bluuebunny/crossref_metadata_2025 huggingface dataset:
Audit Judgment: Analisis Persepsi Etis, Kompleksitas Tugas, dan Keyakinan Diri Auditor
Authors: Muslim  , Andhika Febrianto  , Rahim Syamsuri
Published: December 2023

Audit judgment adalah kebijakan auditor dalam menentukan pendapat mengenai hasil auditnya yang mengacu pada pembentukan suatu gagasan. Banyak cara yang mempengaruhi audit judgment. Salah satunya adalah persepsi etis, kompleksitas tugas, dan self-efficacy. Penelitian ini bertujuan untuk mengetahui pengaruh persepsi etis, kompleksitas tugas, dan self efficacy terhadap audit judment di kantor Badan Pengawasan Keuangan dan Pembangunan perwakilan Provinsi Sulawesi Selatan. Metode analisis yang digunakan untuk menguji hipotesis adalah regresi linier berganda, analisis ini didasarkan pada data dari 30 responden yang telah melengkapi seluruh pernyataan dalam kuisioner untuk memberikan gambaran apakah persepsi etis, komplesitas tugas, dan self-efficacy berpengaruh secara signifikan atau tidak. Hasil penelitian ini menunjukkan bahwa persepsi etis, kompleksitas tugas, dan self efficacy secara parsial berpengaruh terhadap audit judgment auditor Kantor Badan Pengawasan Keuangan dan Pembangunan (BPKP). Ketiga variabel tersebut memiliki pengaruh secara yang positif.
Pembelajaran Geometri Berbantuan Goegebra untuk Meningkatkan Kemampuan Komunikasi Matematis Siswa
Authors: Nidya Nina Ichiana  , Abdul Razzaq  , Andi Kamal Ahmad
Published: December 2023

Pembelajaran geometri merupakan pembelajaran yang penting di satuan SMP, data berikut ini menunjukan bawa sebagian besar siswa yang diajarkan di satuan SMP memiliki presentasi kebutuhan materi sebagai berikut. Materi geometri memperoleh persentase terbesar (41%), dibandingkan dengan aljabar (29%), angka (18%), dan statistika/probabilitas (12%). Sehingga perluh untuk mendesain pembelajaran geometri yang mampuh dipahami siswa secara menyeluruh, sehingga dapat meningkatkan kemampuan komunikasi matematis terutama dalam pembelajaran geometri yang tergolong sulit. Sehingga sangat perluh media pembelajaran baik, salah satu media pembelajaran yang ditawarkan dalam penelitian ini adalah pembelajaran geometri berbantuan Geogebra, kerena pembelajaran pembelajaran geometri menjadi lebih mudah dipahami jika dengan menggunakan perangkat lunak seperti Geogebra. Tujuan dari penelitian ini adalah untuk meningkatkan kemampuan komukasi matematis siswa pada materi Geometri. Metode yang di guanakan dalam penelitian ini adalah metode penelitian kuasi Eksperimen. Hasil penelitian menunjukan bahwa terjadinya peningkatan kemampuan komunikasi matematis siswa secara siginifikan, dengan pencapaian kategori tinggi (>0,7) sebesar 56,25%, dengan kategori sedang (0,3 ≤ x ≤ 0,7)  memperoleh peresentase sebesar 34,38%, sedangkan kategori rendah (< 30) memeperoleh presentasi sebesar 9,38%. Hal ini dapat tarik kesimpulan bahwa sebagian besar siswa mengalami peningkatan kemampuan komunikasi matematis. Pembelajaran geometri merupakan pembelajaran yang penting di satuan SMP, data berikut ini menunjukan bawa sebagian besar siswa yang diajarkan di satuan SMP memiliki presentasi kebutuhan materi sebagai berikut. Materi geometri memperoleh persentase terbesar (41%), dibandingkan dengan aljabar (29%), angka (18%), dan statistika/probabilitas (12%). Sehingga perluh untuk mendesain pembelajaran geometri yang mampuh dipahami siswa secara menyeluruh, sehingga dapat meningkatkan kemampuan komunikasi matematis terutama dalam pembelajaran geometri yang tergolong sulit. Sehingga sangat perluh media pembelajaran baik, salah satu media pembelajaran yang ditawarkan dalam penelitian ini adalah pembelajaran geometri berbantuan Geogebra, kerena pembelajaran pembelajaran geometri menjadi lebih mudah dipahami jika dengan menggunakan perangkat lunak seperti Geogebra. Tujuan dari penelitian ini adalah untuk meningkatkan kemampuan komukasi matematis siswa pada materi Geometri. Metode yang di guanakan dalam penelitian ini adalah metode penelitian kuasi Eksperimen. Hasil penelitian menunjukan bahwa terjadinya peningkatan kemampuan komunikasi matematis siswa secara siginifikan, dengan pencapaian kategori tinggi (>0,7) sebesar 56,25%, dengan kategori sedang (0,3 ≤ x ≤ 0,7)  memperoleh peresentase sebesar 34,38%, sedangkan kategori rendah (< 30) memeperoleh presentasi sebesar 9,38%. Hal ini dapat tarik kesimpulan bahwa sebagian besar siswa mengalami peningkatan kemampuan komunikasi matematis.
The Approach of Kalām to the Physical Universe: Schools and Breaks
Authors: CENGİZ Yunus
Published: December 2023

Since the end of the eighth century, Muslim theologians (mutakallimūn) have been more interested in the physical universe and have put forward theories on subjects such as matter, motion, stasis, and change that were not on their agenda before. As the approaches to physics of Kalām schools are different from each other, the way of thinking about physics in different periods is also different. This study aims to determine the approaches of Muslim theologians to the physical universe. In this context, it can be said that Muslim theologians have five different approaches. The first of these is the supporters of accidents. This approach, which argues that the universe consists of accidents, suggests that it is the work of our minds to see objects as integrated structures. The second is naturalist theologians such as al-Naẓẓām, al-Jāḥiẓ, and Thumâma. Their common feature is that they accept the nature of objects. According to this approach, objects must behave according to their nature without needing any other intervention. al-Naẓẓām developed a theory suitable for this approach and tried to support it with experience. al-Naẓẓām, who rejects atomism, insists that objects are composed of opposite components and that they have an internal dynamism that allows them to be in constant motion. al-Jāhiz, on the other hand, did many experiments to learn the nature and movements of animals. The third approach to the physics of Kalām is atomist theologians. Atomism is the most common physics approach in Kalām. According to this approach, objects are not divided infinitely. The universe is made up of indivisible particles. This approach insists that there are voids between atoms. Atomist theologians, who give some examples to defend their ideas, do not accept that objects have nature. Instead, they developed the theory of impetus (iʿtimād) to explain motion. The fourth approach is both atomists and naturalist theologians. This approach, led by Abū al-Qāsim al-Kaʿbī, argues that the universe consists of atoms and that every object has a nature. This approach says there is no void in the universe and tries to prove this idea by explaining many phenomena. The fifth approach is taken by theologians who evaluate the physical universe with Aristotle’s theory of four causes. After al-Ghazzālī, Ashʿarī theologians tried to harmonize Aristotle’s theory of four causes, which formed the basis of his physics, with their theological theses. The article discusses what methods are followed to achieve this.
Simulation Hypothesis and Theism: An Assessment in the Context of Multiverse
Authors: YILMAZ Aykut Alper
Published: December 2023

Today, when plots, buildings and items in virtual universes are put up for sale, the question of whether the universes inhabited by real individuals can be produced is being debated. Many philosophers and scientists think that if technology continues to advance at its current rate, we will soon be able to produce universes similar to ours in the virtual environment. This point is the starting point of the famous simulation hypothesis. According to this theory, which many philosophers find reasonable, if we can produce virtual universes, it is highly probable that conscious beings in these universes can create their universes. But this situation also suggests the opposite: How can we be sure that we are not living in a simulation? Based on this argument, Nick Bostrom, an Oxford University philosopher, argues that we are almost certainly in a simulation. Because if most of the existing universes are simulations, it is much more likely that we are living in one of the virtual universes rather than the real one. Well, if the universe we live in is one of infinite universes and was brought into existence and designed by conscious beings in other universes, what would this mean for theism? From the perspective of classical theism, this universe was created and designed by God. For example, proponents of the cosmological argument claim that the universe had a beginning, while advocates of design proof argue that God designed this universe. Some assume that the idea that there are an infinite number of universes other than the one we live in is contrary to theism. Again, in many studies, we come across that the theory of multiverses is handled as an understanding of the universe in opposition to theism. While this study does not aim to defend the truth or falsity of the simulation hypothesis, it suggests that if this theory is assumed to be true, there will be no serious danger to theism. While doing this, the discussions in the context of the theory of multiverses and theism will be mentioned, and it will be argued that simulation universes do not contradict the existence of God.
Yazarlık Anlaşmazlıkları: Öğrenci mi danışman mı ilk yazar olmalı?
Authors: DEMİR Abdullah
Published: December 2023

Yazarlık anlaşmazlıkları, akademik dünyada öğrenci-danışman ilişkisinde ortaya çıkabilmektedir. “Danışman teze dayanan bir makaleye doğrudan yazar olarak eklenmeli mi?”, “Makalede ilk yazar öğrenci mi yoksa danışman mı olmalı?”, “Birden fazla yazar olduğunda yazar sıralaması akademik unvanlara göre mi belirlenmeli?” veya benzeri sorular, yüksek sesle dillendirilmese de öğrenci-danışman ilişkisinde akla gelebilmektedir. Yazar, çalışmanın ortaya çıkarılmasına “yazarlık sıfatını hak edecek düzeyde katkısı olan” kişi veya kişileri ifade eder. Dolayısı ile makalede sadece yazarlık sıfatını hak edecek düzeyde katkısı olan kişiler yazar olarak belirtilmelidir. Yazar sıralaması da yazarlık sıfatını hak edecek düzeyde katkı yapanların “katkısı oranına” göre en yüksekten en düşüğe doğru sıralanmalıdır. Bu sıralama, yazarların idari veya akademik unvanı dikkate alınarak değiştirilmemelidir. “Yazarlık sıfatını hak edecek düzeyde katkı” sağlanıp saplanmadığı nasıl belirlenecektir?”. Bu soru, CRediT: Katkı Sunanları Belirleme Taksonomisi ile net bir yanıta kavuşmuştur. CRediT, araştırma ve yayına katkıda bulunanların süreçte oynadıkları rolleri belirlemek için kullanılan 14 katkı çeşidini içeren bir taksonomidir. Bu katkı çeşitleri; “Kavramsal Tasarım, Veri Toplama/Literatür Taraması, Analiz, Araştırma, Finansman, Proje Yürütücülüğü, Beşerî ve Fiziksel Unsurları Sağlama, Yazılım Desteği, Danışmanlık ve Liderlik, Veri Doğrulama, Görselleştirme, Metnin Yazımı, Metnin Geliştirilmesi ve Tashihi” şeklinde sıralanmaktadır. Bu katkılardan her biri, katkı sahibinin emeğini temsil etmektedir. Yazar olarak anılabilmek için bu rollerden en az üçünde katkı sağlamış olmak gereklidir. Çalışmalarda yazarların katkı oranı, İSNAD Atıf Sistemi’nde önerildiği üzere; “Araştırmanın Tasarımı (CRediT 1), Veri Toplanması (CRediT 2), Araştırma - Veri Analizi- Doğrulama (CRediT 3-4-6-11), Makalenin Yazımı (CRediT 12-13) ile Metnin Geliştirilmesi ve Tashihi (CRediT 14)” başlıkları altında puanlanabilir. Çalışma için sağlanan “Finansman ve Destekler (CRediT 5)” de metinde mutlaka belirtilmelidir. Çalışmaya yazarlığı hak edecek düzeyde katkı sağlamayan kişi veya kurumlara ise isimleri anılarak teşekkür edilir. Yazarlar, çalışmanın hazırlanmasında yapay zekâ destekli teknolojileri kullanmışlarsa bu teknolojileri nasıl kullandıklarını belirtmeleri de faydalı olacaktır. Bunların kullanımına dair kriterler şu an tüm dünyada tartışılmaya devam etmektedir. Bu tür anlaşmazlıkları önlemek için açık ve net yazarlık kriterlerinin belirlenmesi önem taşımaktadır. Bu amaçla İSNAD Atıf Sistemi’nin 2024 yılında yayımlanacak üçüncü edisyonuna “Yazarlık Katkılarını Belirleme” başlığı eklenecektir.
Blockchain and fintech technologies in the digital space of financial and industrial companies
Authors: Domashenko Svitlana , Hres-Yevreinova Svitlana , Zadoia Yurii , Starostenko Dmytro , Salin Serhii
Published: December 2023

The relevance of the article lies in examining the functional relationship between blockchain and fintech technologies in the innovative digital space of financial and industrial companies. The research aims to investigate the directions for the development of large integrated systems of financial and industrial capital, based on the principles of intensive production. The research methodology included the following methods: analytical (literature review, quantitative analysis), methods of comparison, generalization, and systematization. In particular, quantitative analysis was applied to calculate the index of digital cyber protection, which serves as an indicator and summarizes the safe properties of information resources in the digital space of banking institutions and their ability to prevent cyber-attacks on the financial and industrial capital of subjects in united spheres of economic activity. The results of the research have shown that the optimal criteria for the index of digital cyber protection are financially linked to industrial capital. The article substantiates the macroprudential policy of Ukraine’s banking sector based on blockchain regulators and fintech technologies from the EU, which foster the intensive development of technological competitiveness among financial institutions. The article can be useful for financial and industrial executives, banking institutions, consulting firms, and educators seeking insights into the integration of blockchain and fintech technologies.
CURRENT TRENDS IN THE DEVELOPMENT OF FUNCTIONAL FOOD INDUSTRY IN THE REPUBLIC OF KAZAKHSTAN AND ABROAD
Authors: Baizhanova Sholpan , Konarbayeva Zulfiya , Kaldybekova Zhanat
Published: December 2023

Modern society development is quite a contradicting process, on the one hand we could see outstanding achievements of science and technology, on the other hand it is difficult to ignore dangerous environmental situation, an increase in information, changes in the nature and rhythm of life and nutrition. Currently, it is obvious that the way of eating is the most important factor affecting a person's health, his ability to work, the ability to resist all kinds of external influences and, ultimately, determining the duration and quality of life.
Analyzing the collected data, we came to the conclusion that functional food plays a significant role in the concept of healthy nutrition.  It is expected the growth of the market will increase the already high demand for nutritional and fortifying dietary supplements.
The work shows the analysis of registered specialized food products by countries producers.  The leading countries in terms of supplies are Japan, the USA, Russia and Germany. The share of domestic products was determined, making possible to see which forms prevail in the structure of the range of specialized food products in our republic.
The Implementation of Merdeka Curriculum Towards Early Childhood Education
Authors: Hariyani Indaria Tri , Sulistiyani Sulistiyani , Soemarmi Soemarmi , RZ Fida
Published: December 2023

The issues faced by early childhood education or PAUD dealing with the implementation of the Merdeka curriculum is the teachers’ readiness in implementing the Merdeka curriculum. The purpose of this research is to assist PAUD teachers in preparing for the implementation of the Merdeka curriculum. The research method used in this study was qualitative descriptive, that is, concerning the real condition of six teachers at one PAUD school in Surabaya. The data were gathered by using interviews and observations of the head of school, curriculum representatives, and all teachers for guidelines for interviews that have been validated by three validators. The data analysis was done using an interactive model by Miles and Huberman, which consists of four stages: data collection, data reduction, data presentation, and conclusion. The results of this study showed that the Merdeka curriculum has already been implemented in PAUD, but it requires some improvement and development since the Merdeka curriculum only begins the first year at PAUD. Therefore, there is little research on the implementation of the Merdeka curriculum, so it is recommended to undertake further in-depth research into the application of the Merdeka curriculum at the next level of school.
Reducing the risks of nuclear war; the role of health professionals
Authors: Zielinski Chris
Published: December 2023

According to the United Nations, the risk of nuclear weapons use is higher than at any time since the Cold War: "The Russian Federation’s recent announcement of plans to station non-strategic nuclear weapons in Belarus represents the first 'nuclear sharing' agreement made since the Treaty on the Non-Proliferation of Nuclear Weapons entered into force in 1970." At this moment of extreme danger, we are preparing to distribute an editorial on the role of health professionals in reducing nuclear danger. We hope to time the announcement of the release of this editorial to the August 6 anniversary of the bombing of Hiroshima to underline the very real danger that nuclear weapons may be used again.
The editorial was co-authored by the group of journal editors and other supporters of the Nobel-prizewinning International Physicians for the Prevention of Nuclear War listed below. All of the authors’ journals will be publishing the editorial.
Having so many respected journals around the world publishing the editorial should attract political and media attention. We hope that giving health professionals a more prominent voice in this debate will encourage profound changes in the system of nuclear arms control that has resulted in the current dangerous situation that threatens the health of people and the planet.
Psychosocial Burden and Coping Abilities of Caregivers of Children with Sickle Cell Disease Attending Government-Owned Tertiary Health Care Facilities in Ogun State, Southwest Nigeria
Authors: Alabi Adekunle , Ogundeyi Morufat , Mautin Gbenayon , Ekundayo Adeola
Published: December 2023

Objective: Sickle cell disease is a chronic inherited haematological disorder affecting predominantly people of African, Arab and Indiana ancestries with the highest reported burden of 150,000 children in Nigeria. The chronicity and physical and psychosocial complications of the disease pose a significant psychosocial burden on children and their caregivers. This study assessed the psychosocial burden and coping abilities of primary caregivers of children with sickle cell disease.
Method: It was a descriptive cross-sectional study done in two public tertiary health institutions in Ogun State. Semi-structured interview-based validated questionnaires were administered to assess their psychosocial and health burden. The coping ability of the caregivers was determined. Descriptive statistics and non-parametric tests were used for data analysis.
Results: Two hundred and twenty-four primary caregivers were interviewed. The moderate to severe psychosocial burden was 34.4%. Some (21.4%) found it difficult to cope with the care of the children and 12.1% believed it had a severe impact on their health. Major factors reported were frequent hospitalization, emergencies, school absenteeism, crisis and hospital bills. Caring for these children caused a general atmosphere of tension and marital disharmony in 17.4% and 17.9% of the respondents, respectively. The stress level was higher among female caregivers, low socio-economic class, single parenthood and older caregivers. Female child, age and severity of illness had a significant impact on the burden and coping levels.
Conclusion: The caregivers experienced some psychosocial burden and difficulty in coping. Frequent hospitalization and the high cost of health care placed significant strain on them.
CryptoImperforate Hymen with a Huge Abdominal Mass and Massive Hematocolpometra in a 15-Year-Old Girlmenorrhea with a Huge Abdominal Mass and Massive Hematocolpometra in a 15-Year-Old Girl
Authors: Ipinnimo Oluwadare Martins , Okoye Ifeanyi Martins , Adeniyi Kayode , Ipinnimo Tope Michael , Ipinnimo Oluseyi Igbekele , Ezrah Chukwunonso Onyejide
Published: December 2023

Background: Imperforate hymen is one of the commonest embryological defects of the lower genital tract which occurs due to failure of canalization of the sinovaginal bulb. Its incidence is 1 in 2000 girls.
Case Presentation: This case is of a 15-year-old nullipara who presented on account of a 2-month history of recurrent abdominal pain, hesitancy, and primary amenorrhea. Her physical examination reveals a huge abdominopelvic mass about the size of a 26 weeks intra-uterine gestation, and a vagina examination revealed an imperforate hymen. A pelvic ultrasound confirmed a massive hematometra and hemaltocolpos leading to a diagnosis of imperforate hymen. She had a hymenotomy with a cruciate incision to drain the menstrum.
Conclusion: Pediatricians and gynaecologists need a high index of suspicion to diagnose this defect for earlier treatment and reduced morbidity due to late diagnosis.
Time to treat the climate and nature crisis as one indivisible global health emergency
Authors: Zielinski Chris
Published: December 2023

Over 200 health journals call on the United Nations, political leaders, and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency.
A narrative review of strategies to improve childhood vaccination coverage in Low- and Middle-Income Countries
Authors: Otaigbe Idemudia
Published: December 2023

Background: Childhood vaccination is a fundamental human right and a core component of successful primary care. It has positive benefits on population health as it reduces the burden and costs associated with infectious diseases.
Main Body: Despite the immense benefits of childhood vaccination, vaccine coverage remains poor in many Low- and Middle-Income Countries (LMICs) due to several barriers. Examples of these barriers include parental misperceptions about vaccine safety, poor vaccine distribution networks and insufficient funding for childhood vaccination programs. It is therefore necessary to design suitable and effective strategies to overcome these barriers.
Conclusion: This narrative review article discusses effective strategies to improve vaccine coverage in Low- and Middle-Income Countries (LMICs).
Design and Performance Analysis of Defected Ground Slotted Patch Antenna for Sub-6 GHz 5G Applications
Authors: Hossain Md. Najmul , Islam Al Amin , Rahim Md. Abdur , Hossain Md. Imran , Rahman Md. Arifour
Published: December 2023

Recently, there have been notable advancements in wireless communication systems to address the deficiencies of fourth generation (4G) wireless technology, such as insufficient spectrum bandwidth, slow data transfer rates, and constrained network capacity. These issues may be addressed in fifth generation (5G) wireless technology, which is no longer stand-alone. This article proposes and designs a defected ground slotted patch antenna (DGSPA) for 5G (Sub-6 GHz band) applications. It can work at 3.5 GHz in the 5G N77 band, Sub-6 GHz 5G, LTE Band 42, and WiMAX. The suggested antenna has an overall dimension of 38×38×1.575 mm3 and is built on the Rogers RT5880 substrate material, whose dielectric permittivity is 2.2. The CST software is used as the simulation tool to analyze the designed antenna’s performance. The novelty of the recommended antenna is in terms of its small size with defective ground structure (DGS), high antenna gain, perfect impedance matching, and improved impedance bandwidth. The role of the DGS is evaluated by comparing the antenna’s performance with and without the DGS. It has been noticed that the DGS-backed antenna had an impedance bandwidth improvement of more than 11MHz, whereas the impedance profile is (50.086−????0.179) Ω, which denotes 50 Ω pure resistivity. It will operate within the frequency range of (3.4828 - 3.522) GHz with an impedance bandwidth of 69.2 MHz. The proposed antenna’s reflection coefficient (|????1,1|) is obtained as -54.028 dB at the resonating frequency of 3.5176 GHz, whereas the radiation gain and efficiency are observed as 6.463 dB and 93.475%, respectively. Thus, due to its promising performance based on radiation pattern, optimum efficiency, and higher bandwidth, the recommended defected ground slotted patch antenna can efficiently be used for the application of Sub-6 GHz 5G services.
Disappearing diplopia - An unusual presentation of Tolosa-Hunt syndrome: A case report
Authors: Nasim Fathima , Fasrina Mohamed , Bowattage Sunil , Kularatne Kierthie
Published: December 2023

Tolosa-Hunt syndrome (THS) is a rare benign treatable cause of painful ophthalmoplegia with frequent VI, III, IV cranial nerve (CN) involvement. Optic and trigeminal nerve involvement is rare but described. The disease is characterized by severe preceding or concomitant headache and remarkable response to steroids. Although labelled benign residual neurology is not uncommon in THS.We present a case of THS in a middle-aged Sri Lankan male who presented initially with vertical diplopia and normal contrast enhanced CT scan, treated as for idiopathic IV nerve palsy. A month henceforth he developed severe episodic headache with autonomic symptoms, right sided ptosis and progressive visual impairment with improved diplopia, normal fundoscopy, inflammatory and infective markers and autoimmune profile. MRI brain showed enhancing lesion of cavernous sinus extending to orbital apex consistent with THS. He showed dramatic improvement with steroids with complete resolution of neurology at the end of 4 weeks.THS should be considered in a patient presenting with disappearing painful diplopia. Headache may mimic primary headache syndromes and may not precede ophthalmoplegia. Imaging may be initially normal. MRI is mandatory for diagnosis as histology is not always feasible. Steroid responsiveness can be diagnostic if more sinister differentials are ruled out.
Acute Cytomegalovirus infection complicated with Haematophagocytic Lymphohistiocytosis in a young male with an inaugural diagnosis of Systemic Lupus Erythematosus: A case report
Authors: Jezeema Z. K. M. , Costa Madushika , Kularatne Kiertie , Bowattage Sunil , Zavahir Fasrina
Published: December 2023

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease due to a diverging immune response resulting in immune-mediated damage to tissues with significant morbidity and mortality. Cytomegalovirus (CMV) is a constantly encountered, widespread herpesvirus with a mild impact on immunocompetent hosts but can lead to significant morbidity and mortality in the immunocompromised host. Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal clinical condition with a collection of symptoms resulting from exaggerated immune activation, response, and cytokine storm. HLH can be primary which is genetically predisposed, and secondary which is usually preceded by an infection or an inflammatory process which then is referred to as macrophage activation syndrome. Here we report a rare case of a young male with an inaugural diagnosis of SLE complicated with HLH following a recent CMV infection.
The wild boar Sus scrofa cristatus attacks in Sri Lanka: a case series and review of literature
Authors: Thalgaspitiya Sujeewa , Wijerathne Buddhika , Madusanka Mahesh
Published: December 2023

The wild boar, Sus scrofa, is a mammal found in Eurasia and North Africa. The incidence of attacks has slowly risen due to the dwindling forest cover, an increase in population, and intrusion into the wild boar’s natural habitat. Injuries caused by wild boars include soft tissue injuries, fractures, internal organ damage, and, in some instances, death. Here, we describe three cases of wild boar attacks presented at Teaching Hospital Anuradhapura. Early intervention, stabilization, and transportation to the appropriate tertiary care are crucial.
Factors associated with initiation of tobacco smoking among schooling adolescents in the age group of 13 – 15 years in the Kandy district, Sri Lanka
Authors: Rambukwella Roshan , Dissanayake Devani
Published: December 2023

Adolescent smoking problem has still remained a public health concern, but factors that contribute to the initiation of adolescent smoking are not well-known in Sri Lanka. The study aimed to determine the factors associated with the initiation of tobacco smoking among schooling adolescents in government schools in the age group of 13-15 years in the Kandy district. A cross-sectional study was conducted in selected government schools of Sinhala, Tamil, and English mediums in the Kandy district. The subjects were selected using a stratified multi-stage cluster sampling method. A pretested self-administered questionnaire was used. The factors associated with the initiation of smoking were determined by a multivariable analysis using logistic regression.A total of 1395 students (Male 52.9%) were included in the study. The initiation of tobacco smoking was significantly associated with being a male student (Adjusted Odds ratio (AOR)=26.24; 95% CI=7.49-91.44), the parent being a smoker (AOR=6.04; 95% CI=2.83-12.91), education level of a father below GCE O/L (AOR=5.65; 95% CI=2.20-14.49), education level of mother below GCE O/L (AOR=2.63; 95% CI=1.18-6.25), presence of household member who smokes (AOR=7.10; 95% CI=2.76-18.29), social network use (AOR=10.73; 95% CI=3.63-31.75) and the parent being a quitter (AOR=0.29; 95% CI=0.11-0.79). Factors identified for smoking initiation give a clue to intervene in the target population focusing family related and other modifiable factors.
Nursing Performance and Smartphone Use in Clinical Settings
Authors: Noghan Nesa , Sadri Mohadese , Hejazi Sima Sadat , Noghan Nima , Jalilv Meysam , Shirahmadi Samaneh
Published: December 2023

Objectives:

The present study was conducted to examine the relationship between smartphone dependency and its effect on clinical tasks of nurses in educational and medical centers of Hamadan, in western Iran.

Method:

In this cross-sectional study, 248 nurses were selected via the proportional allocation sampling method. The required data were collected using a self-report, reliable and validated questionnaire, covering patterns of smartphone use, smartphone dependency, effects of smartphone dependency, and influence of smartphone on the clinical performance of nurses. The collected data were analyzed through descriptive statistics and logistic regression analysis.

Results:

The average age of the participants was 30.43 (± 5.68) years. The average smartphone dependency, effects of smartphone dependency, and clinical performance of the examined nurses were, respectively, 38.65 (20.93), 20.78 (13.90), and 29.48 (10.03). Clinical performance of nurses decreased with age (P = 0.02) and increase of smartphone dependency (P = 0.02), effects of smartphone dependency (P ≤ 0.001), and smartphone use while working (P ≤ 0.001). Higher work experience (P = 0.02) and the application of smartphone multiple capabilities (P = 0.02) had positive effects on the clinical performance of the examined nurses.

Conclusions:

The results of this study indicated that using smartphones affects the clinical performance of nurses, and if not well managed, it can lead to some physical, psychological, and social problems for the individual nurse, patients, and society. Thus, training nurses and developing regulations for the use of smartphones in the workplace must be considered by the relevant authorities.
Does Burnout Lead to Poor Organizational Commitment among Prison Officers in Sri Lanka?: Findings from a Cross-Sectional Study
Authors: Wijegoonewardene Nimali F. , Vidanapathirana Janaki P.
Published: December 2023

Burnout is a recognized risk factor for poor organizational commitment across occupational groups. This has not been explored among Sri Lankan prison officers previously. The aim of this article is to identify whether burnout was an associated risk factor for poor organizational commitment in this occupational group. A cross-sectional study was conducted among 1803 prison correctional and rehabilitation officers in 32 prison institutions across the country. Multistage sampling was used. The “Organizational Commitments Questionnaire” was used following judgmental validation. Risk factors identified through literature were analyzed using bivariate analysis, followed by logistic regression analysis. Three-hundred and sixty-six participants (20.3%) had poor organizational commitment. Burnout was found significant in the bivariate analysis, and in the logistic regression analysis at P < 0.001 (odds ratio: 2.2, 95% confidence interval: 1.7–2.8). Burnout was an associated risk factor for poor organizational commitment in Sri Lankan prison officers. Interventions for employee burnout would contribute to improved organizational commitment.
Estimating Air Pollution in Operation Rooms Generated from Cautery, Drills, and Other Equipment, Utilizing a Particulate Counter and Gas Analyzer
Authors: Rao Rajana S. , Sasiharan Gopalakrishnan Madhavan , Ganapathy Sachit
Published: December 2023

Background:

Air pollution, especially indoor air pollution, is increasingly recognized as a worldwide hazard that reduces life expectancy. Pollution caused by equipment such as surgical cautery is not just a nuisance but a workplace hazard that exposes the staff to respirable particulate matter and toxic chemical agents. It has not yet received much recognition in India, nor have mitigating measures like smoke evacuators and dedicated scavenging systems become prevalent.

Methods:

We aimed to do a prospective observational study of the extent of this hazard in the operation rooms in our tertiary care, Government-run hospital using a consumer-grade pollution measuring equipment (CAIR +™, Prana Air, New Delhi). We measured and compared the particulate pollutant matter (PM) levels, Total Volatile Organic Compounds (TVOC), formaldehyde, and carbon dioxide at multiple areas of interest at different time points.

Results:

The particulate pollution level in PM 1.0, PM 2.5, and PM 10 and TVOCs rose many times the baseline near the surgical team during cautery use. It remained high near the anesthesia workstation. The median PM 2.5 level in µg/m3(micrograms/cubic meter) was 181 near the surgical team during cautery use, and it was 25 at the anesthesia workstation. This peak level was 30 times the basal level of 6 µg/m3 at the start of the day and was above the annual population-weighted mean PM 2·5 breakpoint of 40 μg/m3 recommended by the National Ambient Air Quality Standards in India.

Conclusions:

The pollution levels increase dramatically when surgical cautery is used, potentially exposing the team to large peak elevations in particulate matter and TVOCs. We recommend the mandatory use of smoke evacuators and optimization of the air conditioning.
Assessment of Work Ability of Patients with COPD in Relation to the Workplace
Authors: Biscevic-Tokic Jasmina , Brekalo-Lazarevic Sanja , Tokic Nedim , Ajanovic Zurifa , Dervisevic Lejla
Published: December 2023

Context:

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic lung diseases and is an important cause of mortality and morbidity in the world. Chronic obstructive pulmonary disease is a heterogeneous and multisystemic disease. Aims of the study was to assess workability of patients with COPD in relation to the workplace.

Settings and Design:

Prospective study.

Methods and Material:

The study was conducted on 150 patients with COPD. Each patient was examined by an occupational medicine specialist and a standardized COPD Questionnaire was completed. A physical examination was performed with special emphasis on auscultatory findings on the lungs. Spirometric testing was performed. Using the statistical methods, the results of the parameters of temporary (number of lost working days) and permanent incapacity (exercised right to some kind of disability) of the examined group were analyzed.

Statistical Analysis Used:

Descriptive statistics. SPSS 10.0. Results of the study showed that out of 150 patients, 48.67% had preserved working capacity for jobs. There are mostly jobs without special working conditions. Out of 150 patients, 51.33% had reduced working capacity for jobs.

Conclusions:

These are mostly workplaces with special working conditions, where respondents are exposed to the harmfulness of the workplace. Reduced working capacity was found in 51.33% of examined simple.
Ergonomic Risk Analysis and Muscle Complaints of Office Workers in the Government Office, Surabaya City
Authors: Haqi Dani N. , Martiana Tri , Notobroto Hari B. , Paskarini Indriati , Alayyannur Putri A. , Haidar Mochamad A.
Published: December 2023

The work environment of office workers has hazards. One of the hazards is nonergonomic conditions. Nonergonomic conditions increase musculoskeletal disorders (MSDs) risk and interfere with work productivity. This research describes ergonomic risk levels and muscle complaints in office workers while working with computers. The population of this research was 32 office workers in one of Surabaya city government offices. Rapid Office Strain Assessment (ROSA) method to measure ergonomic risk and Cornell Musculoskeletal Discomfort Questionnaires (CMDQ) method to measure muscle complaints. Most workers have a high risk of experiencing MSDs. Workers experience muscle complaints in the neck, right shoulder, left shoulder, upper back, and lower back. Intervention is needed in work facilities and office ergonomics socialization to workers.
Data Management: The First Step in Reproducible Research
Authors: Soundararajan Soundarya , Mishra Sukhdev
Published: December 2023

Reproducibility is a preferred aim in any scientific research, including occupational health research. Datamanagement is an important and essential step in marching towards reproducibility. A good datamanagement helps us stay organized, improve transparency, quality and fosters collaboration. Here we discuss how to organize and prepare for data management, how data management facilitates interoperability and accessibility, followed by storing and dissemination of data. We wrap up by providing pointers on what needs to be included in the data management plans.
A Retrospective Study on Tinnitus Prevalence and Disease Associations in the Hospital-Based Population
Authors: Yilmaz Oguz , Yeral Cem
Published: December 2023

Background:

Tinnitus is the perception of sound, which is not generated by external stimulus. Due to its clinical heterogeneity, lack of objective measurements and accompanying symptoms, a gold standard treatment, i.e., effective for every patient has not been established yet. The aim of the present study was to assess the prevalence and characteristics of tinnitus, disease, and lifestyle factors associated with tinnitus.

Materials and Methods:

Data were obtained from a total of 224 patients (mean age 46.21 ± 12.65), 141 men and 83 women, who attended the audiology department between 2015 and 2021.

Results:

We found that the tinnitus pitch perception (PP) of males was significantly higher than females (P < 0.001). In addition, we observed a significant positive correlation between tinnitus PP and tinnitus loudness perception (P < 0,005). 12.1% (27 patients) of the individuals included in the study had metabolic disorders (Vitamin D deficiency, diabetes, and cholesterol). Fifty-four percent (121 patients) of the individuals included in the study had normal hearing.

Conclusions:

Metabolic and cardiovascular diseases should be taken into account for tinnitus anamnesis. The amount of tinnitus patients with normal hearing is also notable.
Changing Trends in Managing Facial Nerve Paralysis Secondary to Temporal Bone Fractures: Our Institutional Experience
Authors: Sethi Ashwani , Galagali Jeevan R. , Sethi Deepika , Mishra Awadhesh Kumar
Published: December 2023

Aim:

The aim of the present study is to share our experience in managing high-grade posttraumatic facial nerve paralysis using both surgical as well as nonsurgical approaches.

Materials and Methods:

A retrospective analysis of 31 cases of high-grade (House–Brackmann [HB]: V/VI) facial nerve paralysis following undisplaced temporal bone fracture treated at our tertiary care hospital between 2016 and 2019 was done. Patients’ assessment included clinical, audiological, computer tomography scans, and electromyography (EMG) evaluation. Fourteen of the cases presenting between February 2016 and November 2017 underwent surgical decompression of the facial nerve based on our prevailing institutional protocol during that period. However, the next 17 patients presenting between January 2018 and May 2019 were managed conservatively on the basis of our surgical experience in managing such patients before this period and some contemporary data suggesting good results with conservative management, using oral steroids and facial physiotherapy. The patients were assessed clinically and using EMG at 4 weekly intervals as a standard institutional protocol.

Results:

Among the 14 patients who underwent surgical decompression, lesions were predominantly found in the perigeniculate region. Analysis of results after 12 months revealed 86% (12 out of 14) of cases who underwent surgery had a satisfactory recovery (HB Grade I-II). A satisfactory recovery was achieved in 94% (16 out of 17) of conservatively managed patients (HB Grade I-II). However, there was no statistically significant difference identified between the outcomes of the two groups.

Conclusion:

The outcome of patients presenting with high-grade facial paralysis with unfavorable EMG findings secondary to undisplaced temporal bone fractures is generally good with or without surgical intervention. The recovery may take around 2–3 months to initiate. We recommend giving nonsurgical conservative management to such patients with regular clinical and electrophysiological monitoring.

Clinical Significance:

The outcomes and our experience of managing such cases may be useful for clinicians in deciding the course of action in patients presenting with high-grade facial nerve palsy following temporal bone fractures.
Extended High-frequency Hearing Loss in Chronic Suppurative Otitis Media Patients Complaining of Tinnitus but with Normal Cochlear Function on Conventional Pure-tone Audiometry
Authors: Gupta Nitika , Bhagat Samiksha , Thakur Shivane , Kalsotra Parmod , Saraf Aditiya
Published: December 2023

Objective:

The aim of the study is to find the incidence of extended high-frequency hearing loss (EHFHL) in chronic suppurative otitis media (CSOM) patients complaining of tinnitus but with normal cochlear function on conventional pure-tone audiometry (PTA). CSOM often results in conductive hearing loss, but recent studies have shown sensorineural hearing loss, thus indicating inner ear damage.

Study Design:

The stud design was a prospective study.

Setting:

The study was conducted at a tertiary care hospital.

Methods:

In a prospective observational study, a total of 141 patients with CSOM were reviewed. Seventy-four CSOM patients presented with tinnitus, and the mean age of presentation was 31.4 ± 6.82 years. Only those with normal cochlear function based on PTA (250 Hz to 8 kHz) were included. They were further tested at extended frequencies of up to 12 kHz. The severity of tinnitus was assessed using the Tinnitus Handicap Index Questionnaire.

Results:

The prevalence of EHFHL in the normal cochlear function CSOM patients with tinnitus was 68.9%, whereas the prevalence in the tinnitus negative group was 22.38%. EHFHL and tinnitus in CSOM patients show statistically significant association (P < 0.05). Furthermore, there was a significant association between the severity of tinnitus and EHFHL.

Conclusion:

The findings demonstrate that the patients of CSOM with tinnitus and normal hearing in conventional PTA have EHFHL that indicates damage has occurred in the inner ear. The severity of the tinnitus can be predicted by the degree of higher frequency hearing loss.
Comparison of the Functional and Audiological Success of Temporalis Fascia and Tragal Perichondrium as a Graft in Type 1 Tympanoplasty
Authors: Prinja Sumit , Kumar Kuldeep , Singh Gurbax , Bansal Garima , Pushkal
Published: December 2023

Context:

Temporalis fascia and tragal perichondrium are the most commonly used graft materials in tympanoplasty, though contradictory reports are available in literature regarding their efficacy.

Aims:

To investigate the success rates and hearing outcomes of temporalis fascia and tragal perichondrium as grafts used for Type 1 tympanoplasty.

Settings and Design:

The present prospective study was carried out for a period of 18 months including 60 patients of either sex from 18 to 70 years of age.

Subjects and Methods:

This prospective study included 60 consecutive cases of chronic otitis media in a tertiary care center randomized in two groups of 30 patients each to be subjected to Type 1 tympanoplasty using either temporalis fascia graft (Group A) or tragal perichondrium (Group B). Graft uptake rates and subjective as well as objective hearing improvement at 1 and 3 months postoperative follow-up were compared.

Statistical Analysis Used:

IBM-compatible Statistical Package for the Social Sciences (SPSS) version 21.0.

Results:

The mean age of presentation in Group A was 31.30 years and in Group B was 30.67. In our study, the graft uptake after 3 months of surgery was 87% in the temporalis fascia graft group and 90% in the tragal perichondrium graft group. The mean pre- and postoperative PTA at 1 month and 3rd month postoperatively showed that there was significant improvement in hearing after 1 month in the temporalis fascia graft group compared to the tragal perichondrium graft group.

Conclusions:

Both temporalis fascia and tragal cartilage perichondrium are suitable graft materials for tympanoplasty. Graft uptake was superior with tragal perichondrium, while hearing improvement was better with temporalis fascia at 1 month postoperatively, although the results were not statistically significant at 3 months postoperative.