bluuebunny/crossref_metadata_2025 huggingface dataset:
The Direct Support Workforce: An Examination of Direct Support Professionals and Frontline Supervisors During COVID-19
Authors: Pettingell Sandra L. , Bershadsky Julie , Anderson Lynda Lahti , Hewitt Amy , Reagan John , Zhang Alicia
Published: June 2023

Direct support professionals (DSPs) and frontline supervisors (FLSs) have critical roles in home and community-based services for people with intellectual and developmental disabilities. Low wages and high levels of responsibility created a long-term crisis in recruitment and retention and are exacerbated by the COVID-19 pandemic. A national sample of DSPs and FLSs were compared on demographics and work-related circumstances using data from the third Direct Support Workforce COVID-19 Survey. Significant differences were found in demographics, hours worked, wages, wage augmentations, and quality of work-life. Policy recommendations to address the worsening workforce crisis are provided.
Financial Planning Among Parents of Children With Intellectual and Developmental Disabilities
Authors: Agarwal Rumi , Heron Laura M. , Burke Shanna L.
Published: June 2023

Families of children with intellectual and developmental disabilities (IDD) experience significant financial hardship, which could improve through financial planning and utilization of accounts such as the Achieving a Better Life Experience (ABLE). Unfortunately, current rates of banking are low among individuals with disabilities, and no study has examined this phenomenon specifically among families of children with IDD. In this cross-sectional study, 176 parents shared their financial planning and utilization experience. Findings indicate that parents worry about their child's financial future, however, paradoxically, are not engaging in financial planning. Utilization of ABLE, checking and savings accounts, and special needs trusts are also low. Parents reported several programmatic and personal barriers which could inform immediate programmatic changes and long-term policy considerations.
Factors Influencing Parents' Decisions to Create a Business for Their Adult Child With Intellectual Disability
Authors: Malouf Emily T. , Dymond Stacy K.
Published: June 2023

Obtaining and maintaining work can be a challenge for many people with intellectual disability (ID) and parents can play an integral role in supporting their child to secure employment. The purpose of this qualitative research study was to understand factors that influence parents' decisions to create a business for their adult child with ID. Nine parents were identified through purposeful and snowball sampling. Parents participated in individual interviews and data were analyzed using thematic analysis. Our findings suggest that school experiences, expectations for work, presence of specialized support, and encouragement and suggestions from others influenced parents' decisions to create a business. In light of the findings, we discuss how parents' previous experiences and responsiveness influenced the creation of the business.
PENGUATAN KUALITAS SPIRITUAL LANSIA MELALUI KEGIATAN SHOLAWAT DI UPT PELAYANAN SOSIAL TRESNA WERDHA BANYUWANGI
Authors: Wahyu Efendi  , Rozi Maftukhah Khoirun Nissa , Nafi’atus Salma SW  , Soffy Balgies
Published: June 2023

This study aims to improve and strengthen the spirituality of the elderly at UPT Tresna Werdha Social Services Banyuwangi. Problems faced related to the spiritual quality of the elderly include; First, there is no special spiritual guidance, especially in studies with the theme of prayer for the elderly because religious activities only focus on the science of monotheism. Second, the elderly are not used to practicing prayers every day. Third, the elderly have not been able to improve and strengthen spiritually so that there is anxiety in the elderly. This study uses a CBR (Community Based Research) approach which is qualitatively carried out. The CBR method is a research method with the community to address existing problems. Researchers used two activities as a tool to improve and strengthen the Spiritual Quality of the Elderly. The first activity is a religious activity with the theme "recitation and reading of sholawat". The second activity is the screening of Sholawat every morning.The results of the activities carried out by researchers are that this research activity has succeeded in strengthening the spirituality of the elderly. This is evidenced by the fact that the elderly are very enthusiastic, conducive and participate in "recitation and prayer readings" activities and are also consistent in reading prayers every day.
Keyword: Eldery Spiritual, Social Service, Religious, Sholawat
Recent advances of drugs monitoring in oral fluid and comparison with blood
Authors: Casati Sara , Binda Maddalena , Dongiovanni Paola , Meroni Marica , D’Amato Alfonsina , Roda Gabriella , Orioli Marica , Del Fabbro Massimo , Tartaglia Gianluca M.
Published: June 2023

The use of alternative matrices in toxicological analyses has been on the rise in clinical and forensic settings. Oral fluid (OF), as non-invasive fluid, has attracted attention in the field of drug screening, both for therapeutic and forensic purposes, as well as for medical diagnosis, clinical management, on-site (real time) doping and for monitoring environmental exposure to toxic substances. A good correlation between OF and blood is now established for drug concentrations. Therefore, OF might be a potential substitute of blood, especially for long-term surveillance (e.g., therapeutic drugs) or to screen a large number of patients, as well as for the development of salivary point-of-care technologies. In this review, we aimed to summarize and critically evaluate the current literature that focused on the comparison of drugs detection in OF and blood specimens.
Tea Art
Authors: Braga Thiago
Published: June 2023

This paper sheds light on the operative dynamics of Chinese Contemporary Tea Art, eschewing a formalist reading that equates it with the gongfu ceremony, taking as a jumping-off point instead the Chinese terms that are usually translated into Tea Art: chayi and chadao. I analyze Tea Art through analytics that are raised by its own practitioners, namely the interrelated yet irreducible logics of yi and dao. First, I analyze the yi logic of chayi, demonstrating how the aesthetic register of Tea Art evokes broader, historically rooted ideas about the role of aesthetics as a vector for the moral transformation of society. Second, I turn to the dao logic of chadao, where I illustrate the ways in which Tea Art practice incorporates popular discourses on the interconnectedness of humans and their environment through interpretations of the dao and its adjacent concepts, transforming it into a modality of self-work that reconfigures one’s relationship to self, other, and nature. Third, I place the rise of Tea Art in a sociocultural context to demonstrate that it is neither the revival of an ancient Chinese tradition nor a purely invented tradition but rather a highly complex contemporary phenomenon built at a critical juncture of the Chinese modernization project where urbanites have increasingly pondered issues of spiritual and psychological well-being.
Where Have All the Oungan Gone?
Authors: Lowe Lenny J.
Published: June 2023

This article examines the conflation of oungan (priest-healer) with bòkò (“sorcerer”) among Haiti’s Charismatic Christians. The phenomenon, however, is hardly new, having been a strategy in earlier campagnes anti-superstitieuses by the Catholic Church. More recently, the “spiritual warfare” strategies of Haiti’s Charismatic Christians, who measure all things according to a strict moral binary, constitute a significant intensification of the Christian moral assault on Vodou. By contrast, anthropologists and other pro-Vodou voices in the twentieth century insisted on a careful distinction between the two ritual specialists. Despite their very different motivations, however, I argue that both the Christian conflation of oungan and bòkò and the anthropological effort to define a “pure” Vodou rest upon the same binary moral framework. Because of this shared framework, both ultimately fail to capture the relational moral perspective that Vodou has long held in the face of the violence of slavery and the shifting complexities in contemporary Haiti.
Insecticidal activity of ethanolic plant extracts on Aedes aegypti larvae
Authors: Alvarez-Valverde Victor , Rodríguez Gerardo , Argüello Vargas Silvia
Published: June 2023

[Objective] The objective of this study was to determine the larvicidal activity against A. aegypti of ethanolic extracts of plants commonly found in Costa Rica. [Methodology] Larvicidal activity of ethanolic extracts of plants was determined in this study using the WHO/VBC/81.807: WHO/VBC/81. from 1981. An analysis PROBID for dose response was conducted to determine LC50 of the most prominent extracts. [Results] A total of six extracts with the highest toxicity were chosen, with the stem extract of Ipomoea cairica having the lowest LC50 of 0.0341 mg/mL, followed by I. cairica leaf extract with an LC50 of 0.121 mg/mL. The larvicidal activity of ethanolic extracts of plants was determined in this study, with an emphasis on the larvicidal potential of I. cairica as an environmentally friendly alternative for the control of A. aegypti. [Conclusions] The larvicidal activity for ethanolic extracts of different plants, with an emphasis on the larvicidal potential of I. cairica as an environmentally friendly alternative for the control of A. aegypti.
Color change of Chinese fir through steam-heat treatment
Authors: Cao Yongjian , Jiang Jinghui , Lu Jianxiong , Huang Rongfeng , Jiang Jiali , Wu Yanmei
Published: June 2023

Dark brown wood color is a current trend and widely appreciated by consumers in the furniture and decoration markets. Heat treatment is one of the most effective methods to darken wood’s appearance. The influence of steam-heat treatment on color change of Chinese fir (Cunninghamia lanceolata (Lamb.) Hook.) was investigated within the temperature range from 170 to 230 °C and time from 1 to 5 hours in an air-tight chamber within an atmosphere comprising less than 2 percent oxygen. Saturated steam was used as a heating medium and a shielding gas. The results showed that the chroma difference (△C*) decreased gradually, while the color difference (△E*) and hue difference (△H*) increased with an increase in temperature and length of time. An analysis of variance (ANOVA) and a multi-comparison analysis revealed that the treatment temperature plays a more important role in darkening wood color during the process of steam-heat treatment in comparison with the treatment time. The results suggest that a more desirable wood color can be achieved with the technology of steam-heat treatment.
The effect of offset printing ink on laser toner ink agglomeration under neutral pulping conditions
Authors: Xie Sujin , Tong Guolin , Chin Yungchang F.
Published: June 2023

1-octadecanol is known to be a highly effective agglomerating agent for laser toner ink. However, the office waste paper used in the actual production often contains various types of inks. The effect of the offset ink and types of surfactants with different charge characteristics were studied relative to the agglomeration of the laser toner ink under neutral pulping conditions. It was found that the addition of a small amount of the offset ink printed waste paper was beneficial for the agglomeration of the laser toner ink. The optimal percentage of addition is 12.5% to 25%. The offset printed ink had a positive charge of 0.001±0.0005 mEq/g when the offset ink was treated by 70˚C water at neutral conditions. Addition of a proper amount of cationic surfactant was beneficial to improve the agglomeration at any ratio of the mixed laser printed and offset waste papers. When the percentage of offset waste paper was less than 50%, the addition of anionic surfactant and nonionic surfactant was harmful for agglomeration, and there was no significant effect at higher offset content.
Batch and fixed bed adsorption studies of lead (II) cations from aqueous solutions onto granular activated carbon derived from Mangostana garcinia shell
Authors: Chowdhury Zaira Zaman , Zain Sharifuddin Mohd. , Khan Rashid Atta , Rafique Rahman Faizur , Khalid Khalisanni
Published: June 2023

The feasibility of granular activated carbon (GAC) derived from Mangostene (Mangostana garcinia) fruit shell to remove lead, Pb2+ cations was investigated in batch and fixed bed sorption systems. Batch experiments were carried out to study equilibrium isotherms, kinetics, and thermodynamics by using an initial lead (Pb2+ ions) concentration of 50 to 100 mg/L at pH 5.5. Equilibrium data were fitted using Langmuir, Freundlich, and Temkin linear equation models at temperatures 30°C, 50°C, and 70°C. Langmuir maximum monolayer sorption capacity was 25.00 mg/g at 30°C. The experimental data were best represented by pseudo-second-order and Elovich models. The sorption process was found to be feasible, endothermic, and spontaneous. In column experiments, the effects of initial cation concentration (50 mg/L, 70 mg/L, and 100 mg/L), bed height (4.5 cm and 3 cm), and flow rate (1 mL/min and 3 mL/min) on the breakthrough characteristics were evaluated. Breakthrough curves were further analyzed by using Thomas and Yoon Nelson models to study column dynamics. The column was regenerated and reused consecutively for four cycles. The result demonstrated that the prepared activated carbon was suitable for removal of Pb2+ from synthetic aqueous solution using batch, as well as fixed bed sorption systems.
Termiticidal properties of some wood and bark extracts used as wood preservatives
Authors: Tascioglu Cihat , Yalcin Mesut , de Troya Teresa , Sivrikaya Huseyin
Published: June 2023

The feasibility of using naturally extracted solutions as wood preservative chemical was tested. Extracts extracted from mimosa (Acacia mollissima Willd.), quebracho (Shinopsis lorentzii Griseb.), and Pinus brutia Ten. bark were used to treat sapwood of Scotch pine (Pinus sylvestris L.), beech (Fagus orientalis L.), and poplar (Populus tremula L.) at two different retention levels (6% and 12% weight/weight) against the subterranean termite Reticulitermes grassei Clement (Blattodea: Rhinotermitidae). The lowest mass loss and highest termite mortality rates were recorded for mimosa and quebracho extract treated woods at the 12% concentration level. Pine bark extract seemed to be ineffective as a wood preservative chemical even at the highest retention level. The results suggest that mimosa and quebracho extracts can be utilized as an environmentally-sound alternative wood preservative chemicals for indoor applications against Reticulitermes grassei.
TECHNOLOGICAL FEATURES OF MANUFACTURING ALLOY AK7h STRENGTHENED WITH ZIRCONIUM INTRODUCED WITH ZIRCONIUM TETRAFLUORIDE
Authors:   National Technical University of Ukraine «Igor Sikorsky Kyiv Polytechnic Institute», Ivanchenko D. , Yamshinskij M.
Published: June 2023

The paper considers the important features of the technology of strengthening AK7ch aluminum alloy with zirconium introduced with its tetrafluoride. The choice of a complex flux containing zirconium tetrafluoride in its composition is justified. It is indicated that in order to recover zirconium from its tetrafluoride in the aluminum melt, it is first of all necessary to ensure the formation of sodium or potassium fluorozirconate in the strengthening mixture. The mechanism of recovery of zirconium from tetrafluoride is presented. Technological recommendations for obtaining AK7ch alloy are given. It has been established that the complex flux intended to the alloy, which is modified, must be injected into liquid aluminum before the introduction of other alloying elements, namely silicon and magnesium. The maximum appropriate temperature for injecting zirconium into the aluminum melt from the complex flux is indicated. The maximum amount of zirconium that was recovered is 0.4%. The microstructure and mechanical properties of an alloy strengthened by zirconium from its tetrafluoride, which was injected into the alloy in the amount from 0.8 to 1.2%, were studied. As a result of the modification of aluminum alloy AK7ch with zirconium, the grains of silicon solution in aluminum (α-phase) are grind. No other structural changes are observed. The value of tensile strength and relative elongation of the alloy increases by 1.3 and 1.7 times, respectively.
PHYSICO-CHEMICAL METHODS OF INCREASING THE CRACK RESISTANCE OF ALLOY AM4.5Cd (VAL10). NOTICE 1: EXPERIENCE OF USING AN RING SAMPLE
Authors:   Physico-Technological Institute of Metals and Alloys of the NAS of Ukraine, Bielik V. , Prigunova A. , Shaіgam V. , Vernydub A.
Published: June 2023

On the example of the AM4.5Kd (VAL10) alloy treated in the liquid state with hydrogen, the efficiency of using the well-known ring test for the study of physicochemical methods of influencing the crack resistance of wide-range aluminum alloys, which are prone to the formation of hot cracks during solidification, was studied. To achieve this goal, an annular mold mold was made according to the recommended dimensions, experiments were carried out on the effect of hydrogen treatment of the melt on the crack resistance of castings. Saturation with hydrogen was carried out by blowing the melt with water vapor, the degree of gas saturation was estimated from the porosity of the castings, calculated from the change in their density compared to the control sample obtained in a mold with sufficient power. Despite the measures taken to increase the sensitivity of the annular sample and obtain stable results, which consisted in adjusting the dimensions of the mold, in particular, the size of the central rod, during compression of which the hardening melt creates tensile stresses leading to the formation of a hot crack, as well as optimizing the thermal regime for obtaining a casting by increasing the initial mold temperature from 22 0С to 217-249 0С, the sensitivity of this sample under the experimental conditions remained too low. In 60 % of cases, gas saturation of the melt contributed to a reduction in the crack propagation process when using a mold at room temperature and up to 100 % when the mold was heated to a temperature of 228 0C to 260 0C. However, in both the first and second cases, 28 % of similar data were obtained on castings from the initial melt not saturated with hydrogen. This casts doubt on the reliability of the positive effect of hydrogen treatment and became the basis for the conclusion that it is inappropriate to use this type of sample in studies of physical and chemical effects on the melt in order to increase the crack resistance of the AM4.5Kd (VAL10) alloy due to a possible error in assessing the effectiveness of their impact, and also to decide on the need to develop a new sample, devoid of the identified shortcomings.
ANALYSIS OF THE STRUCTURAL-CHEMICAL MILL DUPLEX-SYSTEMS OF SILICATE-SILICIDE OF LUNG-EARTH METALS. Message 3. The mechanism of desulfurization in the smelting of blast-furnace pig iron
Authors:   Institute for Problem of Materials Science National Academy of Science of Ukraine, Belov B. , Trotsan A. , Vlasova O.
Published: June 2023

The mechanism of cast iron desulfurization through structural and chemical reactions in smelting slags corresponding to the composition of the main mineral phases is presented: monticellite (MT, SiO2MgOCaO) → mervinite (MP, 2SiO2MgO3CaO) → ockermannite (OK, 2SiO2MgO2CaO) →diopside (DP, 2SiO2MgOCaO) → rankinite (pH, 2SiO23CaO) and eutectic slags (E, 3SiO2MgO4CaO). A sequential series of adsorption capacity of slag phases with respect to sulfur (АС, mas. %) and the depth of metal desulfurization – Δ(S), ppm was determined: Е (3.54/36) → MR (4.8/49) → OK (5, 7/59) → DP (7.14/74) → MT (9.8/103) → RN (20/222). In factory conditions, the efficiency of smelting slags of eutectic composition and diopside for ladle processing of cast iron was tested. The expediency of using such blast furnace slags for ladle processing of cast iron has been established, which at a consumption of 5-10 kg/t provide a desulfurization depth of 200-400 ppm. The consumption of slag is significantly reduced with the additional deoxidation of smelting slags with carbon during the release of melt in the ditch of the foundry and in the pig iron ladle.
Effect of adding lactic acid bacteria to maize silage on nutritive quality, fermentation properties and in vitro digestibility
Authors: AYDIN Sadık Serkan , DENEK Nihat
Published: June 2023

This study aimed to determine the effects of adding lactic acid bacteria to maize silage on the nutritionalf quality, its fermentation properties and its in vitro organic matter digestion (IVOMD). In the study, pre-fermented juices (PFJ) prepared from different water-soluble carbohydrate (WSC) sources at the rate of 5% and commercial homofermentative and heterofermentative lactic acid bacteria (LAB) were added to silages. Groups were designed as (I) control, (II) Glucose-PFJ, (III) Fructose-PFJ, (IV) Sucrose-PFJ, (V) Molasses-PFJ, (VI) Homofermentative LAB (HoLAB) and (VII) Heterofermentative LAB (HetLAB). When the lactic acid bacteria (LAB) count, lactic acid (LA), acetic acid (AA), LA/AA ratio, pH and yeast values of the natural fermented lactic acid bacteria liquids prepared by adding 5% different easily soluble carbohydrate sources to meadow grass fermentation values of the groups were examined, the differences between them were statistically significant.
The differences between the groups in the CA, ADF, IVOMD and methane (CH4) values of the silage groups prepared by adding PFJ were found to be statistically significant. The differences in the fermentation characteristics of the silages (pH, ammonia-nitrogen (NH3-N), LA, AA, LA/AA, CO2 and total yeast mold after aerobic stability) were statistically significant. When all parameters were examined, it was concluded that the addition of PFJ, which is prepared by adding 5% fructose to the meadow grass plant, to the maize silage has positive effects on IVOMD, ME, CH4, LA and yeast-mold and can be used instead of commercial inoculants.
Effect of TiB2 and BN coatings on stress state of Si3N4‒TiC ceramics surface layer under force loading
Authors: Kuzin V. V. , Fedorov M. Yu.
Published: June 2023

Изучены особенности влияния покрытий TiB2 и BN на деформацию и напряженное состояние поверхностного слоя Si3N4‒TiC-керамики под действием силового нагружения. Установлено, что покрытие BN более благоприятно влияет на напряженно‒деформированное состояние структурных элементов керамики, чем покрытие TiB2. Влияние покрытий TiB2 и BN на напряженное состояние границы между керамикой и покрытием не столь однозначно: в пользу каждого покрытия свидетельствуют по три коэффициента.
Efficacy of Low-Intensity Extra Corporal Shockwave Therapy (LI-ESWT) In Patients With Erectile Dysfunction
Authors: Islam Rayhan , Rahaman Khandakar Shafiur , Elwer Hossain Hawlader Mohammad D
Published: June 2023

Objective: Erectile dysfunction (ED) is a common cause of sexual disorders in men with limited treatment options. This study aimed to determine the efficacy of low-intensity extra corporal shockwave therapy (LI-ESWT) in patients suffering from ED.
Materials and methods: A single-group, pre-test, and post-test pre-experimental study were conducted. Thirty-one ED patients were prospectively selected according to the eligibility criteria. In each session, 3000 shocks were applied at 5 points over the penis. Eight sessions were delivered in total with a 2–3-day interval. The patient’s condition was assessed using the International Index of Electric Function (IIEF-5) questionnaire at baseline and one month after the last treatment session. Paired t-test was used to determine the difference between the pre-test and post-test.
Results: Mean age of the patients was 44.6 (± 14.70) ranging from 25 to 78 years. The majority of them were married (83.9%) and service providers (51.6%). We have also found 51.6% overweight, 9.7% obese, 48.4% diabetic, 45.2% hypertensive, 12.9% with enlarged prostate, 45.2% smoker, 25.8% alcoholic, and 71% with sleep disturbances. During the pre-test, 9.7% had severe ED and 51.6% had moderate ED. After the treatment, no patients were found with severe ED, and few of them had moderate ED (9.7%). The mean difference in IIEF-5 score during the pre-test and post-test was statistically significant (p= < 0.001).
Conclusion: The study showed efficacy of LI-ESWT in a subset of patients with ED. Future studies with larger sample size, placebo group, and longer follow-up periods are recommended.
Missing Cells - A Rare Case of Persisting Thrombocytopenia in Pregnancy With Dengue and Role of Romiplostim in These Cases
Authors: Sinha Ruchita , Datta Mamta Rath , Singh Vinita
Published: June 2023

Objective: Dengue cases in pregnancy have high morbidity and mortality. More so if it leads to immune thrombocytopenic purpura which causes a drastic decrease in platelet, increasing chances of bleeding and mortality and pregnancy itself being a state of hemodynamic instability.
Case report: Here, we present a case of dengue causing secondary immune thrombocytopenia. Managing these cases is challenging and need a multidisciplinary approach and should be done at a higher center. In previous reports, thrombocytopenia in such cases responded to steroids or IVIG. But in our case patient did not respond to either of them but to Romiplostim. There are only a few studies on the use of Romiplostim in dengue and dengue induced ITP and more study is required.
Conclusion: Dengue induced persistent thrombocytopenia is rare but should always be kept in mind in managing these cases.
Telehealth Systems for Midwifery Care Management during the COVID-19 Pandemic: A Systematic Review
Authors: Shamsabadi Ahmadreza , Qaderi Kowsar , Mirzapour Pegah , Mojdeganlou Hengameh , Mojdeganlou Paniz , Pashaei Zahra , Bahador Fateme , Zhianifard Akram , Abedi Ali , Mehraeen Esmaeil
Published: June 2023

Background: Intrinsic features of COVID-19 disease, including the severity of the virus transmission and mortality rates, make it difficult to provide obstetric care to pregnant women. In this regard, telemedicine can provide comprehensive midwifery care relying on new technologies, such as virtual clinic, telehealth, tele-monitoring, m-Health, wearable sensors, and the internet of medical things. The objective of this study is to identify the application and requirements of a telehealth system for midwifery care.
Methods: We conducted a literature search from 2019/12/1 to 2022/10/1 using the following electronic scientific databases: Web of Science, Scopus, PubMed, Science Direct, and Google Scholar. We carried out hand searches from the reference lists of retrieved studies of journals.
Results: We showed that, during COVID-19 pandemic, prenatal care via telehealth increased and telehealth is a good strategy for prenatal and post-partum disease managements. Mental health services are also feasible via telehealth. These new technologies also reduce the risks associated with interpersonal contacts in COVID-19 pandemic.
Conclusion: With the COVID-19 pandemic, telehealth became the norm. The future of medical services will be built around this technology and that is a great opportunity to move toward a great evolution.
Does Progesterone Prevent Preterm Labor in Complicated Monochorionic Twin Pregnancies after Radiofrequency Ablation of One Fetus?
Authors: Rahimi-Sharbaf Fatemeh , Jabbari Forooghozaman , Ghaemi Marjan , Saedi Nafiseh , Shirazi Mahbobeh , Golshahi Fatemeh , Sahebdel Behrokh , Heidary Zohreh
Published: June 2023

Background: Twin pregnancies have a higher risk of preterm labor than singletons. Otherwise, progesterone using to reduce the risk of preterm labor in twin pregnancies remains controversial. Therefore, this study evaluated the effect of intramuscular progesterone to prevent preterm labor in complicated monochorionic diamniotic twin pregnancies after Radiofrequency Ablation (RFA) of one fetus.
Methods: Pregnant women with monochorionic diamniotic twin pregnancies of 16 to 26 weeks of gestational age in an academic center were randomly assigned to receive intramuscular 17-hydroxy progesterone caproate weekly until 36 weeks of gestational age after RFA of one fetus and a control group who did not receive intervention after RFA. Demographic and obstetrical characteristics, as well as maternal, fetal and neonatal outcomes were compared between groups.
Results: In total, 79 participants were recruited in the study. The mean±SD of gestational age at delivery in case and control groups were 34.6±3.8 and 34.6±5.1 with no significant difference (p=0.967). Neonatal outcomes including birth weight (p=0.870), intensive care unit admission (p=0.415), premature preterm rupture of membrane (p=0.115) and pregnancy outcome (live birth, fetal demise or neonatal death) (p=0.524) were not different either. Indeed, gestational age at delivery was inversely related to cervical length at the time of procedure and maternal body mass index, but these differences were not statistically significant. Also, there was no significant difference in terms of gestational diabetes, which was a worrying complication of 17-hydroxy progesterone caproate.
Conclusion: Although 17-hydroxy progesterone caproate seems to be safe with no apparent maternal and neonatal side effects, it does not prolong pregnancy after RFA. Further studies with longer follow up and larger sample size are suggested.
Evaluation of Elevated Liver Enzymes and their Association with Increased Risk of Perioperative Mortality in Heart Transplant Patients
Authors: Sadrinezhad Amin , Jahangirifard Alireza , Pirsalehi Ali , Abdi Saeed , Mansouri Gilani Seyedeh Nazanin , Emami Habib
Published: June 2023

Background: Cardiovascular disease, which itself can lead to liver disorders, is known as the most common cause of death in many countries, including Iran. Elevated liver enzymes can increase mortality risk after transplantation in most heart surgeries. This study aimed to investigate the effect of elevated liver enzymes before and after transplantation on the risk of perioperative mortality in heart transplant patients.
Methods: The information of this historical cohort study was prepared using patients’ hospital records from 2014 to 2019. The data belonged to demographic information, medical history, and laboratory data of 203 patients admitted to Dr. Masih Daneshvari Hospital. More than three times normal institutional ranges defined elevated liver enzymes. Also, the number of deaths within 30 days after transplantation was considered to determine perioperative mortality. The Chi-square test and regression method were used to analyze the data using SPSS software.
Results: Mortality of patients with elevated liver enzymes before and on the first, second, and third days after heart transplantation was 4.08, 3.95, 3.75, and 4.89 times higher than those with normal liver enzymes, respectively. Increasing the Model for End-Stage Liver Disease (MELD) score was associated with a significantly increased risk of death (p<0.001).
Conclusion: Elevated liver enzymes before or three days after heart transplantation are significantly associated with perioperative transplant death. Optimization of liver function before transplantation can play an important role in preventing mortality.
Study of the Effect of High Dose Vitamin D on the Improvement of Bacterial Vaginosis in Vitamin D Deficient Women
Authors: Nikvarz Naemeh , Ghasemnejad Berenji Morteza , Mousavy Sima , Vazifekhah Nima
Published: June 2023

Background: The current evaluation was planned to study the effect of vitamin D on improving bacterial vaginosis in premenopausal women with vitamin D deficiency.
Methods: This study was an open-label clinical trial. Forty premenopausal vitamin D deficient women with bacterial vaginosis enrolled in this study. Patients received metronidazole tablet 500 mg twice daily for seven days in both groups. In the vitamin D group, patients also received 50000 IU per day for five days.
Results: Fourteen days after completion of the study, the number of patients complaining of malodor vaginal discharge, vaginal itching, and discharge discoloration was significantly lower than that in the control group. Regarding the laboratory results, in the vitamin D group, the numbers of Gardnerella vaginalis, gram-negative bacilli, and clue cells in the smear of vaginal secretions were significantly less than in the control group (p<0.05). Furthermore, none of the patients had a positive whiff test after treatment in the vitamin D group (p<0.05). Fourteen days after the completion of the study, the plasma level of 25-OH vitamin D in the vitamin D group was significantly higher than that in the control group. However, the short course of high-dose vitamin D therapy did not increase the plasma concentration of 25-OH vitamin D to the average level.
Conclusion: Vitamin D supplementation can improve the therapeutic response to metronidazole in vitamin D deficient women with BV. However, large-scale double-blind, randomized clinical trials must confirm this finding.
Antibacterial and Anti-biofilm Effects of Chitosan Nanoparticles on Streptococcus Mutans Isolates
Authors: Valian Azam , Goudarzi Hossein , Nasiri Mohammad Javad , Roshanaei Amin , Sadeghi Mahounak Farzaneh
Published: June 2023

Background: Dental caries is an infectious disease caused by bacterial colonization and biofilm formation. Streptococcus mutans (S. mutans) is mainly responsible for dental caries development. Considering the side effects of synthetic antibacterial agents, attempts are ongoing to find antimicrobial agents with minimal or no side effects for preventing dental caries. Based on the reported antibacterial activity of chitosan, this in vitro study aimed to assess the antibacterial and anti-biofilm effects of chitosan nanoparticles on S. mutans clinical isolates.
Methods: S. mutans isolates were isolated from supragingival plaque and carious lesions of patients by standard biochemical tests and Polymerase Chain Reaction (PCR) of the gtfB gene. The antibacterial activity and Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) of chitosan nanoparticles against S. mutans was evaluated by the agar well-plate and broth micro-dilution test, respectively. Also, the effect of chitosan nanoparticles on biofilm formation was evaluated using micro-titer plate method. Data were analyzed using ANOVA.Methods: S. mutans isolates were isolated from supragingival plaque and carious lesions of patients by standard biochemical tests and Polymerase Chain Reaction (PCR) of the gtfB gene. The antibacterial activity and Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) of chitosan nanoparticles against S. mutans was evaluated by the agar well-plate and broth micro-dilution test, respectively. Also, the effect of chitosan nanoparticles on biofilm formation was evaluated using micro-titer plate method. Data were analyzed using ANOVA.
Results: Fifteen S. mutans isolates were collected from patients. The chitosan nanoparticles synthesized had a diameter of 20–30 nm. The chitosan nanoparticles showed antibacterial activity against S. mutans isolates. MICs and MBCs ranged from 0.625-2.5 µg/ml and 1.25-5 µg/ml, respectively. All isolates evaluated in this study were biofilm-forming and 5 of these produced a strong biofilm. The chitosan nanoparticles inhibited biofilm formation at 0.75 µg/ml concentration.
Conclusion: Chitosan nanoparticles had antibacterial and antibiofilm activity on S. mutans clinical isolates. This study suggests the potential of chitosan nanoparticles as antimicrobial agents against cariogenic Streptococci.
The Clinical, Laboratory and Imaging Tests in Diagnosing Acute Appendicitis in Children: A Retrospective Study in a Tertiary University Hospital in Tehran, Iran
Authors: Ghadimi Mahani Fariba , Alimadadi Hossein , Memarian Sara , Gharib Behdad
Published: June 2023

Background: Acute Appendicitis (AA) is a common cause of emergency room visits among children. Non-specific symptoms of appendicitis may pose a major challenge. Due to the lack of access to imaging modalities in all facilities and its high cost, the evaluation of clinical symptoms and examination results is important in diagnosing acute appendicitis. 
Methods: This study is a retrospective cross-sectional study. Patients admitted to our emergency department and were suspected of having acute appendicitis by pediatric residents, and underwent an appendectomy during 2013-2018 were included. A checklist of the patients’ clinical signs and symptoms, and laboratory results and imaging findings completed from the records of these patients.
Results: We reviewed the files of 300 patients with a clinical diagnosis of acute appendicitis and having an appendectomy. Leukocytosis was found in 248 (82.7%), neutrophilia in 240 (80%) and CRP level equal or above 12 mg/L was observed in 107 (35.7%) patients. Ultrasound was performed in 283 patients (94.33%); of which 228 (80.56%) were reported as acute appendicitis. Abdominal CT scan was performed in 19 patients (6.33%); of which acute appendicitis was reported in 17 patients (89.47%).
Conclusion: The results of this research showed that RLQ tenderness, and nausea/vomiting are the most common signs and symptoms, and leukocytosis is the most common laboratory finding in children with acute appendicitis. It can be suggested that relying just on the clinical presentation of AA (RLQ tenderness, fever, nausea/vomiting, anorexia and leukocytosis), can lead to the correct diagnosis of 78% of the suspected patients.
Attendance and Distribution Patterns of Patients in a Private Dental Clinic During the COVID-19 Pandemic
Authors: Panahandeh Narges , Parhizkar Ardavan , Ghasemianpour Bavandi Majid , Asgary Saeed
Published: June 2023

Background: To investigate the effects of the COVID-19 pandemic on the patients’ attendance/distribution patterns within different departments and the perception of the dental team providing dental services during the COVID-19 outbreak in a private dental clinic. Moreover, the impact of SARS-CoV-2 on dental professionals next to the role of personal protective equipment in the prevention of infection in the corresponding teams was simultaneously investigated.
Methods: A clinic located in the northern part of Tehran was selected. Forty-four dentists with 48 staff members were involved in treatment teams. Preventive strategies, i.e., personnel/operator/patient management comprising full Personal Protective Equipment (PPE), high–volume evacuation suctions, primary screening questions, pulse oximetry, the patient’s body temperature measurement as well as administrative controls, e.g. disinfection of surfaces and using stairs instead of lifts, were implemented to manage the prevalence of disease and analyze the impact of COVID-19 on the distribution/attendance patterns of patients.
Results: During 6 months, a 26% reduction in the number of patients was observed after the pandemic; however, men’s and women’s distributions were not affected. The department of orthodontics reported a 6% increase in new cases whereas the department of pediatric dentistry revealed the least changes in the number of patients. In the departments of operative dentistry, prosthodontics, oral/maxillofacial surgery, and periodontics, the number of patients was reduced by 10- 30%. In addition, three dentists and four staff members were affected by COVID-19 during the mentioned period.
Conclusion: It seems that the potential for COVID-19 transmission in dental clinics is relatively low.
Anatomical Variations of the Sphenoid Sinus and its Adjacent Critical Structures Using Cone Beam Computed Tomography: A Cross-Sectional Study
Authors: Valizadeh Solmaz , Rezaiefard Mohammadhosein , Mohammadpour Masoud , Jamalzadeh Navid
Published: June 2023

Background: The aim of the study was to determine the anatomical variations of the sphenoid sinus and its adjacent critical structures using Cone-Beam Computed Tomography (CBCT).
Methods: This cross-sectional study was conducted on CBCT scans of 67 females and 84 males between 18 to 67 years. Presence/ absence of intersphenoid septa, sphenoid sinus pneumatization and its type (conchal, presellar, sellar, and postsellar a and b), protrusion of the optic canal and carotid canal into the sphenoid sinus, optic canal and carotid canal dehiscence, and Anterior Clinoid Process (ACP) pneumatization was evaluated on CBCT scans, and their prevalence and correlation were calculated. Data were analyzed by the Chi-square test (alpha=0.05).
Results:The prevalence of intersphenoid septa was 98.68%. Postsellar type a was the most common type of sphenoid sinus pneumatization with a prevalence of 41.3%. The prevalence of conchal, presellar, sellar and postsellar b types was 0, 11, 30, and 17.7%, respectively. The prevalence of optic canal and carotid canal protrusion into the sphenoid sinus was 50 and 52.7%, respectively. The prevalence of optic canal and carotid canal dehiscence was 48.3 and 40.3%, respectively. The prevalence of ACP pneumatization was 45%. Optic canal and carotid canal protrusion had a significant correlation with ACP pneumatization (p<0.001). Also, carotid canal and optic canal protrusion and dehiscence were significantly correlated with degree of sphenoid sinus pneumatization (p<0.001).
Conclusion: Sphenoid sinus pneumatization significantly increases the likelihood of carotid canal, optic canal protrusion into the sphenoid sinus and their dehiscence, therefore, a preoperative 3D imaging is strongly recommended prior to trans-sphenoidal surgical procedures.
Comparison of Virtual and Actual Education Models on the Learning of Internal Interns during COVID-19 Pandemic
Authors: Mottaghi Azadeh , Alibeik Nazanin , Abolmaali Meysam , Savaj Shokoufeh , Shakiba Behnam , Alimoradzadeh Raheleh , Basharkhah Soheil , Bozorgmehr Ramin , Soltani Arabshahi Kamran , Rahimian Neda
Published: June 2023

Background: Following the outbreak of coronavirus and its impact on the educational process of medical students, attention was paid to e-learning due to the importance of education and research. The aim of the present study is an evaluation of virtual and actual education models on the learning of internal interns during the COVID-19 pandemic.
 Methods: The present study is a trial that was performed on 112 internal interns of hospitals from January to December 2020. Each participant was randomly assigned to one of the actual or virtual educational model groups with personal consent. Educational method was case-based discussion in both groups. The learning outcomes of the interns of these two groups were compared in 9 areas with 95% confidence level and 5% random error. Data about age, sex, type of residence (home or dormitory), pre-internship score (≤150 or >150) and entrance exam rank (≤300 or >300) were collected. Data were analyzed using SPSS Version 20.
Results: The mean ±SD age of the participants was 24.9±2.3 years, 46% of participants were men and 54% of them lived in dormitories. The results of the study show that the difference in pre-test and post-test scores with actual and virtual education models in the male and female is significantly different (p-value=0.020). Virtual education for men and actual education for women have resulted in higher difference scores in pre-test and post-test. Actual and virtual education models were not different in academic achievements of the participants. Thus, the scores obtained in 9 areas did not make a significant difference between the two types of educational models.
Conclusion: The comparison of virtual and actual education demonstrated that there is no significant difference between these two methods in student output. Given the conditions that have been created by COVID-19 in the world, it seems that the use of virtual education can be a good alternative to educating medical students so that education does not stop.
Predictors of Miscarriage in the West of Iran: A Case-Control Study
Authors: Mosayebi-Molasaraie Masoumeh , Doosti-Irani Amin , Pilevari Shamim , Cheraghi Zahra
Published: June 2023

Background: Since the risk factors for miscarriage vary in different societies, the present study was conducted to investigate the effect of the related factors on miscarriage in the west of Iran (Zanjan city). We aimed to determine the modifiable and non-modifiable predictors of miscarriage.

Methods: In this case-control study, 219 cases and 420 controls were selected among those living in the Zanjan (a city located in western Iran) in 2019. Data were collected by a 25-item checklist of medical records available in the comprehensive urban health service center. For assessing the effects of explanatory variables on miscarriage, the multiple logistic regression model was used at a 95% confidence interval. All analysis was conducted by Stata 14 software.
Results: Short birth interval (less than 36 months) (OR=2.4, p<0.001) and ectopic pregnancy (OR=3.5, p<0.011) increase the odds of miscarriage. In other words, high education reduced the odds of miscarriage (OR:0.07,p<0.001).
Conclusion: In the present study, increasing age, low education level, history of previous coagulation, previous spontaneous abortion, history of previous ectopic pregnancy and short birth intervals (less than 36 month) were associated directly with miscarriage.
Psychiatric Aspects of Chemical Warfare
Authors: Shamabadi Ahmad , Akhondzadeh Shahin
Published: June 2023

The Article Abstract is not available.
Organizational Professionalism and Self-Assessment: Realization of a Necessity
Authors: Mashayekhi Jannat , Biroudian Saeed , Saeedi Tehrani Saeedeh
Published: June 2023

Background: The recent rapid developments in medical science and technologies have brought about powerful medical tools; however, the professional commitment has failed to keep pace. Professionals’ reluctance or failure to practice professional behavior has significantly challenged society’s trust in professionalism. Consistent assessment of the profession, at least through measuring the capabilities and encouraging the elimination of shortcomings, can serve as an effective tool to preserve or restore this trust. Numerous assessment methods are recommended to measure the level of professionalism among the members of the medical society. Sometimes, professionalism is defined using shared values and sometimes various lists of professional behaviors are suggested. However, no comprehensive definition has been proposed for professionalism. Professionalism is normally individual. This study sought to provide a comprehensive definition of professionalism and accordingly explains organizational professionalism. In addition, it tried to define profession assessment through a non-systematic review of online resources using Web of Science, Science Direct, and PubMed databases. Professionalism is a belief system or a driving force to create these lists to improve healthcare, according to which professionalism requires collective action. The philosophy underlying the common standards of physicians regarding the patient-physician relationship confirms the importance of teamwork and organizational professionalism. Following professional autonomy, assessment of the members of a profession is carried out via self-assessment. Meanwhile, the continuation of the self-assessment system entails patients’ trust in their physician and society’s trust in the profession of medicine. Furthermore, the medical profession should operate with more transparency, thus the society can feel that the self-assessment is  really effective. Thus, constant and dynamic self-assessment is started with the physicians and expanded through the clinical team. The profession should administer systematic professionalism in all dimensions of the health system. In addition, it should guard its self-assessment privileges obtained from society and seek the assistance of ordinary individuals in society, patients, and experts in fulfilling this task.