bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between Self-Care Behavior and Diabetes Self-Management Education in Patients with Diabetes Mellitus Type 2
Authors: Uly Nilawati , Fadli Fadli , Iskandar Ratnasari
Published: November 2022

Diabetes mellitus type 2 is a disease caused by disruption of insulin secretion and insulin resistance. One aspect that plays an important role in the management of this disease is diabetes self-management education. Good self-care behavior will make diabetes management controlled and prevent complications and make the quality of life better. The purpose of this study is to determine the effect of self-care behavior and the magnitude of the influence of knowledge, patient motivation, family support, and self-efficacy on diabetes self-management education for type 2 diabetes mellitus patients. The method used in this study was a quantitative approach using cross-sectional methods. The sample used was 115 patients with type 2 diabetes mellitus in Palopo Regency. The analytical method used is the Structural Equation Model (SEM) using Amos 2.0 and SPSS 20 (IBM Corp). The findings of the study showed that self-care behavior in patients with diabetes mellitus of type 2 was influenced by knowledge factors by 89%, motivation factors by 82.8%, family support by 84.9%, and self-efficacy factors by 78.4%. Meanwhile, diabetes management of type 2 diabetes mellitus patients was influenced by treatment factors by 75.5%, blood sugar control factors by 88.1%, dietary factors by 60.9%, physical activity factors by 87.3%, and foot care factors 53. , 8%. The structural model of this study explains the variable care cell behavior with self-care management of 47.5%. Therefore, the management of diabetes mellitus must be more active in providing education to sufferers so that their knowledge or family members can increase and understand how to carry out diabetic management properly.
Molecular phylogeny and revision of species groups of Nearctic bombardier beetles (Carabidae, Brachininae, Brachinus ( Neobrachinus))
Authors: Ikagawa Raine M. , Moore Wendy
Published: November 2022

Bombardier beetles of the genusBrachinusWeber are notorious for their explosive defensive chemistry. Despite ongoing research on their defense mechanism, life history, and ecology, the group lacks a robust molecular-based phylogeny. In this study, three loci from mitochondrial and nuclear genomes (COI, CAD, 28S) are used to reconstruct the phylogeny of the large subgenus Neobrachinus, and test species group boundaries hypothesized by Erwin (1970) based on morphological characters. Erwin’sfumansspecies group is found to be polyphyletic, and is herein re-defined with eight new species groups erected to reflect clades based on molecular evidence: thecinctipennis,cyanipennis,galactoderus,gebhardis,mexicanus,phaeocerus,quadripennis, andtenuicollisspecies groups. Erwin’scordicollisgroup is also expanded to include Brachinus (Neobrachinus) medius and theamericanusgroup.
Nicolae Ceauşescu and the Jiu Valley miners' strike of 1977
Authors: Spiridon Raluca Nicoleta
Published: November 2022

The miners' strike of 1‐3 August 1977, in the Jiu Valley, Romania's largest coalfield, was a rare example of popular revolt against the regime of Nicolae Ceauşescu, although it did not take on an explicitly political character. This article places the strike in its international
and domestic, political, and especially economic, contexts. The miners' unrest was the result of deteriorating living and working conditions, as the regime, increasingly in debt to western banks and hit by the global economic downturn, accelerated industrial investment at the expense of other
sectors. This mass strike, which mobilised around a third of the miners in a proletarian 'bastion', shook the regime, and even brought Ceauşescu to visit the Jiu Valley in person, and it extracted a range of concessions. However, as archives of the Securitate secret police show, masked
methods of repression were used against the miners and their leaders, while concessions were quickly reneged upon. This strike against a 'workers' state' anticipated further breaks in the social pact between the regime and the Romanian people, culminating in the fall of Ceauşescu in
December 1989.
Les centres municipaux de santé : un dispositif au cœur des politiques locales de santé et de leurs tensions
Authors: Martinache Igor
Published: November 2022

Organisations à mi-chemin entre les secteurs hospitaliers et libéraux, les centres municipaux de santé ( cms ) constituent un dispositif ancien mais permettant de répondre à certaines problématiques (ré)émergentes en termes de santé publique. S’appuyant sur une enquête menée dans deux municipalités de l’ancienne « banlieue rouge » parisienne, ce texte s’emploie ainsi à montrer comment ces derniers peuvent permettre une territorialisation des actions en même temps qu’une prise en charge globale des patients, dans le double sens d’un suivi dans la durée et d’une attention aux multiples dimensions des déterminants de santé. Ces lieux privilégiés de la coordination des soins et d’initiation d’expérimentations sont cependant également traversés par les contradictions plus générales des politiques de santé actuelles, qui tentent de faire mieux avec moins. Le renforcement et la coordination des équipes et partenariats externes exigent ainsi un travail important mais souvent invisibilisé et donc peu valorisé, qui se heurte du reste aux cultures professionnelles et routines de travail existantes. Le financement des actions passe quant à lui de manière croissante par la réponse à des appels à projets qui peuvent se faire au détriment de dispositifs structurels pourtant impliqués par la volonté de développer la prévention et l’éducation pour la santé au-delà de la seule approche curative.
The perspectives of stakeholders on the effectiveness of green financing schemes in Malaysia
Authors: Ezuma Raja Elyn Maryam Raja , Matthew Nitanan Koshy
Published: November 2022

Growing concerns of climate crisis mitigation in Malaysia over the decades have created pressure for public listed companies and small and medium enterprises in the country to adopt a different approach in their business operations. Green financing schemes such as the Environmental,Social and Governance (ESG) indicator,the FTSE4Good index by the regulatory body Bursa Malaysia for public listed companies and the Green Technology Financing Scheme stemming from the National Green Technology Policy by the Malaysian Green Technology and Climate Change Centre,address the need to improve operations sustainably through financing. Based on interviews with government agencies and public listed companies,this paper presents the effectiveness of the guidelines and schemes in place from their perspectives. The value drivers,challenges and impact from adhering to the FTSE4Good index were discovered. Findings found that the government is a central player in ensuring the initiatives' effectiveness. Although there have been improvements over the years in the industry since its introduction,barriers are still lingering that may hamper the extent of the initiatives' effectiveness. Suggestions are made as a feedback mechanism for improved green financing towards Malaysia's aspiration on becoming a high-income nation by 2025 and in support of the Sustainable Development Goal 9: Industrial innovation and infrastructure. To realise that aspiration,every player in the industry plays a critical role in greener operations,including the small and medium enterprises.
A distribution-free newsvendor model considering environmental impact and shortages with price-dependent stochastic demand
Authors: Khan Irfanullah , Malik Asif Iqbal , Sarkar Biswajit
Published: November 2022

In today's competitive and volatile market, demand prediction for seasonal items is a challenging task. The variation in demand is so quick that the retailer cannot face the risk of understocking or overstocking. Unsold items need to discarded, which has environmental implications. It is often difficult to calculate the effects of lost sales on a firm's monetary values, and environmental impact is not a concern to most businesses. These issues concerned with the environmental impact and the shortages are considered in this paper. A single-period inventory mathematical model is formulated to maximize expected profit in a stochastic scenario while calculating the optimal price and order quantity. The demand considered in this model is price-dependent, with several emergency backordering options to overcome the shortages. The demand probability distribution is unknown to the newsvendor problem. The only available demand data are the mean and standard deviation. In this model, the distribution-free method is applied. A numerical example is provided to demonstrate the model's applicability. To prove that this model is robust, sensitivity analysis is performed.
Distributivni učinci ukidanja »socijalno motiviranih« sniženih stopa PDV-a radi povećanja izdašnosti i obuhvata ciljanih transfera: mikrosimulacijska analiza za Hrvatsku
Authors: Rubil Ivica
Published: November 2022

Many countries, including Croatia, support households in need not only through social transfers, but also through ‘socially motivated’ reduced VAT rates for goods such as food. These measures are also useful to those who are richer, so the question arises whether it is more desirable to increase social benefits that target low-income housholds. This paper analyses distributive effects of a hypothetical reform of the Croatian system of taxation and transfers which includes: (a) abolition of socially motivated reduced VAT rates; (b) increase of generosity and the number of the users of guaranteed minimum benefit and the users of allowance for vulnerable energy buyers. The reform is designed to be virtually neutral fiscally in the sense that almost all additional VAT is spent on the increase of guaranteed minimum benefit and allowance for vulnerable energy buyers. Results of the analysis conducted by a detailed microsimulational model of taxation and transers that uses the data from EU-SILC and the Survey on household consumption show that the reform reduces poverty and inequality based on income after taxation and transfers, in spite of the increase of the regressivity of VAT and the decrease of the progressivity of the guaranted minimum benefit and allowance for vulnerable energy buyers. Key words: VAT, social benefits, microsimulations, inequalities, poverty, reform
15th ISTR International Conference: Navigating in Turbulent Times: Perspectives and Contributions from the Third Sector
Authors: Baturina Danijel
Published: November 2022

ISTR (International Society for Third Sector Research), petnaesta međunarodna konferencija, naziva Navigating In Turbulent Times: Perspectives and Contributions from the Third Sector održana je 12.-15. srpnja u Montrealu, Kanada1 . Konferencija je bila slavljeničkog karaktera, slaveći 30 godina ISTR zajednice
Kennlinien und auswahl von entstaubern
Authors: Anselm Wilhelm , Anselm Werner
Published: November 2022

No disponible
El tercer congreso internacional de química del cemento
Authors: Calleja J.
Published: November 2022

No disponible
Über die verfahren zur herstellung von gipsschlackenzement und neue entwicklungsmöglichkeiten
Authors: Köberich Fritz
Published: November 2022

No disponible
Reihenversuche mit sulfathüttenzement
Authors: Koenig Hans Werner
Published: November 2022

No disponible
New procesa for cement manufacture
Authors: Witt J.C.
Published: November 2022

No disponible
El hormigón vertical (2ª. Parte) - Dimensiones y características de la cocción en el mismo (continuación)
Authors: Anselm Wilhelm
Published: November 2022

No disponible
Soil moisture determination
Authors: Di Gleria J. , Kazo B.
Published: November 2022

No disponible
Verringerter mahlplattenverschleiss an rohrmühlen durch neuartige mahlplatten
Authors: Bellwinkel A.
Published: November 2022

No disponible
Dosiergeräte zur mühlenbeschickung
Authors: Taubmann H.
Published: November 2022

No disponible
The improvement of concrete strength by electro-osmosis
Authors: Pogany A.
Published: November 2022

No disponible
Effect of quebracho extract on clays
Authors: White Theodore
Published: November 2022

No disponible
Contribution à la mesure de la granulométrie des constituants céramiques
Authors: Kiefer Ch.
Published: November 2022

No disponible
Progress in porous and hollow ceramics for construotion
Authors: Singer F. , Singer S.S.
Published: November 2022

No disponible
Permeability of concrete
Authors: Nigam P.S.
Published: November 2022

No disponible
Neue spezialwasserzähler für betonmischmaschinen
Authors: Kluge F.
Published: November 2022

No disponible
Contribución al estudio de las normas de diferentes países para el cemento Portland. IIb.- Composición mineralógica
Authors: Gaspar Tebar D. , Fraga Sánchez S.
Published: November 2022

No disponible
Contribución al estudio de las normas de diferentes países para el cemento Portland. IIId.- Tiempo de fraguado
Authors: Gaspar Tebar D. , Fraga Sánchez S.
Published: November 2022

No disponible
Contribución al estudio de las normas de diferentes países para el cemento Portland. IIIf.- Arena normal
Authors: Gaspar Tebar D. , Fraga Sánchez S.
Published: November 2022

No disponible
Contribución al estudio de las normas de diferentes países para el cemento Portland. IIIg.- Preparación de probetas. C) Preparación de probetas
Authors: Gaspar Tebar D. , Fraga Sánchez S.
Published: November 2022

No disponible
Contribución al estudio de las normas de diferentes países para el cemento Portland. IIIh.- Resistencia mecánica
Authors: Gaspar Tebar D. , Fraga Sánchez S.
Published: November 2022

No disponible
A guide to setting and burning. 3
Authors: Starkie F.
Published: November 2022

No disponible
Tunnel drying in the brick industry
Authors: Stechemesser R.
Published: November 2022

En un secadero túnel, con aire introducido por presión y con circulación cíclica, se consiguen las mayores ventajas prácticas. Se reduce el peligro de la condensación de humedad, evitándose, por consiguiente, el reblandecimiento de los ladrillos y la formación de grietas durante el secado.
Designing efficient autoclave plants
Authors: Selden John K.
Published: November 2022

Las experiencias realizadas en Anchor Concrete Products, Inc., Buffalo, N.Y., y otras instalaciones construidas recientemente, ponen de manifiesto las ventajas de los autoclaves cilíndricos de gran diámetro.
Un mortier insecticide
Authors: Siegrist Adrien
Published: November 2022

No disponible
Steifemessung an gipsbrei und gipsmörtel
Authors: Albrecht W.
Published: November 2022

Se describen diferentes aparatos que permiten medir la consistencia de la pasta y del mortero de yeso. Se indican los resultados de algunos ensayos comparativos.
Wisconsin firm makes vibrated pipe
Authors: Peck R.L.
Published: November 2022

Se presentan en este artículo, de forma detallada, las distintas etapas del proceso de fabricación, así como las características, de los tubos producidos por la Madison Concrete Pipe and Products Company, Madison, Wis.
Neuartige, pilzförmige wärmeaustauscher im drehofen
Authors: Masurov D.
Published: November 2022

No disponible
Magnetita iron ore concrete
Authors: Henrie J.O.
Published: November 2022

No disponible
Importancia del momento en que se realiza el curado del hormigón
Authors: Waters T.
Published: November 2022

No disponilble
El horno vertical su estado actual
Authors: Soria Santamaría F.
Published: November 2022

No disponible
Factors influencing the physical properties of refractory concretes
Authors: Fensen W.C. , Livovich A.F.
Published: November 2022

No disponible
Effect of carbon dioxide on fresh concrete
Authors: Kauer J.A. , Freeman R.L.
Published: November 2022

No disponible
The rapid determination of cement content in concrete and mortar
Authors: Chadda L.R.
Published: November 2022

No disponible
Possibilités nouvelles dans le durcissement rapide des ciments, mortiere et bétons
Authors: Duriez M. , Lézy R.
Published: November 2022

No disponible
The Sedimentation Volume of clay
Authors: Pate K. , Noble W. , Clews F.H.
Published: November 2022

No disponible
Der einfluss der verformungsgesohwindigkeit auf die struktur plastisoher keramisoher massen
Authors: Haase Th. , Petermann K.
Published: November 2022

No disponible
Régulation des fours-tunnels par stabilisation du débit de mazout
Authors: Delikichkine S.N.
Published: November 2022

No disponible
Die Wärmerechnung fur Luftstron - Mahltrocknungsanlagen
Authors: Bornschein G.
Published: November 2022

No disponible
L’emploi d’indicateurs radioootifs dans les pates refractaires
Authors: Levitovitch E.V.
Published: November 2022

No disponible
Les Mickeys de Kerléna
Authors: de Kergariou Étienne , Le Minoux Régis
Published: November 2022

Le docteur Victor Lefranc, bâtisseur à Roscoff d’une clinique privée connue sous le nom de clinique Kerléna, y avait fait réaliser en 1933 par l’artiste et décorateur Charles de Kergariou, dit Kerga, un décor pour les chambres de l’étage des enfants. Découverte en 2021, lors de la démolition du bâtiment, cette composition a suscité l’étonnement général. L’artiste avait en effet représenté des ribambelles de Mickey Mouse, le personnage créé par Walt Disney et devenu iconique par la suite. Or la petite souris était apparue pour la première fois sur un écran cinq ans plus tôt, en 1928, aux États-Unis. Cet article tente de comprendre les conditions de réalisation et les raisons du choix des personnages de ce décor peu commun.
COVID-19 Optimization-Based Vibration Controller for a Flexible Manipulator
Authors: İlman Mehmet Mert , Arıkuşu Yılmaz Seryar
Published: November 2022

Flexible manipulator real-time vibration control methods are effective, but finding the right control gain is difficult. The reason for this is that traditional approaches are not permitted by up-to-date and novel architectures. Current population-based meta-heuristic optimization approaches, on the other hand, can provide solutions for such challenges, as they are inspired by many natural phenomena. Therefore, in the study, the Coronavirus herd immunity optimization (CHIO) method, inspired by the herd immunity mechanism, which is a COVID-19 control method, was used for the optimization of a flexible manipulator control gains. Gray-wolf-optimizer (GWO), another up-to-date population-based algorithm, and traditional particle swarm optimizer (PSO) were used to compare the success of the method. The findings reveal that when it comes to optimizing the vibration controller gains of flexible manipulators, CHIO can outperform its contemporary and traditional competitors.
Fabrication and Stabilization of a Low-Cost Rotary-Inverted Pendulum Setup (STRIPS 1.0)
Authors: Bhat Tufail Ahmad , Koul Majid Hameed
Published: November 2022

This paper presents the fabrication and Stabilization of a low-cost in-house developed Rotary Inverted Pendulum Setup (STRIPS 1.0), commonly known as a Furuta Pendulum. The developed setup consists of a base frame on which an arm is mounted to allow rotary motion in the horizontal plane and a pendulum link subsequently mounted on the other end of the arm to allow rotation in the vertical plane. Essentially the setup possesses 2- DOF (Degrees of Freedom); however, since the actuation is provided at the arm axis only, the setup behaves as an under-actuated one. Owing to the inherently unstable nature of these under-actuated systems, full-state feedback and an LQR (Linear Quadratic Regulator) controller are designed and implemented, which maintain the pendulum link in the upright position even if disturbed about its linear region of control. In particular, a set of gains are chosen for a particular performance criterion and implemented using a MATLAB interface with the micro-controller on the developed setup, allowing a restricted arm movement.
Empowering Rural Area Students Through Education
Authors: Sinaga Grace
Published: November 2022

The sweet and curious gaze of the kids in the village touched the author's heart deeply, and it even felt like they have waited for this team's appearance for a long time although they had not known of it yet. To be educated means we have a chance to change and elevate our life better, and to have a choice to pursue our dreams. In order to achieve that, in 2019, the author and two friends built a non-profit organization called Wonogiri Youth Alliance. This is a nonprofit organization that provides education programs to reduce educational inequality, especially in rural areas of Wonogiri. As a multicultural country, Indonesia has many potential conflicts, such as religion, ethnicity, race, and inequality in development (Kurniawan & Miftah, 2021). One of the most crucial life provisions is a good education.
Metaverse
Authors: Sarkar Anuska
Published: November 2022

Metaverse is an emerging concept in the world of technology which is being anticipated to become the next biggest market in have near future. It can be defined as the next generation social media in an improvised and modernised form. Big tech giants viz. Microsoft, Facebook, along with other big companies have already invested millions of dollars in the development metaverse believing that it will make its way to the world market of education, technology, and economy. The world's largest counties such as China, India, USA, UK, Korea, Japan have heavily invested in companies which are working towards developing metaverse. It is to be noted that metaverse comes along with several drawbacks viz data privacy, social harassment and bullying, detachment with the actual world, and too much dependence on technology that will eventually result in extreme digitization.
Pilot Implementation of Innovative Proposal for Service Level Improvement in a Spare Parts Trading Company
Authors: Ramos-Valle Emma , Paulino André , Chavez Pedro , Alvarez José C. , Nallusamy S.
Published: November 2022

In the context in which spare parts trading companies are becoming increasingly competitive, the level of service is essential to be able to compete in the market. This indicator is affected by on-time deliveries, which are a key factor in meeting customer demand, as this determines customer satisfaction and thus has an effect on the company's profitability. For a company to deliver its products on time, the warehouse processes must work efficiently, making the picking process one of the most critical of them. It must also run a proper inventory procurement process in order to have stock on hand to fulfill customer orders. This case study focuses on increasing the level of service in a company that sells spare parts for mining, which was found to have a low service level of 66.1%, in contrast to the recommended level for the sector, which is 85.9%. Therefore, the implementation of the 5S methodology, Systematic layout planning, demand forecasting, and cycle counting are proposed as tools to solve the root causes of the problem. The main results indicated a reduction in picking times of 36.70%, an increase in demand forecast accuracy of 13.45%, and an increase in Inventory Record Accuracy (IRA) of 5.42%.
Selection of a Pavement Structure from Technically Established Alternatives Based on Construction Cost, Energy Consumption, and Carbon Footprint
Authors: Taktak Wissem , Loulizi Amara
Published: November 2022

This paper presents a procedure to select a pavement structure from technically established alternatives. The general proposed process relies on calculating the present worth of total cost resulting from construction, maintenance/rehabilitation, energy consumption and carbon footprint during those activities as well as recycling of the materials at their end life. However, depending on data availability, the general process could be reduced to just the construction phase as is the case in most developing countries where required pavement performance data is scarce. The reduced procedure was validated on four types of pavements for six traffic levels and three subgrade types. Under the conditions considered in this study, it was found that concrete pavements have high construction, embodied energy, and carbon footprint costs (the environmental impact represents about 66% of the total cost) as compared to other pavement types. Full-depth asphalt pavements were found to be the best ecological type, their construction cost is a little higher than the environmental one with a distribution of about 53% and 47%, respectively. Inverted pavements seem to be a good alternative to weak subgrades although the costs associated with environmental effects contribute to about 52% of the total cost.
Spark Plasma Sintering of Dinickel Boride Reinforced Titanium Matrix Composites
Authors: Ayodele Olusoji Oluremi , Olubambi Peter Apata
Published: November 2022

The synthesis of dinickel boride (2.5 wt.% and 7.5 wt.%) reinforced with titanium matrix was achieved using the spark plasma sintering. The characterization of the sintered samples was investigated with an X-ray diffractometer (XRD), Optical microscope (OM), and Scanning electron microscope (SEM). The OM and SEM images of the sintered samples revealed lamellar structures with particle distributions. The relative densities of the sintered samples increased from 94.3% to 97.3%, while the microhardness values increased from 181 HV1 to 275.2 HV1 due to the addition of Ni2B particles. Furthermore, the tensile properties of the sintered composites decreased with increasing Ni2B contents. The addition of Ni2B particles increased the wear resistance of the fabricated samples. The fractography of the sintered composite showed ductile and brittle failures.
Applications of strategically acquired gradient echo imaging to neurodegenerative diseases
Authors: Haacke E. Mark
Published: November 2022

Background: One major thrust in radiology today is image standardization with a focus on rapid, quantitative, multi-contrast data collection and processing.

Methods: Strategically acquired gradient echo (STAGE) imaging1-4 is one such method that uses multiple flip angles and multiple echo times. It can provide 8 qualitative and 7 quantitative images as well as transmit field B1 transmit field and B1 receive field maps in 4-6 minutes or less on a 3T magnetic resonance (MR) scanner. STAGE provides qualitative images in the form of proton density-weighted images, T1 weighted images and T2* weighted images. STAGE provides quantitative data in the form of proton spin density (PSD), T1, T2* and susceptibility maps as well as segmentation of white matter, gray matter and cerebrospinal fluid via simulated double inversion recovery (sDIR) images. STAGE has been tested using the NIST phantom and yields intrasubject errors of only 1-2% and intrasubject variation of 2 to 5%. Contrast-to-noise ratio (CNR) measurements show that the T1WE images are comparable to the conventional T1W MP-RAGE images. Today these quantitative measures are providing new biomarkers for imaging a variety of neurodegenerative diseases (Figure 1).

Results: During the last few years, we have focused on measuring iron content and neuromelanin (NM) in the substantia nigra (SN) for comparing idiopathic Parkinson’s disease (PD) with healthy controls and patients with other movement disorders. We have found that the volume of NM, the iron content of the SN, the volume of the SN and the N1 sign all together can provide an area under the curve of 95% in distinguishing PD from healthy controls.5 We have developed a template of the midbrain to allow for automatic detection and quantification of these properties. We use tSWI to enhance the N1 sign visibility. We have also used STAGE to study multiple sclerosis (MS) lesions. QSM can be used to map changes in white matter susceptibility and potentially correlated with demyelination. We provide a composite image using tSWI combined with fluid-attenuated inversion recovery (FLAIR) to highlight those lesions that are purely inflammatory from inflammatory demyelinating lesions. Recently we have begun to study the use of absolute water content as a measure of lesion atrophy. Higher water content means a higher likelihood of tissue damage. This also explains why the presence of “black holes” seen in T1W images of MS patients tends to correlate with the expanded disability status score.

Conclusions: In summary, STAGE provides a comprehensive clinical imaging protocol that, combined with diffusion-weighted imaging (DWI) and FLAIR, can yield a standardized 10-minute (3T) o 15-minute (1.5T) imaging protocol of the entire brain across all manufacturers.
Ovarian hyperstimulation syndrome following the use of GnRH agonist trigger of final oocyte maturation and freeze–all strategy
Authors: Khalife Dalia , Ghunaim Suleiman , El Taha Lina , Odeh Omar , Habr Natasha , Awwad Johnny
Published: November 2022

Rationale:

The current literature has a surprising controversy regarding the use of low-dose human chorionic gonadotropin (hCG) for luteal support as an explanation for the development of ovarian hyperstimulation syndrome, and this is because of the gap in the listing of the predisposing factors that put women at an increased risk of ovarian hyperstimulation syndrome.

Patient concerns:

A case of 25-year-old woman presented with abdominal pain, distention, dyspnea, and nausea with a 6.5 kg increase in weight from baseline. Ultrasonographic examination showed bilaterally enlarged multicystic ovaries after gonadotropin-releasing hormone (GnRH) agonist triggering and cycle segmentation with no hCG rescue administration.

Diagnosis:

Moderate/severe ovarian hyperstimulation syndrome.

Interventions:

The woman was admitted to the hospital for medical management of moderate/severe ovarian hyperstimulation syndrome, and pain management was advanced to patient-controlled anesthesia with the start of low molecular weight heparin. On day 2, albumin therapy followed by a furosemide chase was started due to an increase in abdominal girth. On day 1, Cabergoline was maintained, and on day 2 the GnRH antagonist Cetrorelix was started.

Outcomes:

The woman’s clinical condition improved, and a clinical pregnancy was eventually achieved during the first cryo-warmed blastocyst cycle.

Lessons:

Ovarian hyperstimulation syndrome can still happen even after the use of GnRH agonist and avoidance of hCG support. Segmentation of in vitro fertilization with complete avoidance of hCG for luteal support remains the best approach.
A Study of Malaria in Bangladesh
Authors: Nath Arvind
Published: November 2022

Background:

Malaria still occurs in Bangladesh which is one of the countries of the South-east Asia region.

Materials and Methods:

The study design included an online search of all data pertaining to Malaria in Bangladesh from the year 2020 onwards.

Results:

During 2020, 90% of Malaria cases in Bangladesh occurred in just 3 districts of the country.

Conclusion:

The number of imported cases of Malaria from Bangladesh to India and vice versa would decrease if anti-Malaria measures are stepped up in the respective countries' border districts.
Priapism as the Initial Presentation in Chronic Myeloid Leukemia Is a Red Flag Sign
Authors: Saha Aritra , Visvesvaran Salitteeswaran , Narzari Sudem , Das Krishnangshu , Pegu Ajit Kumar , Dhanowar Rajesh Kumar
Published: November 2022

Chronic myeloid leukemia (CML) is a myeloproliferative disorder of the hemopoietic stem cells, which may occasionally present with symptoms of leukostasis secondary to hyperleukocytosis, which includes headache, priapism, and dreaded ones such as stroke and myocardial infarction. This is a case of a 23-year-old man who presented with priapism and was subsequently found to have CML. The patient later developed stroke and succumbed to it. This case demonstrates that the importance of treating CML patients presenting with signs of hyperleukocytosis promptly and cautiously to prevent the impending grievous complications.
“Baboon” Syndrome
Authors: Das Dipankar , Dutta Anupam , Dangoria Bidisha , Damani Chetan , Hussain Imdadul
Published: November 2022

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), previously known as Baboon syndrome, is a symmetrical erythematous rash on the gluteal and intertriginous areas observed after exposure to systemic drugs. This was the case of a 35-year-old woman who presented to medicine OPD (outpatient department) of Assam Medical College and Hospital (AMCH), Dibrugarh with a history of a macular rash over the right and left armpit and right upper back, buttocks and inner aspect of the left thigh.
Assessment of Language Proficiency and Enhancement Among 1st Phase MBBS Undergraduates
Authors: Vanamali Dharma Rao , Gara Himavathy Kodandarao , Hatekar Abhay Dadaji , Baa Jeneeta , Pardeshi Surekha , Sonowal Naruttam , Panigrahy Sarita , Mulkutkar Sachin , Sar Mamata
Published: November 2022

Background:

Limited language proficiency (LLP) in English and state language may constrain the impetus of a medical undergraduate for effective communication, social interaction, and academic progression. Hence, the study aimed to explore the extent and perceptions pertaining to language barrier among medical undergraduates and to obtain feedback about language and communication skill sessions of foundation course.

Materials and Methods:

This multi-centric cross-sectional study across five medical colleges in India involved participation of 691 1st phase MBBS undergraduates. The study was conducted in two phases: (a) at the beginning of Foundation course before initiation of language training classes and (b) at the end of training sessions. The questions were either semi-structured or multiple-choice type regarding (a) sociodemographic characteristics, (b) schooling details, and (c) questionnaire regarding proficiency of English and local language and emotional and cognitive responses toward LLP.

Results:

Out of 691, proficiency for English and respective state language was confirmed by 170 (24.6%) and 318 (46.02%), respectively. Ninety (13.02%) students had no acquaintance for respective state languages. Difficulty in understanding concepts when taught in English and communication breakdown were expressed by 121 (18.22%) and 263 (38.95%) students, respectively. Regarding language and communication skill sessions, improvement in English and state language was expressed by 495 (71.63%) and 521 (75.4%), respectively. The sessions rating was highest for usefulness, followed by quality.

Conclusion:

Approximately 75% and 50% of MBBS undergraduates of 1st phase expressed LLP for English and state language, respectively, which represents a liability. Language enhancement benefited students in terms of usefulness and better comprehension of medical terminologies and colloquialism. Circumspection of language barrier among medical undergraduates would bridge the gap of linguistic knowledge and communication goal.
Referencing in Scientific Writing and Research
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: November 2022

In general, research activities are essential, but it is equally important to ensure that the research findings are shared with different researchers across the world. In simple terms, referencing refers to giving credit to the intellectual work of a person/s or the source of information. Referencing is a strategy that tends to provide support to the statements made by the researchers in their own work. It is one of the most effective strategies to reduce the incidence of plagiarism, as it gives an opportunity for the authors to let the readers know about the ideas which are theirs and those which are contributions of other researchers. To conclude, referencing is an important aspect of the research writing and has been linked with multiple benefits to the authors, readers, and other researchers. Thus, it is our responsibility to envisage citation of appropriate references in the research work, so that more people become aware of the similar kind of works and replicate them in their individual settings.
Clinico-etiological Profile of Lower Respiratory Tract Infections in HIV-positive Patients
Authors: Rajkhowa Darpan , Kalita Bipul Chandra , Sai Malisetty Sreenivas
Published: November 2022

Background:

The type of pathogens responsible for opportunistic infections in human immunodeficiency virus (HIV)-infected persons varies from region to region. Till date, very few studies covering respiratory tract infections in HIV-positive patients have been conducted in this part of the country. This study was conducted in order to get better understanding of the clinical picture of lower respiratory tract infections (LRTIs) in HIV-positive patients in this region.

Aim:

The aim was to study the LRTIs in HIV-positive patients.

Settings and Design:

Eighty-one patients were diagnosed as HIV-positive with LRTIs, attending to Department of Medicine at Assam Medical College and Hospital, Dibrugarh, Assam, India.

Materials and Methods:

Personal and family history was collected with emphasis on the duration of HIV-positive status, any chronic illness, sexually transmitted diseases, history of blood transfusions, or any surgical procedures. A detailed general and systemic examination was done.

Statistical Analysis Used:

The data collected were tabulated in MS Excel and analyzed using SPSS 20.0. The categorical variables were summarized as frequency and percentages.

Results:

Mycobacterium tuberculosis was responsible for 18.52% of cases of LRTIs, whereas fungal etiology was found in 7.41% of the cases. The most common bacterial and fungal pathogens isolated were Streptococcus pneumoniae (23.46%) and Candida albicans (7.41%), respectively.

Conclusion:

Low CD4 cell count is an important indicator for the risk of pulmonary tuberculosis and fungal LRTIs, as shown in our study. Periodic CD cell count in HIV-positive patients is important in this regard.
Stress, Cardiovascular Diseases and Exercise – A Narrative Review
Authors: Popovic Dejana , Lavie Carl J.
Published: November 2022

The assuredness that adverse life stressors can lead to major negative impacts on an individual's health has been held since antiquity. Stress is considered a state of homeostasis being challenged, with biological consequences that can cause cardiovascular diseases (CVD). Stressors may be diverse and include a variety of psychological stressors, such as family stress, job strain, effort-award imbalance, long working hours, insecurity, social isolation, and lack of purpose in life. However, stressors may also be physical, immunological, metabolic, or environmental. Type of personality, anxiety, depression, pessimism or hostility, previous experience, genomics, body composition, nutritive and training status modulate stress responses and are important co-stressors. Chronic stress is linked with altered neurohormonal activity, which increases apoptotic pathways in cardiomyocytes. These pathways contribute to impaired myocardial contractility, increased risk of myocardial ischemia, infarction, heart failure, and arrhythmias. While stress is a vital risk factor for CVD, it has not been a major focus of preventive strategies. The purpose of this article is to review the impact of stress on CVD risk with an emphasis on approaches for stress reduction. Strength and endurance exercise, although being stress itself, leads to better adaptiveness to other types of stress, and by far has played an inevitable role in CVD risk reduction. Innovative strategies to combat CVD are strongly needed and exercise may be the best population-level cost-effective approach.
Computed-tomography-guided interventional radiology as a tool for salvaging the uterus in a nulliparous patient
Authors: Olowoyeye OA , Akinajo OR , Babatunde GO , Abudu AA
Published: November 2022

Interventional radiology is a minimally invasive therapeutic approach that may be of benefit for some gynecological conditions. We present the case of a 40-year-old nulliparous woman with postoperative pyometra following open myomectomy who was considered for a hysterectomy, but the gynecologist requested that an attempt be made at percutaneous drainage of the abscess to salvage her uterus. We achieved a successful computed-tomography-guided percutaneous drainage of the abscess.
Influence of various application systems on the amount of extruded irrigant in simulated immature teeth with regard to gravity
Authors: Namsoy E , Serefoglu B , Hulsmann M , Caliskan MK
Published: November 2022

Background:

Gravity impact has been mainly evaluated in mature teeth related to debris extrusion, even though it may affect the amount of apically extruded irrigant. In the literature the influence of gravity on the amount of apically extruded irrigant in immature teeth has been studied by a 45o inclined plate to mimic the position of the maxillary teeth and 90o for the mandibular teeth. However, patients are positioned horizontally in the dental chair while treatment. There is no study in the literature testing the horizontal position to mimic the clinical settings realistically.

Aim:

The aim of this study was to evaluate the influence of various irrigation systems on the amount of extruded irrigant in simulated immature maxillary and mandibular teeth irrigated in vertical and horizontal positions.

Materials and Methods:

Twenty-five maxillary central incisors with an apical opening of 1.3 mm in diameter were included. Irrigation procedures were performed with EndoVac, closed-ended, and open-ended needles using a VATEA peristaltic pump. The amount of apically extruded irrigant was determined using a microbalance. Statistical analysis was performed using the Kruskal–Wallis test.

Results:

The EndoVac system caused almost no irrigant extrusion in all tested positions (P > 0.05); however, closed-ended and open-ended needles extruded more irrigant in a mandibular vertical position compared to maxillary vertical (P < 0.05) and maxillary horizontal positions (P < 0.05). Open-ended needles extruded the highest amount of irrigant.

Conclusions:

The EndoVac macrocannula is a more reliable and safer irrigation system as it prevents irrigant extrusion independent of the position of the tooth.
Comparison of daytime and after-hours surgical treatment of femoral neck fractures
Authors: Karagoz B , Keceli O , Cukurlu M , Agir I
Published: November 2022

Background:

The timing of surgery for femoral neck fractures in young adults remains controversial. Nonetheless, the debate continues about whether orthopedic trauma cases should be operated daytime or after hours.

Aim:

This study compared the clinical and radiological outcomes of surgery on femoral neck fractures during daytime versus after-hours.

Patients and Methods:

A total of 124 patients aged 18–60 years who were operated for femoral neck fractures between 2015 and 2020 were included in the study. The patients were separated into two groups. Seventy-two patients operated between 08:00 and 17:00 hours were defined as the daytime group and 52 patients operated between 17:01 and 07:59 hours were defined as the after-hours group. Demographic data, reduction quality, duration of operation, intraoperative estimated blood loss (EBL), postoperative complications, revision rates, and postoperative Harris hip score results of the two groups were recorded for analysis.

Results:

There was no significant difference between the groups in terms of age, gender, body mass index, smoking, fracture type and follow-up time, reduction quality, postoperative complication rates, revision rates, and Harris hip score results. Waiting times until surgery, operation duration, and intraoperative EBL amounts were, in the daytime group, significantly higher than in the after-hours group.

Conclusion:

In this study comparing femoral neck fractures operated on daytime and after-hours in adults, the waiting time until surgery was found to be higher in the daytime group. Operation duration and EBL were higher in the after-hours group.
Assessing the quality of immunization data from administrative data in Enugu State, South-East Nigeria
Authors: Ogbuabor DC , Ghasi N , Okenwa UJ , Nwangwu Chukwunweike N , Ezenwaka U , Onwujekwe O
Published: November 2022

Background:

Studies evaluating immunization data quality and its determinants in low- and middle-income countries are scarce.

Aim:

Therefore, this study assessed the accuracy of routine immunization data and its associated factors in Enugu State, South-East Nigeria.

Materials and Methods:

This was a descriptive cross-sectional, mixed-method study. A multi-stage sampling technique was used to select 60 out of 180 primary health facilities in six local government areas (LGAs). Routine data on Bacillus Calmette Guerin (BCG), pentavalent vaccine dose3 (Penta3), and Measles2 vaccinations in tallied registers, facility reports, and District Health Information System II (DHIS2) in 2020 were abstracted using a questionnaire. The dependent variables were the accuracy ratios of the facility and DHIS2 reports. We collected data on the independent variables including LGAs, type of location, facility type, tool availability, tool use, frequency of supervision, defaulter tracing, and vaccine tracking. Additionally, semi-structured, in-depth interviews were conducted with 35 purposively selected actors on factors affecting the data quality. The proportions of facilities with normal, under-, or over-reporting were summarized in percentages. The median accuracy ratios and interquartile range (IQR) were also reported. Differences in median accuracy ratios were tested using the independent sample median test. We tested the predictive model using a generalized linear model. Statistical significance was set at P < 0.05. The qualitative data were analyzed using content analysis.

Results:

The accuracy of facility reports ranged from 38% to 68% (normal), 17–30% (under-reporting), and 15–35% (over-reporting) of health facilities. In DHIS2, the accuracy ranged from 5% to 10% (normal), 37–42% (under-reporting), and 53–63% (over-reporting) of health facilities. The median (IQR) accuracy ratios of facility reports were 100.0% (98.3–103.2%), 100.0% (98.5–103.6%), and 100.0% (81.6–110.2%) for BCG, Penta3, and Measles2, respectively. The median (IQR) accuracy ratios of DHIS2 reports were 83.6% (43.3–192.7%), 88.4% (37.8–200.8%), and 46.2% (10.7–202.7%) for BCG, Penta3, and Measles2, correspondingly. No facility characteristic predicted the accuracy of routine immunization reports. Reasons for inaccurate data include untimely recording, wrong counting, delayed reporting, infrequent supervision, lack of data audits, resource constraints, and high workload.

Conclusions:

Routine immunization data are not always accurate in Enugu state. Continuous efforts to improve the data monitoring system, supervision, data audits, funding, and staffing are warranted.