bluuebunny/crossref_metadata_2025 huggingface dataset:
A Digital Health Perspective on Medication Use and Polypharmacy Management for Improving Healthcare Outcomes in Geriatric Patients
Authors: Umar Tungki Pratama , Tanasov Andrei , Stevanny Bella , Agustini Dessy , Dave Tirth , Nabhan Ayman , Madany Maysa , Ibrahim Muiz , Nguyen Dang , Jain Shivani , Jain Nityanand
Published: December 2023

The high prevalence of multiple comorbidities poses unique medication-related challenges for geriatric patients. Polypharmacy is a particular concern since taking several medications simultaneously increases the likelihood of adverse drug events and the risk of drug interactions while decreasing patient adherence. These factors are associated with suboptimal health outcomes and a heightened burden on the healthcare system (insurance claims) and the patient (out-of-pocket expenses). These challenges can significantly affect the quality of life of geriatric patients. This chapter critically examines the impact of medication use and polypharmacy on the quality of life of older patients. In addition, the authors discuss how artificial intelligence-based digital tools and precision medicine can address these issues by streamlining medical decision-making, improving the patient experience, and allowing remote monitoring. Finally, they interpret the findings from the lens of ethical considerations associated with the adoption and implementation of digital applications and gadgets.
Scientometric Analysis of Teaching Geriatric Dentistry in Institutions of Higher Education
Authors: Adakawa Murtala Ismail , Sokolova Elizaveta Vitalievna , Harinarayana N. S.
Published: December 2023

This chapter investigates scientometric analysis of teaching geriatric dentistry in institutions of higher education. The analysis is divided into two components: research on geriatric dentistry and research on teaching geriatric dentistry. The study used Scopus to retrieve published studies on these themes using “geriatric AND dentistry OR teaching” or “geriatric AND dentistry OR education” with 22,707 results. Similarly, the search terms used for the second strand are “teaching AND geriatric AND dentistry” or “education AND geriatric AND dentistry,” which gave 516 documents. It was found that a number of authors stand out prominently based on the combination of the number of publications and their citation impact. Many indicators of scientometric parameters such as mapping research productivity of countries, influential authors in the field of geriatric dentistry, metrics, etc. were highlighted. Since research in geriatric dentistry is continuous, teaching current trends and learning emerging developments in the field are necessities.
Transformation of Labor and Politics of the Senses
Authors: Tomas del Corro Leandro , Mendiburu Joaquin Ignacio , Pellón Ignacio
Published: December 2023

The authors intend to reflect on the “metamorphosis of work” in the dairy farms of the Villa María Basin (Córdoba, Argentina) as a consequence of the robotization and automation of production. In this sense, they emphasize the changes in the “politics of the senses” that update the ways of touching and looking at the dairy farms, simultaneously updating the demands of capital for the use of labor force and introducing new mechanisms of control and surveillance. The proposed approach recovers testimonies from the protagonists of the “metamorphosis” indicated to reflect on the policy of changes in capitalism.
How to Make Mental Healthcare More Accessible
Authors: Ferrigno Giulio
Published: December 2023

Within the AI academic realm, the burgeoning significance of mental healthcare has prompted global governments to prioritize comprehensive mental health programs. Recent data underscore the heightened importance of mental health relative to physical well-being. Nevertheless, the concept of mental health recovery has only recently gained substantial attention, especially in the COVID-19 pandemic. However, few studies investigated the role of AI in mental health. This chapter investigates the question: “How can AI make mental healthcare more accessible during emergencies like the COVID-19 pandemic?” To grapple with this research question, the chapter employs a single-case study approach centered on Headspace, a company leveraging AI to revolutionize mental healthcare accessibility. The case study analysis reveals the AI therapy's transformative power in addressing these needs innovatively while maintaining scientific rigor. The chapter concludes by proposing a novel framework for AI therapy.
Communication Strategies Behind the Expressions of Dissent During the COVID-19 Pandemic
Authors: Milošević Nemanja
Published: December 2023

The chapter presents some of the key communication strategies that can be observed in the expressions of dissent that increased considerably during the pandemic. The dissenting narratives—that is, the texts that speak against dominant institutions and the socio-political consensus by combining elements of conspiracy theories and populism—thrive for two major reasons. First, the narratives voice political sentiments that a significant portion of the population can identify with; they speak against injustices in a way that many would endorse and, simultaneously, include some of the rhetoric of new populist movements on the right. Second, the way dissent is expressed is consistent with the new ways of knowledge acquisition, as the claims are made with the appeal to the individual perspective, fear, and enjoyment. Such conclusions are based on the analysis of the vehement opposition to the World Economic Forum's “The Great Reset” agenda and the pandemic-related conspiracy theories of David Icke.
Recent Applications of Convolutional Neural Networks in Medical Data Analysis
Authors: Dai Ling , Zhou Mingming , Liu Haipeng
Published: December 2023

Cutting-edge artificial intelligence techniques especially deep learning algorithms have shown great potentials in data-driven diagnostics. Convolutional neural networks (CNNs) have been widely applied in image analysis, pattern recognition, and anomaly detection. CNNs can automatically learn features from images, avoiding human bias and improving the efficiency. The multi-layer deep network structure enables CNN to extract features at different abstraction levels in images, enhancing semantic information in images and improving its performance in various tasks such as classification, segmentation, and detection. CNN exhibits great potentials in the diagnosis, prognosis and classification of various diseases. Whereas, there are some unmet challenges in data quality and quantity, data security and privacy, model interpretability, and ethical considerations. This chapter summarizes the advantages and challenges of the state of the art, and future directions under the context of healthcare 5.0, providing a reference for clinical researchers, data scientists, and biomedical engineers.
Deep Learning for Facial Skin Issues Detection
Authors: Rastogi Rohit , Shahjahan Md. , Yadav Piyush , Gupta Mayank
Published: December 2023

Facial skin problems can have a profound impact on an individual's self-esteem and mental well-being, sometimes leading to depression. Early detection and treatment of these conditions are crucial for effective intervention. This system uses advanced techniques such as CNN, deep CNN with random forest, and random forest algorithms. The proposed system offers a potential pre-diagnostic tool, enabling individuals to assess their facial conditions before consulting a dermatologist. By providing an early checkup, the system aims to improve the overall quality of dermatological care and outcomes for patients. Through this project, the authors aspire to empower individuals to take control of their skin health and well-being. This research represents a significant step towards revolutionizing the field of dermatology, bridging the gap between technology and patient care. By leveraging the insights gained from facial skin problem detection, the authors strive to create a future where no individual suffers in silence, but instead embraces a life free from the constraints of skin troubles.
AI and Transit-Oriented Development Strategy Towards Sustainable Cities for the Business Environment
Authors: Reejo R. J. , Panicker Resmi C.
Published: December 2023

Fast-growing cities and populations require technological adaptability for sustainable urban development. Technology can improve the physical environment and boost global commerce with inclusive and sustainable urban design concepts. In this chapter, the authors evaluate the potential of Artificial Intelligence (AI) technologies for sustainable urban designs to promote Transit-Oriented Development (TOD) and the global business environment. First, the study emphasizes the need for AI technologies in urban development. Section two discusses the primary AI tools used in urban design, and section three explains why transit-oriented development is recommended in urban planning. The study examined pertinent literature, empirical research, and credible data from Google Scholar and Science Direct. It shows that AI technologies enable sustainable urban development that promotes business, and TOD urban design promotes good living in New York, London, Copenhagen, Hong Kong, and Singapore.
Remote Work Policies
Authors: Hermann Anett , Claes Marie-Thérèse , Clar-Novak Maria
Published: December 2023

Remote work is a well-known concept that experienced an enormous upswing with the COVID-19 pandemic and the associated massive digitization processes as well as the changed attitudes, desires, and motivations of employees for new work concepts and their unwillingness to return to the office. The discussion about the changed work design is diverse and often revolves around the topics of trust and control. Affected are changing leadership concepts, effects on teamwork, engagement of the employees, and organizational culture, as well as issues such as greater participation and inclusion of diverse workers and new human resource policies. The authors will explore the question of how remote work policies must be designed to do justice to the principles of personnel and organizational policy. Based on our study, they demonstrate that remote work brings many advantages to the organization on an individual, team, and organizational level. However, they identified the “dark side” of remote work, especially for women with care responsibilities, as a negative impact on their professional activities.
Impact of the Coronavirus Pandemic on the Well-Being of Healthcare Workers in a South African Haemodialysis Facility
Authors: Ramnarain Rakhee , Gerwel Proches Cecile Naomi
Published: December 2023

The aim of the study is to determine the impact of the coronavirus (COVID-19) pandemic on the well-being of clinical haemodialysis healthcare workers of an organization specializing in renal care and dialysis. This qualitative study made use of purposive sampling. Online semi-structured with in-depth interviews were conducted with nine clinical haemodialysis healthcare workers from a private dialysis facility. Data were analyzed using thematic analysis. The findings revealed that well-being was negatively impacted during the pandemic due to the fear of infecting others with the virus. This affected all aspects of their lives from the workplace to personal life, and to their community and religious/spiritual beliefs. Social distancing and the nature of their job deprived participants of social and emotional support. Some of the stress factors to wellbeing were stigmatization, isolation, lack of recognition, and inadequate availability of resources (e.g., safe transportation, training, and shortage of staff).
Deep Neural Networks Based Modeling to Optimize Water Productivity of a Passive Solar Still
Authors: Halimi Soufiane , Cherrad Noureddine , Belhadj Mohammed Mustapha , Belloufi Abderrahim , Chelgham Mounira , Mouissi Fares , Messaoudi Youcef , Touati Soufiane , Aliouat Khadra
Published: December 2023

Solar stills (SSs) have emerged as highly efficient solutions for converting saline or contaminated water into potable water, addressing a critical need for water purification. This study aims to predict and optimize SS performance, emphasizing the importance of enhancing productivity in various applications, including domestic, agricultural, and industrial settings. Several influencing factors, such as sunlight intensity, ambient temperature, wind speed, and structural design, are crucial in determining SS performance. By harnessing the power of contemporary machine learning techniques, this study adopts Deep Neural Networks, with a special emphasis on the Multilayer Perceptron (MLP) model, aiming to more accurately predict SS output. The research presents a head-to-head comparison of diverse hyperparameter optimization techniques, with Particle Swarm Optimization (PSO) notably outpacing the rest when combined with MLP. This optimized PSO-MLP model was particularly proficient when paired with a specific type of solar collector, registering impressive metrics like a COD of 0.98167 and an MSE of 0.00006. To summarize, this research emphasizes the transformative potential of integrating sophisticated computational models in predicting and augmenting SS performance, laying the groundwork for future innovations in this essential domain of water purification.
The Influence of Preconsolidation Pressure on Undrained Shear Strength Characteristics of Peaty Clay in Sri Lanka
Authors: Priyamali M. W. S. , Priyankara N. H.
Published: December 2023

This research study investigated the effect of preconsolidation pressure on the shear strength parameters of very soft peaty clay based on a series of laboratory tests. The study included 15 Consolidated Undrained (CU) triaxial tests on peaty clay extracted from the Nilwala river basin, with preconsolidation pressures ranging from 0 to 100 kPa in 20 kPa intervals and cell pressures of 50, 100 and 150 kPa. The results indicated that the peak deviator stress of peaty clay decreased with increasing preconsolidation pressure, indicating decrease in its shear strength parameters with preconsolidation pressure. It was observed that peaty clay is highly sensitive to disturbance and requires sufficient time to regain its shear strength once its natural microstructure is altered. The study has significant implications for the construction of embankments on soft soils, particularly peaty clays. It highlights the need for accurate estimation of the undrained shear strength parameters of peaty clay, considering soil composition, structure and type of loading. It also emphasizes the importance of minimizing disturbance during construction activities to avoid compromising the stability of embankments.
Improvement of Earth into Concrete as an Eco-friendly Building Material – Effect of Soil Gradation and Chemical Admixtures
Authors: Galabada Harsha , Dharmaratne P. D. , Malkanthi S. N. , Halwatura R. U.
Published: December 2023

Environmental concerns and economic crises have been more critical in recent years, making it impossible to continue construction using traditional resources (cement, sand, and natural aggregates) in the same way as before. However, the use of earth is a cost-effective solution and it can enhance the sustainability of construction materials by employing soil as a building material. This study evaluated soil consistency that would be acceptable to make soil concrete and analysed the effect of chemical admixtures in achieving the maximum possible strength. Hence, the study suggested the possibility of using soil to form concrete as a replacement for cement concrete to the maximum extent with self-compacting properties. The soil was used to produce the concrete, stabilizing with cement and chemical admixtures were used to improve the strength and workability. According to the experimental investigation, it can be concluded that soil can be used as concrete with a characteristic strength of 15 MPa. The recommended native soil consistency for soil concrete should be developed by rearranging the native soil gradation to 5%–10% fines, 55%–71% sand, and 24%–40% gravel. The recommended cement amount as the stabilizer is 16% to 18% of the weight of the improved dry soil mixture. The strength and workability can be further improved by employing suitable chemical admixtures. Finally, this extensive study concluded that soil could be used to produce concrete for the construction industry through applications with minor improvements to the existing soil.
A Wavelet Transform-based Feature Extraction Pipeline for Elephant Rumble Detection
Authors: Silva Chamath K. , Piyathilake Vinuri , Keppitiyagama Chamath , Sayakkara Asanka P. , Kumarasinghe Prabash , Jayasuriya Namal , Sampath Udayanga
Published: December 2023

Elephants generate infrasonic vocalisations that traverse through the air for long distances. Utilising this phenomenon, a previous work proposed a system, called Eloc, to localise and track elephants in the wild. The Eloc system has been demonstrated to be accurate in calculating the location of infrasonic sources. However, it still lacks the capability to accurately distinguish elephant infrasonic calls from various other infrasonic sources using limited computing power on board. Addressing this problem, the work presented in this paper introduces an approach to distinguish elephant infrasonic calls with a high accuracy on low-resourced hardware. Firstly, a sequence of operations are performed to reduce the effect of noise in the infrasonic signal captured by an Eloc node. Secondly, a wavelet-based signal reconstruction technique is applied to extract spectral features from the infrasonic signal. Finally, the extracted features are fed to a pre-trained machine learning classifier to distinguish the infrasonic vocalisations of elephants. The experimental evaluation using Asian elephant (Elephas Maximus Maximus) infrasonic vocalisation datasets demonstrates that the proposed approach is capable of accurately distinguishing elephant infrasonic calls on low-resourced hardware platform of the Eloc system, with accuracy levels over 82% under varying environmental conditions.
Stimulation Strength Determined by Superantigen Dose Controls Subcellular Localization of FOXP3 Isoforms and Suppressive Function of CD4+CD25+FOXP3+ T Cells
Authors: Lee Juyeun , Park Nogi , Nicosia Michael , Park Joo Youn , Pruett Stephen B , Seo Keun Seok
Published: December 2023

Staphylococcal superantigens induce massive activation of T cells and inflammation, leading to toxic shock syndrome. Paradoxically, increasing evidence indicates that superantigens can also induce immunosuppression by promoting regulatory T cell (Treg) development. In this study, we demonstrate that stimulation strength plays a critical role in superantigen-mediated induction of immunosuppressive human CD4+CD25+FOXP3+ T cells. Suboptimal stimulation by a low dose (1 ng/ml) of staphylococcal enterotoxin C1 (SEC1) led to de novo generation of Treg-like CD4+CD25+FOXP3+ T cells with strong suppressive activity. In contrast, CD4+CD25+ T cells induced by optimal stimulation with high-dose SEC1 (1 µg/ml) were not immunosuppressive, despite high FOXP3 expression. Signal transduction pathway analysis revealed differential activation of the PI3K signaling pathway and expression of PTEN in optimal and suboptimal stimulation with SEC1. Additionally, we identified that FOXP3 isoforms in Treg-like cells from the suboptimal condition were located in the nucleus, whereas FOXP3 in nonsuppressive cells from the optimal condition localized in cytoplasm. Sequencing analysis of FOXP3 isoform transcripts identified five isoforms, including a FOXP3 isoform lacking partial exon 3. Overexpression of FOXP3 isoforms confirmed that both an exon 2–lacking isoform and a partial exon 3–lacking isoform confer suppressive activity. Furthermore, blockade of PI3K in optimal stimulation conditions led to induction of suppressive Treg-like cells with nuclear translocation of FOXP3, suggesting that PI3K signaling impairs induction of Tregs in a SEC1 dose-dependent manner. Taken together, these data demonstrate that the strength of activation signals determined by superantigen dose regulates subcellular localization of FOXP3 isoforms, which confers suppressive functionality.
Analysis of lymphocyte subsets in COVID-19 patients: a retrospective observational study
Authors: Ciriello Maria Matilde , Tommasi Nicoletta , Massarino Costanza , Cassinari Antonella , Bensi Thea , Doglio Raffaella , Roveta Annalisa , Maconi Antonio
Published: December 2023

In this retrospective study, we analyzed the possible predictive changes in lymphocyte subsets of Coronavirus Disease 19 (COVID-19) hospitalized patients. We enrolled 107 COVID-19 patients older than 18 years of age, admitted to Alessandria Hospital with a confirmed diagnosis of SARS-CoV-2 infection by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR), who performed the analysis of lymphocyte subsets, between 2020 March 01 and 2021 May 31. Patients have been split up into two groups, based on clinical manifestations: group 1 non-severe disease (n=44) and group 2 severe disease (n=63), according to the World Health Organization (WHO) interim guidance. For the comparison between the two groups of patients, statistical significance was tested with the Mann-Whitney and the Chi-Square test. In the group of patients with severe disease, the blood cell analysis showed a significant reduction in the counts of total lymphocytes, absolute CD3 lymphocytes, and CD8 lymphocytes, as well as a significant reduction in monocyte percent and a very significant increase in neutrophil counts. From the results obtained, it can be stated that lymphocytopenia is associated with the progression of the disease and increased mortality.
Development of an Interprofessional Competency Course Across Multiple Health Professions
Authors: Bates Dana , Bell Kathryn , Corvus Talina , Fryer Melissa , Sarmiento Monica , Kawaguchi Jeffrey , Moore Jessica
Published: December 2023

Context

Although interprofessional education (IPE) is not a new concept in health profession programs, the integration of this collaborative approach into athletic training education is still relatively new. Interprofessional education learning experiences can be embedded in a current course, presented in a stand-alone course, or integrated into service learning, simulation, or clinical education. Regardless of implementation strategy, IPE learning experiences should be adapted to each institution in response to program needs and resources available.

Objective

To describe the development of an IP course that includes 10 health profession programs.

Background

Although athletic training programs are required to implement IP collaborative practices, some institutions may experience challenges in developing strategies to meet this goal. Opportunities to engage in IPE initiatives may be present within your own college, institution, and community.

Description

We will describe the implementation of an IP course that included 10 health profession programs. The paper will outline the course design, course delivery, outcomes/data, and lessons learned along the way to support the continued advancement of IPE in athletic training programs. This course, through revisions, also included foundational understanding for concepts of cultural humility and the competence continuum along with strategies for respectful and effective team building in a diverse and IP environment.

Clinical Advantage(s)

Through this course, athletic training students are able to interact and collaborate with students from varied health profession programs, which leads to an increased level of rapport among students as well as discussions and integration of diversity, equity, and inclusion. The course also provides athletic training students with opportunities to educate future health professionals about athletic training.

Conclusion(s)

When contemplating implementing an IPE course, administrators should consider other health programming and students in their respective colleges, campuses, and communities. Other considerations for successful course development include administrative support and buy-in.
24-hour levodopa–entacapone–carbidopa intestinal gel may improve disabling dyskinesia: A case report
Authors: Rožanković Petra B , Lasić Slaven
Published: December 2023

Levodopa–entacapone–carbidopa intestinal gel is a novel formulation of infusion-based therapy for patients with advanced Parkinsonˈs disease.There is a lack of data in the literature on its effectiveness on motor fluctuations and dyskinesia in patients with Parkinson’s disease.

We present the case of troublesome dominantly bi-phasic dyskinesia and nocturnal motor symptoms successfully treated with continuous 24-hour levodopa–entacapone–carbidopa intestinal gel monotherapy.
Neuropsychiatric, cognitive, and imaging profile of patients with dementia with Lewy body: A tertiary care center experience
Authors: Rakesh Kempaiah , Holla Vikram , Bhattacharya Amitabh , Kumar Keshav , Janardhan Reddy Y C , Kumar Pal Pramod , Kamble Nitish
Published: December 2023

Background:

Dementia with Lewy body is a neurodegenerative disorder and is the second most common cause of dementia after Alzheimer’s disease. We aimed to study the demographic, clinical, neuropsychological, and imaging characteristics of these patients.

Methods:

The current study is a retrospective chart review of 37 patients who met the diagnostic criteria of probable dementia with Lewy body. The relevant demographic data and clinical details including detailed history, examination, clinical scales (unified Parkinson’s disease rating scale scores in OFF and ON states), mini mental status examination scores, and neuropsychological and imaging findings were retrieved from the medical records.

Results:

There were 33 men in the study. The mean age was 67.08 ± 9.27 years, mean age of disease onset was 63.76 ± 8.67 years, and mean duration of illness was 3.32 ± 2.2 years. In most of the patients, rapid eye movement sleep behavior disorder preceded the illness by 5.5 ± 6.88 years. The patients had good response to levodopa with significant improvement in the unified Parkinson’s disease rating scale part III score (P = 0.0018). The mean mini mental status examination score was 16.97 ± 5.96. Brain magnetic resonance imaging showed diffuse cerebral atrophy (42.4%) as the most common finding. Fluorodeoxyglucose–positron emission tomography (n = 8) showed hypometabolism in the occipital lobes with sparing of the posterior cingulate gyrus. Neuropsychological assessment showed impairment in mental speed, focused and sustained attention, verbal fluency, working memory, planning, set shifting, response inhibition, verbal learning and memory, and visuospatial construction.

Conclusions:

There was early cognitive impairment with multiple domains affected. In most of the patients, brain magnetic resonance imaging showed atrophy and occipital lobe hypometabolism on fluorodeoxyglucose–positron emission tomography.
Bilateral striopallidodentate calcinosis due to primary hypoparathyroidism presenting with chorea and seizure
Authors: Sahoo Lulup Kumar , Pattnaik Srimant , Sahoo Srikanta Kumar , Mangaraj Swayamsidha , Mishra Ajit Prasad , Wagh Nilesh
Published: December 2023

Bilateral striopallidodentate calcinosis (BSPDC) is a rare genetic neurodegenerative disorder. There are multiple causes of BSPDC; however, primary hypoparathyroidism is the most common cause of secondary BSPDC. BSPDC can present with various neurological conditions, including movement disorders such as parkinsonism, chorea, and dystonia. Here, we report the case of a 48-year-old man who had a past history of seizure and presented to our department with chorea (predominant right hemichorea). On detailed evaluation, he was found to have low calcium, high phosphate, and low parathormone, suggestive of primary hypoparathyroidism. There was remarkable improvement in chorea with treatment. We suggest that hypoparathyroidism should be suspected in all cases of BSPDC and movement disorders.
Comparative Evaluation of the Mechanical Properties of a Bioactive Material Enhanced by Phytosynthesized Nanoparticles: An In vitro Study
Authors: Lath Harshita , Patri Gaurav , Bajoria Atul Anand , Banka Aanchal
Published: December 2023

Aims:

The aim was the study was to evaluate and compare the mechanical properties of ACTIVA Bioactive Base/Liner (ABBL) enhanced with phytosynthesized titanium dioxide nanoparticles (nTiO2) and nano-curcumin (nCur).

Methodology:

Thirty samples each of ABBL (Group 1), ABBL + nTiO2 (Group 2), and ABBL + nCur (Group 3) were prepared for testing the compressive strength (CS) and flexural strength (FS). Forty-five cylinders (15 per group) (6 mm × 4 mm) were fabricated for CS and 45 for three-point bending FS measurements (22 mm × 2 mm × 2 mm). They were tested in a universal testing machine at a crosshead speed of 0.5 mm/min for CS and 0.5 mm/min with 20 mm space between the two supports for FS measurements.

Statistical Analysis:

Intergroup comparison of CS and FS was assessed using one-way ANOVA. The level of significance was set at 0.05.

Results:

Intergroup comparison showed an overall significant difference (P = 0.016 for CS) and (P = 0.001 for FS), where Group 1 had the highest and Gr 3 the least strength. No significant difference was observed between Group 1 and Group 2, while Group 3 showed significantly low strength when compared to Group 1.

Conclusions:

ABBL + 3% nTiO2 showed nonsignificant decrease while ABBL + 7% nCur showed significant decrease in mechanical properties.
Evaluation of the Effect of Nanocoating on Mechanical and Biofilm Formation in Thermoplastic Polyurethane Aligner Sheets
Authors: Krishnakumaran Mahalakshmi , Mahalingam Janisha , Arumugam Shanthinipriya , Prabhu Deepak , Parameswaran T. M. , Krishnan Balaji
Published: December 2023

Objective:

The objective of this research is to determine whether the thermoplastic polyurethane (TPU) coated with carboxymethylcellulose chitosan has better mechanical and antibacterial action (anti-Streptococcus mutans) when utilized in intraoral simulations with synthetic saliva.

Materials and Methods:

The TPU sheets (n = 45) were divided into three groups. Control (n = 15) consists of as-received TPU sheets. Test 1 consists of TPU sheets coated with carboxymethyl cellulose (CMC) chitosan (CHI) (n = 15). Test 2 consists of thermoformed nano-coated TPU (n = 15). For the polyurethane sheets, CHI-CMC sheets, and thermoformed CHI-CMC sheets, scanning electron microscopy (SEM) and three-point flexural tests were conducted and assessed. The materials testing software was used to calculate the elastic modulus and tensile strength. To study the bacterial accumulation, the cut circles of the TPU aligner were placed in centrifuge tubes with 2.5 mL of bacterial suspension at a concentration of 104 or 105 CFU/mL. SEM was done to assess the presence of cell growth in all three groups.

Results:

According to SEM analyses of bacterial buildup, the coated TPU had minimal biofilms compared to the bare TPUs numerous biofilms. The effect of aging on coating thickness reveals that the thickness of thermoformed coated TPU films dramatically decreased over time, while the thickness of coated TPU films was maintained. When TPU is coated with CMC/CHI, the elastic modulus and tensile strength were observed to improve.

Conclusion:

The development of a super-hydrophilic coating by the CHI CMC coating on TPU sheets improved the coating's biocompatibility while also changing the shape of the multilayer film to prevent bacterial adhesion. The effect on the improvement in the mechanical properties diminished after the material underwent a thermoforming process. It is therefore suggested that the nanofilm be used in therapeutic applications following the thermoforming process.
Diagnostic Imageology of Goldenhar Syndrome: Report of a Rare Case
Authors: Kunjumon Sreekanth P. , Mathew Anoop Kurian , Suma MS , Iqbal Mohammad Zuraiz
Published: December 2023

Goldenhar syndrome is a rare disorder that normally affects just one side and is distinguished by a variety of anomalies in internal organs, vertebrae, and craniofacial tissues. Although this sickness varies genetically and has been linked to a variety of factors, its etiology is unknown. We describe a case of hemifacial microsomia linked with Goldenhar syndrome that was clinically and radiographically investigated using cone-beam computed tomography. Several classical indications of the condition were present in the patient along with few uncommon ones. The many facets of this uncommon disease have been covered, with a focus on early detection and a multidisciplinary approach to treatment.
Rehabilitation of a Patient with Cleft Palate Using a Hollow Lightweight Fixed Prosthesis
Authors: Jagrathi S. , Hegde Chethan
Published: December 2023

Cleft lip and palate are the most common orofacial anomalies affecting the quality of life of an individual. Bilateral cleft lip and palate are the most difficult to treat due to missing premaxilla, and removable prosthesis is the only treatment in such situations to satisfy esthetics, function, and phonetics. In this case report, we have discussed a novel technique of rehabilitating a bilateral cleft palate patient with a fixed hollow prosthesis that would replace the missing hard and soft tissue, yet is light weighed. This unique prosthetic solution could set a new standard of treatment in a seemingly compromised situation.
Development of Efficacious and Less Toxic Endodontic Irrigants from Biosurfactants of Bacterial Origin – A Confocal Laser Scanning Microscope Study
Authors: Parhar Manreet , Bhullar Kanwalpreet Kaur , Arya Ridhima
Published: December 2023

Aim:

The study compared the penetration depth and area of Bacillus
subtilis and Pseudomonas
aeruginosa biosurfactants inside the dentinal tubules against sodium hypochlorite at three levels (coronal, middle, and apical) under a confocal laser scanning microscope.

Materials and Methodology:

Three experimental groups and one control were created using freshly extracted thirty-five maxillary central incisors; Group 1: B.
subtilis biosurfactant; Group 2: P.
ae
ruginosa biosurfactants; Group 3: sodium hypochlorite; and Group 4: distilled water. The experimental data were statistically analyzed by two-way analysis of variance, duly coupled with Tukey's post hoc test to draw concrete conclusions between paired comparisons, and P < 0.05 was considered statistically significant.

Results:

P.
aeruginosa and B.
subtilis biosurfactant showed the maximum mean penetration depth and area at all the level as compared to sodium hypochlorite.

Conclusion:

Biosurfactants showed better results than sodium hypochlorite in reaching to higher penetration depth and area at all the three levels.
Dental Anxiety Assessment through the Drawings of Children and Influence of Art Therapy
Authors: Patil Amol. N. , Hambire Chaitali U. , Hambire Umesh V.
Published: December 2023

Background:

Assessment of dental anxiety in children is difficult because of their immature cognitive and emotional development. Drawings are well well-established emotion assessment tool. These can be used as nonverbal methods of communication for expressing the children's anxiety and emotions. Art therapy utilizes creative therapy interventions to deal with children suffering from emotional problems.

Aims and Objectives:

The aim of the study is (1) To assess the drawings of children for the presence of dental anxiety. (2) To study the effectiveness of art therapy on dental anxiety in children.

Materials and Methods:

One hundred and twenty children within the age group of 6–12 years were part of this study. The pretest assessment of dental anxiety was done using Frankl and Five facial anxiety scales. All the participants received local anesthesia during their first treatment session. At the end of the treatment session, all the participants were asked to draw a picture of their experience. The drawn figures were assessed by a psychologist. The children were allotted randomly into the study group (n = 60) and control group (n = 60). Art therapy was given to 60 children in the study group for three consecutive appointments. The posttest assessment of dental anxiety was done using Frankl and Five facial anxiety scales after completion of the entire dental treatment.

Results:

The pretest scores revealed very high level of dental anxiety in 33 (55%) children in study group and 34 (56.67%) children in control group. The posttest scores of study group, who received the art therapy, revealed that 24 (40%) children had little anxiety and 32 (53.33%) children had some anxiety. Whereas in the control group, the posttest scores showed 20 (33.33%) children had high anxiety and 39 (65%) children had very high anxiety scores. There was a significant correlation between the objective score of dental anxiety and the subjective scores of CD: H.

Conclusion:

Drawings can be used as an assessment tool for the detection of dental anxiety and art therapy effectively reduces the anxiety in pediatric patients undergoing dental treatment.
Outcome of manual small incision cataract surgery in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma
Authors: Desinayak Naresh , Mannem Navya , Panda Amita , Kanungo Gayatri , Mishra Sukhada , Mohapatra Santosh Kumar
Published: December 2023

Purpose:

The study aimed to analyze the surgical outcome of manual small incision cataract surgery (MSICS) in patients with pseudoexfoliation syndrome (PXF) and pseudoexfoliation glaucoma (PXG) and compare them with those of controls.

Settings and Design:

This prospective, observational, and comparative study included 150 cases of PXF with cataracts, 150 cases of PXG with cataracts, and 200 cases of cataracts without PXF as controls.

Methods:

MSICS was performed in all cases under peribulbar anesthesia. Intraoperative complications, if any, were noted. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and postoperative complications were recorded at follow-up on day 1, day 7, and after 1 month.

Statistical Analysis Used:

IBM SPSS 24.0 statistics, SPSS South Asia Pvt Ltd.

Results:

Lines of improvement in BCVA were significantly better in the control group (8.7 ± 1.7) than that in the PXF (7.5 ± 2.1) and PXG groups (6.4 ± 2.7). IOP significantly decreased from baseline to 1 month postoperatively in the PXG group than in the PXF and control groups (mean difference: 3.8 ± 7.5 mm Hg). Intraoperative iridodialysis and zonular dialysis were significantly high in the PXG group with a proportion of 4 and 20%, respectively. Postoperative choroidal detachment and hyphema, six cases each, were found significantly high in the PXG group.

Conclusion:

Although the BCVA improvement was less and the complications were high in patients with pseudoexfoliation, especially those with PXG, the reduction in IOP was significant. MSICS can be considered favorably in patients with PXF and PXG, with adequate precautions to manage anticipated complications.
Trabeculectomy with concurrent intravitreal bevacizumab in neovascular glaucoma
Authors: Khan Sardar M , Rao Aparna
Published: December 2023

Purpose:

To evaluate the clinical efficacy of concurrent intravitreal bevacizumab (IVB) injection with trabeculectomy with mitomycin-C (MMC) in neovascular glaucoma (NVG).

Methods:

Patients with NVG who underwent trabeculectomy with concurrent IVB (group 1) and those who underwent IVB sequentially, followed by trabeculectomy with MMC (group 2) in 1–2 weeks between January 2021 and August 2022, were included in this retrospective hospital-based study. The need for medications for intraocular pressure (IOP) control at 6 months in the two groups was the primary outcome measured and compared between the groups. The association of the need for medications postoperatively with clinical variables was assessed using stepwise multivariate regression statistics.

Results:

We finally included 40 patients (n = 12 in group 1, n = 28 in group 2) with no significant differences in presenting age between groups. The IOP at 1 day and 1 week were not significantly different between groups though the IOP at 1, 3, and 6 months. IOP was lower in group 1 eyes with the 6-month IOP, being significantly lower in group 1, P = 0.05. Three eyes in group 1 and 11 eyes in group 2 required anti-glaucoma medications in the postoperative period. Multivariate regression identified preoperative IVB >3 (β =0.7, P < 0.001) and recurrent vitreous hemorrhage (β = 0.7, P = 0.004) as prognostic factors (R
2 = 40.6%) determining the need for anti-glaucoma medication (AGM) postoperatively in both groups.

Conclusion:

Concurrent IVB with trabeculectomy with mitomycin-C is a feasible alternative in patients with NVG with refractory high-presenting IOP. This may serve to address raised IOP as well as retinal ischemia, thereby improving surgical success rates in the most challenging NVG cases.
Evaluation of ganglion cell-inner plexiform layer thickness in the diagnosis of pre-perimetric glaucoma and comparison to retinal nerve fiber layers
Authors: Yadav Vineet K , Rana Jagriti , Singh Arti , Singh Kamal J , Kumar Santosh , Singh Shivangi
Published: December 2023

Purpose:

Evaluation of ganglion cell-inner plexiform layer thickness in the diagnosis of pre-perimetric glaucoma (PPG) and comparison to retinal nerve fiber layers.

Methods:

This study was a prospective hospital-based study. A total of 30 PPG and control patients were studied for retinal nerve fiber layer thickness (RNFL) and ganglion cell-inner plexiform layer complex (GC-IPL) by spectral-domain optical coherence tomography. PPG was defined as eyes with a normal visual field and one or more localized RNFL defects that were associated with a typical glaucomatous disc appearance. Diagnostic abilities of GC-IPL, optic nerve head (ONH), and RNFL parameters were computed using area under receiver-operating curve (AUROC), sensitivity, and specificity.

Results:

GC-IPL parameters showed significant changes in PPG cases as compared to normal subjects in each region (P value < 0.001). RNFL parameters also differed significantly from normal subjects in all quadrants (P value 0.003 to < 0.001). Within GC-IPL parameters, the superotemporal region had the maximum area under the curve (AUC), followed by inferior, superior, and inferotemporal regions. Within RNFL parameters, the inferior quadrant had the maximum AUC, followed by superior and nasal quadrants. the GC-IPL parameters in PPG showed that the AUC of the GC-IPL parameters was much higher than those of the ONH and RNFL values.

Conclusion:

Although both the parameters RNFL and GC-IPL showed significant changes in PPG patients compared to healthy subjects, a higher AUC of GC-IPL points toward the higher sensitivity of GC-IPL than RNFL for detecting glaucoma in early stages.
Cancer care and economic burden—A narrative review
Authors: Muralidharan Shrikanth , Gore Manisha , Katkuri Sushma
Published: December 2023

Cancer care poses a significant economic burden in India, where noncommunicable diseases contribute to a large number of deaths and disability-adjusted life-years. Despite economic growth, equitable wealth distribution remains a challenge, leading to inequalities in healthcare access. India's healthcare system is primarily privatized, financed through out-of-pocket expenditure (OOPE), and lacks coverage for a majority of the population. As a result, individuals without financial means face catastrophic health consequences when seeking necessary healthcare. OOPE in India's healthcare system is a major concern, with medicines accounting for a significant portion of expenses, followed by diagnostic tests and consultation fees. Nonmedical expenses also contribute to the financial burden. Cancer care specifically faces substantial financial challenges, with high treatment costs, reduced workforce participation, and the need for distress financing. Cancer-related OOPE is predominantly borne by patients and their families, leading to significant financial strain. The lack of comprehensive health insurance coverage and limited access to publicly funded healthcare services exacerbate the problem. Catastrophic health expenditure (CHE) in cancer care is prevalent, pushing households into financial distress and potentially impoverishment. Efforts have been made to address this issue, such as increasing public spending on healthcare and implementing health insurance schemes. However, challenges remain in ensuring their effectiveness and reach. The role of family care physicians is crucial in supporting patients and their families during catastrophic health expenditures related to cancer-related palliative care. They coordinate care, provide advocacy, emotional support, symptom management, and facilitate end-of-life discussions. Comprehensive measures are needed to strengthen healthcare infrastructure, improve access to affordable cancer care, enhance health insurance coverage, and implement supportive measures for cancer patients. Additionally, promoting preventive measures and early detection can help reduce the need for expensive treatments and decrease the risk of catastrophic health expenditures.
Focal hand warming for post-anaesthesia shivering control: A simple and safe non-pharmacological approach in resource limited-area
Authors: Deb Prakash , Das Rituparna , Bhattacharyya Prithwis
Published: December 2023

Post-anaesthesia shivering is a common complication and has multiple deleterious effects. Sometimes multiple non-pharmacological interventions applied together may not control post-anaesthesia shivering adequately, necessitating the use of drugs in some cases. Hand warming is commonly used to warm up the body since time immemorial but its role in preventing post-anaesthesia shivering has not been evaluated. This case series describes the application of this simple and safe method of focal hand warming along with other non-pharmacological measures to suppress post-anaesthesia shivering, whereby possible use of drugs could be avoided.
The psychosocial burden of androgenetic alopecia in Saudi Arabia: A cross-sectional study
Authors: Almashali Mohammed A. , Alotaibi Manar A. , Alkhanani Alanoud H. , Al Dera Norah M. , Alwadany Muhannad M. , Almousa Abdulelah S. , Shadid Asem M.
Published: December 2023

Background:

The most prevalent cause of hair loss is androgenetic alopecia. Improved therapeutic modalities may result from knowing how stress affects hair growth, incorporating stress-coping methods into the treatment of hair loss disorders, and developing new pharmacotherapeutic approaches. This study aimed to examine the psychosocial burden of androgenetic alopecia in Saudi Arabia.

Materials and Methods:

A cross-sectional online survey study was conducted among patients with androgenetic alopecia in Saudi Arabia in February 2023. A previously developed questionnaire was adapted from a previously published tool and used in this study. This association between patients' characteristics and the level of psychosocial disease was identified using binary logistic regression analysis.

Results:

This study included 1230 patients. The majority of the patients (78.0%) reported that they felt embarrassed by their androgenetic alopecia. The median score of the psychosocial impact of androgenetic alopecia on the patients was 1.00 (0.00–2.00), which is equal to 10.0%, reflecting a low level of psychosocial burden on the patients by their condition. Binary logistic regression analysis identified that patients without a family history of androgenetic alopecia were 36.0% less likely to be affected psychosocially by their condition (P < 0.01).

Conclusions:

A low-level psychosocial effect was seen in our study among individuals with androgenetic alopecia. Further research should be done to determine how the type of alopecia affects patients' psychological results, as well as the influence of the disease's duration on those outcomes. Dermatologists are recommended to raise patients' knowledge of their disease and lessen stigmatization in the meantime.