bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-utility analysis of endoscopic lumbar discectomy following a uniform clinical pathway in the Korean national health insurance system
Authors: Kim Chi Heon , Choi Yunhee , Chung Chun Kee , Yang Seung Heon , Lee Chang-Hyun , Park Sung Bae , Kim Keewon , Chung Sun Gun
Published: June 2023

Introduction

Full-endoscopic lumbar discectomy (FELD) is a type of minimally invasive spinal surgery for lumbar disc herniation (LDH). Sufficient evidence exists to recommend FELD as an alternative to standard open microdiscectomy, and some patients prefer FELD due to its minimally invasive nature. However, in the Republic of Korea, the National Health Insurance System (NHIS) controls the reimbursement and use of supplies for FELD, but FELD is not currently reimbursed by the NHIS. Nonetheless, FELD has been performed upon patients’ request, but providing FELD for patients’ sake is inherently an unstable arrangement in the absence of a practical reimbursement system. The purpose of this study was to conduct a cost-utility analysis of FELD to suggest appropriate reimbursements.

Method

This study was a subgroup analysis of prospectively collected data including 28 patients who underwent FELD. All patients were NHIS beneficiaries and followed a uniform clinical pathway. Quality-adjusted life years (QALYs) were assessed with a utility score using the EuroQol 5-Dimension (EQ-5D) instrument. The costs included direct medical costs incurred at the hospital for 2 years and the price of the electrode ($700), although it was not reimbursed. The costs and QALYs gained were used to calculate the cost per QALY gained.

Result

Patients’ mean age was 43 years and one-third (32%) were women. L4-5 was the most common surgical level (20/28, 71%) and extrusion was the most common type of LDH (14, 50%). Half of the patients (15, 54%) had jobs with an intermediate level of activity. The preoperative EQ-5D utility score was 0.48±0.19. Pain, disability, and the utility score significantly improved starting 1 month postoperatively. The average EQ-5D utility score during 2 years after FELD was estimated as 0.81 (95% CI: 0.78–0.85). For 2 years, the mean direct costs were $3,459 and the cost per QALY gained was $5,241.

Conclusion

The cost-utility analysis showed a quite reasonable cost per QALY gained for FELD. A comprehensive range of surgical options should be provided to patients, for which a practical reimbursement system is a prerequisite.
Temporal assessment of entomological surveillance of Trypanosoma cruzi vectors in an endemic area of northeastern Brazil
Authors: Sampaio George Harisson Felinto , da Silva Andressa Noronha Barbosa , de Negreiros Christiane Carlos Araújo , Honorato Nathan Ravi Medeiros , Martins Rand Randall , Aguiar Lúcia Maria Abrantes , Sales Letícia Mikardya Lima , Brito Carlos Ramon do Nascimento , Guedes Paulo Marcos da Matta , da Câmara Antonia Claudia Jácome , Galvão Lúcia Maria da Cunha
Published: June 2023

Entomological surveillance is essential for the control of triatomines and the prevention of Trypanosoma cruzi infection in humans and domestic animals. Thus, the objective of this study was to evaluate entomological indicators and triatomine control during the period from 2005 to 2015 in an endemic area in the state of Rio Grande do Norte, Brazil. This observational and retrospective study was developed based on data analysis related to active entomological surveillance activities and chemical control of infested housing units (HU) in the Agreste mesoregion of the state of Rio Grande do Norte, Brazil, in the period between 2005 to 2015. The quantitative analysis of housing units surveyed for entomological indicators was performed by linear regression of random effects (p < 0.05). The effect of the number of HU surveyed on the entomological indicators was analyzed by fitting a linear random effects regression model and an increasing intradomiciliary colonization rate was significant. In the period evaluated 92,156 housing units were investigated and the presence of triatomines was reported in 4,639 (5.0%). A total of 4,653 specimens of triatomines were captured and the species recorded were Triatoma pseudomaculata (n = 1,775), Triatoma brasiliensis (n = 1,569), Rhodnius nasutus (n = 741) and Panstrongylus lutzi (n = 568), with an index of natural infection by T. cruzi of 2.2%. Only 53.1% of the infested HU were subjected to chemical control. Moreover, there was a decrease in the total number of HU surveyed over time associated with an increase in the index of intradomiciliary colonization (p = 0.004). These data demonstrated that entomological surveillance and control of vectors in the Agreste mesoregion of the state has been discontinued, emphasizing the need for more effective public policies to effectively control the vectors, in order to avoid the exposure of humans and domestic animals to the risk of T. cruzi infection.
Hepatitis C virus seroprevalence among patients enrolled at the opioid substitution therapy center in Bihar: A cross-sectional study
Authors: Kumar Ashish , Mahajan Hemant , Chaturvedi Sanjay , Kumar Ashok , Kumar Shiril , Sahoo Ganesh Chandra , Das Vidya Nand Rabi , Pandey Krishna
Published: June 2023

Background and aim

Hepatitis C virus (HCV) infection poses a major public health challenge in Indian settings due to its huge population and easy transmissibility of HCV among individuals who inject drugs (PWID, which is increasing in India). The National AIDS Control Organization (NACO), India has started the Opioid Substitution Therapy (OST) centers to improve the health status of opioid dependent PWID and prevent the spread of HIV/AIDS among them. We conducted a cross-sectional study to find out the HCV sero-positive status and associated determinants in patients attending the OST centre in the ICMR-RMRIMS, Patna.

Materials and methods

We utilized the routinely collected (as a part of the National AIDS Control Program) and de-identified data from the OST center from 2014 to 2022 (N = 268). We abstracted the information for exposure variables (such as socio-demographic features and drug history) and outcome variable (HCV serostatus). The association of exposure variables with HCV serostatus was examined using robust Poisson regression.

Results

All the enrolled participants were male and the prevalence of HCV seropositivity was 28% [95% confidence interval (CI): 22.7% - 33.8%)]. There was a rising prevalence of HCV seropositivity with number of years of injection use (p-trend <0.001) and age (p-trend 0.025). Approximately, 6.3% participants were injecting drugs for >10 years and reported the maximum prevalence of HCV seropositivity (47.1%, 95% CI: 23.3%-70.8%). In adjusted analyses, being employed compared to unemployed patients [adjusted prevalence ratio (aPR) = 0.59; 95% CI: 0.38–0.89]; graduated patients compared to illiterate patients [aPR = 0.11; 95% CI: 0.02–0.78]; and patients with education up to higher secondary compared to illiterate patients [aPR = 0.64; 95% CI: 0.43–0.94] had significantly lesser HCV seropositivity. A-one year increase in injection use [aPR = 1.07; 95% CI: 1.04–1.10] was associated with 7% higher prevalence of HCV seropositivity.

Conclusions

In this OST center-based study of 268 PWIDs residing in Patna, ~28% of patients were HCV seropositive, which was positively associated with years of injection use, unemployment, and illiteracy. Our findings suggest that OST centers offer an opportunity to reach a high-risk difficult to reach group for HCV infection and thus support the notion of integrating HCV care into the OST or de-addiction centres.
Targeting patients for early COVID-19 therapy; Pre-infection metabolic dysfunction, polycystic ovary syndrome and risk of severe disease in patients under 65: A Massachusetts community-based observational study
Authors: Sama Susan R. , Gore Rebecca , Bauer Ann Z. , Garber Lawrence , Rosiello Richard , Sundaresan Devi , McDonald Anne , Kriebel David
Published: June 2023

Introduction

The demographics of those developing severe coronavirus disease (COVID-19) outcomes are shifting to younger patients. In an observational study utilizing electronic health records from a Massachusetts group medical practice, we identified 5025 patients with confirmed COVID-19 from March 1 to December 18, 2020. Of these, 3870 were under 65 years of age. We investigated the hypothesis that pre-infection metabolic or immunologic dysregulation including polycystic ovary syndrome (PCOS) increased risk of serious COVID-19 outcomes in patients under 65 years of age.

Materials and methods

We compared those with COVID-19 related hospitalization or mortality to all other COVID-19 patients, using a case control approach. Using logistic regression and propensity score modeling, we evaluated risk of developing severe COVID-19 outcomes (hospitalization or death) in those withpre-infectioncomorbidities, metabolic risk factors, or PCOS.

Results

Overall, propensity score matched analyses demonstratedpre-infectionelevated liver enzymes alanine aminotransferase (ALT) >40, aspartate aminotransferase (AST) >40 and blood glucose ≥215 mg/dL were associated with more severe COVID-19 outcomes, OR = 1.74 (95% CI 1.31, 2.31); OR = 1.98 (95% CI 1.52, 2.57), and OR = 1.55 (95% CI 1.08, 2.23) respectively. Elevated hemoglobin A1C or blood glucose levels were even stronger risk factors for severe COVID-19 outcomes among those aged < 65, OR = 2.31 (95% CI 1.14, 4.66) and OR = 2.42 (95% CI 1.29, 4.56), respectively. In logistic regression models, women aged < 65 with PCOS demonstrated more than a four-fold increased risk of severe COVID-19, OR 4.64 (95% CI 1.98, 10.88).

Conclusion

Increased risk of severe COVID-19 outcomes in those < age 65 withpre-infectionindicators of metabolic dysfunction heightens the importance of monitoring pre-infection indicators in younger patients for prevention and early treatment. The PCOS finding deserves further investigation. Meanwhile women who suffer from PCOS should be carefully evaluated and prioritized for earlier COVID-19 treatment and vaccination.
Tinieblas: El franquismo en el cine español (1975–2000), Loscos Carmina Gustrán (2022)
Authors: Cornellà-Detrell Jordi
Published: June 2023

Review of: Tinieblas: El franquismo en el cine español (1975–2000), Loscos Carmina Gustrán (2022)

Madrid: Marcial Pons, 447 pp.,

ISBN 978-8-41875-219-3, p/bk, €34.20

ISBN 978-8-41875-262-9, e-book, €32.00
Uprooting as a pre-commercial thinning operation in young Norway spruce stands
Authors: Saksa Timo , Miina Jari , Luukkonen Olli
Published: June 2023

Uprooting, as a mechanical pre-commercial thinning operation (PCT), removes competitive, undesired trees with roots to prevent or reduce the need for a second PCT. The state of 66 young Norway spruce (Picea abies (L.) H. Karst.) stands was explored 3–5 years after uprooting to assess the quality of uprooting in terms of the number of competing birches (Betula spp.) and the probability of freely growing crop tree spruce (no competing trees taller than 2/3 of the crop tree’s height). In the uprooted spruce stands, the number of birches was, on average, about 3800 stems ha−1, and in every fifth stand, it was less than 2000 stems ha−1. The number of birches increased with increasing site wetness (TWI), site fertility and thickness of the humus layer. In 80% of the stands, there were at least 1000 freely growing spruces ha−1, which is approximately the stem number to be left growing after first thinning in a spruce stand. If the height of crop tree spruces was 125 cm at uprooting, the probability of freely growing stems varied from 0.6 to 0.8 in typical cases. According to simulations at the first thinning stage, in most stands, birch was less than 10% taller than spruce, and the volume of birches was low enough that, in the future, spruce and birch would grow in the same crown layer as a mixed spruce–birch stand. The results showed that uprooting can serve as the only PCT operation in a planted spruce stand. The quality obtained by uprooting can be improved with careful selection of timing and conditions for uprooting; the optimal uprooting time is when crop tree spruces have reached about breast height.
Dresser és Jéna
Authors: Gimesy Péter
Published: June 2023

Tanulmányomban a hazánkban kevésbé ismert művészeti író, botanikus,
formatervező, iparművész Christopher Dresser (1834–1904) életművének első
szakaszában (1859) szerzett jénai doktori címének hátterét ismertetem.
Ennek a doktori címnek és Dresser jénai paradigmát a modern
formatervezéssel összekötő szerepének azért is van jelentősége, mert
egyszerre képviseli a 19. század elejének romantikus természetfilozófiai
hagyományait – ezen belül is Goethe növénytani műveinek szellemiségét – és
a század közepén kialakuló természettudományos (Darwin) és ipari
forradalom, modern művészeti látásmódot is előkészítő közegét. Véleményem
szerint a romantikus tudományok örökségeként Dresser és kortársai egyszerre
képviselték az elődök vitalizmusát (jelen esetben: mögöttes, gyakran
panteisztikusan az anyagot szervező, teleologikus erőt magyarázó elv) a
legmodernebb funkcionalizmussal együtt.
Politics of Islamic Law in Indonesia: Indonesianization of Islamic Law
Authors: Kamsi Kamsi
Published: June 2023

Abstract: Indonesianization of Islamic law contains two tendencies; first, is the ideal of building Islamic law that characterizes Indonesia by freeing itself from Arab culture and making Indonesian custom as one of the sources of Islamic law. The peak is marked by the emergence of the concept of Jurisprudence of Indonesia. The second tendency is constitutional-oriented Indonesianness, which is to formulate Islamic law in the form of legislation through consensus (Ijma`) of Indonesian clerics. The author argues that such a process of Islamic law becomes a national law. Given Indonesia is a country with a population of bhinneka (Plurality). In this article the author analyzes with the theory of differentiation in unification that is paying attention to diversity (plurality), in the form of a codification of law that contains legal unification as well as legal differentiation. And in the process of enactment toward the Indonesianization of the law it is necessary to note the existence of the national guidance principles, namely: the law in Indonesia must guarantee the integration or the integrity of the nation, the law must be created democratically, the law must encourage the creation of social justice and must pay attention to the principles of humanity, principles of human rights, and the principle of equality before the law.Abstrak: Indonesianisasi hukum Islam mengandung dua kecenderungan; pertama, adalah cita-cita membangun hukum Islam yang berciri khas Indonesia dengan membebaskan diri dari budaya Arab dan menjadikan adat Indonesia sebagai salah satu sumber hukum Islam. Puncaknya ditandai dengan munculnya konsep fikih Indonesia. Kecenderungan kedua adalah keindonesiaan yang berorientasi konstitusional, yakni memformulasikan hukum Islam dalam bentuk peraturan perundang-undangan melalui konsensus (Ijma`) ulama Indonesia. Penulis berpendapat bahwa proses demikian menjadikan hukum Islam sebagai hukum nasional. Mengingat Indonesia adalah negara dengan penduduk yang plural. Dalam artikel ini penulis menganalisis dengan teori diferensiasi dalam unifikasi yaitu memperhatikan pluralitas, dalam bentuk satu kodifikasi hukum yang mengandung unifikasi hukum sekaligus diferensiasi hukum. Dalam proses pemberlakuan menuju Indonesianisasi hukum perlu diperhatikan adanya kaedah-kaedah penuntun nasional, yaitu: hukum di Indonesia harus menjamin integrasi bangsa, hukum harus diciptakan secara demokratis, hukum harus mendorong terciptanya keadilan sosial, dan harus memperhatikan prinsip kemanusiaan, prinsip hak asasi manusia, dan prinsip persamaan di depan hukum.
Law Enforcement in the Practice of Bribery in Business and Trade in Indonesia: Between Theory and Practice
Authors: Atikasari Hartini , Amira Btari , Arifin Ridwan
Published: June 2023

Abstract: Abuse of power for the sake of business and trade profit has become an increasingly average occurrence in the practice of public procurement in this era of moral disruption. It is commonplace that government officials make an illicit arrangement with companies through bribery scheme to win tenders in the procurement of goods and services. This practice resulted in a shift of ideology and abuse of authority by government officials. This practice is contrary to the professional code of ethics, so it is necessary to settle such cases through juridical channels. The intervention of public officials in determining the award of contracts of government projects to certain parties has resulted in a crisis of public trust in law enforcement in Indonesia. This article reviews the basic principles of the criminal act of corruption and the commitment and integrity of government officials in implementing the professional code of ethics, and upholding honesty in order to achieve equitable law enforcement. This paper proves and confirms that the abuse of power by government officials for the sake of business profit in the public procurement has weakened Indonesia’s investment sector. In many cases, these activities may even lead to unfair competition in the trade and business sectors.Abstrak: Memperdagangkan otoritas guna melancarkan praktik bisnis dan perdagangan merupakan hal yang banyak terjadi di era disrupsi moral ini. Para pejabat pemerintah sering kali bekerja sama dengan para pengusaha dengan cara membantu memberikan stimulus berupa kemenangan tender dalam pengadaan barang dan jasa. Praktik tersebut mengakibatkan terjadinya penyalahgunaan wewenang oleh para pejabat pemerintah. Hal ini bertentangan dengan kode etik profesi, sehingga diperlukan penyelesaian perkara melalui jalur yuridis. Adanya intervensi pejabat publik dalam penetapan pihak yang menangani proyek pemerintah menyebabkan terjadinya krisis kepercayaan publik terhadap penegakan hukum di Indonesia. Artikel ini menelaah ulang dasar pokok aturan-aturan tentang tindak pidana korupsi serta bagaimana komitmen dan integritas para pejabat pemerintah dalam melaksanakan kode etik profesi, menjunjung tinggi kejujuran guna mewujudkan penegakan hukum yang adil. Tulisan ini membuktikan dan menegaskan bahwa perdagangan otoritas dalam praktik bisnis melemahkan sektor investasi Indonesia. Pada banyak kasus, kegiatan ini bahkan cenderung memperkuat kondisi persaingan tidak sehat dalam sektor perdagangan dan bisnis.
Alteration of Hadith Functions in TikTok Social Media
Authors: Miski Miski , Habibillah Putri Ghoida’
Published: June 2023

This article categorized as a netnographic study that refers to uploads on the TikTok platform with various kinds of discussions in the name of the prophet's Hadits or Sunnah. Therefore, the three questions proposed are: 1) how does the Hadits in the TikTok experience a change in function? 2) How efficient is TikTok in conveying the prophet’s teachings? 3) What are the motivations that trigger users to upload content based on the prophet's Hadits? By conducting the content analysis of this study, it could be conclude that: 1) the Hadits  which have spread on TikTok have changed their function, which originally served as a bayan, have now become certain tools for certain purposes, 2) in that narrow space, the prophet's Hadits could not be delivered comprehensively and completely because the facilities provided by TikTok could not accommodate all explanations so that siltation appears, 3) the wide range and the availability of features that support the transaction process contribute the creation of a massive commodification process. In addition, this paper also reviews the transfiguration of pretensions which are implied in the TikTok circulation chain. Some of these things denoted that the hadits circulating on the TikTok have problems that could not be ignored.
Study of Living Hadith on the Khataman al-Qur’an Tradition over Graves in North Padang Lawas
Authors: Ramadan Ilham
Published: June 2023

This study aims to describe the tradition of Quranic Khataman in the graveyard preserved by the people of North Padang Lawas. This research uses a qualitative type with a living hadith approach. This research shows that this tradition is a public reception to the hadith relating to the remains of the pilgrims leaving the burial area as well as the reward and prayers from a righteous child to both parents.  There are several hadiths that form the basis of theological references to the implementation of the Quranic khatam tradition. First, the narration of Bukhari's (1252) and (1338). Second, the narration of Muslims (3084) and (1631). There are several important questions that are the focus of research. First, what is the urgency and procedure for carrying out the Khataman Al-Qur'an tradition? Second, how the Study of Living Hadith plays a role in the tradition of khataman al-Qur'an over the grave. The results of this study found the conclusion that the tradition of quranic khatam above the graveyard is the reflection of the understanding of the hadith. and the procedures for its implementation are adapted to the guidance of local clerics and religious leaders.
ANALISIS KASUS WANPRESTASI DALAM PERJANJIAN SEWA-MENYEWA YANG MENGGUNAKAN MATA UANG ASING BERDASARKAN UNDANG-UNDANG NOMOR 7 TAHUN 2011 TENTANG MATA UANG (STUDI KASUS PUTUSAN NOMOR : 22/Pdt.G/2018/PN.JKT.PST.)
Authors: Gustavito Daffa Farel , Priyono Ery Agus , Aminah Aminah
Published: June 2023

Perjanjian di Indonesia sering menggunakan mata uang asing untuk pembayarannya. Perkara putusan 22/Pdt.G/2018/PN.JKT.PST. Ketentuan pada Undang-Undang Nomor 7 Tahun 2011 tentang mata uang yang mewajibkan penggunaan mata uang Rupiah, suatu transaksi menggunakan uang asing dipertanyakan keabsahannya berkaitan dengan syarat sebab yang halal dari perjanjian tersebut sebagaimana diatur dalam Pasal 1320 KUHPerdata. Penelitian ini bertujuan mengetahui kekeliruan pertimbangan hakim dan akibat hukum wanprestasi perjanjian sewa menyewa pada Putusan Nomor: 22/Pdt.G/2018/PN.JKT.PST, dengan metode pendekatan yuridis ive mendasarkan pada data sekunder dan data primer dianalisis menggunakan analisis deskriptif-analitis, hakim tersebut tidak mempertimbangkan penggunaan mata uang asing tersebut yang bertentangan dengan Undang-Undang No. 7 Tahun 2011 serta tidak memenuhi syarat sah perjanjian yang keempat yang diatur dalam Pasal 1320 jo. Pasal 1335 jo. Pasal 1337 KUHPerdata, kemudian hakim tidak mempertimbangkan konversi nominal gugatan dalam perjanjian mata uang asing menjadi mata uang Rupiah. Akibat hukum yang timbul adalah perjanjian tersebut batal demi hukum.
Review: Forgeries and Historical Writing in England, France, and Flanders, 900–1200 By Robert F. Berkhofer III. The Boydell Press, 2022. Pp. xi, 348
Authors: Zagórska Paulina
Published: June 2023

Review: Forgeries and Historical Writing in England, France, and Flanders, 900–1200 By Robert F. Berkhofer III. The Boydell Press, 2022. Pp. xi, 348
Phytocrystallization of silver nanoparticles using Cassia alata flower extract for effective control of fungal skin pathogens
Authors: Muruganandham Moorthy , Sivasubramanian Kanagasabapathy , Velmurugan Palanivel , Arumugam Natarajan , Almansour Abdulrahman I. , Kumar Raju Suresh , Mahalingam Sakkarapalayam M. , Sivakumar Subpiramaniyam
Published: June 2023

A feasible alternative to classic chemical synthesis, the phyto-mediated production of silver nanoparticles (AgNPs) utilizing aqueous flower petal extract of Cassia alata as a reducing agent is reported for the first time. Characterization of synthesized AgNPs was carried out using various techniques viz., ultraviolet-visible spectroscopy (UV-Vis), X-ray powder diffraction (XRD), high-resolution transmission electron microscope (HRTEM), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM) with energy dispersive X-ray analysis (EDX). The results of the FTIR research conducted in this study show different bond stretches with varying durations, which can be seen at various faraway points. AgNPs are mainly spherical and vary in size from 20 to 100 nm, according to TEM images. The highest X-ray energy surge, at 3 keV, is visible in the EDX spectrum. The XRD pattern showed that four diffraction peaks could be assigned to the 111, 200, 220, and 311 planes of the face-centered cubic crystalline silver, respectively, at 32.05, 46.27, 55.25, and 57.39°. Optimization of production parameters including pH, metal ion concentration, and substrate concentrations were studied. In addition, the bioactivity was evaluated against Trichophyton rubrum, Aspergillus fumigatus, Candida albicans, Epidermophyton floccosum, and Mucor sp. using the agar diffusion method. Furthermore, their antioxidant properties were assessed using 2,2-diphenyl-1-picryl-hydrazyl-hydrate assay and ferric ion reducing antioxidant power tests. MTT assay was performed using human fibroblast cell line (L929) to determine the cell viability and cytotoxicity through increased metabolism of the tetrazolium salt.
Motion vector steganography algorithm of sports training video integrating with artificial bee colony algorithm and human-centered AI for web applications
Authors: Tong Jinmao , Cao Zhongwang , Fu Wen
Published: June 2023

In multimedia correspondence, steganography schemes are commonly applied. To reduce storage capacity, multimedia files, including images, are always compressed. Most steganographic video schemes are, therefore, not compression tolerant. In the frame sequences, the video includes extra hidden space. Artificial intelligence (AI) creates a digital world of real-time information for athletes, sponsors, and broadcasters. AI is reshaping business, and although it has already produced a significant impact on other sectors, the sports industry is the newest and most receptive one. Human-centered AI for web applications has substantially influenced audience participation, strategic plan execution, and other aspects of the sports industry that have traditionally relied heavily on statistics. Thus, this study presents the motion vector steganography of sports training video integrating with the artificial bee colony algorithm (MVS-ABC). The motion vector stenography detects the hidden information from the motion vectors in the sports training video bitstreams. Artificial bee colony (ABC) algorithm optimizes the block assignment to inject a hidden message into a host video, in which the block assignment is considered a combinatorial optimization problem. The experimental analysis evaluates the data embedding performance using steganographic technology compared with existing embedding technologies, using the ABC algorithm compared with other genetic algorithms. The findings show that the proposed model can give the highest performance in terms of embedding capacity and the least error rate of video steganography compared with the existing models.
Low-cost MRI devices and methods for real-time monitoring of flow and transfer phenomena in milli-channels
Authors: Guerroudj Feryal , Guendouz Laouès , Hreiz Rainier , Commenge Jean-Marc , Klopffer Lucie , Louvet Nicolas , Mathieu Laurence , Perrin Jean-Christophe
Published: June 2023

An NMR/MRI methodology is developed for the study of flows in miniaturized systems handling volumes of fluid in the microliter range. Specific MRI devices are implemented, including radiofrequency coils with millimetric dimensions whose size and geometry correspond to the studied systems. We follow a low-cost development procedure of home-made milli-RF coils, including their dimensioning, the simulation of the produced electromagnetic field, their fabrication and their integration in experimental devices. In each of the two cases presented the filling factor is optimized and the sensitivity of the measurement is greatly improved over standard commercial instrumentations by a factor up to 17. Two applications are then discussed: the characterization of the hydrodynamics in an anchor shaped micromixer and the monitoring of the development of a biofilm at the pore scale.
Ensemble-based statistical verification of INM RAS Earth system model
Authors: Tarasevich Maria A. , Tsybulin Ivan V. , Onoprienko Vladimir A. , Kulyamin Dmitry V. , Volodin Evgeny M.
Published: June 2023

Modern numerical models of the Earth system are complex and inherit its natural chaotic behaviour. The numerical results depend on various specifications of the simulation process, including computing systems, compilers, etc. Due to the chaotic behaviour, these minor differences lead to significant and unpredictable deviations. Therefore, some procedure verifying that simulation results describe the behaviour of the same physical system is of practical importance.

The present paper proposes a statistical verification algorithm developed for the INM RAS Earth system model. Different ensemble generation techniques and statistical estimators are evaluated for verification suitability. The ability of the method to detect the deviations in the simulation results is demonstrated on a series of cases. Practical guidelines on how to choose the perturbation amplitude for the ensemble generation are provided for various verification cases.
Türkiye’deki Mahkûm/Hükümlü Kişilerle Yapılmış Çalışmaların Değerlendirilmesi: Bir İçerik Analiz Çalışması (2011-2021)
Authors: ŞAYLAN Günce , YILDIRIM Belgin
Published: June 2023

Amaç: Bu çalışma; literatürde yapılmış mahkûm ve hükümlülerle ilgili çalışmaların tespiti ve bu çalışmalarla ilgili olarak yapılmış mahkûm çalışmalarına eleştirel bir bakış ortaya koymak amacıyla yapılmıştır. Gereç ve Yöntem: Literatürde son on yılı kapsayacak şekilde (2011-2021) Yök tez veri tabanı kullanılarak ‘mahkûm’, ‘hükümlü’ anahtar kelimeleri ile tarama yapılmıştır. Tarama sonucunda 209 çalışmaya ulaşılmıştır. Dahil edilme kriterlerini sağlayan 144 çalışma, araştırmaya dahil edilmiştir. Bulgular: Bu çalışmaların büyük çoğunluğu (%75,2) sosyal bilimlerle ilgili çalışma disiplinlerince yapılmıştır. Sadece %18,0’ı sağlık bilimleri enstitüsü alanında mahkûm/hükümlülerle ilgili çalışma yapılmıştır. Sonuç: Mahkûm/hükümlü birey toplumun hassas ve incinebilir gruplarından biridir. Mahkûm ve hükümlülerle yapılan çalışmaların dağılımının sadece bazı disiplinlerce ele alınması bu toplumsal sorunun çok faktörlü bir şekilde ele alınmasını olumsuz etkilemektedir.
Networks of trade and exchange along the Israeli Silk Road: the silk and cotton finds from Nahal Omer, Negev Desert
Authors: Hildebrandt Berit , Shamir Orit , Galili Roy , Shamir Nofar , Bar-Oz Guy
Published: June 2023

Excavations at Nahal Omer, an Early Islamic way station in the Negev Desert (sixth to ninth centuries AD), have yielded exotic textiles such as silks and cottons. Through a new study of these textiles, this project investigates the trade networks and global connectivity along this little-known artery of the Silk Road.
İskeletsel Sınıf II Olan Hastanın RME-Twinblok Apareyi ile Tedavisi: Olgu Sunumu
Authors: BAKA Zeliha Müge
Published: June 2023

İskeletsel Sınıf II maloklüzyonlar, sıklıkla maksiller prognati, mandibuler retrognati veya ikisinin kombinasyonu ile karakterizedir. Pubertal atılımın başlangıcında üst çene darlığının eşlik ettiği Sınıf II divizyon 1 maloklüzyonu olan çocuklarda hızlı üst çene genişletmesi sonrası fonksiyonel apareyler sıklıkla uygulanır. Bu vaka raporunda amaç, iskeletsel Sınıf II maloklüzyona sahip bir hastanın rapid maksiller ekspansiyon (RME) ve twinblok apareyi ile tedavisini sunmaktır.

Kronolojik yaşı 11 yıl 8 ay olan kadın hasta üst dişlerinin ileride, alt çenesinin geride olması şikayetiyle kliniğimize başvurmuştur. Hastanın tedavisinde RME’li twinblok apareyi uygulanmıştır. Twinblok apareyi ile fonksiyonel tedavi 12 ay sürmüştür. Daha sonra sabit ortodontik tedavisine geçilmiştir. Toplam tedavi süresi 2 yıl 3 aydır.

Tedavi sonunda ideal Angle Sınıf I kapanış elde edilmiştir. Hastanın profilinde çarpıcı bir iyileşme gözlenmiş, ideal dudak kapanışı sağlanmıştır.
Farklı kalınlıklardaki CAD-CAM materyallerinin opalesans ve kontrast oranlarının karşılaştırılması
Authors: YILMAZ SAVAŞ Tuba , YILDIZLAR Seda
Published: June 2023

Amaç: Bu in vitro çalışmanın amacı, farklı kimyasal kompozisyona sahip çeşitli kalınlıklardaki üç farklı CAD-CAM materyalinin opalaseans parametresi (OP) ve kontrast oranının (CR) karşılaştırılmasıdır.

Gereç ve Yöntem: Doksan adet A2 renkte örnek; lösitle güçlendirilmiş feldspatik seramik (LS, G-Ceram), lityum disilikat seramik (LD, IPS e.max CAD) ve rezin nano seramik (RN, Lava Ultimate) CAD-CAM bloklardan 0,5 mm, 0,7 mm ve 1 mm kalınlığında olacak şekilde hazırlandı (n=10). Renk ölçümleri siyah ve beyaz arka planlar üzerinde bir spektrofotometre ile gerçekleştirilerek CIE L*a*b* verileri kaydedildi. Örneklerin OP ve CR değerleri hesaplandı. İstatistiksel analiz iki yönlü ANOVA ve Bonferroni testleri ile yapıldı (α=0,05).

Bulgular: Materyal ve kalınlık temel etkisi ile materyal ve kalınlık etkileşimi OP ve CR için önemli bulundu (P
A Retrospective Clinical Evaluation Of Narrow Diameter Implant Supported Dental Prosthesis: Early Results
Authors: BAŞAĞAOĞLU DEMİREKİN Zeynep , FINDIK Yavuz
Published: June 2023

Background: Narrow-diameter implants are planned for specific clinical conditions as locator implants between adjacent teeth with a narrow bone width or with only a narrow area in between. They are especially advantageous when restoring narrow teeth like lateral maxillary and mandibular incisors and first premolars.

Methods: In the period between 2018 and 2019, 21 patients were rehabilitated with implant treatment. A total of 32 implants were placed (The Straumann® Bone Level Tapered Implants, ∅ 2.9 mm). The survival rates of the implants were analyzed and prosthetic complications were evaluated.

Results: The accumulative 36-month survival rate of the implants was 96.9%. Prosthetic complications were mainly limited to loosening occlusal screws. No implant abutment fractures, screw fractures, or porcelain chipping were observed.

Conclusion: The results show that narrow implants provide satisfactory treatment outcomes. Narrow implants can be preferred in cases, where the dental operation area is not wide enough.

Keywords: Narrow Diameter Implants, Fixed Dental Prosthesis, Survival Rate.
Unilateral Dudak Damak Yarıklı Hastalarda Nazopalatin Kanalın Konik Işınlı Bilgisayarlı Tomografi ile Değerlendirilmesi Evaluation of the Nasopalatine Canal with Cone-Beam Computed Tomography in Patients with Unilateral Cleft Lip and Palate
Authors: ERSU Nihal , COŞGUNARSLAN Aykağan
Published: June 2023

Amaç:

Dudak damak yarıkları (DDY) kraniyofasiyal bölgede en sık görülen malformasyonlardır. Nazopalatin kanal (NPK) genellikle maksiller orta hatta ve insizör dişlerin posteriorunda bulunur. Kanal oral kaviteye insiziv foramen (IF) aracılığı ile açılır; nazal septumun her iki tarafında Stensen foramen (SF) ile nazal kavitede sonlanır. DDY'li hastalarda oluşan çeşitli anatomik ve dental değişikliklere bağlı olarak maksillar ön bölgede estetik ve fonksiyonel bozulmalar söz konusudur. Bu bölgenin rehabilite edilebilmesi amacıyla implant tedavilerine sıklıkla başvurulur. İmplant cerrahisi sonrası olası post-operatif komplikasyonlardan kaçınılması amacıyla bölge anatomisinin Konik Işınlı Bilgisayarlı Tomografi (KIBT) ile değerlendirilmesi önemlidir. Bu çalışmanın amacı, KIBT görüntülerinde, DDY'li bireyler ile sağlıklı kontrollerde NPK morfolojisini ve lineer ölçümlerini karşılaştırmaktır.

Gereç ve Yöntemler:

Çalışma retrospektif olarak yürütülmüştür. Çalışmaya 22'si unilateral DDY hastası, 25'i kontrol grubu hastası olmak üzere 47 birey dahil edilmiştir. NPK'nın morfolojik, boyutsal özellikleri ayrıca Stenson foramen ve insiziv foramen çapları KIBT görüntüleri üzerinde değerlendirilmiştir.

Bulgular:

Çalışma grubu ve kontrol grubu arasında yaş ve cinsiyet açısından anlamlı fark yoktu. NPK morfolojisi, NPK uzunluğu, NPK sayısı, SF sayısı, SF çapı, IF çapı açısından iki grup arasında istatistiksel olarak anlamlı fark bulundu. DDY’li grupta huni şeklinde NPK daha fazla izlenirken, kontrol grubunda silindirik NPK daha fazlaydı. Çalışma grubunda daha geniş NF çapı ve SF çapı bulunmasına rağmen NPK uzunluğunun daha kısa olduğu saptandı. IF sayısı ise iki grup arasında istatistiksel anlamlı fark göstermedi.

Sonuç:

Bu çalışma, DDY'li hastalarda NPK'nin anatomik değişkenlik gösterdiğini doğrulamaktadır. Bu nedenle, DDY hastalarında maksillar ön bölgeye yönelik cerrahi girişimler öncesinde bölgenin KIBT ile ayrıntılı anatomik değerlendirilmesinin yapılması önem arz etmektedir.
ÜST BİRİNCİ BÜYÜKAZI DİŞLERİNDE MB2 KANALIN MB1’E UZAKLIĞININ KIBT GÖRÜNTÜLERİYLE TESPİTİ
Authors: ÇETİN Bilgün , AKGÜNLÜ Faruk
Published: June 2023

Amaç: Üst çene birinci büyük azı dişlerin kanal tedavilerinin en önemli başarısızlık nedenleri arasında mesiobukkal 2. (MB2) kanalların varlığı gelmektedir. Oldukça karmaşık bir kök kanal anatomisine sahip bu dişlerin MB2 kanalların lokalizasyonu da çeşitlilik gösterebilmektedir. Bu çalışmada MB2 kanalların varlığının insidansının tespiti ile kanal ağızlarının meziobukkal 1. (MB1) kanal ağızlarına olan uzaklığının konik ışıklı bilgisayarlı tomografi(KIBT) görüntüleri kullanılarak ölçülmesi amaçlanmaktadır.

Gereç Ve Yöntemler: Çeşitli nedenlerle çekilmiş rastgele seçilmiş 300 adet KIBT görüntüsü retrospektif olarak taranarak kanal tedavisi görmemiş en az bir adet üst birinci büyük azı dişi bulunan hastalara ait 126 adet görüntü seçilmiştir. Bu görüntüler içerisinden 191 adet diş çalışmaya dahil edilmiştir. Dişler bir ağız diş ve çene radyolojisi uzmanı tarafından MB2 kanal varlığına göre ayrılmış ve MB2 kanal ağızlarının MB1’e göre uzaklığı birkaç gün arayla iki kez ölçülmüştür. İki ölçümün ortalaması alınarak tek bir ölçüm elde edilmiş ve veriler IBM SPSS Version 22.00 istatistik programıyla analiz edilmiştir.

Bulgular: Çalışmaya dahil edilen 190 adet diş içerisinden 82(%43,2) tanesinde MB2’e rastlanmıştır. MB2 kanalının MB1’e olan uzaklığının ölçümlerinde kadın ve erkek arasında anlamlı fark bulunurken (p=0,03), sağ ve sol dişler açısından anlamlı bir fark bulunamamıştır (p=0,829). İki kanal ağzının birbirine olan uzaklığı tüm dişlerde ortalama 2,56 ±0,34mm olarak tespit edilmiştir.

Sonuçlar: Üst birinci büyük azı dişlerinde % 43,2 oranında MB2 kanal görülmektedir. Bu çalışma MB1 e göre konumu ve uzaklığı konusunda endodontist ve klinisyenlere bilgiler sunarak söz konusu dişlere yapılan kanal tedavisinin başarısının artması konusunda yön gösterici olabilir.

Anahtar Kelimeler: KIBT, Maksiller büyük azı, Mesiobukkal kanal
MOD DEFEKTE SAHİP MANDİBULER MOLARLARDA FARKLI MİNİMAL İNVAZİV RESTORASYONLARIN STRES DAĞILIMINA ETKİSİ: SONLU ELEMANLAR ANALİZİ ÇALIŞMASI
Authors: DEMİREL Mehmet Gökberkkaan , ALKAN Mesut , MOHAMMADİ Reza
Published: June 2023

Amaç: Diş dokusundan daha az madde kaldırmak ve daha iyi estetik sonuçlar elde etmek için inlay, onlay ve overlay restorasyonlar, posterior dişlerdeki geniş kaviteler için iyi bir tedavi seçeneğidir. Bu çalışmanın amacı farklı minimal invaziv restorasyonlarla rehabilite edilen, Mezio-okluza-distal (MOD) kusurlu mandibular büyük azı dişlerine gelen stres dağılımını incelemektir.

Gereç ve Yöntem: Daha önce çekilmiş sağlam bir mandibular molar diş uygulama için bulundu ve inlay, onlay ve overlay restorasyonların hazırlanmasına uygun preperasyonlar yapıldı. Her aşama sonrasında model tarayıcı ile taranarak EXOCAD programına aktarıldı ve aynı formatla ilgili restorasyonlar dizaynlandı. Tüm datalar Solidworks programına aktarılarak çakıştırma işlemi yapıldı ve ABAQUS programında restorasyona üç farklı materyalin özellikleri verilerek her birine aksiyal yönde 600 N kuvvet, modellerin okluzal tablalarına uygulandı.

Bulgular: Elde edilen sonuçlardan bağımsız olarak, herhangi bir doku ya da restorasyona gelen kuvvetler, dayanım sınırlarının üzerinde değildi. Mineye iletilen maksimum principal stresleri karşılaştırıldığında en yüksek değer inlay için en düşük değer ise overlay için bulundu. Direkt, restorasyonda ortaya çıkan stresler için en yüksek maksimum principal stres değerleri overlay için görülürken, onlay ve inlay arasındaki fark çok da büyük değildi. Zirkonyum içerikli cam seramiklerde (Vita Suprinity) ortaya çıkan stres, rezin matrikse sahip seramik materyallere (Cerasmart, Shofu Block HC Hard) kıyasla daha fazla olsa da; destek dokulara iletilen stresin daha az olduğu tespit edilmiştir.

Sonuç: Minimal invaziv restorasyon seçenekleri düşünüldüğünde restorasyonun kapladığı alan ve tüberkül sayısı arttıkça mineye iletilen kuvvet de belirgin şekilde azalır. Bunun yanında daha yüksek elastik modülüne sahip restorasyonların kullanılması destek dişte oluşabilecek mine kırıklarını önlemek açısından daha iyi bir seçenektir.

Anahtar Kelimeler: CAD/CAM Seramikler, Minimal İnvaziv Restorasyonlar, Sonlu Elemanlar Analizi
Daimi Birinci Büyük Azı Dişlerinin Çekimi Sonrası Daimi Dentisyonun Değerlendirilmesi
Authors: AYDIN Elif Merve , DEMİRCİLER Ayşe Betül , TASA YİĞİT Tuğba
Published: June 2023

Amaç: Daimi birinci büyük azı dişlerinin erken çekimi sonrası istenen, ikinci büyük azı dişinin boşluğu kapatarak ikinci küçük azı dişiyle kontak oluşturmasıdır. Bu çalışmanın amacı; daimi birinci büyük azı dişlerinin çekimi sonrası, çekim boşluğunun kapanmasının ve orta hattaki kaymanın incelenmesidir.

Gereç ve yöntem: Pedodonti Kliniğinde 7-12 yaş arasında, tek taraflı daimi birinci büyük azı dişleri çekilmiş 26 hastanın çekim öncesi ve çekim sonrası panoramik radyografları (OPG) karşılaştırıldı. Çekim öncesi ve sonrası daimi ikinci büyük azı ve ikinci küçük azı dişleri arası mesafe ve orta hat kaymaları OPG üzerinden hesaplandı. Elde edilen verilerin istatiksel analizi IBM SPSS programı ile yapıldı.

Bulgular: Hastaların, diş çekimi yaş ortalaması 10,30±1,37 olup, ortalama takip süresi 20,46±6,17 ay olarak tespit edilmiştir. 11 erkek 15 kız çalışmada değerlendirilmiştir. Çekim öncesi ve çekim sonrası arasında ortalama yer kaybı 7,09±3,01 olarak belirlenmiştir. Çekim boşluğunun tamamen kapanması 7 dişte gözlenmiştir. Hastaların 20’sinde orta hat kayması görülmüş ve 15 dişin çekilen dişin tarafına doğru kaydığı gözlemiştir. Orta hat kayma miktarının ortalaması 1,71±3,01 olarak tespit edilmiştir.

Sonuç: Çalışmamızda, çekimden sonra az sayıda vakada çekim boşluğunun kapandığı görülmüştür. Ayrıca orta hat kaymasının sık görüldüğü tespit edilmiştir. Daimi birinci büyük azı dişlerinin çekimlerinin değerlendirildiği daha fazla sayıda klinik çalışmaya ihtiyaç vardır.

Anahtar kelimeler: Birinci daimi büyük azı dişi, Boşluk kapanması, Erken çekim
DENTOALVEOLAR YARALANMALARDA ERKEN TEDAVİ UYGULAMASININ PROGNOZ AÇISINDAN ÖNEMİ: OLGU SUNUMU
Authors: DOĞAN Gizem , KÜÇÜKKOLBAŞI Hasan , DURMUŞ Ercan , KALAYCI Abdullah
Published: June 2023

AMAÇ

Dentoalveolar ve perioral yumuşak doku yaralanmaları çeşitli travmalara bağlı olarak genellikle kavga, düşme, trafik kazası ve spor yaralanmaları sonucunda meydana gelir. Diş yaralanmalarının çoğu ön dişleri, özellikle de maksiller santral dişleri etkiler. Konküzyon, sublüksasyon ve lüksasyon süt dişlerinde en sık görülen yaralanmalar iken, daimi dişlerde en sık komplike olmayan kron kırıkları görülür.

Üç olgu içeren bu serinin amacı çocuklarda görülebilen travmatik yaralanmalara erken müdahale edildiğinde dentoalveolar yapılarda gözlenen olumlu iyileşme sürecinin aktarılması bununla beraber müdahaleye geç kalındığında dentoalveolar yapı kayıplarının gösterilmesidir.

OLGU

İlk iki olguda benzer yaştaki çocuk hastalarda görülen dentoalveolar yaralanmalara, hastaların kliniğimize erken başvurması sonucu uyguladığımız tedavilerin olumlu sonuçlar verdiği yapılan takipler sonrasında gözlemlenmiştir. Bir diğer olguda ise travma alan hasta aradan uzun zaman geçtikten sonra kliniğimize ağrı ve şişlik şikayetiyle başvurmuştur. Gelişen olumsuz durum hastada diş ve kemik kayıplarına neden olmuştur.

BULGU

Bahsedilen olgulardaki travma hastalarından kliniğimize erken başvuranlar için tedavi süreci olumlu sonuçlanmış ve uzun dönemde başarı sağlanmıştır. Ancak üzerinden zaman geçen olguda hastada kemik ve diş kaybıyla sonuçlanan, hastayı estetik, psikolojik ve de fonksiyonel olarak etkileyen bir süreç ortaya çıkmıştır.

SONUÇ

Dental travmalar genellikle komplikedir ve yaralanmaların erken tedavisi uzun vadeli sonuç elde etmek için oldukça önemlidir. Hekimin bilgisi ve tedaviye yaklaşımı aynı zamanda hasta ve ailesinin yaralanma konusunda bilinç düzeyi, travma sonrası sağlık kuruluşuna başvurma süresi gibi birçok faktör prognozu önemli ölçüde etkilemektedir.

Anahtar Kelimeler: Dentoalveolar yapı, erken tedavi, travma
Farklı adeziv uygulama tekniklerinin dentine mikrogerilim bağlanma dayanımlarının değerlendirilmesi
Authors: YENİER YURDAGÜVEN Gülşah , TARIM Berna
Published: June 2023

Amaç: Bu çalışmanın amacı, basitleştirilmiş adeziv sistemlerde farklı adeziv uygulama tekniklerinin dentine olan mikrogerilim bağlanma dayanımına (μTBS) etkisini değerlendirmektir.

Gereç ve Yöntemler: Yetmiş iki adet çekilmiş çürüksüz insan üçüncü büyük azı dişi rastgele 18 gruba ayrıldı (n=4). Dentin yüzeyleri #600-grit silikon-karbit kağıt ile cilalandı. Kontrol grubunu Clearfil SE Bond [SE] (Kuraray), deney gruplarını iki aşamalı etch&rinse Adper Single Bond2 [SB] (3M ESPE) ve tek aşamalı self-etch Clearfil S3 Bond [S3] (Kuraray) oluşturdu. Test edilen adezivler, üretici firmanın talimatları [Kontrol] veya %2 Klorheksidin ile [CHX], veya iki kat adeziv uygulaması ile [x2K] veya ilave hidrofobik reçine tabaka [HR] ile uygulandı. Kompozit blok (Filtek Ultimate, 3M ESPE) tabaklama yöntemiyle oluşturuldu ve distile suda bekletildi (24 saat/37°C). 1mm2 reçine-dentin çubuklarına (Isomet) ayrılarak hemen [24sa] veya 37°C’de altı ay [6.ay] suda bekletildikten sonra μTBS testine tabi tutuldu (Bisco) (Çapraz kafa hızı 0.5 mm/dk). Veriler Three-way ANOVA ve post-hoc Tukey testleri kullanılarak analiz edildi (p0.05). Tüm grupların 6.ay µTBS değerleri anlamlı düzeyde azalmıştır (p
Evaluation of the Rubber Dam Use of Dentistry Students
Authors: AŞAR Enes Mustafa
Published: June 2023

Aim: The use of rubber dam is the gold standard among isolation methods in dentistry. The aim of this study is to evaluate the students' approach and knowledge level on the use of rubber dam in dentistry.

Materials and Methods: In this study, a questionnaire was created with the help of an online form builder on Google. In the survey, 18 different questions were asked in the form of multiple choice and checkboxes about the use of rubber dam. The questions used in the survey were prepared by compiling from the questions asked in the literature. Survey questions were sent to 286 people online. A total of 262 students participated in the survey.

Results: Participants were %43 male and 57% female. The ages of the participants are between 20-44. Of the participants, 64% stated that they did not know how to use a rubber dam, and 97% reported that they did not use a rubber dam in clinical routine. While the rate of those who never used a rubber dam was 82% in adult patients, it was 85% in pediatric patients. Despite this, 84% of the participants think that the use of rubber dam should be mandatory in vital endodontic treatments and 71% in non-vital endodontic treatments. Most of the participants find the rubber dam useful in terms of isolation success and aspiration safety. In the answers given, the lack of knowledge and education was chosen as the most common reason for not using a rubber dam. For this reason, 96% of the participants do not consider themselves sufficient in the use of rubber dam.

Conclusion: The use of rubber dam has numerous clinical benefits for the physician. For this reason, necessary theoretical and practical training should be supported for the widespread use of rubber dams.