bluuebunny/crossref_metadata_2025 huggingface dataset:
Key regional aspects of public health of Krasnodar Krai for 2018–2020
Authors: Akhedzhak-Naguze Saida K. , Shiltsova Tatyana A. , Naguze Adam A. , Khuako Saida  A. , Khurum Bella R. , Kuksina Valeriya A. , Lavrinenko Milana N.
Published: January 2023

BACKGROUND: The regional dimension of public health is one characteristic of public health that reflects the effectiveness of social and economic change in society. The key components of which are health and demographic indicators. The regions current demographic situation is an essential component of comprehensive medical and social research. Health and demographic indicators describe the dynamics, state, and prospects of social and economic changes in health and society as a whole. The increase in the population and labor resources due to migration growth, the increase in mortality rates, the decline in the birth rate, and the aging of the nation presupposes the development and implementation of additional medico-demographic approaches to the strategic development of the region.
AIMS: Аnalysis of key indicators of public health of Krasnodar Krai, including the main medico-demographic indicators in the dynamics for 20182020.
MATERIALS AND METHODS: A retrospective analysis on some aspects of the regions public health for 20182020 was conducted. Included in the development are medico-demographic indicators of the population, fertility, mortality, natural increase (losses), and so forth, in the dynamics for 20182020. Data from the Federal Service of State Statistics and statistical data of reporting forms of medical organizations of Krasnodar Krai Information about medical organization (p. 30) were used in the study for the period under consideration. The study applied statistical, analytical, and descriptive methods. The statistical processing of the material was carried out with the help of Microsoft Office software package.
RESULTS: Analysis of key regional medico-demographic indicators of Krasnodar Krai for the analyzed period from 2018 to 2020 has made it possible to identify population growth. These indicators include the increase in migration, the number of children, the population under working age, women of childbearing age, the decrease in the total and total fertility rates, the population of working age, and the increase in the overall mortality rate, which includes the working age and population loss. Diseases of the circulatory system, the nervous system, and neoplasm took the largest share in the structure of mortality in 2020. In the structure of mortality, diseases of the circulatory system, nervous system, and neoplasm took the largest share. One of the reasons for the increase in total mortality in 2020 was the death rate from COVID-19.
CONCLUSIONS: The analysis of the main medico-demographic indicators as one of the key components of public health of Krasnodar Krai for 20182020 has been conducted.
Interview Method in State Capitalism Literature: Main Issues and Suggestions
Authors: KARAOĞUZ Hüseyin Emrah
Published: January 2023

Interview technique is one of the widely used methods in social sciences. This article examines how the interview method is applied in state capitalism literature. First, using the ISI Web of Science (WoS) database, it identifies 25 articles (among 177) that used the interview method in their analyses on state capitalism. The keyword “state capitalism” is searched in all SSCI articles (titles, abstracts, keywords, etc.) to find contributions on state capitalism (WoS categories of Political Science, Public Administration, Economics, International Relations, and Sociology). Then, the article investigates how the method is applied in these works. It highlights that practitioners of the interview method seldom engage with the related methodological literature. Despite intriguing debates and valuable contributions, how the interview method is drawn on to support analyses and drive main arguments are not generally clear. Thus, more engagement with the methodological literature would be useful in more explicitly and systematically describing (i) the execution of the method (date, length, mode, etc.), (ii) elaboration of saturation, and (iii) how the interview data are analyzed and presented to the readers, including coding, use of software, and use of direct quotations.
Nitel Araştırmalarda Geçerlilik ve Güvenilirlik: Bir Model Önerisi
Authors: TUTAR Hasan
Published: January 2023

Bilimsel bir çalışmanın niteliği, araştırmanın güvenilir ve geçerli olmasıyla yani bilimsel bir çalışmanın sonuçlarının olgusal dünyada olup-bitenleri açıklama ve temsil edebilme yeteneği ile doğrudan ilişkilidir. Araştırma bulgularının hangi bilimsel temelde elde edildiğini gösteren geçerlik ve güvenirlik ölçütü tüm görgül çalışmalar için önemli bir bilimsellik ölçütüdür. Nicel araştırmalarda geçerlilik ve güvenirlik ile ilgili belirsizlik olmamakla birlikte nitel araştırmalarda geçerlilik ve güvenirlikle ilgili önemli belirsizlik alanları bulunmaktadır. Bu kavramsal incelemenin temel amacı, nitel araştırmalar için geliştirilmiş olan geçerlilik ve güvenirlik ölçütlerinin ne ölçüde güvenilir ve geçerli olduğunu tartışarak işlevselliği yüksek bir model geliştirmenin imkânını sorgulamaktır. Araştırma amacı ve konuya uygunluğu nedeniyle kavramsal inceleme olarak tasarlanmıştır. Araştırma için geniş bir literatür taraması yapılarak ve konunun sorun alanları eleştirel bir incelemeye tabi tutularak söz konusu sorunun giderilmesine dair eşitli önerilerde bulunulmuştur. Araştırmada nitel araştırmaların geçerlilik ve güvenirliği konusunda ileri sürülen önerilerin, literatürdeki boşluğun doldurulmasına ve bundan sonraki araştırmalarda yol gösterici olmasına katkı sağlayabileceği düşünülmektedir.
Eğitim Bilimleri Araştırmalarında Nitel Bir Yöntem Olarak Gömülü Teorinin Kullanımı
Authors: AYDUĞ Damla
Published: January 2023

Eğitimin bir bilim olarak gelişmesinden bu yana bilimsel yöntemlerle olan ilişkileri araştırmalara konu olmuştur. Bu süreçte öncelikle pozitivist paradigmalardan etkilenen eğitim bilimleri ardından yorumsamacı paradigmadan etkilenerek günümüze kadar gelmiştir. Bu çalışmada da yorumsamacı paradigma doğrultusunda ortaya çıkan nitel yöntemlerden biri olan gömülü teorinin eğitim araştırmalarındaki kullanımına ilişkin bir değerlendirme yapmak amaçlanmıştır. Araştırmada ilk olarak gömülü teori desenin özelliklerinden, gömülü teoride çalışma grubundan, veri toplama araçlarından ve veri analizinden bahsedilmiştir. Ardından gömülü teorinin eğitim araştırmalarında kullanım durumuna değinilmiştir. Sonuç olarak gömülü teorinin eğitim bilimleri alanlarına özgü kuramların geliştirilmesi adına önemli bir yöntem olduğu ve araştırmalarda daha fazla kullanılması gerektiği çıkarımında bulunulabilir.
R Programlama Dili ile Kümeleme Analizi
Authors: GÜRLER Cem
Published: January 2023

Kümeleme analizi sıklıkla kullanılan, temelde, birbirine benzeyen gözlemleri bir araya gruplamayı amaçlayan çok değişkenli bir istatistik yöntemidir. Kümeleme analizi, hiyerarşik ve hiyerarşik olmayan algoritmalar şeklinde iki ana başlık altında toplanabilir. Bu iki başlık arasındaki farklardan biri, hiyerarşik olmayan algoritmaların, analiz öncesinde küme sayısına ihtiyaç duymasıdır. Ayrıca, hiyerarşik algoritmalarla oluşan küme üyelikleri nihaidir ve değişmezler. Hiyerarşik olmayan algoritmalarda ise, küme üyelikleri, sabit kalana kadar değişmektedir. İstatistiksel yöntemlerde, özellikle son yıllarda açık kaynak kodlu programların ve programlama dillerinin kullanımı yaygınlaşmıştır. Mevcut çalışmada, R programlama dili kullanılarak, hiyerarşik ve hiyerarşik olmayan kümeleme algoritmalarına yönelik uygulamaların gösterilmesi amaçlanmıştır. Ayrıca, kümeleme analizi öncesinde küme sayısının nasıl belirlenebileceği de R programlamayla gösterilmiştir. Küme sayısının belirlenmesi için literatürde sıklıkla kullanılan Elbow, ortalama Silhouette ve GAP istatistiği yöntemleri kullanılmıştır. Çalışmada analizler için factoextra() ve cluster() paketleri kullanılmıştır. Ayrıca çalışmada kullanılan kodların ve görsellerin gösterimi RMarkdown’da üretilmiştir. Kümeleme sonuçlarının nasıl yorumlandığının gösterimi için k-ortalamalar sonucunda oluşan kümeler yorumlanmıştır.
Development of a COVID-19 Vaccine Hesitancy Single Session Group Intervention for US Veterans
Authors: Mitchell Emily , Sullivan Sarah , Hamerling-Potts Kyra , Dobbs Matthew , Geraci Joseph , Goodman Marianne
Published: January 2023

Background: COVID-19 vaccine hesitancy remains problematic and is particularly prevalent in minority and underserved communities. Aim and Scope: The development and initial efficacy of a single-session Vaccine Hesitancy-focused Telehealth Group at a Veterans hospital in the Bronx, NY are described. This single-session telehealth group integrated motivational interviewing, psychoeducation, and a “vaccine positive” peer with the goal of addressing COVID-19 vaccine hesitancy and improving vaccination rates. Methods: This project was approved by the quality assurance and improvement team at the James J. Peters VA Medical Center in the Bronx, NY. From the vaccine-hesitant Veteran referrals received from providers, eight vaccine hesitancy groups, averaging 3.5 participants per session, were conducted. Thirty Veterans total participated in the telehealth group. Results: Two-thirds of the participants have received the COVID-19 vaccine, with the vast majority of participants receiving the vaccine after the group. About half of the participants (n=14) were more willing to get the vaccine following the intervention and none experienced an increase in hesitancy. Conclusions: Preliminary results suggest this may be one intervention to increase vaccine acceptability and COVID-19 vaccination rates. Program strengths, limitations, and suggestions are discussed.
The Effect of Fluence on Neutrophil Kinetics in Zebrafish Wounds Using Real-time In Vivo Imaging
Authors: Paredes Andre , Tsiampas Panayiotis , Mangos Steve , Patil Rachana , Koh Timothy , Donoghue Michael , Benedetti Enrico , Bartholomew Amelia
Published: January 2023

Background: Neutrophils participate in a cooperative defense strategy with macrophages following tissue injury. Application of low dose electromagnetic radiation via 635 nm wavelength can enhance macrophage recruitment to the wound, decrease tissue levels of ROS and speed healing. The impact of this wavelength on neutrophil activity in vivo is not well-described. Given that wound healing can be enhanced if collateral damage by neutrophils within the wound is decreased, we investigated how neutrophil kinetics changed during these accelerated reparative responses. Methods: Zebrafish, transgenic for the fluorescent neutrophil marker, mpx-dendra2, underwent defined fin tissue injury, and were randomized to one of two laser treatment groups, 3 J/cm2 (n=57), or 18 J/cm2 (n=69) or to the control group, 0 J/cm2 (n=164). Electromagnetic wave exposures were administered by a 635-nm continuous 5mW He:Ne laser with recipients randomized by dose delivered. Fish were three-dimensionally time-lapse imaged 30-120 minutes post injury (mpi) and wound healing documented at 24 hours post-injury. Individual neutrophil movement was tracked according to distance from wound center. Results: The lower treatment fluence, 3 J/cm2, significantly decreased neutrophil migration speed into the wound, increased reverse migration, and promoted stasis outside the adjacent wound area when compared to control and higher energy doses. The 3 J/cm2 treatment groups also exhibited more rapid wound closure when compared to control or higher fluence.  Conclusions: Unlike our previous work in macrophages in which low fluence treatment enhanced the speed of forward directed migration into the wound, the response of neutrophils was decreased speed into the wound, increased reverse migration, and stasis outside the areas of the wound edges. These findings advance the notion that low fluence treatments reduce neutrophil inflammatory responses within the wound by their reduced presence within the wound. Reduced neutrophil-mediated collateral damage may work in concert with enhanced macrophage wound activity to promote faster wound healing.
Zero Contrast Percutaneous Coronary Intervention – A novel approach to reduce Contrast Induced Acute Kidney Injury
Authors: Kumar Prathap , Jino Blessvin , Rajendran Manu
Published: January 2023

Iodinated contrast media are required in all cases who undergo coronary angiography and percutaneous coronary interventions (PCI). Though the modern contrast media (both low-osmolar and iso-osmolar) have lesser adverse effects than the older generation contrast media, they may lead to life threatening complications in few cases. Contrast induced acute kidney injury (CI-AKI) is one such complication where the presentation may vary from asymptomatic mild elevation in serum creatinine to life threatening uremia. Various pre-procedural and procedural steps are followed commonly to prevent CI-AKI and reducing the contrast volume is one of the most important steps. Indeed, multiple studies have proven that reducing the contrast volume during PCI reduces the risk of CI-AKI. More recently, intra-coronary imaging guided zero-contrast PCI has emerged as an important method to prevent CI-AKI. Though randomised controlled trials comparing low-contrast PCI and zero-contrast PCI are lacking, this technique is being used widely by experienced operators. Technical expertise in complex PCI and meticulous analysis of intra-coronary imaging, particularly intravascular ultrasound (IVUS), are mandatory for this procedure.
Different strategies in treatment of malignant cells
Authors: Schardt F. , Henke E. , Zernecke-Madsen A.
Published: January 2023

Malignant cells build up a protective scaffold in form of fibrin meshwork surrounding the tumor cells and provide an extracellular matrix (ECM) consisting of proteoglycans, collagens, glycoproteins, and glycosaminoglycans. Simultaneously, they produce stem cells in an early cancer stadium, which gain the energy and oxygen for their metabolism from the anaerobic glycolysis and are therefore independent of arterial supply. Many publications show that heparins have a wide variety of efficiencies to tumor metabolism because they have the highest negative charge density of any known biological molecules. Therefore, they should be exogenously added in high dosages. In an ambulant trial with daily exogenously added heparins, methadone and a combined clopidogrel/aspirin therapy the survival probability over 12 months was significantly higher than without (p<0,001). Additionally, zoledronic acid was given as infusion every 2 months. This auxiliary treatment has the potential to support established therapies. With methadone, heparins, zoledronic acid and clopidogrel/aspirin we present as supplement to the oncological therapy a model in treatment of malignant cells. Key words: malignant cells, methadone, heparin, zoledronic acid, anticoagulants.
Treatment for an Adult Patient with Slowly Progressive Idiopathic Scoliosis Using a Unique Anterior Scoliosis Correction Technique: A Case Report
Authors: Antonacci M. , Yung Anthony , Antonacci Christopher , Cuddihy Laury , Betz Randal
Published: January 2023

Adolescent idiopathic scoliosis (AIS) can continue to progress after skeletal maturity. Once the progression is severe, posterior spinal fusion (PSF) is the gold standard for surgical treatment. While effective in achieving curve correction, PSF is associated with many problems, including loss of spinal flexibility, uncorrected sagittal deformity, and adjacent segment disease. We present a case of a 50-year-old woman with a documented 38º thoracic curve as a late teen who experienced curve progression after skeletal maturity to >70 ° and underwent Anterior Scoliosis Correction (ASC), a motion-preserving scoliosis correction surgery. Her progressive curve improved from 71º Lenke 1A main thoracic curve to 28°, with a 59% correction being maintained within 5° (33°) at 7 years. She also obtained a 50% correction of her compensatory lumbar curve and correction of hypokyphosis from 2.4° to 23° at 7 years. Along with improvement of her thoracic kyphosis, her lumbar lordosis decreased to a normal range of 60° from 70°, giving her better overall alignment. This case report suggests that motion preserving surgical treatment may be considered for some select adult patients with progressive scoliosis. Key Words: Progressive Scoliosis, Anterior Scoliosis Correction
Medical Consultation – Resonating with Patients, not exchanging digital information
Authors: Byrne Aidan
Published: January 2023

Historically, the medical consultation has been seen as a process during which patterns of words/meanings are exchanged between individuals, in the same way that digital computers exchange information. Recent developments have characterised the human brain as using analogue processes. This suggests that human interaction should instead be seen as a process of resonance or synchronisation. The implication is that teachers should recognise communication as a complex, highly personal ability developed through life long experience and that success should be seen as staff being able to resonate with their patients and effectively ‘feel what they feel’.
Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis
Authors: Gosalia Helin , Wei Diana , Goadsby Peter
Published: January 2023

Cluster headache is a primary headache disorder and is the most prevalent of the trigeminal autonomic cephalalgias. Cluster headache significantly impacts those affected, necessitating early diagnosis and management. Despite unique clinical features, such as patients experiencing attacks in a circannual pattern and often with a circadian rhythm within bouts, cluster headache patients often are misdiagnosed, mismanaged and have a delay in diagnosis. Preclinical, neuroimaging and clinical studies have advanced our understanding of cluster headache pathophysiology. The trigeminovascular system, the trigeminal autonomic reflex, and the hypothalamus are all involved in the pathophysiology of cluster headache. As our understanding of the pathophysiology of cluster headaches has evolved, new therapeutic options, such as calcitonin gene-related peptide monoclonal antibodies, non-invasive vagal nerve stimulation and sphenopalatine ganglion stimulation, have proved to have efficacy in the treatment of cluster headache. Herein, we aim to review developments to aid readers in their understanding of this debilitating disorder.
Ulipristal Acetate (UPA) in Emergency Contraception: The Mechanism of Action, Toxicity and Perspectives
Authors: Mozzanega Bruno
Published: January 2023

After recalling that Levonorgestrel Emergency Contraceptive Pills never delay or suppress ovulation, but impair the luteal body functions, and, consequently, the embryo-implantation, we focus on the mechanism of action (MOA) of ellaOne®: micronized UPA (Ulipristal Acetate) 30mg and on UPA- toxicity. EMA and, after it, the National Drug Regulatory Institutions and the most renowned International Gynecological Societies present ellaOne® as an anti-ovulatory drug which is safe even in repeated assumption, also during the same menstrual cycle. We’ll try to understand whether this dogma is supported by experimental data in literature. As to the MOA, EMA reports (EMEA-261787-2009) that Ulipristal blocks the synthesis of the proteins necessary to begin and maintain pregnancy, and that Ulipristal and mifepristone were approximately equipotent as to their ability to terminate pregnancy. Besides, EMA further evidences (EMA/73099/2015) that it is unknown whether it is possible to use ellaOne® for abortion. Data in Literature evidence that ellaOne® can delay ovulation only when is taken in the very first fertile days of the cycle. In the pre-ovulatory, most fertile, days - when most intercourses do occur and over 70% fertilizations ensue - it never prevents ovulation, like placebo. On the contrary, whenever it is taken in the cycle, it consistently impairs the endometrium that becomes an inhospitable ground for the embryo: endometrial gene expression is completely subverted compared with that of the normal luteal phase. Recently, an UPA-based drug used for uterine fibroids-treatment (Esmya®) was withdrawn from the market because it caused fulminant hepatitis requiring transplantation (EMA/455818/2020). It was prescribed by the hospital for 3-6 months and carefully followed-up. The strict post-marketing surveillance allowed to link UPA-administration and tissue-accumulation to liver-failure. Surprisingly EMA, while revoking Esmya®, warranted for the safety of ellaOne®, though it is taken by millions of women unaware of the risk, repeatedly without prescription, without medical supervision and any possibility of post-marketing surveillance, in UPA-cumulating doses even greater than with Esmya®. Finally, we criticize the attempt to propose UPA in daily contraceptive pills, at doses even double than in Esmya® and for much longer periods, to fertile women aiming at preserving their fertility and health.
The Role of Dynamic Core and Mirror Neuron System in Dissociative Disorder
Authors: Okano Kenichiro
Published: January 2023

This paper examines the current problems in understanding and conceptualizing the “personalities” of individuals with dissociate identity disorder while seeking a biological correlation of these personalities. First, the current theoretical ambiguity and potential problems regarding how we understand personalities in dissociate identity disorder are delineated by examining current international diagnostic criteria and views proposed by leading experts on the topic. The general trend is not to acknowledge each personality as having an independent sense of self, but rather a partial and fragmentary one, which does not seem to match well with its clinical manifestations. The author subsequently proposes that each personality has an independent neurological correlate, a neural network integrated as a dynamic core, as proposed by G. Edelman and G. Tononi. Although their theory is not designed to explicate personalities in dissociate identity disorder, the biological correlates of the personalities might be approximated to a coexistence of multiple dynamic cores, which was predicted by them, and partially exemplified by brain functions in split-brain experiments. The author then draws on the current understanding of the mirror neuron system discovered by G. Rizzolatti, V. Gallese, et al., which forms a basis for the understanding of how our sense of self is formed. They propose that the potential dysfunction of the mirror neuron system in a traumatic and critical situation might explain how different personalities are formed. Finally, the article discusses how these advances might be incorporated into our understanding and treatment of individuals with dissociate identity disorder.
Effect of Incorporating Computerized Insulin Dose Adjustment Algorithms into a Remote Patient Monitoring Program on HbA1c Levels in Patients with Type 2 Diabetes
Authors: Pulicharam Juvairiya , Davidson J. , Bubb Chard , Evans Steven , Davidson Mayer
Published: January 2023

Aims: To evaluate the effect of Federal Drug Administration-cleared computerized insulin dose adjustment algorithms (CIDAAs) incorporated into a Remote Patient Monitoring (RPM) program on HbA1c levels. Material & Methods: Type 2 patients receiving insulin for >6 months with HbA1c levels ≥8.0% enrolled in a Medicare Advantage plan were recruited into 3 arms; Group A (RPM plus CIDAAs, N=40), Group B (RPM but no CIDAAs, N=42), and Group C (usual care with no RPM or CIDAAs, N=33). In Groups A and B, glucose readings of >200 mg/dL and <70 mg/dL triggered alerts and health educators contacted patients for counseling to avoid future episodes. Results: Baseline HbA1c levels (% ± SD) were not statistically different among Groups A (9.5 ± 1.5), B (9.2 ± 1.1) and C (9.0 ± 0.9). At 6 months, HbA1c levels fell twice as much in Group A (-1.5 ± 1.0) as in Groups B (-0.7 ±1.5) and C (-0.7 ± 1.2) (P <0.001). Alerts >200 mg/dl were significantly less in Group A (N=942) than in B (N=1111) (P = 0.002) but alerts <70 mg/dL were not significantly different (235 vs 209). In Group A, baseline per patient daily insulin doses of 78 units rose 40% to 109 units. Six patients in Group C had emergency room visits for hypoglycemia but none in Groups A and B. Conclusions: The RPM program lessened clinical hypoglycemic risk but required CIDAAs to markedly increase insulin doses effectively and safely to significantly lower HbA1c levels twice as much as either RPM alone or usual care.
Utilizing a Flipped Classroom Approach to Facilitate Learning in the Health Sciences: A Systematic Review of the Literature
Authors: Whittington Kelli , Roy Titas
Published: January 2023

It is essential that the training occurring across programs in the health sciences not only provides students with the knowledge necessary to correctly perform their role, but also to safely practice as health care professionals in the workforce. Curriculum in health science programs is typically very content heavy, which requires both the instructor and student to wade through vast amounts of information in order to determine the crucial elements necessary to practice. Additionally, it is not sufficient for a student to simply memorize content; they must be able to apply that content to clinical practice. Utilizing an active learning strategy such as the flipped classroom fosters the student’s ability to apply content to practical situations, they are likely to encounter in their professional practice.
Presentation and Patterns of Celiac Disease in Indian Subcontinent: A Literature Review
Authors: Siddiqui Anjum , Agrawal Aparna , Kumar Praveen , Ghotekar Lekhraj , Taneja Sanjana
Published: January 2023

Gluten, in genetically susceptible individuals induces an immune mediated enteropathy called Celiac disease (CD). It is an established cause of malabsorption, with the worldwide prevalence being 1% in the general population. It is found across all age groups, from infants to the elderly with 20% patients being diagnosed in the seventh decade of life. It has varying clinical presentations ranging from silent asymptomatic forms which are diagnosed during screening to life threatening forms with severe malabsorption to atypical presentations, with the symptom spectrum extending beyond the gastrointestinal tract which are more common in adults. High index of suspicion, robust screening and testing, followed by strict adherence to gluten free diet is a must to curb and cure the disease. Patients tend to face difficulties not only during diagnosis, but also with compliance and availability of a gluten free diet, in addition to significant economic and psychosocial burden, which is more predominant in developing countries. Screening of high-risk groups like first-degree relatives of celiac disease, patients with severe malnutrition, other autoimmune diseases, refractory anaemia and irritable bowel syndrome should be done to enhance case detection. In low middle income countries, judicious resource utilisation takes precedence, hence, tackling a multifactorial disease such as celiac disease becomes challenging. Repeated follow ups, awareness among patients and doctors, encouragement, availability of testing and dietary counselling is necessary for management of the disease in such settings. Improving sanitation and feeding practices may also play role in decreasing incidence, considering childhood GI infections are a well-established risk factor. Increased availability of serological tests (IgA/IgG anti-tTG, anti -EMA and anti-DGP), biopsy, genetic testing and other newer modalities under research have improved the diagnostic accuracy. Poor compliance increases the risk of GI malignancy, non-Hodgkin’s lymphoma, Hepatocellular carcinoma and MALToma. Hence adherence is a must to prevent complications. A wide variety of treatment modalities are being evaluated to bring into force alternative strategies for management. Only providing gluten free diet is often not sufficient for improvement of nutritional status in patients with CD. Hence, micronutrient supplementation should also be encouraged to meet the unmet needs.
Relationship of Social Vulnerability, COVID-19 Mortality, Life Expectancy, and Chronic Disease Prevalence: Policy Implications for Public Health and Social Sciences Funding
Authors: Fos Peter , Honore Peggy , Kellum Katrina
Published: January 2023

Background: The Centers for Disease Control and Prevention and its affiliate the Agency for Toxic Substances & Disease Registry established an index to identify the social vulnerability for natural disasters and infectious disease outbreaks for communities in the United States. This index, potentially, may be useful in evaluating the impact of social vulnerability on health. Aim: The objective of the study is to identify the relationship of the Social Vulnerability index with COVID-19, chronic diseases, and life expectancy.  Methods: Social Vulnerability Index values were obtained for counties in Georgia, Louisiana (parishes), Michigan, and Mississippi. Current data on COVID-19, diabetes and obesity prevalence, premature age-adjusted death rates, and life expectancy were obtained from the County Health Ranking and Roadmaps. Pearson’s correlation coefficients were calculated for the relationship of social vulnerability and health outcomes. The relationship of funding for public health and social services interventions that target the social determinants of health as a mechanism for reducing community vulnerabilities was also examined. Results: Correlations were determined between social vulnerability and several health outcomes, both infectious and chronic diseases. Life expectancy was correlated with social vulnerability, overall and by race. Study findings found a positive correlation between social vulnerability and COVID-19 infections and mortality, premature age-adjusted mortality, and the prevalence of diabetes and obesity. There is a negative correlation between social vulnerability and life expectancy. Additionally, life expectancy was greater in non-Hispanic Whites compared to non-Hispanic Blacks. Conclusion: The study results can be used to guide policies directed to improvements in the social determinants of health that target reductions in community vulnerabilities. Social vulnerability of communities can be reduced with adequate resource allocations in public health and social services to mitigate untoward health outcomes associated with natural disasters and disease outbreaks.
Non-Operative Treatment Options in Primary Glenohumeral Osteoarthritis: A Comprehensive Review
Authors: Martini Liborio , Velasquez Ausberto , Abache Andres
Published: January 2023

Primary glenohumeral joint osteoarthritis is a growing pathology with multifactorial aethiology that affects younger and older population. Treatment must be focused on reducing pain, regaining functionality, and slowing the course of the disease. Surgery and non-operative methods are available for treating it and are a frequent source of controversy, the latter being applied to patients with factors that may relatively contraindicate surgery. Practitioners must be acquainted with the therapeutic choices and the current status of the evidence. Given that nonsurgical therapy may be beneficial in relieving symptoms, it should be considered first-line treatment, particularly in low-demand individuals with symptoms that have shown themselves sub acutely. Literature is lacking of high quality evidence on this matter, and up to date, there have not been any high quality studies comparing different options. Optimal treatment of primary glenohumeral osteoarthritis depends on specifically patient´s needs, therefore a combination of all the resources available could represent the best option and result in better outcomes.
Founder-flush effect found in Vibrio cholerae by MLVA of Nigerian samples
Authors: Akinsinde Kehinde , Sack David , Iwalokun Bamidele , Oyedeji Kolawole , Fowora Muinah , Ngwa Moise , Luo Wensheng , Debes Amanda , Li Shan , Stine O
Published: January 2023

Introduction: We analyzed the multilocus variable tandem repeat analysis (MLVA) genotypes from DNA of toxigenic Vibrio cholerae O1 patient isolates from Nigeria collected by the Nigerian Institute of Medical Research between 2016 to 2021. Findings: Sixty distinct MLVA genotypes were observed among the 144 Isolates. There were two large clonal complexes (CC) of related genotypes that differed by change at a single locus. The locus with the most alleles was P5. Each genotype is represented by the number of repeats at each of the five loci, in order. The first CC was observed from 2016 to 2019, but not afterwards. A single genotype of the first CC was observed in 2016, 5 genotypes in 2017, 6 in 2018 including 2 previously observed in 2017 and 1 in 2019. The second CC was observed only in 2021. Three genotypes - 8,4,6,18,y where y = 33, 34 or 35 – were observed in isolates collected at multiple locations. These genotypes were observed in 8, 7 and 7 of the 11 outbreaks, respectively. All three genotypes were present in Gombe, Plateau and Jigawa. Only one outbreak did not have any of these three genotypes. 15 of 18 other genotypes were unique to a location. In Gombe, Katsina, Kebbi, Lagos, Niger, Plateau and Taraba, an isolate with a founder genotype (8,4,6,18,y) was collected prior to isolates with genotypes unique to that site. Discussion: The genotypes of V. cholerae isolates collected from the outbreaks of cholera follow a founder-flush pattern. One or more genotype(s) [the founders] give(s) rise to multiple other genotypes as the outbreak expands and spreads [the flush] over time and space in Nigeria. Our data and analyses are consistent with the founder-flush phenomena. Keywords: cholera, MLVA, founder-flush, Nigeria, surveillance, Africa, Vibrio cholerae
Acute in vivo toxicity of neonicotinoid pesticide residues in common Egyptian fruits
Authors: Elshebiney Shaimaa , El-Araby Marwa , Khattab Amr
Published: January 2023

Pesticide residues in food is a major health hazard. Contamination of pesticide residues in common Egyptian fruits was studied. Samples of peach and cantaloupe (500g each) from five different local markets were examined. Fruit samples were liquid-liquid extracted. Thiamethoxam was detected in three cantaloupe samples at 0.085 mg/kg and acetamiprid in two samples at 0.24 mg/kg, whereas acetamiprid was detected in all the peach samples at 0.08 mg/kg. Detected levels were below MRL. Male albino rats were given either distilled water (0.2 ml) or acetamiprid (17 µg/kg) or thiamethoxam (6 µg/kg) orally for 6 consecutive days. Doses were calculated according to the estimated average daily intake of fruits (~100 g) and extrapolated to rats. Thereafter, oxidative state of liver and brain was evaluated besides liver function tests and assessment of histopathological features. Serum GPT was in normal range in thiamethoxam-exposed rats, while it showed a marked increase in acetamiprid-exposed rats. sGOT was elevated after exposure to both compounds, though total protein and sGSH were not affected. Oxidative insult was expressed in liver tissue through increased MDA, NO and protein carbonyl contents, although the antioxidant GSH pool was not depleted after pesticide exposure. Acetamiprid boosted the cytokine IL-1 level. Histopathological examination of liver tissue showed inflammatory degenerative changes. Acetamiprid affected the DNA integrity in blood. Brain oxidative state was not changed. These pesticides should be further studied for guiding local regulations towards safer use to avoid long term associated health hazards.
A Rehabilitation Protocol for Stroke Patients using Virtual Reality
Authors: Chan Moon , Ravindran Senthilkumar , Al-Subhi Hammad , Al-Riyami Saif
Published: January 2023

Rehabilitation training for stroke patients is mostly based on face-to-face contact. This affects the routine training during the coronavirus disease outbreak in many hospitals worldwide, including Oman. Perhaps, this problem can be overcome using a virtual reality system. This protocol study aims to compare the outcome measures of the two groups of stroke patients (virtual reality intervention vs. conventional control) on these two modes of rehabilitation training. A randomized controlled trial with pre-/post-study of 42 stroke patients (21 control vs. 21 intervention) with upper limb motor impairments, aged 18-65 years old, newly admitted to the rehabilitation clinic in Oman, will be recruited. Basic demographic data and three major outcome assessments will be collected pre-/post-period. Baseline assessment (pre) on admission to the stroke rehabilitation program and after completion (post). Participants will be assessed by Barthel Index, Action Research Arm scale, and time spent per session with costs involved by the workforce in training. Repeated measures general linear model will examine the within, between, and interaction effects while adjusted by demographic data. All analyses will use IBM SPSS software, and a statistical significance level of p<0.05 will be employed. This research protocol aims to evaluate the feasibility and effectiveness of VR in improving motor control in stroke patients with upper limb weakness by comparing a low-cost VR platform with face-to-face training. If the proposed training protocol is helpful and easy to use, it could become a reliable tool to assist healthcare professionals for stroke patients during their rehabilitation training. This protocol will contribute to the theoretical discussion of integrating high-tech equipment with healthcare theory for stroke patients with learning disabilities. Also, adopting a virtual reality system could aid if a sudden pandemic outbreak. It could continue offering its services while maintaining a high standard of care for stroke sufferers.
Repetitive Nicotine Exposure on Efficacy of Temozolomide and Radiotherapy on Cultured Glioblastoma Cell Lines
Authors: McConnell Diane , Herbert Joseph , Miller Douglas , Litofsky N.
Published: January 2023

Purpose: Of patients with glioblastoma who smoke tobacco, 16 to 28% will continue to smoke following diagnosis. Use of nicotine-containing products may enhance proliferation, migration and radioresistance and detrimentally affect treatment and prognosis of glioblastoma. The aim of this study is to identify effects of a period of nicotine exposure on efficacy of subsequent treatment with temozolomide and radiation therapy on 5 glioblastoma cell lines. We hypothesize that prior and continued nicotine exposure would reduce tumoricidal effects of temozolomide and radiation therapy. Methods: After 5 glioblastoma cell cultures are exposed to nicotine prior to treatment with temozolomide and /or radiation, proliferation, migration, colony forming assays, and enzymatic expression of matrix metalloproteinases are assessed. Results: Proliferation is not affected by exposure of physiologically relevant concentrations of nicotine prior to treatment with temozolomide or irradiation. Nicotine exposure has variable effects which include enhancement of migration rate, metalloproteinase expression, and colony formation for some glioblastoma cell lines subsequently treated with temozolomide and /or radiation therapy. Conclusions: These findings suggest that continued smoking or use of other nicotine-containing products during treatment could result in increased aggressiveness and invasion of residual tumor cells causing a resistance to treatment in some glioblastoma.
Dendritic Cell Therapy in the palliative Treatment of Pancreatic Cancer Patients. Experience in 200 Patients
Authors: Gansauge Frank , Poch Bertram
Published: January 2023

Purpose: Despite improved diagnostic and therapeutic facilities median survival in pancreatic cancer is still unsatisfactory Here we retrospectively analyzed the outcome of immunotherapy in the additional palliative treatment of pancreatic cancer with long antigen exposition dendritic cell therapy (LANEX-DC®) in 200 patients who were treated at our institution (intent-to- treat-analysis). Patients: Data were available of 200 patients.The mean interval between first diagnosis and start of treatment was 1,5 months. 148 patients received one cycle of dendritic cell therapy, 52 patients received 2 or more cycles of dendritic cell therapy. Results: Therapy was well tolerated and no serious side effects were observed. The survival rate after 6 months was 70,9 % and afters 9 month 51,0%. The median survival time according to Kaplan- Meier regression analysis was 9,1 months. Median survival was significantly higher in the group of patients who started immunotherapy within 1,5 months following diagnosis (7,9 months versus11,8 months, p=0,009). Patients with two or more cycles of dendritic cell therapy lived significantly longer than patients with just one cycle (17,5 months versus 7,4 months, p=0,001). Interestingly younger patients < 65 years of age lived significantly longer as patients >= 65 years of age (p = 0,004). Conclusion: We were able to demonstrate in a large retrospective cohort analysis that additional treatment with dendritic cells is highly effective and extends the median survival times up to 17,5 months in case of regular repetition of dendritic cell therapy. Furthermore, we were able to demonstrate that median survival can be increased by early beginning dendritic cell therapy.
The Effect of Domestic Consumption on Natural Rubber Farmgate Price in Indonesia
Authors: Pramananda Penggawa Pietra , Rifin Amzul , Nauly Dahlia
Published: January 2023

The decline in natural rubber farmgate prices in recent years directly impacted Indonesia’s natural rubber market. In response to this phenomenon, the government plans to increase natural rubber domestic consumption to raise Indonesia’s rubber price. This study aimed to determine the effect of increasing natural rubber domestic consumption on natural rubber farmgate prices and analyze other factors those influence it. The Error Correction Model was used to identify the variables that significantly affect Indonesia’s natural rubber farmgate price. The data used in this study were monthly data from January 2012 to December 2017. Results showed that natural rubber domestic consumption did not significantly affect the Indonesia natural rubber farmgate price. However, in the long run, Indonesia’s natural rubber farmgate price was influenced by the previous period of Indonesia’s natural rubber prices, world natural rubber prices, world crude oil prices, and exchange rates. While in the short run, Indonesia’s natural rubber farmgate price was influenced by the previous period of Indonesia’s natural rubber prices, world natural rubber prices, and exchange rate.
Design of PI and PID Control System for Induction Motor Control on Gamma Irradiator Characterization Prototype Using a Modified Ziegler-Nichols Method
Authors: Damayanti Rissa , Syawaludin Beny , Gunawan Hyundianto Arif
Published: January 2023

The irradiator simulator's induction motor drive control system is carried out to maintain safety and accuracy in the loading/unloading process and product transportation system. Control is done by maintaining the speed of the induction motor at a certain speed so that the travel time for the loading/unloading process is predetermined. This study aims to answer the existing problems using the PI and PID control systems and prove that using the control system will give better results than the current system applications. In this study, the gain configuration for the PI controller that best fits the design requirements is obtained at a Kp value of 0.038, a Ki of 2.18, and a Phase Margin ( ) of 70°, resulting in a motor rotational speed that can achieve stability at the set point determined by the setting time is 0.90 seconds. The maximum overshoot is 0% and has a steady state error value of 0.00013. Then the gain configuration for the PID controller that best fits the design requirements is obtained at a value of Kp of 0.0066, Ki of 10.85, Kd of 9.9x10-7 and with a Phase Margin ( )  of 50°, resulting in a motor rotational speed that is high. Able to achieve stability at the specified set point with a setting time of 0.63 seconds and a maximum overshoot of 0%, the steady state error value of 0.00013. From the results obtained, it can be seen that this PI and PID control method can be used as an alternative control system on the induction motor drive system on the irradiator simulator. The controller can control the system according to the specified conditions so that the irradiation process time accuracy improves or increases.
Class II malocclusion- mini plate assisted non-extraction treatment approach
Authors: Gadhiya Nitin Dinesh , Bhoir Neeta , Sabharwal Kretikka , Narkhede Sameer , Shetty Karthick
Published: January 2023

Class II mal-occlusion and its non-extraction treatment approach can be quite a garbled decision for an orthodontic professional, as it has varied modalities to it depending on variety of factors such as patients facial type and profile, malocclusion of the teeth, age of the patient, overjet and overbite and many more. The non-extraction treatment of class II malocclusion without extraction mostly requires posterior movement of the maxillary dentition, anterior movement of the mandibular dentition or a combination of both; is a sine qua non. An era of appliance techniques have been developed over time and used to distalise the maxillary molars with positive clinical results, with no disposition to question their veracity. However patient co-operation remains the major concern, orthodontic mechanics requiring minimal patient co-operation are discernible and relevant.With the use of dental mini-implants and mini-plates as anchorage, the distal movement of anterior or posterior teeth or both without anchorage loss has become possible. Among these devices, mini-implants have been advantageous due to its easy placement and removal but it does have its share of setbacks being the failure rate with respect to long term retention and stability over the course of treatment. Hence mini-plates take over the dogmata of the mini-implants, even though it requires special minimal surgical technique and anatomic specificity for its placement but is very aberrant when it comes to retention and stability over a long period of time and minimal patient cooperation.Sliding mechanics with the aid of mini-plate assisted anchorage and its application for treatment of skeletal class I and class II malocclusion have been described and its application in non-extraction treatment will be enlightened. The following case reports the use of mini-plates as an anchorage aid for distalisation of maxillary molars.
“A” – Two way device
Authors: Garabadu Anand
Published: January 2023

As Orthodontists, the most common procedure we practise on a daily basis is Bonding. As we all know bracket positioning is very important for getting a desired result in correction of malocclusion. The instrument used in the procedure is known as Boone guage. This instrument assures the clinician to properly position the brackets during the bonding procedure.

The other instrument which is used popularly to engage the modules/O- rings in a crowded or severly malaligned arch is Tucker. If these two instrument are purchased can cost approximately Rupees five hundred to two thousand.Since the introduction of novel severe acute respiratory syndrome coronavirus -2 and its spread through the world, dentist, in general are at high risk. So sterilization is of utmost importsance and instead of sterilizing two intrument, here we can do it on one which is timesaving and user friendly.

The concept of fabricating this instrument is avoid buying costly instrument. The spatula used for fabrication is plastic and is safe for use and can be sterilized.