bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for labor epidural conversion failure requiring general anesthesia for cesarean delivery
Authors: Grap Shannon M. , Patel Gaurav R. , Huang Jessica , Vaida Sonia J.
Published: April 2022

Background and Aims:

To evaluate the rate and risk factors of labor epidural conversion failure requiring general anesthesia for Caesarean delivery (CD).

Material and Methods:

Pregnant patients requiring conversion from labor to CD with a pre-existing labor epidural at our institution from 2009 to 2014 were identified. Through a retrospective review, we compared successful epidural conversion with those who required general anesthesia for CD. Patient characteristics were analyzed to identify risk factors for failed epidural conversion for CD.

Results:

A total of 673 patients were included in the study. The rate of epidural conversion failure was 21%. Main risk factors for epidural conversion failure requiring general anesthesia included: younger maternal age (95% CI 0.94, P = 0.0002) and supplementation of intravenous fentanyl (95% CI 0.19, P < 0.0001) or midazolam (95% CI 0.26, P = 0.0008) during CD. A higher risk of conversion failure was also associated with a more urgent CD (CD category 1, 2, and 3 vs category 4).

Conclusion:

Consistent with previous reports, young age and the urgency of CD increases the likelihood of epidural conversion failure. While conversion failure is likely multifactorial and complex, many of these factors are suggestive of inadequate and poorly functioning labor epidurals prior to CD. Prospective studies to further evaluate these factors are necessary, and the best prevention of epidural conversion failure is diligent diagnosis and evaluation of ineffective labor epidural analgesia prior to impending CD.
Role of endotracheal tube size on nasal and laryngeal morbidity during awake fiberoptic nasotracheal intubation: A Randomized controlled trial
Authors: Vinayagam Stalin , Arikrishnan Thirumurugan , Kundra Pankaj , Saxena Sunil Kumar
Published: April 2022

Background and Aims:

Awake fibreoptic nasotracheal intubation is associated with adverse airway and hemodynamic complications. The aim of this study was to evaluate the role of endotracheal tube size on nasal and laryngeal morbidity during awake fibreoptic-guided nasotracheal intubation.

Material and Methods:

Eighty patients recruited to undergo awake fibreoptic intubation were randomly allocated to Group C (standard size endotracheal tube) and Group S (small size endotracheal tube followed by exchange to standard size using Airway Exchange Catheter under general anesthesia). Nasal morbidity was assessed by incidence of epistaxis, olfactory acuity, and mucociliary clearance. Patient discomfort during intubation was assessed using grimace score and hemodynamic parameters were recorded. Postoperatively, the incidence of nasal and laryngeal injury was recorded using nasendoscopy and telelaryngoscopy, respectively.

Results:

Demographic profile between the two groups was comparable. Epistaxis was noted in 47.5% of patients in group C as compared to 12.5% in group S. Postoperative olfactory acuity was decreased [2 (1-4) vs 4 (2-5)] and saccharin clearance time was prolonged (314 s vs 134 s) in Group C as compared to Group S. (P-value <0.001) Higher grimace score [2 (1-3) vs 1 (0-2)] and increased hemodynamic response was demonstrated in Group C. (P-value <0.001) Incidence of nasal injury [2 (1-4) vs 1 (0-2)] and laryngeal injury [1 (0-2) vs 0 (0-2)] was more in Group C as compared to Group S.

Conclusion:

Awake fibreoptic nasotracheal intubation with small size endotracheal tube followed by exchange to standard size under general anesthesia reduces nasal, laryngeal, and hemodynamic complications.
Anaesthesia for tracheal resection and anastomosis
Authors: Marwaha Ashwin , Kumar Akhil , Sharma Shikha , Sood Jayashree
Published: April 2022

Tracheal resection anastomosis is one of the most challenging surgeries. Notable advances in this field have made possible a variety of surgical, anesthetic, and airway management options. There are reports of newer approaches ranging from use of supraglottic airway devices, regional anesthesia, and extracorporeal support. Endotracheal intubation with cross-field ventilation and jet ventilation are the standard techniques for airway management followed. These call for multidisciplinary preoperative planning and close communication during surgery and recovery. This review highlights the anesthetic challenges faced during tracheal resection and anastomosis with specific considerations to preoperative workup, classification of tracheal stenosis, airway management, ventilation strategies, and extubation. The newer advances proposed have been reviewed.
Comparison of intrathecal bupivacaine-fentanyl and bupivacaine-butorphanol combinations for joint replacement surgeries
Authors: Sharma Aakriti , Kumari Anita , Gupta Ruchi , Kaur Shubhdeep , Arora Deepika , Kaur Keerat
Published: April 2022

Background and Aims:

The objective of the study was to compare duration of analgesia of fentanyl versus butorphanol as adjuvants to bupivacaine in spinal anesthesia.

Material and Methods:

A prospective, randomized, double-blinded study conducted in 80 patients of 18–75 years age group and American Society of Anesthesiologists Grades I and II undergoing joint replacement surgeries. A total of 40 patients in each Group A and Group B received 0.5% bupivacaine 3 ml with 25 mcg fentanyl and 25 mcg butorphanol respectively, in a total volume of 3.5 ml made with saline. Duration of analgesia, number of rescue analgesia, sensory, and motor block characteristics were compared between the two groups. Statistical analysis was done using t test and Chi-square test with SPSS 19.0 software.

Results:

Mean duration of analgesia was found more in Group B in comparison to Group A (P < 0.05). A number of doses of analgesic required postoperatively were more in Group A compared to Group B (P < 0.001). Time required for onset of sensory and motor block was comparable in both the groups. However, two segment regression of sensory block was slower in Group B compared to Group A (P < 0.05).

Conclusion:

We conclude that addition of butorphanol 25 μg as an adjuvant to 0.5% hyperbaric bupivacaine provided prolonged duration of analgesia compared to 25 mg fentanyl.
Online Faculty Development
Authors: Filipe Helena P. , Golnik Karl C. , Geary Amelia , Buque Amelia , Mack Heather G.
Published: April 2022

PURPOSE:

Faculty development for procedural specialists aims at developing both their medical education and surgical competence. This has been challenging during the COVID-19 pandemic, especially in under-resourced settings and African Lusophone ophthalmology community has been no exception. The Mozambican College of Ophthalmology (MOC) and the Continuing Professional Development Committee of the International Council of Ophthalmology (ICO) established a collaboration to enhance simulation-based clinical teaching competence in cataract surgery.

METHODS:

Ten Mozambican ophthalmologists experienced in teaching cataract surgery participated in a group mentoring assisted 6 month/11 flipped-learning online experience on curriculum design, which included practice-based and social learning strategies, continuous bidirectional feedback, individual and group reflection opportunities, and the demonstration of declarative and procedural competencies. Program evaluation consisted of pre and post-test knowledge assessment; individual homework, informed by curated reading and a recorded lesson; feedback surveys for each module and one month after the program's conclusion, and a longitudinal project on creating a simulation-based education session on one step of cataract surgery.

RESULTS:

Participants a) highlighted the opportunity to advance their scholarly teaching skills as facilitators; b) showed an increase in knowledge post-test, expressed commitment to improve their learning experiences´ design, include interactive educational methods, and provide constructive feedback; and c) formed a sustained community of practice of ophthalmologists educators (CoP).

CONCLUSION:

This online faculty development program, assisted by group mentoring, held during the COVID-19 pandemic, facilitated the development of a CoP and was effective in enhancing teaching competence in curriculum design to apply in simulation-based learning environments.
The Impact of COVID-19 Pandemic on Ophthalmic Referrals within a Tertiary Academic Center in Oman
Authors: Al Busaidi Aisha , Mal Washoo , Rafei Mohammed A. , Al-Yaqoobi Amina , Panchatcharam Sathiya , Al-Mujaini Abdullah S.
Published: April 2022

PURPOSE:

To investigate the impact of coronavirus infection disease-19 (COVID-19) pandemic on ophthalmic referrals within an academic tertiary center in Oman.

METHODS:

Retrospective chart review of internal referrals received and evaluated by the ophthalmology department between March 1and August 31, 2020 (COVID-19 period) compared to a corresponding period in 2019 (pre COVID-19). Data included patient demographics, referral details, ocular diagnosis, intervention, and discharge plan.

RESULTS:

Referral volume significantly decreased by 58.2%; from 2019 prepandemic to 510 (P = 0.001), with the lowest in April and May 2020. Patient demographics did not differ significantly, but “urgent” referrals reduced by 96.2% (P < 0.001). Main reasons for referrals were reduced vision and screening in both periods. During pandemic, referrals for screening purposes increased from 30.3% to 37.9% (P = 0.013) and for reduced vision decreased from 30% to 23.3% (P = 0.021). Dry eye syndrome increased in frequency during 2020 (from 2.9% to 7.3%, P = 0.002) but cataracts and conjunctivitis both decreased (from 4.7% to 2.1%, P = 0.046 and from 2.3% to 0.3%, P = 0.013, respectively). Ocular trauma remained stable (from 0.8% to 0.3%, P = 0.456), but the proportion of chemical injuries increased by 13.7% (P = 0.025). There was a drastic decrease in interventions from 37% to 26.1% (P < 0.001) and an increase in discharge rate from 61.2% to 75.8% (P < 0.001).

CONCLUSION:

The impact of COVID-19 pandemic on ophthalmic referrals within a tertiary academic centre in oman referral reductions and changes in pattern and characteristics as an epiphenomenon of COVID-19 reflect the extent of impact specifically in an Omani context. This information is vital for planning proper resource utilization, the adoption of innovative care delivery, and improving referral system pathways.
“Separate the Wheat from the Chaff” – Descemet’s Stripping Endothelial Keratoplasty Graft Failure due to Accidental Implantation of Full-Thickness Precut Tissue
Authors: Srirampur Arjun , Mansoori Tarannum , Balijepalli Pasyanthi
Published: April 2022

We present an interesting case of failed Descemet's stripping endothelial keratoplasty (DSEK) graft, due to accidental implantation of a full-thickness precut tissue. A repeat DSEK was planned, and during the surgery along with the DSEK graft, an extra thick corneal tissue was also retrieved. Careful evaluation of both the explanted tissues revealed that the primary surgeon failed to separate a precut DSEK graft and implanted the entire full-thickness tissue. After the repeat DSEK, there was improvement in corneal edema and visual acuity.
Magnitude and Determinants of Computer Vision Syndrome among College Students at a Saudi University
Authors: AlDarrab Abdulrahman , Khojah Abdulaziz A. , Al-Ghazwi Mohammed H. , Al-Haqbani Yazeed J. , Al-Qahtani Naif M. , Al-Ajmi Mohammed N. , Alenezi Saad H. , Almasoud Mohammmed K. , Al-Yahya Abdulaziz F.
Published: April 2022

PURPOSE:

To review students’ perceived symptom-based computer vision syndrome (CVS) and its determinants and to suggest preventive measures.

METHODS:

This cross-sectional survey was conducted in 2021 at a university in Central Saudi Arabia. The presence and severity of symptoms related to CVS were investigated. The total CVS symptom score was the outcome variable. The CVS score was correlated to participants’ demographics, visual habits when using digital devices, and knowledge about CVS. Due to skewed distribution, a nonparametric method was used for analysis.

RESULTS:

Overall, 521 students were surveyed. The prevalence of CVS based on at least one symptom was 96% (95% confidence interval 94.3–97.7). The median score was 8.0 (interquartile range 4.0–12.0). Of the 24 possible CVS scores, 42 students (8%) had scores of 18 or more (severe CVS). Being female (Mann–Whitney [MW] P < 0.001), being older (Spearman P < 0.001), refractive error (MW P < 0.001), the presence of dry eye (MW P < 0.001), using devices other than a desktop computer (KruskalWallis) P = 0.03), and more than 6 h constantly working with a device (MW P = 0.001) were correlated with a higher CVS score. Older age, female, refractive error, and using digital devices for more than 6 h were the independent and significant predictors of CVS in college students.

CONCLUSION:

Most of the students suffered from mild-to-moderate CVS symptoms. Health promotion for prevention and periodic ophthalmic consultations are recommended. Identified predictors should be the focus when implementing strategies to combat CVS in the adolescent Saudi population.
A Novel Missense Variant C.2571 (P.Ala857=) of the DHX38 Gene in a Saudi Family Causes an Autosomal Recessive Retinitis Pigmentosa
Authors: Al-Johani Saud , Alabdullah Abdulelah , Nowilaty Sawsan R.
Published: April 2022

We present two cases of a novel missense variant mutation in the DHX38 gene, which is associated with autosomal recessive retinitis pigmentosa (RP) in two Saudi sisters who presented with poor visual acuity since childhood. On initial examination, the best-corrected visual acuity was 20/300 in both eyes for the two sisters. Fundus examination revealed widespread retinal pigmentary changes, linear peripheral hyperpigmentation clumps, bone spicules, and bilateral optic nerve drusen with bilateral macular hyperpigmentation. Spectral-domain optical coherence tomography scans reveal losses of the outer retinal layer and the presence of subretinal fibrosis and thinning of the choroid. Molecular sequencing analysis of the DHX38 exome identified a novel missense mutation of the homozygous variant c. 2571 (p. Ala857=), which co-segregates with the autosomal recessive RP gene that encodes the premRNA splicing factor, PRP16. The aim of this report is to describe the clinical feature associated with this variant and to provide additional evidence that DHX38 is involved in RP. To the best of our knowledge, this variant has not been described in the literature.
Pertrochanteric Hip Fracture Fixation with 3 Hole and 4 Hole DHS Side Plates - A Retrospective Patient Record Review
Authors: Akinyemi Tosin Olusoga , Mannan Syed , Ayeni Funbi Anthony
Published: April 2022

Introduction:

Dynamic hip screw fixation (DHS) with a 4-hole side plate and 4 bi-cortical screws is considered by many to be the standard implant for extracapsular hip fractures. The 4-hole side plate, however, has several disadvantages including longer incision, increase in operating time, bleeding and increased wound morbidity. Biomechanical studies have shown that most of the force in a 4-hole DHS fixation is borne by the proximal three screws. This study (specifically) compares the outcome of fixation using 3-hole and 4-hole DHS in extracapsular hip fracture fixations (with the hypothesis being that 3-hole plate is adequate even in unstable intertrochanteric fractures.

Patients and Methods:

A total of 72 consecutive patients who had DHS fixation with either a 3 hole or 4 hole DHS side plate and who were either directly operated or supervised by a single consultant were recruited. Fractures were classified using the AO fracture classification system as stable (AO/OTA 31A1–31A2.1) and unstable (31A2.2–31A3.3 subtypes) for ease of comparison. Failure was defined as metalwork breakage, nonunion, screw cut-out or pull out or any other complications of bone healing requiring a revision.

Results:

A total of 23 patients (68.1%) were female, whereas 49 patients (31.9%) were male. Fractures in 33 patients were classified as stable with the (AO/OTA 31A1–31A2.1) and unstable in 39 patients with (31A2.2–31A3.3 subtypes). Thirty-three (45.8%) patients had fixation with 3-hole side plate, whereas 39 (55.2%) patients had fixation with 4-hole side plate. In the 3 hole group, 17 patients had stable fractures, whereas 16 patients had unstable fracture configuration while in the 4-hole DHS side plate group, 16 patients had stable fracture configuration, whereas 23 patients had unstable fracture. The mean change in hemoglobin was lower for the 3-hole DHS group (3 hole-6.64 g/l versus 4Hole 12.41 g/l) (t = 1.732, P = 0.090, P ≤ 0.05). One patient in each group also had metalwork failure with screw cut-out through the head and the other being (screw breakage) complete failure of the screw necessitating conversion to total hip arthroplasty.

Conclusion:

Three-hole DHS plate offers comparable outcome with its 4-hole counterpart even with unstable intertrochanteric fractures, with slightly less blood loss and smaller scars.
Paediatric Cardiac Anaesthesia Perspective in Komfo Anokye Teaching Hospital Kumasi
Authors: Singh Sanjeev , Okyere Isaac , Singh Arti
Published: April 2022

Background:

Infant mortality due to congenital malformations has an incident rate of 8 cases per 1000 live births. Due to Africa's inadequate health-care systems, congenital cardiac disease (CCD) remains a paediatric health-care issue. CCD patients undergo an open-heart operation (OHO) at the Komfo Anokye Teaching Hospital (KATH) in Kumasi.

Aim:

This study aimed to compare trends of cardiac anaesthesia protocols before and after 2014 and to assess the efficiency and quality of surgical care provided to children with CCD following the implementation of new cardiac anaesthesia protocols in 2014.

Materials and Methods:

Groups A and B were represented by the years before and after 2014. This was a retrospective study involving 118 patients who underwent OHO under general anaesthesia from 2007 to 2016 after obtaining Institutional ethical approval.

Results:

In Groups A and B, the mean length of hospitalization in days and cardiac care unit stay in days were (6.87 ± 3.51 and 4.20 ± 3.66) (P = 0.046) and (3.14 ± 2.37 and 1.96 ± 2.85) (P = 0.382), respectively. In Group B, ultrafast track extubations increased from 7.25% to 39.71% (P = 0.021), while patients mean mechanically ventilation time decreased by 82.34 ± 11.70–23.48 ± 7.94 h (P = 0.018). In the first 48 h, the chest tube's postoperative drainage reduced by 133 ± 28.46–95 ± 20.38 ml (P = 0.018) and haemorrhage leading to re-exploration decreased 11.77%–1.50% (P = 0.019). After 2014, postoperative haemorrhage, the chest tube's drainage, and re-exploration were statistically significantly reduced by tranexamic acid.

Conclusions:

This ten-year program primarily focused on selecting simple cases and simplifying anaesthesia protocols after 2014. Given the success of our OHO program at KATH Kumasi, there is a need for a paradigm shift to sustain OHO programs in other parts of Africa.
Prenatal Alcohol Intake and Knowledge of its Effect
Authors: Mbadugha Chisom Joy , Arinze Joyce Chinenye , Odoh Nneka Chekwube , Obiekwu Adaobi Lilian , Omotola Ngozi Joy , Okafor Chiamaka Jennifer
Published: April 2022

Background:

Alcohol consumption during pregnancy is a major public health concern due to its noxious effect on both the mother and fetus.

Aim:

The study aim was to determine the prevalence of prenatal alcohol intake, knowledge of its effects, and associated factors among pregnant women attending antenatal clinic, Poly General Hospital, Enugu.

Materials and Methods:

A descriptive cross-sectional survey was adopted and simple random sampling was employed to select 248 pregnant women from the total population. Data were obtained using structured questionnaires, summarized using descriptive statistics, and presented in tables. Statistical analysis for associations between level of educational attainment, occupation of the pregnant woman, and knowledge of the effects of alcohol consumption was performed using Chi-square tests.

Results:

The prevalence of alcohol use during pregnancy was 40.3% with beer (48.8%) and palm wine (48.8%) being the major alcoholic beverages taken. Majority (59.7%) of the participants had good knowledge of the effects of alcohol consumption in pregnancy while less than half (33.9%) had good knowledge of the effect on the unborn baby. Previous drinking habits before pregnancy (3.48 ± 0.84) and unwanted pregnancy (3.17 ± 0.93) were the major perceived factor influencing their alcohol intake. Educational level was not significantly related to knowledge of alcohol effects on pregnancy.

Conclusion:

Regardless of the knowledge of the harmful effect of alcohol on the fetus and maternal health, a significant proportion of mothers continue to consume alcohol during pregnancy. Therefore, there is a need for widespread education of women of childbearing age focused on driving behavioural change with regards to alcohol intake in pregnancy.
Huge Pelvic Lipomatosis as an Unusual Cause of Acute Urinary Retention
Authors: Abiahu Joseph Amauzo , Orakwe Dubem Ejikeme , Mbaeri Timothy Uzoma , Onu Onyekachi Amos , Odo Chinonso
Published: April 2022

Pelvic lipomatosis is a benign tumor of adipose tissues rarely seen in young males. Its clinical presentation is variable. Acute urinary retention is unusual pattern of presentation. This reports a case and management of huge pelvic lipomatosis in a 33-year-old African male presenting with lower urinary tract symptoms and acute urinary retention. The relevant literatures were also reviewed.
An Unusual Cause of Pyogenic Liver Abscess. The Conundrum of Broom Splinter. Report of Two Cases
Authors: Balogun Olanrewaju Samuel , Jeje Emmanuel A. , Fatuga Adedeji Lukman , Atoyebi Oluwole Ayoola
Published: April 2022

Pyogenic liver abscess is an uncommon but potentially fatal disease. Very few cases of liver abscess due to foreign bodies have been reported. We report our experience in two patients who were successfully managed for liver abscess due to impaled broom splinter. Broom splinters were swallowed unnoticed during consumption of Jute leaves (Corchorus olitorus) (”Ewedu”) soup. Definitive diagnoses in both cases were made at surgery. This is the first case of broom stick-induced liver abscess to be reported in the literature.
Outcome of Delivery among HIV-Positive Women that Attended the Antenatal Clinic at the University of Benin Teaching Hospital, Benin City, Nigeria
Authors: Shehu Aisha Yibaikwal , Ogboghodo Esohe Olivia , Enaruna Nosakhare , Jamda Mustapha Abubakar
Published: April 2022

Background:

Human immunodeficiency virus (HIV) has been reported to be associated with several adverse pregnancy outcomes. There are limited data on the extent by which HIV-positive pregnant women in this part of the world are affected.

Aim:

The aim of this study was to assess the pregnancy outcome of HIV-positive pregnant women who attended the antenatal clinic.

Materials and Methods:

A retrospective analysis of the case notes of HIV-positive women that enrolled in the prevention of mother-to-child (PMTCT) clinic from January 1, 2020, to December 31, 2020. All data collected were entered and analyzed using the IBM SPSS version 25.0 software.

Results:

A total of 1817 women attended the antenatal clinic and 127 (6.9%) were HIV positive and enrolled in the PMTCT program. Out of the 127 HIV-positive women, only 102 (85.0%) utilized the delivery service. HIV was found to be more common among women within the age group of 30–39 years. Majority 105 (82.6%) of the women were aware of their HIV status before index pregnancy and were on treatment, 62 (60.78%) of the women had a vaginal delivery, whereas 34 (33.3%) had a caesarean delivery. A total of 6 (4.7%) women had a miscarriage. There was no maternal death. Of these pregnancies, 7 (5.5%) were stillbirths, 18 (18.8%) were preterm deliveries, and 10 (11.2%) had a low birthweight.

Conclusion:

Despite antiretroviral therapy, HIV-positive pregnant women had adverse pregnancy outcomes; therefore, they should be managed with a multidisciplinary approach to ensure good maternal and fetal outcomes.
A Systematic Review of Urethral Complications Following Male Circumcision
Authors: Muhammad Musa Yahaya , Agbo Christian Agbo
Published: April 2022

Background:

Male circumcision is one of the most common elective surgical procedures worldwide. Adverse events affecting the urethra may occur following the procedure.

Aim:

The aim of this paper is to provide a review of the existing literature on urethral complications of male circumcision.

Materials and Methods:

A search of PubMed and Google Scholar was conducted between November 20, 2020, and November 30, 2020 and updated on January 12, 2021. Several keywords related to male circumcision were searched on the two databases. A further manual search of the reference lists of relevant papers was carried out. Studies that reported frequencies of urethral complications following circumcision were included in the analysis. A total of 83 candidate papers were identified and studied before arriving at 38 studies that contained sufficient information suitable for the analysis.

Results:

Overall, we found that the reported frequencies of urethral complications of male circumcision varied (range 0.01% to 39%; median 1.7%). Meatal stenosis (MS) and urethrocutaneous fistula (UCF) were by far the most frequently reported urethral complications of male circumcision with cases reported in 30 and 18 studies, respectively. Meatitis and urethral stricture were the other urethral complications found in our search.

Conclusion:

The urethral complications of male circumcision we found were UCF, MS, meatitis/meatal ulcer, and urethral stricture. Neonatal circumcision and circumcision by untrained providers are associated with higher incidences of urethral tragedies following male circumcision. The type of male circumcision provider is also a determinant of the frequency of complications.
An Assessment of Factors Motivating Patients to Seek Orthodontic Treatment in a South-Western Nigerian Teaching Hospital
Authors: Ndukwe Anne Nkechi , daCosta Oluranti Olatokunbo , Sanu Oluwatosin Oluyemi , Isiekwe Michael Chukwudi
Published: April 2022

Background:

Motivation is a concept that describes the conscious or unconscious stimuli for the action toward a desired goal. The motivations for seeking an orthodontic treatment among the population are diverse. Identifying the underlying motivation for treatment is helpful in reducing dissatisfaction with orthodontic treatment outcome.

Aim:

This study aimed to assess motivating factors for seeking orthodontic treatment and to compare these factors between adolescents and adults attending a Nigerian teaching hospital.

Patients, Materials and Methods:

Self-administered questionnaires were distributed among 130 subjects (79 adolescents and 51 adults). The subjects were asked to assign a score to the motivating factors listed based on their relative importance using a 5-point Likert scale which ranged from 1 to 5, with 5 rated as very important and 1 rated as very unimportant. The choice of motivating factors was compared between the adolescents and adults and between sexes in each group. Data obtained were analyzed using IBM Statistical Package for Social Sciences (IBM SPSS) version 21.0. P ≤ 0.05 was considered statistically significant.

Results:

Improvement in dental appearance was the main motivating factor for almost all subjects and there was no statistically significant difference between adolescents (60.8%) and adults (68.6%), P = 0.591. A significantly higher (P < 0.001) number of the adults, (35, 68.6%) chose improvement in facial aesthetics as a motivating factor for orthodontic treatment compared with 29 (44.6%) adolescents. The least motivating factors which were chosen by adolescents were improvement in chewing (9, 13.8%) and relief of temporomandibular joint symptoms (4, 6.2%). There was no statistically significant difference in the choice of motivating factors between female and male in both the adolescent and adult groups.

Conclusion:

Aesthetic concerns were the most important motivating factors in adolescents and adults seeking orthodontic treatment.
Quality of Life of Patients with Diabetes Mellitus Attending a Tertiary Hospital in Uyo, South–South Nigeria
Authors: Morgan Uduakobong Morgan , Etiobong Etukumana
Published: April 2022

Background:

Diabetes mellitus (DM) is one of the noncommunicable diseases that influence the quality of life (QoL) of people living with the disease. It is a known metabolic condition with a feature of excessive blood glucose levels due to defects in insulin production, insulin action, or both. Assessment of QoL is useful in the measurement of outcomes during the management of chronic diseases.

Aim:

This study aims at determining the QoL of patients with DM that presented at the general outpatient clinic (GOPC) of a tertiary hospital in South–South Nigeria.

Patients, Materials and Methods:

A cross-sectional study of 134 patients suffering from DM who attended either the GOPCs or diabetic clinics of the University of Uyo Teaching Hospital was done between January and March 2018. A semi-structured questionnaire was used to obtain information from the respondents on sociodemographic characteristics, duration of DM, and presence or absence of hypertension. The following assessments were done on the respondents: blood pressure, body mass index, and glycated hemoglobin levels. The assessment of the QoL of patients was done using WHOQoL-Bref instrument. Descriptive statistics of the data was done. Mean and standard deviation (SD) were computed from the continuous variables, while frequency and percentages of categorical variables were also determined. Odds ratio was employed to compare differences in proportions or groups. The level of statistical significance was set at P < 0.05. Data analysis was done using Epi Info version 3.5.4.

Results:

The respondents consisted of 82 females and 52 males (M: F = 1:1.6) with a mean age of 54.79 (±SD 10.53) years. The overall QoL was good (91%). Poor monthly income was associated with poor QoL.

Conclusion:

The study finding indicated that poor income adversely affects the QoL of persons with DM. Chronic medical conditions such as DM require long-term care with financial/economic implications. Consequently, support systems (financial support inclusive) need to be strengthened for a better QoL.
Coptocampylodon? rhaeticus n.sp., a New Problematic Microfossil (“incertae sedis”) from the Rhaetian Dachstein Limestone of the Northern Calcareous Alps (Germany, Austria)
Authors:   University Leoben, Institute for Geosciences, Germany, Schlagintweit Felix , Missoni Sigrid ,   University Leoben, Institute for Geosciences, Prospektion and Applied Sedimentology, Gawlick Hans-Juergen ,   University Leoben, Institute for Geosciences, Prospektion and Applied Sedimentology
Published: April 2022

A new problematic microfossil is described as Coptocampylodon? rhaeticus n.sp. from the Rhaetian Dachstein Limestone of the Northern Calcareous Alps. The new species is composed of a long cylindrical and an irregular rounded body, both showing narrow axial cavity. It is similar to Coptocampylodon? elliotti RADOIČIĆ 1969 from the Cenomanian of Montenegro, but lacks the longitudinal grooves in the cylindrical part. In the Alpine Dachstein Limestone it has been detected at several localities where it occurs as an abundant constituent of biosparitic limestones along with the benthic foraminifera Triasina hantkeni MAJZON, Aulotortus sinuosus WEYNSCHENK,Duostominidae and dasycladales Griphoporella curvata (GÜMBEL)and Diplopora adnetensis FLÜGEL.
Mean field equations and domains of first kind
Authors: Bartolucci Daniele , Malchiodi Andrea
Published: April 2022

In this paper, we are interested in understanding the structure of domains of
first and second kind
, a concept motivated by problems in statistical mechanics and mean field equations. We prove some openness property for domains of first kind with respect to a suitable topology, as well as some sufficient condition, in terms of the Fourier coefficients of the Riemann map, for a simply connected domain to be of first kind. Finally, we show that the set of simply connected domains of first kind is contractible.
WORKSHOP STRATEGI PEMBELAJARAN TINGKAT SEKOLAH DASAR PADA MASA PANDEMI COVID-19 DI SD NEGERI 162 PALEMBANG
Authors: Sunedi Sunedi , Dirgantara Marvinda Rizki Dita , Syaflin Sylvia Lara , Ayurachmawati Puji , Dedy Adrianus , Prasrihamni Mega , Jumiat Jumiat , Ifnuari Moh. Reza
Published: April 2022

The Covid-19 outbreak is a more rapidly contagious disease caused by a type of coronavirus. In the country of Indonesia itself, it enforces a policy of Restricting Community Activities to suppress the spread of this virus. Even the local government implemented a lockdown policy in schools to give students a break and began implementing online learning methods (on the network). The pattern of the online learning strategy system is a distance learning system using the internet network. The purpose of this PkM is how to learn strategies for elementary school levels during the covid-19 pandemic. The partner school for this activity is SD Negeri 162 Palembang, which consists of 25 teachers. The method used is lectures and online workshops. This activity produces several strategies for learning activities that can be used by teachers as current learning strategies (Online).And the teacher has understood the use of strategies that can be used for online student learning
PELATIHAN PEMBUATAN MEDIA PEMBELAJARAN INTERAKTIF BERBASIS POWER POINT BAGI GURU-GURU DI SMA AL-FALAH HMM TIMIKA
Authors: Rasul A. , Subhanudin Subhanudin , Sutirta Habibi
Published: April 2022

The purpose of this service activity is to provide training and knowledge to teachers who teach at SMA Al-Falah HMM Timika about making power point-based learning media that are useful as teaching materials to make it easier for teachers to explain or explain various learning materials to be taught. The steps taken by the team in carrying out this activity are as follows: (1) Action planning, (2) Action Implementation, (3) Observation/Evaluation, and (4) Reflection. The existence of learning media will make it easier for teachers to explain various materials in learning
3D YAZICIYLA BASKILANMIŞ UÇUCU KÜL KATKILI HARÇLARIN RÖTRE ÖZELİKLERİNİN ARAŞTIRILMASI
Authors: UYGUNOĞLU Tayfun , TOPÇU İlker Bekir , ERGÜR Ömer
Published: April 2022

Üç boyutlu (3D) baskı yazıcılar inşaat sektörüne yeni bir boyut kazandırmıştır. 3D baskılı harçlardaki sertleşmiş çimento hamurunun doğal kuruma büzülmesi çok yüksek çimento/ince agrega oranlarına sahip olmaları nedeniyle büzülme davranışı açısından büyük risk oluşturmaktadır. Bu çalışmada, mineral katkı içeren 3D baskı harçlarının yazdırıldıktan sonra zamana bağlı kuruma büzülme davranışları araştırılmıştır. Harçların bileşiminde mineral katkı olarak %0, %10 ve %20 oranlarında uçucu kül kullanılarak farklı harçlar tasarlanmıştır. Mineral katkı çimentoyla ağırlıkça yer değiştirme yöntemine göre kullanılmıştır. Harçlar 3D yazıcıda tek katman olarak baskılandıktan sonra laboratuar ortamında 40 güne kadar boy değişimleri ölçülmüştür. Her bir ölçümün ilk boya oranına göre kuruma büzülme oranları belirlenmiş ve karşılaştırılmıştır. Elde edilen bulgulara göre uçucu kül kullanımıyla kontrol harçların büzülme oranları önemli derecede azaltılmıştır.
Exploring Various Tourism and Its Implication
Authors: Venkateswaran C , Ramachandran M , Sathiyaraj Chinnasamy , Sowmiya S , Manjula Selvam
Published: April 2022

This article reviews the development of tourism. Indigenous communities to stabilize Tourism as a tool is increasingly viewed, Many of them are looking forward to tourism for a better future. The Australian federal and, more recently, emerging interventions of state / territorial governments seek to develop tourism policies that facilitate market
growth and product development in the domestic sector. Two discussions will explore the effects of tourism on their livelihood and Botany in terms of lifestyle. Interviews and Based on personal observations with Potek, we consider Impact of the tourism community. There is no limit to tourism, along with Podek's responses to tourists' expectations and their native development. Evaluating and adequately considering the views of residents when planning tourism development, in any kind of tourism activities before investing Is an important step, as it is an important element in enhancing the sustainability of tourism and the traditional Proximity. That is, “ Between apartments Perceptual distance and traditional development in a particular area. A series of trends have been identified that describe the development of sustainable tourism research. Theoretical discussions of these findings, Proper technique and For practical
implications for sustainable tourism development Present the contribution of the magazine. For sustainable tourism research Future directions are also discussed.
Wie international ist die Promotion in Deutschland? Eine Analyse auf Basis der National Academics Panel Study
Authors:   Deutsches Zentrum für Hochschul- und Wissenschaftsforschung (DZHW), Willige Janka
Published: April 2022

In der hier vorgestellten Sonderauswertung der 1. Welle der National Academics Panel Study (Nacaps) werden zwei Perspektiven der Internationalität der Promotion in Deutschland behandelt: die temporäre promotionsbezogene Auslandsmobilität inländischer Promovierender sowie die Situation internationaler Promovierender in Deutschland. Im Fokus der Betrachtung der inländischen Promovierenden steht die Frage, welchen Nutzen sie Auslandsaufenthalten zuschreiben und welche Hindernisse sie diesbezüglich wahrnehmen. Zudem werden ausgewählte Aspekte ihrer Auslandsmobilität thematisiert, wie die Aufenthaltsarten, die Zielregionen und die Einschätzung der beruflichen Zukunft außerhalb Deutschlands. Die Situation der internationalen Promovierenden wird unter Berücksichtigung verschiedener Dimensionen des Promotionsalltags beschrieben, z. B. des unmittelbaren Umfelds der Hochschule (Betreuung und soziale Integration). Außerdem werden ihre Vorstellungen von der beruflichen Karriere nach Abschluss der Promotion beleuchtet.
Time, Migration and Forced Immobility
Authors: Stock Inka
Published: April 2022

This book is concerned with the effects of migration policy making in Europe on migrants in the Global South and is based on in-depth ethnographic research in Morocco with migrants from Sub-Saharan Africa.
Proactive Personality and Innovative Work Behaviors: The mediating role of Knowledge Creation Ability
Authors: Hanif Fatima , Sarwat Nosheen
Published: April 2022

The aim of this study was to understand the effect that proactive personality has on individuals’ knowledge creation ability and innovative work behaviors. This study proposed a model which assists in understanding the effects that proactive personality has on innovative work behaviors through individual knowledge creation. The results were based on data that was collected through a cross-sectional field survey. The data consisted of a diverse paired sample of employees and their supervisors (N=249) who belonged to various organizations in Pakistan. The results of the main effects regression revealed that proactive personality had a positive relationship with both knowledge creation ability and innovative work behaviors. To test the mediating hypothesis, mediating regression analysis was used which showed that individual knowledge creation ability mediated the link between proactive personality and innovative work behaviors. The results of the mediation were also confirmed through a Sobel test.  The study adds to the body of knowledge by investigating the antecedents and outcomes of knowledge creation ability. In addition, it uniquely contributes to the body of research by providing an underlying mechanism through which proactive personality predicts innovative work behavior. The topic of individual knowledge creation ability that has been overlooked previously by research has been elaborated in this study.
Making Sense of Leadership Language: An Analysis of Mr. Imran Khan’s Spoken Political Discourse
Authors: Ashraf Kashmalah , Nayab Durr-e- , Tahir Sana
Published: April 2022

Language has variety of roles in the lives of human beings. It speaks volumes about how someone uses language and makes it distinct from one culturally diverse person to another. Language in this sense plays a crucial role in determining how and what individuals say and, in turn, such language use in the political discourse will be reflected upon by others, positively or negatively. Politicians within any system, often depends on the language to assert power, persuade and convince people of their ideologies. This paper considers the language used by the Former Prime Minister of Pakistan, Mr. Imran Khan as demonstrated in his spoken political discourse. More specifically, it attempted to analyse the language as used by a well-known politician and leader. The study holds qualitative analysis of Mr. Imran Khan’s spoken political discourse to interpret Imran Khan’s word choices to reflect his intention in a political realm. For sure, it can convince and persuade people in believing particular desire, ideology or even action. For this purpose, Imran Khan during his leadership locally and internationally were analysed based on the theoretical framework of Fairclough's three-dimensional model. The study reveals several findings including Mr. Imran’s linguistic and rhetorical strategies in demonstrating his leadership in Pakistan and abroad.
Evaluation of an Intercropping System: Lettuce and Radish Growing in Fruit Sapling Production
Authors: KARLIDAĞ Hüseyin , KUTSAL İbrahim Kutalmış , KARAAT Fırat , KÜÇÜK Rabia , KAN Tuncay
Published: April 2022

Agricultural production is one of the most negatively affected sectors from increasing population and global warming. Increasing food demand along with narrowing agricultural production areas increased the need for sustainable agricultural approaches where the unit area is better utilized. Intercropping systems are of those approaches based on the principle of growing more than one crop in the same area. In this study, it was aimed to analyze the opportunities of increasing land-use efficiency in open field fruit sapling production. For this aim, lettuce and radish were grown on the inter-rows of almond, apple, apricot, cherry, and pear sapling growing lines. When compared with control plants, results indicated a slight negative effect of intercropping systems on sapling quality. Yield and growth characteristics were lower in the vegetables subjected to intercropping. On the other hand, Land Equivalent Ratio (LER) and Net Economic Profit (NEP) were higher in intercropping systems. LER value varied between 1.86 and 1.97, and NEP value between 3328 and 6962 USD/da. These results indicated that land-use efficiency was increased with the examined intercropping systems. As a result of the study notwithstanding the quality and yield loses, it was concluded that intercropping of lettuce and radish in fruit sapling production is a beneficial growing application for the mentioned aims.
Kognitif Sağlıklı Yaşlılarda D Vitamini Depresyon ile İlişkili Olabilir mi?
Authors: GÖKDENİZ YILDIRIM Açelya , DOST Fatma Sena
Published: April 2022

Amaç: Depresyon, yaşlılarda morbidite ve mortaliteye sebep olan geriatrik sendromlardan biridir. Depresyonun erken tanı ve tedavisi bireyin yaşam kalitesi için önemlidir. D vitamini depresyon patofizyolojisinde rol oynayan bir nörosteroid hormondur ve eksikliği yaşlılarda sık görülmektedir. Bu çalışmanın amacı, yaşlılarda sık görülen geriatrik sendromlardan biri olan depresyonun D vitamini ile ilişkisini değerlendirmektir.Gereç ve Yöntemler: Çalışmaya 60 yaş ve üzeri 392 hasta alındı. Çalışmamız kesitsel retrospektif olarak dizayn edildi. Katılımcıların sosyodemografik verileri, komorbiditeleri, laboratuvar parametreleri, geriatrik depresyon ölçeği puanları, yürüme ve denge ölçeklerini içeren Ayrıntılı Geriatrik Değerlendirme verileri hasta takip dosyalarından incelenerek değerlendirildi. Elde edilen sonuçlarla prevelans analizi yapıldı.Bulgular: D vitamini değerleri, depresyon tanısı olan grupta, depresyon tanısı olmayan gruptan anlamlı olarak düşüktü (p<0,01). Her iki grup yaş açısından benzerlik göstermekteydi. Depresyon tanısı alanlarda kadın cinsiyet oranı daha fazlaydı (p<0,01). Depresyon; düşme, malnutrisyon, kadın cinsiyet, düşük eğitim durumu ve ilaç sayısı ile ilişkili bulundu (p<0,001). Yaş ve cinsiyet faktörü düzeltildiğinde, depresyonun D vitamini ile ilişkisi ortadan kalktı.Sonuç: Depresyon ve D vitamini arasında anlamlı bir ilişki bulunmaktadır. Depresyonu olan yaşlı bireylerde D vitamini değerlerini normalize etmek, oluşabilecek morbidite ve mortaliteyi önlemek için yapılan müdahalelerden biri olabilir. Bu konuda yapılacak destekleyici çalışmalara ihtiyaç vardır.
The Influence of Tax Rates, Tax Payment Mechanisms, Tax Knowledge, Service Quality, And Taxpayer Awareness of Taxpayer Compliance with Religiosity as Intervening Variables
Authors:   State Islamic University of Prof. K.H. Saifuddin Zuhri, Purwokerto, Masumah Siti
Published: April 2022

Taxes is one of the state revenue sources. MSMEs have a large share of state revenue because they pay taxes in the form of obedience to the government. Compliance in paying taxes can be affected by tax rates, payment mechanisms, tax knowledge, service quality, taxpayer awareness, and religiosity. The sample in this study was 112 MSMEs in Banyumas Regency taken with convenience sampling techniques. The hypothesis is tested using linear regression tests and intervening regression tests. The results of this study concluded that tax rates, tax payment mechanisms, and service quality partially did not affect taxpayer compliance. Taxpayer awareness partially affects taxpayer compliance. Tax knowledge through religiosity influences taxpayer compliance, indirectly.
Identity, Community Education and Private Schooling—On Gus Lee’s China Boy
Authors:   School of Basic Education, Hefei Technology College, Hefei, Anhui, Wang Qian
Published: April 2022

Chinese American literature, as a unique part in American literature, since its appearance has undergone dramatic changes and received more and more attention at home and abroad, especially after the 1960s. The special writing style, the gender problem, the emasculated Chinese men and the struggles of oppressed Chinese are always the issues that catch the notice of critics. Among them, the exploration of identity is the most pervasive. From “yellow peril” to “model minority,” Chinese American identity has experienced a great transformation. To interpret this phenomenon, critics have adopted different perspectives, like historical, cultural, religious, psychological and sociological ones. However, few of them pay attention to the influence of education on Chinese American identity formation. Despite several researches about the role of education, most are focused on some limited samples acquired through the qualitative methods. China Boy as the debut of Gus Lee, since the publication has provoked a stir around the world, this research concentrates on the influence of education on the identity formation of Kai Ting, the protagonist, from a scraggy little boy to a strong one in the dilemma of traditional Chinese culture and dominant culture. Through the research of community education and private schooling, the thesis tends to probe into the impact of education on the construction of Chinese American identity.