emergency management and resilience in coastal cities. As an illustration of the potential value of GDSS, we discuss the use of the Pointe Claire teaching case. Participants in the exercise work in groups to approach the case using four different computer-supported decision models to explore and recommend policies for emergency mitigation and city resilience. The case, as well as the decision models, can be a valuable GDSS tool, particularly in the mitigation stages of the emergency management cycle. We present preliminary results from the use of the case, models and a simulation environment in a graduate course. We finish the paper by presenting our experience as a framework for building more efficient and secure emergency management systems through the use of GDSS.
Preferences, Machine Learning, and Decision Support With Cyber-Physical Systems
Authors: Pavlov Yuri P. , Marinov Evgeniy Ivanov
Published: June 2021

Modeling of complex processes with human participations causes difficulties due to the lack of precise measurement coming from the qualitative nature of the human notions. This provokes the need of utilization of empirical knowledge expressed cardinally. An approach for solution of these problems is utility theory. As cyber-physical systems are integrations of computation, networking, and physical processes in interaction with the user is needed feedback loops, the aim of the chapter is to demonstrate the possibility to describe quantitatively complex processes with human participation. This approach permits analytical representations of the users' preferences as objective utility functions and modeling of the complex system “human-process.” The mathematical technique allows CPS users dialog and is demonstrated by two case studies, portfolio allocation, and modeling of a competitive trade by a finite game and utility preference representation of the trader. The presented formulations could serve as foundation of development of decision support tools and decision control.
ePortfolio as a Tool to Support Competency Development in Hybrid Learning
Authors: Frangou Satu-Maarit , Keskitalo Pigga
Published: June 2021

This article presents a research-based study of the role of ePortfolios in the development of vocational students' skills. The authors discuss the process of finding a hybrid learning solution that can address the issues faced by vocational teachers and their students. The authors report on a case study using educational design research (EDR) at the Sámi Education Institute in northern Finland. Data were gathered from students in reindeer herding entrepreneurship and nature guide study programs using interviews, focus group discussions, and the feedback collected from workshops. Based on the findings of the initial workshops, ePortfolios were chosen as a tool for students to develop their vocational proficiency and showcase their academic activities. According to the feedback, ePortfolios potentially promote meaningful vocational study, particularly in the context of changing conditions when the student is far away from campus. The successful use of ePortfolios requires cooperation between students and teachers and commitment to support changes in the learning culture.
Monitoring and Evaluation of Housing Service Delivery in Zimbabwean Local Authorities
Authors: Mlambo Nyemudzai , Govender Ivan
Published: June 2021

This study investigates the effectiveness of monitoring and evaluation systems for housing service delivery in local authorities in the Midlands Province of Zimbabwe. Zimbabwe has been experiencing poor housing service delivery and the Midlands province is characterized by housing backlog, poor quality housing projects, lack of housing finance, lack of technical capacity, and no new partnerships. Despite the Government of Zimbabwe introducing monitoring and evaluation tools in all public institutions to achieve good governance and effective housing service delivery, this did not fully address the housing problems experienced in the province. The research utilized the mixed-methods approach with a case study research design using urban and rural local authorities in the Midlands Province. The article recommended that the three tiers of government should work collaboratively with the aid of a monitoring and evaluation system to solve housing delivery problems. This study is critical for local government housing delivery performance management.
In the Midst of Digital Economy
Authors: Tandon Neelam , Tandon Deepak
Published: June 2021

The financial literacy of urban Indians has been a cause of concern for Reserve Bank, commercial banks, and numerous NGOs and self-help groups. Extant literature has proven that financial illiteracy and poor financial skills lead to evils such as indebtedness leading to bankruptcy filings, poverty, divorce, and depression. Keeping in mind the importance of being able to understand and handle personal finance well by millennials, the authors examined 213 Indian students pursuing a PG course in management in Delhi city. To ascertain the students' level of financial knowledge and examine whether factors like gender, education level, undergraduate area of study, income level, etc., factor analysis is conducted and five independent factors are extracted, explaining 80% of variance. Through the study, five factors determining financial literacy were found—borrowing behavior, investment behavior, financial prudence, transaction behavior, and spending behavior—in Delhi from 2014-2018.
Learn From the Rumors
Authors: Liu Fei , Zuo Meiyun
Published: June 2021

The COVID-19 pandemic is an ongoing global pandemic, which has caused global social and economic disruption. In addition to physical illness, people have to endure the intrusion of rumors psychologically. Thus, it is critical to summarize the correlating infodemic, a significant part of COVID-19, to eventually defeat the epidemic. This article aims to mine the topic distribution and evolution patterns of online rumors by comparing and contrasting COVID-19 rumors from the two most popular rumor-refuting platforms—Jiaozhen in China and Full Fact in the United Kingdom (UK)—via a novel topic mining model, text clustering based on bidirectional encoder representations from transformers (BERT), and lifecycle theory. This comparison and contrast can enrich the research of infodemiology based on the spatio-temporal aspect, providing practical guidance for governments, rumor-refuting platforms, and individuals. The comparative study highlights the similarities and differences of online rumors about global public health emergencies across countries.
Preparation of Superparamagnetic Cobalt Ferrite Nanoparticles with High Saturation Magnetization by Temperature-Controlled Co-Precipitation Method
Authors: Quyen Duong Hong , Hung Nguyen Quang , Hoang Thi Kieu Nguyen
Published: June 2021

In this study, the effect of reaction temperature on the properties of cobalt ferrite nanoparticles was investigated. X-ray diffraction analysis and Fourier transform infrared spectroscopy confirmed that synthesized nanoparticles are cobalt ferrite. Particle sizes and shapes were determined by a transmission electron microscope, and magnetic measurements were done using a vibrating sample magnetometer. The average particle size varies in the range of 5.7 - 10.7 nm as the temperature is raised from 30 to 80°C. With that, there is a transition from ferrimagnetic to superparamagnetic behaviors at 40°C. The critical size of cobalt ferrite nanoparticles for the superparamagnetic limit with zero coercivity is found to be around 6 nm, and its saturation magnetization value is 25.4 emu/g. This value is impressive higher compared to that in the other studies with similar preparation conditions.
Synthesis of Belite-Ye’elimite-Ternesite Cement Clinker
Authors: Ji Dao Peng , Ma Su Hua , Li Wei Feng
Published: June 2021

Belite - ye’elimite - ternesite (BYT) cement clinker has attracted much attention due to its advantages of wide range of raw materials, low energy consumption and low carbon emission compared with ordinary portland cement (OPC). In this experiment, chemical reagents were used as raw materials. The effects of calcination temperature and calcination time on clinker synthesis were studied. The best sintering temperature was determined by sintering in rang of 1150-1300°C (setting a temperature point every 30 °C), and then the samples were sintering for 1-6 hours (setting every hour) to determine the best sintering time. The stable condition of the BYT clinker was determined. The phase composition and microstructure of cement clinker were analyzed by X-ray powder diffraction (XRD) Rietveld refinement and Scanning Electronic Microscopy (SEM). The results showed that the desired clinker could be obtained by sintering at 1210°C for 2 hours. In the presence of C4A3$, the hydration of C5S2$ was accompanied by the formation of gypsum and the precipitation of ettringite.
Research Progress on the Hydration of Portland Cement with Calcined Clay and Limestone
Authors: Tang Jin , Ma Su Hua , Li Wei Feng , Yang Hui , Shen Xiao Dong
Published: June 2021

The use of calcined clay and limestone as supplementary cementitious materials, can have a certain influence on the hydration of Portland cement. This paper reviewed the influence of limestone and calcined clay and the mixture of limestone and calcined clay on the hydration of cement. Both limestone and calcined clay accelerate the hydration reaction in the early hydration age and enhance the properties of cement. Limestone reacts with C3A to form carboaluminate, which indirectly stabilized the presence of ettringite, while calcined clay consumed portlandite to form C-(A)-S-H gel, additional hydration products promote the densification of pore structure and increase the mechanical properties. The synergistic effect of calcined clay and limestone stabilize the existence of ettringite and stimulate the further formation of carboaluminate, as well as the C-(A)-S-H gel, contributed to a dense microstructure.
Synthesis of Fly Ash-Based Zeolite and its Research Progress in Wastewater Treatment
Authors: Li Xin Yu , Guan Dong Dong , Xu Jing Zhe , Jiang Nan Zhe
Published: June 2021

Fly ash is the most common solid waste in the industry, and its high value-added utilization has become a hot issue of study. Carrying out the green synthesis route of zeolite as the raw material of fly ash has become an extremely important scientific significance and practical value. In this paper, the research progress of fly ash-based zeolite was introduced from three aspects, including fly ash activation method, fly ash-based zeolite synthesis method and fly ash-based zeolite in the wastewater treatment sector. The relevant applications of fly ash-based zeolite as an adsorbent material in the treatment of wastewater pollution were summarized, and the development trend has prospected.
Avifaunal Diversity and Water Quality Analysis of Urban Wetlands of Colombo, Sri Lanka
Authors: Munaweera T. I. K. , Bandara K. V. S. N.
Published: June 2021

The present study was carried out to determine the effect of water quality on the diversity and distribution of avifauna in urban wetlands. The bird aggregation and physical and chemical parameters of water bodies were assessed using standard field-based methods. The study recorded 67 bird species of 35 families. The bird population parameters were influenced by total dissolved solids, dissolved oxygen, salinity, and visibility. The Shannon- Wiener species diversity index (Hˊ) ranged between 0.99±0.05 - 1.71±0.03. The density of aquatic birds and species richness ranged between 1677.45±137.2 - 4990.09±151.3 birdskm-2 and 14.85±0.36 - 22.07±0.68 respectively in the five wetlands studied. Shannon- Wiener diversity index (Hˊ) resulted in significant negative relationships with total dissolved solids (R2=0.716; p<0.05), and salinity (R2=0.919; p<0.01). Bird density was positively related with Secchi disk depth (R² = 0.457; p<0.05). Further, bird density negatively correlated with salinity (R² = 0.568; p<0.05) and total dissolved solids (BD = -0.003TDS + 3.903; R² = 0.566; p<0.05). The results of the principal component analysis indicated Secchi disk depth and dissolved oxygen were extremely influenced on Thalangama tank followed by Heen Ela marsh. For the wetland sites of Beddagana and Kiribathgoda, salinity and total dissolved solids were the extremely influential parameters, where Beddagana and Diyasaru Park had an influence from electrical conductivity on the variation of diversity, density, and species richness of the aquatic birds.
Sepsis, Cytokine Storms, and Immunopathology: The Divide between Neonates and Adults
Authors: Greenfield Kara G , Badovinac Vladimir P , Griffith Thomas S , Knoop Kathryn A
Published: June 2021

Sepsis can result from a variety of pathogens, originating from a range of sources. A vast range of presenting symptoms is included in the catch-all term of “bacteremia,” making diagnosis and prognosis particularly troublesome. One underexplored factor contributing to disparate outcomes is the age of the patient. Neonatal sepsis in very-low-birth-weight infants can result in vastly different immunological outcomes unique from sepsis in adults. It is also becoming increasingly clear, both from preclinical experimental models and clinical observations, that the age and history of previous microbial exposures can significantly influence the course of infection from sepsis and cytokine storms to immunopathology. In this study, we will explore key differences between neonatal and adult sepsis, experimental models used to study sepsis, and how responses to the surrounding microbial universe shape development of the immune system and impact, positively or negatively, the course of disease.
Zebrafish otud6b Negatively Regulates Antiviral Responses by Suppressing K63-Linked Ubiquitination of irf3 and irf7
Authors: Zhou Ziwen , Cai Xiaolian , Zhu Junji , Li Zhi , Yu Guangqing , Liu Xing , Ouyang Gang , Xiao Wuhan
Published: June 2021

Ovarian tumor domain-containing 6B (OTUD6B) belongs to the OTU deubiquitylating enzyme family. In this study, we report that zebrafish otud6b is induced upon viral infection, and overexpression of otud6b suppresses cellular antiviral response. Disruption of otud6b in zebrafish increases the survival rate upon spring viremia of carp virus and grass carp reovirus exposure. Further assays indicate that otud6b interacts with irf3 and irf7 and diminishes traf6-mediated K63-linked polyubiquitination of irf3 and irf7. In addition, the OTU domain is required for otud6b to repress IFN-1 activation and K63-linked polyubiquitination of irf3 and irf7. Moreover, otud6b also attenuates tbk1 to bind to irf3 and irf7, resulting in the impairment of irf3 and irf7 phosphorylation. This study provides, to our knowledge, novel insights into otud6b function and sheds new lights on the regulation of irf3 and irf7 by deubiquitination in IFN-1 signaling.
Development and application of a couple-centered antenatal education program in Korea
Authors: Koh Minseon , Kim Jisoon , Yoo Hyeji , Kim Sun A , Ahn Sukhee
Published: June 2021

Purpose: This study was conducted to develop a couple-centered antenatal education program and to test the program’s feasibility. Methods: With a preliminary-experimental study design, 33 pregnant couples who were expecting their first child participated in this study. The program consisted of four sessions (1 hour/session/week) of education and counseling. Data were collected before and after the intervention from September 2018 to April 2019 at a women’s hospital in Daejeon, Korea, with demographic data forms, the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Maternal–Fetal Attachment Scale, Korean Newborn Care Confidence Scale, Wijma Delivery Expectancy/Experience Questionnaire, and Dyadic Adjustment Scale-10. Results: The pregnant women and their husbands were on average 32.30±3.11 and 33.21±6.25 years old, respectively. The mean marriage duration was 2.34±1.63 years, the gestational age was 31.30±2.66 weeks, and 78.8% of the couples had a planned pregnancy. After the program, both the pregnant women and their husbands showed significant improvements in attachment to the fetus and confidence in providing infant care. Prenatal depression, prenatal stress, and fear of childbirth in pregnant women significantly decreased after completing the program. However, the dyadic adjustment score did not change significantly either in the pregnant women or their husbands.Conclusion: A couple-centered antenatal education program seems to be effective for couples adjusting to parenthood, but further studies should explore ways to have a positive impact on couples’ relationships.
Feasibility of local anaesthesia for varicocele correction in one-day-surgery setting. A single center experience
Authors: Saredi Giovanni , Scroppo Fabrizio I. , Capogrosso Paolo , Pirola Giacomo Maria , Capone Lorenzo , Pacchetti Andrea , Gianesini Giuseppe , Maggio Paolo , Carcano Giulio , Dehò Federico
Published: June 2021

Objective: In this study, we compared postoperative outcomes of patients submitted to varicocele correction under general or local anesthesia at a single center. Methods: All patients underwent varicocele surgical treatment with the Colpi-modified Marmar subinguinal technique. They were managed with either general (Group A) or local with ileo-inguinal and ileo-hypogastric nerves block (Group B) anesthesia. The two groups were compared in terms of timing of discharge and post-operative pain as assessed with the numeric rating scale (NRS) at both rest and movement (NRSm). §Results: Overall, 63 patients were included with a mean (SD) age of 25 years ± 5 yrs. The NRS mean score was significantly lower for Group B during the first 4 days after surgery at both rest and movement (all p < 0.05). Patients receiving local anesthesia showed a faster time to first urination (210 vs. 240 min; p = 0.02), although the time to discharge was comparable between the two groups (250 vs. 250 min). Conclusions: These results suggest that local anetshesia for varicocele surgical treatment is feasible and provide better pain control and faster recovery after surgery.
Effective technical ways to improve the vibro-centrifugal separator electric drive for grain cleaning
Authors: Linenko Andrey , Khalilov Bulat , Kamalov Timur , Tuktarov Marat , Syrtlanov Damir
Published: June 2021

Grain production economic efficiency mostly depends on the use of energy-efficient, resource-saving technological equipment that can ensure a high-quality technological process. In this regard, this paper considers ways to improve the vibrating drives of vibration-centrifugal grain separators which have a complex design and involve high operating expenses (the life of vibrator bushing does not exceed 180±20 hours). A linear induction motor was used in this study as a vibrating drive, which directly forwarded working body movement without using any movement converters. This type of motor together with elastic elements helps to implement energy-efficient electric vibrating motion with adjustable vibration parameters. The mathematical model of the vibro-centrifugal grain separator with a linear motor was developed. The model was implemented in the environment of MatLab (Simulink) object-visual modelling, which showed the correlations of the working body vibration parameters with the drive kinematic parameters. The suitability of the model was proved experimentally. The difference between the experimental data and the data obtained by mathematical modelling does not exceed 6%. The comparative assessment results showed that the maintenance intervals increased by 37.8% in the project version compared to the basic version. The proposed technical solution made it possible to obtain the vibrational motion of the centrifuge working body using the linear induction electric motor without the need for a control unit to connect and disconnect it periodically from the mains. This can reduce the starting currents in the inductor windings and increase the reliability of the installation. Thanks to the use of the linear induction electric motor in the vibrating drive of the vibro-centrifugal separators vibrating drive, it is also possible to save metal.
Preoperative and Postoperative Walking Gait in Women With Acetabular Labral Tears and Femoroacetabular Impingement Syndrome
Authors: Freemyer Bret , Durkin Robert , Crawford Scott , Beeler Derek , Stickley Christopher
Published: June 2021

Context

Symptomatic femoroacetabular impingement syndrome (FAIS) is a painful condition that leads to decreased function. How walking gait changes over time within the first year after surgery for FAIS and how these changes present in women are currently unknown.

Objective

To determine biomechanical gait differences between women with FAIS or labral tears and control individuals preoperatively and at 3 and 6 months postoperatively.

Design

Case-control study.

Setting

Laboratory.

Patients or Other Participants

A total of 18 female participants comprising 9 women in the FAIS group (age = 31.44 ± 7.47 years, height = 1.73 ± 0.08 m, mass = 73.61 ± 14.44 kg) and 9 women in the control group (age = 31.44 ± 6.65 years, height = 1.69 ± 0.06 m, mass = 60.93 ± 5.58 kg).

Main Outcome Measure(s)

Between-groups comparisons of the Hip Outcome Score Activities of Daily Living subscale (HOSADL) and gait biomechanics were conducted preoperatively and at the 3- and 6-month postoperative sessions. Statistical parametric mapping was performed on normalized time-series data.

Results

Preoperatively, the FAIS group had poor HOSADL scores (FAIS group = 64.1 ± 15.4 versus control group = 100.0 ± 0, P < .001), walked 15% slower, and exhibited several gait differences compared with the control group. Three months postoperatively, the FAIS group displayed greater vertical ground reaction force (P = .01), ankle-dorsiflexion angle (P = .02), and external dorsiflexion moment (P = .01) in midstance, as well as a greater knee-flexion angle through the second half of stance (P < .001). The FAIS group also demonstrated less hip-extension angle (P = .02) and hip-abduction angle (P = .01) through the second half of stance, which transitioned into less hip extension (P = .040) and hip abduction (P = .03) during the subsequent swing phase. The FAIS group improved their HOSADL to 87.6 ± 7.6 by 6 months postoperatively and had a greater dorsiflexion moment (P = .003) and ankle external rotation during stance (P = .03). In addition, the FAIS group showed a greater external hip external-rotation moment in late stance (P < .001).

Conclusions

The biomechanical differences between groups were most evident at 3 months postoperatively, suggesting that women with FAIS had more postoperative gait compensations in the short term after surgery. By 6 months postoperatively, patient-reported outcomes had markedly improved, and the FAIS group displayed few gait differences compared with the control group.
Utility of the END-IT Score to Predict the outcome of Childhood Status Epilepticus
Authors: Kapoor Dipti , Sidharth  , Garg Divyani , Malhotra Rajiv K. , Kumar Virendra , Sharma Suvasini
Published: June 2021

Introduction:

Scoring systems to predict outcomes in pediatric status epilepticus (SE) are limited. We sought to assess usefulness of the END-IT score in pediatric SE.

Methodology:

We conducted a retrospective study at a tertiary hospital in New Delhi, India. Children aged 1 month–18 years who presented with seizure for ≥5 min/actively convulsing to emergency were enrolled. END-IT score was calculated and correlated with outcome at discharge using Pediatric Overall Performance Category (POPC) scale, in-hospital mortality, and progression to refractory and super-refractory SE (SRSE).

Results:

We enrolled 140 children (mean age 5.8 years; 67.1% males). Seven children died and 15 had unfavorable outcomes. The predictive accuracy of END-IT at a cutoff of > 2: for unfavorable outcome (POPC score ≥3) was: sensitivity 0.73 (95% CI: 0.45–0.92), specificity 0.94 (95% CI: 0.89–0.98), PPV 0.61 (95% CI: 0.36–0.83), NPV 0.97 (95% CI: 0.92–0.99), positive likelihood ratio (13.09), F1 score (0.666); for death: sensitivity 0.86 (95% CI: 0.42–0.99), specificity 0.91 (95% CI: 0.85–0.95), PPV 0.33 (95% CI: 0.13–0.59), NPV 0.99 (95% CI: 0.96–1.00), F1 score (0.48); for RSE: sensitivity 0.80 (95%CI: 0.28–0.99), specificity 0.90 (95% CI: 0.83–0.94), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.99 (95% CI: 0.96–1.00), F1 score (0.35); for SRSE: sensitivity 0.67 (95% CI: 0.22–0.96) specificity 0.75 (95% CI: 0.66–0.82), PPV 0.22 (95% CI: 0.06–0.48) NPV 0.98 (95% CI: 0.94–0.99), F1 score (0.33).

Conclusion:

We demonstrate utility of the END-IT score to predict short-term outcomes as well as progression to refractory and SRSE for the first time among children with SE.
An online study to assess the disposal of personal protective equipment at home amid COVID-19 pandemic in India
Authors: Thakur Archana , Sangle Swapnil Tanaji , Rao Shrilekha , Vaz Rodney Preetham , Singh Pallika , Rasania S. K.
Published: June 2021

Introduction:

In the current COVID-19 pandemic, when most of cases are asymptomatic or mild, and being kept on home isolation, personal protective equipment (PPE) used by them is potentially infectious and needs to be treated like biomedical wastes. The objective of the study is to assess the disposal of PPE used by general public in the current COVID-19 pandemic in India.

Materials and Methods:

This was a 1-week online cross-sectional descriptive study conducted among residents of India, in the age group of >18 years. The sample was convenient. The study tool was online self-designed, semi-structured, pretested, and self-administered questionnaire.

Results:

A total of 559 study subjects were analyzed. Maximum (77.8%) subjects were of age 18–40 years with almost equal proportion of male and female. Overall satisfactory disposal of PPE was done by 9.7% of subjects.

Conclusion:

The PPE disposal in the community is not satisfactory despite majority of the study participants claimed to be aware of PPE disposal guidelines.
Prevalence of tobacco use and associated factors among Injecting Drug Users and Men who have Sex with Men
Authors: Sharma Deepak , Goel Naveen Krishan , Sharma Munish Kumar , Walia Dinesh Kumar , Thakare Meenal Madhukar , Gupta Vanita , Mittal Sandeep , Sharma Manish
Published: June 2021

Introduction:

Tobacco use is a leading cause of ill-health, disability, and death worldwide. The current study aimed at estimating the prevalence of tobacco use and identify factors associated with it among injecting drug users (IDUs) and men who have sex with men (MSM).

Materials and Methods:

A cross-sectional study was conducted among 100 IDUs and 100 MSM each, recruited with the help of outreach workers and peer educators of Nongovernment Organizations working for them. Tobacco usage behavior was assessed using an interviewer-administered questionnaire. Epi Info software for windows (CDC Atlanta) was used to calculate proportions and evaluate the association between tobacco use and independent variables.

Results:

The current tobacco use prevalence among IDUs was 91% (smokers 75%, smokeless tobacco users 45%). Similarly, the current tobacco use prevalence among MSM study participants was 48% (smokers 28%, smokeless tobacco users 32%). Around half of the current tobacco users had tried to quit tobacco in the past 12 months.

Conclusions:

There is a high proportion of tobacco use among both IDUs and MSM. It is therefore of utmost importance to strengthen tobacco cessation efforts in these groups.
Evaluating the effectiveness of a verbal autopsy workshop
Authors: Agarwal Neeraj , Chaudhary Neha , Ahmad Shamshad , Pathak Pankaj Kumar
Published: June 2021

Introduction:

AIIMS Delhi developed an online platform Mortality in India established through Verbal Autopsies, which ultimately provides data on the cause of death in the country. AIIMS Patna being one of the partner institutions in this initiative of AIIMS Delhi, thus, conducted a 2-day workshop of Registrar General of India supervisors with the objective to strengthen the knowledge of participants and improve their practices on writing a good narrative during verbal autopsy (VA) using a key symptom list.

Materials and Methods:

A total of 32 participants attended the 2-day workshop at the Department of Community and Family Medicine, AIIMS Patna, in January 2019. A pretest questionnaire was administered before the start of the workshop and to test the improvement in knowledge of participants after attending the workshop, the same questionnaire was again administered as a posttest at the end of the workshop. Feedback of participants was also collected on a predesigned semi-structured questionnaire. The collected responses were entered in MS Excel 2010. Descriptive and inferential statistics were calculated using SPSS version 16.0 software.

Results:

There was a statistically significant improvement (P < 0.001) in the mean posttest score (8.6 ± 1.2) as compared to the mean pretest score (6.1 ± 2.8). Maximum participants, i.e., 15 (46.8%), reported that filling VA forms in a narrative way was the most useful part of the workshop. All the participants, i.e., 32 (100%), strongly agreed that the workshop was appropriately organized, content of the training was relevant, they were encouraged to actively participate, and adequate material was provided.

Conclusion:

Further intensive workshop with more field training and refresher training at regular intervals is expected in future.
Mental health problems among health-care workers during the COVID-19 pandemic
Authors: Sukumaran Anil Bindu , Manju L. , Jose Regi , Narendran Meghana , Padmini C. , NazeemaBeevi P. , Vijith Divija , Kumari R. Beena , Prakash Shilpa , Nath Jithu S. J. , Benny P. V.
Published: June 2021

Introduction:

As the pandemic of COVID-19 stretches, its wings across the different parts of the world over the past few months, it is very likely that mental health problems increase, particularly among the health-care workers who have higher risk of exposure to the disease and also to sufferings of the people affected with the disease.

Objective:

To assess the prevalence and factors associated with depression, anxiety, and stress among health-care workers from Kerala during the COVID-19 pandemic.

Materials and Methods:

A cross-sectional study among 544 health-care workers from Kerala was conducted by a self-administered online questionnaire in Google Forms by chain referral sampling with Depression, Anxiety, and Stress Scale-21 scale during initial phase of the COVID-19 pandemic. The tests of significance used were Mann–Whitney U-tests and Kruskal–Wallis tests. Odds ratios and 95% confidence interval are estimated.

Results:

During the early pandemic period, 9.7% of health-care workers had mild depression and 13.3% had moderate-to-severe depression. While 4% had mild anxiety and 3.5% had moderate-to-severe anxiety, about 6.8% had mild stress and 6.4% had moderate-to-severe stress. The anxiety symptoms were significantly higher among nurses compared to doctors. Emotional and social support from higher health authorities is a significant protective factor against stress and depression. Frontline workers have 84% higher risk to have depression.

Conclusions:

Frontline health-care workers who are directly involved in the screening, diagnosis, treatment, and care for patients with COVID-19 are at higher risk of experiencing poor mental health outcomes. Emotional and social support from higher health authorities is a significant protective factor against depression and stress among health-care workers.
Diagnostic accuracy of Diabetes in Pregnancy Study Group of India criteria for the screening of gestational diabetes mellitus in primary care setting
Authors: Balagopalan Nitya , Pathak Rambha , Islam Farzana , Nigam Aruna , Kapur Prem , Agarwal Sarita
Published: June 2021

Introduction:

Although the Diabetes in Pregnancy Study Group of India (DIPSI) criterion is recommended by the Government of India guidelines, there is lack of consensus on a universal criterion for diagnosis of gestational diabetes. This has led to a wide variation of pregnant women being diagnosed with gestational diabetes mellitus (GDM). The WHO 1999 and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria are widely used globally and in India as well. The objective of this study was to evaluate the diagnostic accuracy of DIPSI criteria in comparison to WHO 1999 and IADPSG criteria for diagnosis of GDM.

Materials and Methods:

A community-based study was conducted for a period of 1 year. Oral glucose tolerance test was done on 506 pregnant women identified through house-to-house survey. The proportion of GDM cases by WHO, IADPSG, and DIPSI criteria was calculated. The diagnostic accuracy of DIPSI criteria was assessed by calculating sensitivity, specificity, and predictive values taking WHO and IADSPG criteria as gold standard.

Results:

The prevalence of GDM was 14.2% by WHO criteria, 13% by DIPSI criteria, and 27.3% by IADPSG criteria; 10.3% were diagnosed by all the three criteria. The sensitivity and specificity of DIPSI criteria when the WHO criteria was taken as the gold standard was found to be 86.1% and 99.08%. The sensitivity and specificity of DIPSI criteria when the IADPSG criteria was taken as gold standard was found to be 44.93% and 98.91%, respectively.

Conclusion:

The prevalence of GDM is found to be much higher by IADPSG criteria as compared to the WHO and DIPSI criteria. The single-step approach DIPSI criteria have good diagnostic accuracy and can be used in epidemiological studies and are feasible for diagnosis of GDM in primary care settings.
Effectiveness of thiamine therapy in mortality rate in patients with septic shock
Authors: Kanchanasurakit Sukrit , Suthumpoung Pornsinee , Santimaleeworagun Wichai , Nakaranurack Chotirat , Huynh Nina S. , Srisawat Chansinee , Nunta Monnaree , Chirakan Virakarn , Saokaew Surasak
Published: June 2021

Background:

Septic shock is a serious condition leading to increased mortality. Despite previous report of no benefit, thiamine has emerged as potential therapy to reduce mortality in septic shock patients. This study aimed to investigate the effect of thiamine in mortality rate in patients with septic shock.

Methods:

Eight databases, including MEDLINE, EMBASE, Science Direct, Scopus, Cochrane, CINAHL, Open Grey, and Dart-Europe, were systematically searched from the inception of the database up to August 21, 2020. Studies evaluating the effectiveness of thiamine on mortality rate in septic shock patients compared between thiamine and placebo were included. We used random-effects model to analyze the mortality with risk ratio (RR) and 95% confidence interval (95% CI). The subgroup and sensitivity analysis were performed to examine the influence of variables. Publication bias was considered using funnel plot, Begg's test, and Egger's test.

Results:

A total of 3,658 studies were retrieved and reviewed. Five studies were included for meta-analysis. In random-effects meta-analysis of the randomized controlled trials, although not statistically significant, there was a trend which suggested that thiamine may reduce mortality rate in septic shock patients (RR, 0.96; 95% CI: 0.72–1.28, P = 0.774). The result of sensitivity and subgroup analyses also supported the suggestion that thiamine may decrease mortality in septic shock patients. The Begg's test (P = 0.624) and Egger's test (P = 0.777) revealed no publication bias.

Conclusions:

Although not statistically significant, thiamine may reduce mortality rate in septic shock patients. Further prospective studies with larger sample size are warranted.
Traumatic spine injuries in Eastern India
Authors: Jain Mantu , Mohanty Chitta Ranjan , Doki Sunil Kumar , Radhakrishnan Rakesh Vadakkethil , Khutia Susanta , Patra Saroj Kumar , Biswas Mridul
Published: June 2021

Background:

Trauma is the leading cause of hospitalization globally, and trauma-induced spinal injuries can be devastating and permanent. The objective of this study was to describe the pattern, association, and outcome in patients with traumatic spine injury (TSI).

Methods:

A retrospective cross-sectional study was undertaken on patients with TSI who presented to the trauma and emergency department of a level 1 trauma center in eastern India between August 15, 2018, and August 14, 2019, by including 103 patients. Information pertaining to demography, mode of injury (MOI), fracture morphology, neurological grading, and associated spinal or other regional injuries was obtained. Correlation among injury severity score (ISS), neurological damage as per American Spinal Injury Association (ASIA), and morphological patterns was determined.

Results:

The median age was 39 years, and the gender ratio was 5.87:1. Fall from height (43.7%) was the most common MOI. The median ISS was 21, and the percentage of patients with polytrauma was 73% (ISS > 15). The cervical region (n = 30) was the most common site of injury, and multiple vertebral involvement (n = 32) was more common than isolated involvement. Type A pattern (53.4%) was the predominant type, followed by types C and B (29.1% and 15.5%, respectively) for primary spine injury, and type A was the predominant type for secondary spinal injury. Severe neurological damage (ASIA A-C) was noticed in 69 patients. The correlation between ISS and ASIA scores (Spearman's ρ = 0.561, P < 0.001) and between morphology type and ASIA score (Pearson's χ 2= 69.7, P < 0.001) was statistically significant. In total, 53 patients were managed surgically and 24 patients were managed by conservative measures.

Conclusion:

Our study found a predominantly younger population, multilevel involvement, significant neurological damage, multiple associated injuries, and higher ISS among the patients of TSI. The pattern in eastern India is different from previous reports from other parts of the country.
Imaging Advances in Oral Cavity Cancer and Perspectives from a Population in Need
Authors: Subramaniam Narayana , Poptani Harish , Schache Andrew , Bhat Venkataraman , Iyer Subramania , Sunil HV , Chandrasekhar Naveen Hedne , Pillai Vijay , Chaturvedi Pankaj , Krishna Shri H , Krishnamurthy Arvind , Kekatpure Vikram , Kuriakose Moni Abraham , Iyer N. Gopalakrishna , Thakkar Alok , Kantharia Rajesh , Sonkar Abhinav , Shetty Vivek , Rangappa Vidya Bhushan , Kolur Trupti , Vidhyadharan Sivakumar , Murthy Samskruthi P , Kudpaje Akshay , Srinivasalu Vijay Kumar , Mahajan Abhishek
Published: June 2021

Oral squamous cell carcinoma (OSCC) accounts for a third of the cancer burden in India, with a correspondingly high cancer-specific mortality. Although treatment of OSCC in India mirrors that of high-income nations, extreme burden of disease, late presentation, and the associated advanced stage of disease pose unique challenges in a resource-constrained environment. Despite a multimodal treatment paradigm, survival rates are low. Often the cause for late presentation is the delayed diagnosis, inappropriate investigation and referral, and compromised or incorrect treatment, leading to poor patient outcomes and costs to the health-care provider. To address these issues, the first UK-India Symposium on Advances in Oral Cancer Imaging Symposium was organized in Bangalore, India, in April 2019; participants included radiologists, imaging scientists, clinicians, and data scientists from the United Kingdom, India, Singapore, and the United States. Following the discussions held during this meeting, in this manuscript, we present evidence-based guidance for the role of imaging in OSCC, recommendations for service development, and details of future potential for evolution in head and neck imaging.
Evaluation of Incidence and Reasons of Wrong Side Dental Surgery in Central Maharashtra
Authors: Saluja Harish , Sachdeva Shivani , Chawla Kirti , Mohammadi Syeda Nikhat
Published: June 2021

Background:

Wrong side surgery (WSS) has gained national attention now. These errors are as terrifying as these involve patients who have undergone surgery on the wrong body part, undergone wrong procedure, or had a procedure intended for another patient.

Materials and Methods:

A questionnaire survey dealing with WSS was prepared, and 300 dental professionals were randomly mailed. All responses were gathered in Excel and analyzed using software SPSS version 19.

Results:

In the present study, the 213 dental professionals working in dental colleges in Ahmednagar gave the feedback, 29 of them had attempted WSS. The study was carried out on in two groups. The first comprised students undergoing bachelors in dentistry and other group was with professionals completed their bachelors in dentistry. The results were highly significant in those undergoing bachelors in dentistry with more incidence of WSS.

Conclusion:

The Joint Commission on Accreditation of Healthcare Organizations (JCAHOs) found WSSs as the 3rd highest event. The data are definitely more than that recorded in literature but due to fear clutched at the throat people do not disclose their mistakes though it happens.
A group-theoretic generalization of thep-adic local monodromy theorem
Authors: Ye Shuyang
Published: June 2021

LetGbe a connected reductive group over ap-adic number fieldF. We propose and study the notions ofG-$\varphi $-modules andG-$(\varphi ,\nabla )$-modules over the Robba ring, which are exact faithfulF-linear tensor functors from the category ofG-representations on finite-dimensionalF-vector spaces to the categories of$\varphi $-modules and$(\varphi ,\nabla )$-modules over the Robba ring, respectively, commuting with the respective fiber functors. We study Kedlaya’s slope filtration theorem in this context, and show thatG-$(\varphi ,\nabla )$-modules over the Robba ring are “G-quasi-unipotent,” which is a generalization of thep-adic local monodromy theorem proved independently by Y. André, K. S. Kedlaya, and Z. Mebkhout.
Efficacy and side effects of antibiotics in the treatment of acute rhinosinusitis: a systematic review
Authors: Sng W.J. , Wang D.-Y.
Published: June 2021

Background: Acute rhinosinusitis (ARS) is one of the most common diagnoses for which an antibiotic is prescribed. Although the usage of antibiotics in the treatment of mild, moderate or uncomplicated ARS is not recommended by most international guidelines, overuse of antibiotics is still an alarming problem among patients and healthcare practitioners. We thus sought to review the evidence available through a systematic review of the existing literature on antibiotic usage in ARS. Methodology: A search of the PubMed database was conducted for studies on antibiotic and placebo usage in the treatment of ARS. Results: A total of 31 random control trials (RCT) reporting the clinical efficacy of treating ARS and side effects of using cefuroxime axetil, telithromycin, amoxicillin/potassium clavulanate, levofloxacin, moxifloxacin and clarithromycin were included in the review. Among them, 9 studies were performed double-blinded with placebo controls. The results showed that while antibiotics are more efficacious than placebos in the treatment of ARS, the risks of potential side effects need to be weighed against the potential benefit that antibiotics give to the patient. This is especially pertinent as usage of the placebo has shown to be almost as efficacious as using the antibiotic therapy, and also much safer. Conclusion: The usage of antibiotics in ARS is widespread and there seems to be only slight added benefit in the usage of antibiotics over placebo in the treatment of ARS. Hence, larger scale studies should be done in the future to confirm the results of these studies.
Are measurements of peak nasal flow useful for evaluating nasal obstruction in patients with allergic rhinitis?
Authors: Martins de Oliveira Gardenia Maria , Rizzo Jose Angelo , Camargos Paulo Augusto Moreira , Sarinho Emanuel Savio Cavalcanti
Published: June 2021

Background: Nasal obstruction is one of the most bothering allergic rhinitis (AR) symptoms and there is a need for objective parameters to complement clinical evaluation due to blunted perception in many patients. In this study we compare measures of peak nasal inspiratory flow (PNIF) and peak nasal expiratory flow (PNEF) in patients with AR and in individuals without nasal symptoms and correlate them with the perception of nasal obstruction. Methods: A comparative cross-sectional study was conducted in 64 AR patients and 67 individuals without nasal symptoms aged between 16 and 50 years. All subjects had PNIF and PNEF measures and subjective evaluations of nasal obstruction were done through a visual analogue scale (VAS) and a symptoms questionnaire. Results: The results show a lower PNIF and PNEF in AR patients compared to controls. There was no correlation between VAS score and PNIF and PNEF. There was a weak inverse correlation between PNIF and symptoms score. Conclusion: Objective measures of nasal obstruction, especially PNIF, can give useful informations on aspects of the disease different from those obtained from the patient`s perception.
Even cognitively well-functioning adults are unaware of their olfactory dysfunction: Implications for ENT clinicians and researchers
Authors: Wehling Eike , Lundervold Astri J. , Espeset Thomas , Reinvang Ivar , Bramerson Annika , Nordin Steven
Published: June 2021

Background: Past findings of an impact of cognitive impairment on awareness of olfactory dysfunction, and high prevalence of age-associated cognitive impairment motivated the present study of whether middle-aged and elderly adults are unaware of an olfactory dysfunction despite being carefully screened for cognitive impairment. Methodology: The sample included 203 Norwegian participants, aged 46-79 years, 134 women and 69 men, who underwent comprehensive neuropsychological assessment for screening of cognitive impairment. Subjective assessment of olfactory function ("How would you estimate your sense of smell?") was compared with outcome on objective assessment of olfactory function with the Scandinavian Odor Identification Test, which in the present study was shown to be valid for use on Norwegian populations. Results: We found that 79% of this cognitively healthy sample with objectively assessed olfactory dysfunction reported normal olfactory function (57% of functionally anosmics reported normal function). In contrast, only 9% with objectively assessed normal olfactory function reported olfactory dysfunction. Conclusion: A large proportion of cognitively well-functioning middle-aged and elderly adults with an olfactory dysfunction are unaware of their dysfunction. The ENT physician who suspects that the sense of smell may be compromised should, in addition to an anamnesis, assess the patient`s olfactory function objectively.