bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Approach of Exploring Water Value: A Study Based on Sri Lankan Reservoirs
Authors: Colambage D. P. , Wijayapala W. D. A. S. , Siyambalapitiya T.
Published: November 2024

Water, often perceived as a free natural resource, plays a crucial role in meeting societal needs and ensuring its preservation for future generations. The concept of water value highlights its importance, especially in reservoirs, where its value fluctuates based on demand and availability. This paper explores the intrinsic value of water amidst stochastic variations due to weather uncertainties and introduces a novel model for economic dispatch using Dynamic Programming (DP) and Stochastic Dual Dynamic Programming (SDDP) principles. Two new approaches for calculating water value are proposed, expanding beyond the traditional zero-value assumption relative to fuel cost. The first method estimates the water value based on the per-unit generation cost of the most expensive thermal power plant in the Daily Load Curve. The second method calculates the water value as the weighted average cost of variable thermal power plants in the economic dispatch schedule. Additionally, this research examines the water value in the context of both power generation and agriculture, comparing their respective impacts. The paper underscores the importance of incorporating water value concepts into decision-making processes while addressing potential challenges. The research is contextualised within Sri Lanka, highlighting its practical implications.
River Water Treatment in a Filter Filled with Peat and Modeling Particle Capture
Authors: Pannala P. A. S. A. , Dayanthi W. K. C. N.
Published: November 2024

Peat has the potential to be an effective filter medium for river water, addressing not only total suspended solids (TSS) but also other contaminants. However, the breakthrough of TSS will determine the filter's operability. In this study, two identical filter columns filled with peat were continuously supplied with river water for approximately 45 hours. Influent and effluent turbidity, conductivity, pH, and TSS concentrations were measured at 2-hour intervals. The TSS removal efficiency was approximately 100% during the initial 16-hour period, after which it gradually decreased. Irrespective of the breakthrough, the conductivity in the effluent consistently decreased. The pH variation also did not show any interruption. The developed particle capture model yielded determination coefficients (R²) of 0.88 and 0.82 for calibration and verification, respectively. However, the model overestimated until 30 hours, after which it fitted well. The model can be used to estimate the peat-filled filter bed thickness for any required influent flow rate. It is concluded that peat is an effective filter medium for TSS and other contaminants in river water. The conventional governing equation for gravity filters must be modified for peat to develop an optimal particle capture model.
Comprehensive Structural Assessment of Old School Buildings in Sri Lanka
Authors: Kumarasiri P. W. P. B. , Madunoraj B. H. T. , Basnayake G. B. M. A. , Appuhamy J. M. R. S.
Published: November 2024

The deterioration of old school buildings has become a significant challenge to the Sri Lankan Government and the educational system. This study investigated a total of twelve old school buildings, distributed across six distinct schools in Sri Lanka, all of which were constructed in the 1980s and 1990s. Visual inspection was carried out to detect the common defects of the structural elements. Non-Destructive Testing (NDT) and Destructive Testing (DT) methods were performed to determine the existing material properties of the identified deteriorated structural elements. Utilizing the SAP2000 software, a Finite Element (FE) model was developed to simulate a representative school building, considering the architectural and structural similarities shared with the examined old school buildings. Structural analysis was carried out for the typical concrete structural elements and their capacities were closely investigated based on variables such as concrete cover, effective steel area, and grade of the concrete. According to the FE modelling results and the capacity assessment, possible retrofitting methods such as Carbon Fibre Reinforced Polymer (CFRP) jacketing and Reinforced Concrete (RC) jacketing were suggested for these school buildings. For identified minor defects, appropriate repair methods such as Patch repair and Epoxy injection methods were suggested.
Infrared Image-Based Condition Assessment of 33kV SIR Housed ZnO Surge Arresters
Authors: Illesinghe R. S. , Paranavithana N. N. K. , Fernando M. A. R. M. , Abeygunasekara W. L.
Published: November 2024

Lightning surge arresters are key components for the protection and reliability of power systems. During service, surge arresters are aged by deteriorating their properties. It is important to monitor conditions periodically in order to avoid failures of power apparatus. This study proposes an online-based condition monitoring method for surge arresters using principal component analysis (PCA), support vector machine (SVM) and thermal image processing of infrared images captured from 46 energized 33kV lightning surge arresters belonging to Ceylon Electricity Board (CEB). Field-energized aged arresters (18 samples), laboratory-tested aged arresters (27 samples) and a brand-new arrester were taken for the investigation. The main focus was to build a model to identify the healthiness of the lightning surge arresters based on their temperature profiles. Leakage current, insulation resistance and finite element method (FEM) based simulations were considered to validate the healthiness of the arresters. Using this model, it can be visualized whether the surge arrester condition is acceptable, only using a single thermal image of the arrester as an input. Even though, an arrester islocated in good condition region of the proposed model, the distance to the decision boundary indicates how close that arrester to be in unhealthy region.
Managing the RFP Process of Government ICT Projects from a Discursive Perspective
Authors: De Silva W. Tilak R. , Thelijjagoda T. A. S. S.
Published: November 2024

E-government projects which utilize Information and Communication Technology (ICT) to enhance public service delivery and improve governmental efficiency, hold significant promise. However, the success rate of these initiatives, particularly in developing countries such as Sri Lanka, remains alarmingly low. A key factor contributing to this high failure rate is the inadequacy of the Request for Proposal (RFP) process, which often results in budget overruns and project delays due to incomplete or inaccurate requirements. This research explores the pivotal role of RFPs in the successful implementation of e-government projects. Using a mixed-method approach, the study incorporates three case studies, and a Likert scale questionnaire prepared based on case study outcomes. The data for quantitative analysis was collected from questionnaires and quantitative data analysis was done using SPSS software. The findings from data highlight the critical importance of a well-crafted RFP in mitigating budgetary issues and ensuring precise requirement specifications. The study culminates in the development of ten practical guidelines aimed at enhancing the RFP preparation process, thereby increasing the likelihood of success for future e-government projects. Adopting these guidelines will enable government organizations to prepare more effective RFPs, contributing significantly to the overall success of their projects. While the guidelines are broadly applicable, slight adjustments may be necessary depending on the specific nature of the project. These guidelines offer valuable insights for both industry professionals and policymakers in the e-government sector.
ESKAPE pathogen incidence and antibiotic resistance in patients with bloodstream infections at a referral hospital in Limpopo, South Africa, 2014–2019: A cross-sectional study
Authors: Mthombeni Tiyani C. , Burger Johanita R. , Lubbe Martha S. , Julyan Marlene , Lekalakala-Mokaba Molebogeng R.
Published: November 2024

Background: There is a paucity of research on the incidence and antimicrobial resistance (AMR) of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE) pathogens in Africa because of the inadequate establishment of AMR surveillance systems.Objective: This study reports on the incidence and AMR of bloodstream ESKAPE pathogens at a referral hospital in northern South Africa.Methods: This retrospective descriptive study used routinely collected bloodstream isolates (pathogen identification and antimicrobial susceptibility testing performed using automated systems) from the South African National Health Laboratory Service, from January 2014 to December 2019. Resistant phenotypes analysed included methicillin-resistant S. aureus and carbapenem-resistant A. baumannii.Results: The ESKAPE pathogen incidence rate was stable from 2014 to 2019 (p = 0.133). The most isolated pathogens were S. aureus (268/746; 35.9%) and A. baumannii (200/746; 26.8%). Staphylococcus aureus increased from 39 isolates in 2014 to 75 in 2019 (p = 0.132). The incidence rate of A. baumannii increased from 11.9% (16/134) in 2015 to 37.8% (68/180) in 2019 (p = 0.009). Most isolates (417/746; 55.9%) were from the neonatal ward. Carbapenem-resistant A. baumannii increased from 68.8% (11/16) in 2014 to 75.0% (51/68) in 2019 (p = 0.009). Methicillin-resistant S. aureus decreased from 56.0% (14/25) in 2016 to 17.3% (13/75) in 2019 (p = 0.260).Conclusion: Routine data provide essential information on the incidence of ESKAPE pathogens and AMR phenotypes, serving as a basis for an antibiogram, a surveillance tool in antibiotic stewardship programmes.What this study adds: The study provided local information on the incidence and AMR pattern of ESKAPE pathogens, which is essential when developing empiric treatment protocols for appropriate antibiotic prescribing and infection prevention and control practices.
From burning Judith Butler to Gilead: Michelle Bolsonaro’s anti-feminist and anti-gender discourse
Authors: Costin Fuser Marina
Published: November 2024

As former president Jair Bolsonaro was declared ineligible to stand again, his wife, Michelle Bolsonaro, has become the far right’s new possible candidate to run in Brazil’s future presidential elections. In a speech at an event called by Jair Bolsonaro in February 2024, the former first lady gave a religiously motivated speech arguing for an end of the secular State. This article argues that the rapid, but not sudden, rise of evangelical fundamentalism becomes a barrier to the development of a democratic state. The discussion draws an analogy with Margaret Atwood’s dystopia in The Handmaid’s Tale (1985) of a totalitarian state governed by religious fundamentalism, which seems to take Bolsonaro’s speech to the last level. The analysis is augmented by Judith Butler’s most recent book: Who is afraid of gender (2024), highlighting some fundamental points around gender, feminism and democracy in light of Michelle Bolsonaro’s recent political speech.Contribution: The analysis in this article highlights some fundamental points around gender, feminism and democracy in light of Michelle Bolsonaro’s recent political speech.
Salvation and the Gospel of prosperity in Zimbabwe in view of its religious and cultural milieu
Authors: Masvotore Peter
Published: November 2024

This study grapples with the perception of salvation in the health and wealth gospel, the contestations and prospects posed to the religious and cultural environment bedevilled in Zimbabwe. The wide-ranging understanding, escalation and dynamic setting of this health and wealth gospel is explored. Emphasis of the study is centred on crucial nuances of deliverance, instant health and getting rich quickly and how these traditions grow, its transportation from Global North to Global South particularly how this gospel settled in Zimbabwe. The gap to be filled is to explore whether prosperity gospel as given by its proponents in Zimbabwe saves or enslaves in other words, is it a wholistic gospel or a piece meal, sleeping tablet gospel. A desk research methodology of utilising prevailing information obtained from printed books, articles, journals as well as newspapers is used to explore reasons favouring the relocation of the gospel of prosperity to Zimbabwe. The economic, political and religious environment shall be critically evaluated in order to expose extenuating circumstances for its survival and expansion. In conclusion, the study shows that the health and wealth evangelism flourishes better amidst awful financial, unstable and corrupt governance condition of the state. It has been discovered that it takes advantage of the African Traditional Religion(s) that correlated very well to offer the instant, and temporal answer to the predicament of Zimbabwe.Contribution: To ongoing academic studies on prosperity gospel particularly to see that it blooms well in deplorable economic situations and takes advantage of African traditional beliefs that act as catalysts to the crisis. The study also contributes to the Sustainable Development Goals (SDG), one and two aiming to terminate poverty, protect the planet and ensure prosperity for everyone by 2030.
Comparing the Efficacy of Escitalopram with and without Crocin in Restoring I/O Functions and LTP within the Hippocampal CA1 Region of Stressed Rats
Authors: Joodaki Mehran , Radahmadi Maryam , Alaei Hojjatallah
Published: November 2024

Background:

Escitalopram, a pharmacological compound, and crocin, the active compound of saffron, influence brain functions and serotonin levels. This study examined the efficacy of escitalopram with and without crocin in restoring the input-output (I/O) functions and long-term potentiation (LTP) within the hippocampal cornu ammonis 1 (CA1) region of stressed rats.

Materials and Methods:

Rats were divided into six groups: control (Co), sham (Sh), stress-recovery (St-Rec), stress-escitalopram (St-Esc), stress-crocin (St-Cr), and stress-escitalopram-crocin (St-Esc-Cr) groups. They underwent 14 days of restraint stress (6 h/day). After being subjected to stress, they received 14 days of escitalopram (20 mg/kg) and crocin (30 mg/kg), as well as co-administration of these two compounds during the next 14 days. The field excitatory postsynaptic potential (fEPSP) slope and amplitude were measured using I/O functions and LTP induction in the CA1 region. Corticosterone (CORT) levels were also evaluated.

Results:

The fEPSPs slope and amplitude in the I/O functions and LTP induction significantly decreased in stressed rats without therapeutic intervention. These variables in the I/O functions declined in rats with escitalopram administration alone. All electrophysiological parameters showed an increase in rats treated with crocin alone compared to stressed subjects without any treatment. Serum CORT levels decreased only with crocin treatment for stressed rats.

Conclusion:

Neural excitability and memory within the CA1 region were severely disrupted among stressed rats without any treatment. Furthermore, administering crocin alone improved neural excitability and memory post-chronic stress. Treatment with escitalopram alone also impaired neural excitability within the CA1 region. The use of escitalopram with and without crocin did not enhance memory under chronic stress.
Do Exercise and Magnesium Sulfate Improve Infertility Caused by Lithium Carbonate in Male Rats?
Authors: Shoghi Elham , Miri Saideh , Maghool Fatemeh , Niazi Abbas Ali , Fanaei Hamed , Niyazi Parsa , Chahkandi Mohadeseh , Parsi-Mood Abolfazl , Bagheri Hossein , Safari Tahereh
Published: November 2024

Background:

Lithium (Li) is widely used in the treatment of bipolar disorder, but it may lead to toxicity in the reproductive system. Considering the harmful effect of Li consumption on fertility and the positive effect of magnesium sulfate (MgSo4) and moderate-intensity training (MIT) on improving the quality of men’s sperm, the current research was conducted to determine the impact of MIT and MgSo4 on infertility caused by Li.

Materials and Methods:

Seventy-two male rats were divided into 12 groups, control, Li10 mg/kg/day/ip, MgSo4 80 mg/kg/day/ip; MIT; Li40 mg/kg/day/ip; Li10+MgSo4; Li10+MIT; Li10+MgSo4+MIT; Li40+MgSo4; Li40+MIT; Li40+MgSo4+MIT. All animals received the drugs every day. The groups under the exercise protocol followed this program for 42 days (6 weeks). Total sperm count, sperm concentration, total motility, and progressive motility were analyzed. A blood sample was taken from the heart to quantify testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH).

Results:

Li40 mg/kg decreased the progressive motility and quantity of sperms together with nonprogressive motility and immobile sperms increased significantly. Administration of MgSo4 and MIT alone and simultaneously led to a significant improvement in the above mentioned parameters. Li40 mg/kg reduced the serum level of testosterone and LH compared to the control group. On the other hand, the administration of MgSo4 and MIT together with Li40 (Li40+MgSo4+MIT) did not have any effect on serum testosterone levels.

Conclusions:

Li probably causes damage to reproductive functions by affecting the antioxidant system. However, MgSo4 and MIT reduce the impacts of Li on the reproductive system and improved its performance.
Evaluation of the Frequency of Migraine and CVA Patients Based on Circle of Willis Morphological Variations in MRA Images
Authors: Eftekhari Moghadam Ali Reza , Absalan Forouzan , Khatavian Ehsan , Jalilian Milad , Maghsoudi Fatemeh
Published: November 2024

Background:

The Circle of Willis (CoW) forms a critical collateral route for the compensation pathway at the basal cistern of the brain. This study aims to determine if migraine headaches and cerebrovascular accidents (CVAs) are associated with the prevalence and patterns of CoW arterial variations seen in the three-dimensional time-of-flight magnetic resonance angiography technique in patients.

Materials and Methods:

A cross-sectional study was undertaken by a systemic search of electronic databases in the Imaging Center, Abadan’s Taleghani Hospital, Iran, from March 2020 to March 2022. Data on the prevalence of variations in patients who presented for screening for migraine and CVA were extracted and analyzed with Student t-test and the Chi-square method.

Results:

Findings show complete CoW has been visible in 20.19% of our patients. The anterior part of the CoW was almost intact in all patients. The posterior part of CoW was mostly bilaterally hypoplastic (31.73%) or bilateral aplastic (29.81%) and in some rare cases unilaterally varied. In migraine patients, CoW was rarely in its classic form (15%) and was varied bilaterally in 72.5% of the cases. In CVA patients, CoW was in its complete vascular structure in 23.08% and bilaterally varied in 46.15% of all cases.

Conclusions:

Overall, migraine and CVA are associated with anatomical variations in the posterior portions of the CoW. Further larger prospective trials are needed to determine the true prevalence of CoW variations and their pathological significance.
A Rare Case of Anomalous Abdominal Aorta and Absent Right Common Iliac Artery with Review of Literature
Authors: Ahmad Manzoor , Varier Arjun B , Ali Wasif Mohammad , Rabbani Syed Shamayal
Published: November 2024

Anomalies in distal abdominal aorta and iliac arteries are seldom encountered. We report a case of a 48-year-old male who presented with right flank pain and was subsequently diagnosed as a case of right pyonephrosis with nonfunctioning kidney and was planned for the right nephrectomy. A routine preoperative contrast-enhanced computed tomography showed a rare anomaly of the abdominal aorta with an aberrant vessel and absent right common iliac artery for which we had to cautiously plan the surgery.
Coronary Subclavian Steal Syndrome Presenting as Acute Angina in a Postcoronary Artery Bypass Patient: An Unusual Case Report
Authors: Jha Rakesh Kumar , Gupta Anshul Prakash , Anand Subramaniam , Dutta Rohit
Published: November 2024

“Coronary subclavian steal syndrome (CSSS)” refers to a clinical condition, exclusively seen in postcoronary artery bypass graft (CABG) patients, in whom the left internal mammary artery (LIMA) has been used as a native graft to bypass the coronary lesion and to supply the left anterior descending artery. If such patients develop critical stenosis of the subclavian artery proximal to the LIMA graft, there is a reversal of blood flow in the LIMA graft, leading to reduction in the territorial blood supply of the heart. This results in stable or unstable angina, myocardial infarction, and even sudden cardiac death. Considering the seriousness of CSSS, early diagnosis and timely management are warranted to prevent future complications. Hereby, we report a case of the post-CABG patient, who was initially admitted under cardiology care with acute coronary syndrome, later on, diagnosed as CSSS, and managed successfully by percutaneous endovascular intervention.
A rare variant of DAX1 mutation presenting with primary adrenal insufficiency and hypogonadotropic hypogonadism
Authors: Devi Konsam Biona , Baruah Mintu Mani , Nagendra Trupti Prasad , Hussain Sadam , Bhadada Sanjay Kumar , Walia Rama
Published: November 2024

DAX1 mutation causes X-linked adrenal hypoplasia congenita (AHC) and hypogonadotropic hypogonadism (HH) in boys. Onset of adrenal insufficiency (AI) usually precedes the diagnosis of HH. Likewise, our patient was first diagnosed with primary AI at the age of 8 years and later presented at 21 years of age with poorly developed secondary sexual characteristics. The hormonal evaluation was suggestive of low luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone, suggestive of hypogonadotropic hypogonadism (HH). The possibility of DAX1 mutation was considered. Subsequently, whole-exome sequencing revealed a rare variant, NR0B1; c.881T>C (p.Leu294Pro), confirming our diagnosis. Therefore, a high index of suspicion is required in patients with a past history of AI who present with pubertal delay, in whom early initiation of gonadotropins results in favorable outcomes in terms of fertility. Monitoring pubertal development is important during follow-up because early recognition can help in proper management.
Synchronous Paget’s disease of bone, metastatic breast cancer, and acute Charcot neuroarthropathy of the foot: Diagnostic and treatment challenges
Authors: Ghosh Jayaditya , Das Liza , Subin S. , Rastogi Ashu , Aggarwal Piyush , Singh Harmandeep , Sinha Anindita , Bhadada Sanjay Kumar
Published: November 2024

Paget’s disease of bone (PD) and Charcot neuroarthropathy (CN) are rare conditions involving osteoclast activation and increased bone turnover. PD commonly affects the tibia, while CN affects foot bones. Though PD and skeletal metastases from breast carcinoma have co-occurred, the simultaneous presence of PD, CN, and skeletal metastases from breast carcinoma is unprecedented. A middle-aged female with type 2 diabetes presented with symptoms of pain, swelling, and inflammation in the right leg and foot. Diagnostic imaging suggested PD and acute CN. Despite treatment with zoledronic acid, there was no improvement. Later, she developed firm skin lesions and a breast lump, diagnosed as breast carcinoma with cutaneous metastasis. Chemotherapy, radiotherapy, and monthly zoledronic acid were administered. Follow-up imaging showed reduced tibial lesions but persistent skeletal metastases. This case underscores the complexities in diagnosis and management of patients with these concurrent conditions and highlights the need for thorough examination when standard therapies fail.
Adrenal neurofibroma masquerading as phaeochromocytoma
Authors: Jha Vivek , Arjunan Durairaj , Shaharyar Amal , Das Liza , Bhadada Sanjay Kumar
Published: November 2024

This study describes the case of a 48-year-old male who was incidentally found to have a left adrenal mass during routine imaging, despite having no significant medical history or symptoms. Initial laboratory tests revealed elevated plasma-free normetanephrines, leading to a preliminary diagnosis of pheochromocytoma (PCC). Imaging confirmed a left large adrenal mass, which suggested PCC. However, following laparoscopic surgical excision, histopathological examination identified the mass as a neurofibroma, an uncommon and benign tumor in the adrenal gland. Post-surgery, the patient’s biochemical markers normalized, and follow-up imaging showed no residual mass. This case underscores the importance of thorough evaluation and consideration of differential diagnoses in the management of adrenal incidentalomas.
Pediatric adrenocortical tumor manifesting as Cushing’s syndrome and virilization
Authors: Kumar Subhash , Bishnoi Avina , Manayankath Reshma , Chandrashekhar Supreeth , Kumar Ritesh , Agrawal Neeraj Kumar
Published: November 2024

Pediatric Cushing’s syndrome is a rare entity. In younger children, adrenocortical tumors are the common cause of this syndrome. Although clinically it is difficult to differentiate benign adrenocortical adenoma from aggressive carcinoma, the categorization of the tumor by the Wieneke scoring system can assist in predicting the future outcomes. In this study, we report a case of a 2-year-old male child diagnosed with endogenous Cushing syndrome and virilization due to a right adrenocortical adenoma. After a successful right adrenalectomy, the child experienced clinical and biochemical improvement, including weight loss and resolution of cushingoid features, with normalization of blood pressure and hyperandrogenism.
“Caution with choroidals” - choose the right one at right time
Authors: Boral Subhendu K. , Mitra Santanu
Published: November 2024

Background:

During the repair of rhegmatogenous retinal detachment (RRD), pre-existing or intraoperative sudden choroidal detachment (CD), often compromises the surgical outcome and visual prognosis.

Purpose:

To describe video-guided specific approaches for pre-existing or sudden intraoperative CDs during the repair of RRDs.

Synopsis:

Cannula-guided choroidal drainage is necessary to decrease the severity of pre-existing CDs. Complex RRD with massive hemorrhagic CD often warrants a similar approach. Intraoperative sudden CD can be due to sudden hypotony because of a disproportionate increase in outflow due to high suction or a decrease in inflow due to kinking or blockade of the infusion tube/tip by vitreous/detached retina. It may also be due to the leakage around the cannulas in the eyes with thin sclera. Rarely accidental air entry inside the suprachoroidal space due to inadvertent slippage of a non-sutured infusion cannula tip can precipitate sudden kissing CD. If the air infusion pressure is 40 mm Hg or more, this suprachoroidal air can cause a tear in the vortex vein ampullae, and air enters inside the vortex vein. Then, it may go via ophthalmic veins to the cavernous sinus or via pterygoid plexus to the internal jugular vein, superior vena cava, and the right atrium, and can cause pulmonary embolism or less likely occlude systemic arteries via the foramen ovale. This possible life-threatening Venous Air Embolism (VAE), occurring concurrently with Ocular Air Fluid Exchange (OAFE) during vitrectomy, is known as “PRESUMED AIR BY VITRECTOMY EMBOLISATION (PAVE)”. Immediate stoppage of the air infusion and removing it can prevent this accidental PAVE and eventual death. In this era of MIVS, this risk is likely to be higher than in previous decades, when infusion cannulas were used to be sutured to the sclera.

Highlights:

The video describes the strategies for treating pre-existing CD along with RRDs and managing sudden intra-operative CDs, sometimes to prevent PAVE in cases of suprachoroidal air entry.

Video Link:

https://youtu.be/fEstbqVkXH4
Observance of ethical codes of midwifery profession in students and graduates of department of midwifery and reproductive health, Isfahan University of Medical Sciences
Authors: Sohrabi Zahra , Savabi-Esfahani Mitra , Shahriari Mohsen , Salehi Kobra
Published: November 2024

BACKGROUND:

Ethical performance is one of the main components of maternal and fetal care. Nurturing and training students who meet professional ethics in midwifery is of utmost importance. It is essential to assess the level of adherence of students and graduates to the codes of ethics in order to determine the extent of education needs in this regard. Therefore, the present research aims to draw a comparison between the level of adherence to codes of ethics between midwifery students and graduates in the fields of midwifery and reproductive health department at Isfahan University of Medical Sciences.

MATERIALS AND METHOD:

This descriptive cross-sectional study was conducted in 2021–2022 on 93 midwifery students and 107 graduate midwives of Isfahan University of Medical Sciences. It is crucial to note that the study included all-year midwifery students. The data collection tools included a demographic questionnaire and one more questionnaire to assess adherence to the codes of ethics, which were made available to participants through Google Forms. Data were analysed using SPSS software statistics version (SPSS, Chicago, IL, USA). A significance level of 0.05 was considered significant for all tests.

RESULTS:

The mean adherence to codes of ethics was 79.01 ± 14.80 for the students and 79.07 ± 14.55 for the graduate midwives. There was a significant difference in the overall mean score of adherence to the codes of ethics, professional commitments, and self-communication between the two groups of students and graduates (P < 0.05).

CONCLUSION:

Although ethics is addressed in midwifery education programs, it is required to put considerable emphasis on teaching codes of professional ethics to both the students and graduates. Additionally, an educational and clinical setting is required to identify errors and their causes so that it can help take steps towards adhering to codes of ethics.
COVID-19 pandemic effects on the emergency medical services utilization: A systematic review protocol
Authors: Akbari-Shahrestanaki Yousof , Aminizadeh Mohsen , Gholami-Shahrebabakone Azam , Beyrami-Jam Mehdi
Published: November 2024

To the best of our knowledge, to date, there is no comprehensive review study that has explored the effects and impacts of the COVID-19 pandemic on emergency medical services (EMS) systems. Therefore, this systematic review will be conducted to investigate the effects of the COVID-19 pandemic on the delivery of pre-hospital emergency care services in EMS agencies. To achieve the study aims, electronic databases such as PubMed, Scopus, Web of Science, and Google Scholar will be searched for related studies. It seems that reviewing the effects of the COVID-19 pandemic on EMS systems, play an important role in identifying and solving the main challenges of EMS in future pandemics.
Systematic review of ChatGPT accuracy and performance in Iran’s medical licensing exams: A brief report
Authors: Keshtkar Alireza , Atighi Farnaz , Reihani Hamid
Published: November 2024

ChatGPT has demonstrated significant potential in various aspects of medicine, including its performance on licensing examinations. In this study, we systematically investigated ChatGPT’s performance in Iranian medical exams and assessed the quality of the included studies using a previously published assessment checklist. The study found that ChatGPT achieved an accuracy range of 32–72% on basic science exams, 34–68.5% on pre-internship exams, and 32–84% on residency exams. Notably, its performance was generally higher when the input was provided in English compared to Persian. One study reported a 40% accuracy rate on an endodontic board exam. To establish ChatGPT as a supplementary tool in medical education and clinical practice, we suggest that dedicated guidelines and checklists are needed to ensure high-quality and consistent research in this emerging field.
The effects of synbiotic supplementation along with non-surgical periodontal therapy in improving the metabolic status and inflammatory markers in type 2 diabetes mellitus patients with periodontal disease: A double-blind randomized clinical trial
Authors: Yarahmadi Mohsen , Javid Ahmad Zare , Bazyar Hadi , Yousefimanesh Hojat Allah , Nejatian Touraj , Gravand Ehsan , Haghighizade Mohammad Hossein
Published: November 2024

BACKGROUND:

Diabetes mellitus and periodontitis are two common chronic diseases with bidirectional relationship. Considering the role of oxidative stress in the pathogenesis of these two diseases, the use of nutritional supplements with antioxidant properties can be useful. The purpose of this study was to determine the effectiveness of daily synbiotic supplement in the management of patients with type 2 diabetes mellitus (T2DM) and periodontal disease (PD) under non-surgical periodontal therapy (NSPT).

MATERIALS AND METHODS:

In this randomized double-blind placebo controlled clinical trial, 50 patients suffering from T2DM and periodontal disease were recruited and randomly assigned to two groups: intervention group (n = 25), where one capsule of multi-species probiotic plus 100 mg fructo-oligosaccharide supplement (500 mg in each capsule) every day is given, and control group (n = 25), which received one placebo capsule containing 500 mg wheat flour for 8 weeks. At the beginning and end of the study, the serum levels of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), the lipid profile including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) and inflammatory markers such as tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) were measured. All subjects received NSPT including oral health education, scaling, and root planning at the beginning of study. One month after the intervention, the second NSPT was performed. The paired-sample test was used to identify within-group differences. The independent sample t-test (crude model) and the analysis of covariance or ANCOVA (adjusted model) were used to compare the results between the two groups.

RESULTS:

Synbiotic supplement with NSPT significantly decreased serum levels of FBG, HbA1c, TNF-α, and IL-6 compared with the baseline values (all P < 0.05). Furthermore, LDL-C levels significantly decreased compared with the baseline value in both groups (all P < 0.05). Also, the mean changes of IL-6 were significantly lower in the intervention group compared with the control group after the adjustment of confounding factors (P = 0.01).

CONCLUSIONS:

Synbiotic supplementation with NSPT may be beneficial in improving glycemic control and inflammation and decreasing LDL-C in patients with T2DM and PD.
Medical student perception of force application: An accuracy assessment and pilot training program
Authors: Becker Heather , Duncan Riley , Newsome D’Angeleau , Zaremski Kenneth A. , Beutel Bryan G.
Published: November 2024

BACKGROUND:

It is unclear how accurately students can reproduce specific forces that are often required for physical examination maneuvers. This study aimed to determine the baseline accuracy of force application for preclinical medical students, evaluate the effectiveness of a quantitative visual feedback intervention, and investigate whether certain demographics influence accuracy.

MATERIALS AND METHODS:

First- and second-year medical students were enrolled and demographic data were collected. Students blindly applied their estimation of 15 lbs (6.8 kg), 3 lbs (1.4 kg), 10 lbs (4.5 kg), 1.5 lbs (0.7 kg), and 6 lbs (2.7 kg) of force on a scale. Visual feedback training was then performed wherein students applied a series of additional forces unblinded five times, and then blindly administered the same five initial forces 12 minutes and one week later. Accuracy was compared at each time point and a regression analysis was evaluated for predictors of accuracy.

RESULTS:

Thirty-three students participated. The mean baseline accuracy was 38.3%, 41.1% immediately following intervention, and 35.6% one week later (P = 0.66). Accuracy was significantly higher at higher intended forces compared to lower forces (P < 0.05). The number of prior occupations was a positive independent predictor (P = 0.04), and the number of sports played was noted to be a negative predictor (P = 0.01), of baseline accuracy.

CONCLUSIONS:

Medical students’ ability to accurately reproduce clinically relevant forces is poor. There is a clear need to implement a robust training program in medical education, and students may need multiple training sessions to refine this skill.
Stress level and coping strategies among intensive care nurses: A cross-sectional study
Authors: Babkair Lisa A. , Alaamri Marym , Tunsi Afnan , Alhofaian Aisha , Alsulami Nada Manea , Hakami Maryam Y. , Alshehri Norah A. , Alsulami Wed M.
Published: November 2024

BACKGROUND:

Intensive care units (ICUs) are high-stress environments, particularly for nurses, who face numerous stressors that can negatively impact their well-being. This study aimed to examine stress levels and stressors among ICU nurses, investigate their stress coping strategies, and explore the primary stressors in this demanding work environment.

MATERIALS AND METHODS:

Employing a cross-sectional design, this study assessed the stress levels of ICU nurses by using the Perceived Stress Scale and their coping strategies through the Brief-COPE scale, from March 15, 2021, to April 14, 2021. In addition, semi-structured interviews were conducted to gain deeper insights into the main stressors. The study also used critical appraisal tools to ensure quality and rigor.

RESULTS:

Among 103 participants, moderate stress levels were predominant. The most common coping strategies identified were religious activities, approach coping, humor coping, and avoidant coping. Interviews with three participants revealed two main themes: “It is an overwhelming job” and “Just stay strong.” The primary stressors reported were dealing with critically ill patients and nurse shortages, exacerbated by the pandemic crisis.

CONCLUSION:

ICU nurses experience moderate stress levels, primarily due to the challenges of working with critically ill patients and facing multiple stressors. The study highlights the need for future research to test the effectiveness of stress management programs and to further investigate common stressors among Saudi ICU nurses. Health policymakers are urged to provide more support to nurses through appropriate education, protection, and compensation, aiming to reduce work-related stressors and enhance their overall well-being.
Jejunal flap interposition after total gastrectomy in managing patients with familial adenomatous polyposis: A report on the experience of a single centre
Authors: Barbosa José , Lopes Vítor , Sousa Fabiana , Baptista Manuela , Barbosa José Pedro , Barbosa Elisabete
Published: November 2024

Introduction:

Patients with familial adenomatous polyposis (FAP) are characterised by the appearance of colorectal cancer if the disease is left to follow its natural course, which means they frequently undergo prophylactic colectomy at a young age. In these patients, duodenal cancer becomes the leading cause of death, which deems surveillance necessary. Gastric cancer, although rare, can also occur in these patients, and total gastrectomy is the usual treatment option.

Patients and Methods:

We used a pedicled isoperistaltic jejunal flap interposition technique to reconstruct the digestive tract after a total gastrectomy so that duodenal surveillance could be maintained in patients followed in outpatient consultation for genetic diseases. We also describe how this technique was performed fully through laparoscopy in two of these cases.

Results:

We identified four patients with FAP who developed malignant or extensive pre-malignant gastric lesions which were not endoscopically resectable. Two patients were submitted to open surgery and the remaining two underwent laparoscopic surgery. There was no perioperative or post-operative morbidity, and all four patients are alive at the time of writing, with a minimum follow-up of 12 months. They were not diagnosed with major nutritional imbalances and were routinely submitted to endoscopic duodenal surveillance, sometimes including polypectomy, with ease.

Conclusion:

In our experience, this surgical technique has good results, and all surgical steps can be done entirely through laparoscopy, with every advantage this approach entails.
Retrospective Evaluation of Sedation Techniques for Tooth Extraction in Paediatric Patients
Authors: Sharma Mridul , Sahu Amit K. , Kaila Puja , Hassan Ali Abdel H. A. A. , Mansy Mohamed , Thakur Raksha , Homeida Husham E.
Published: November 2024

ABSTRACT

Background:

Dental procedures often require local anesthesia, but managing fearful patients, especially children, can be challenging, potentially leading to dental phobia development. Sedation methods such as conscious sedation, deep sedation, or general anesthesia can aid in managing these patients.

Material and Method:

This study focuses on evaluating various sedation techniques used in an Oral and Maxillofacial Surgery Clinic for adults with special needs requiring dental treatments under sedation or general anesthesia. A retrospective analysis was conducted on 250 adult patients with special needs who underwent dental procedures between January 2019 and December 2023. Data on demographic characteristics, types of procedures, sedation techniques used, dosages, and complications were collected from medical records. Sedation techniques included midazolam-sufentanil, ketamine-midazolam, oral midazolam, chloral hydrate, ketamine, and propofol.

Results:

The midazolam-sufentanil combination was the most commonly used sedation technique (27.2%), followed by ketamine-midazolam (21.6%). Complications such as respiratory issues (2.9%), cardiovascular events (1.5%), nausea/vomiting (4.4%), and prolonged recovery time (2.9%) were observed.

Conclusion:

Overall, the incidence of complications was relatively low, indicating the safety and efficacy of the sedation techniques. Sedation techniques, particularly the midazolam-sufentanil and ketamine-midazolam combinations, were found to be effective and safe for managing dental procedures in adults with special needs. Personalized sedation approaches based on individual patient factors are essential for optimizing outcomes. Further research is needed to explore long-term effects and patient satisfaction.
Atomic Force Microscopic Evaluation of Surface Topographies of Various Rotary Files in Root Canal Preparation in Molar Teeth
Authors: Swathika B , Nagareddy Bharath , Vijith V , Alghamdi Nuha , Samson Angel
Published: November 2024

ABSTRACT

Background:

The efficiency and safety of root canal preparation are significantly influenced by the surface topographies of rotary files. Atomic force microscopy (AFM) provides high-resolution imaging that can reveal detailed surface characteristics of these instruments.

Materials and Methods:

In this study, three types of rotary files (File A, File B, and File C) were used to prepare the root canals of extracted human molar teeth. A total of 30 molar teeth were divided into three groups (n = 10) and prepared using one of the three rotary files. After preparation, the rotary files were analyzed using AFM to measure surface roughness parameters including average roughness (Ra), root mean square roughness (Rq), and maximum peak height (Rp). Statistical analysis was performed using ANOVA and post
hoc tests to compare the differences between the groups.

Results:

The AFM analysis revealed significant differences in the surface topographies of the rotary files. File A exhibited a Ra of 150 nm, a root mean Rq of 180 nm, and a maximum peak height Rp of 300 nm. File B showed an average roughness (Ra) of 200 nm, a root mean Rq of 230 nm, and a maximum peak height (Rp) of 350 nm. File C had an average roughness (Ra) of 170 nm, a root mean Rq of 210 nm, and a maximum Rp of 320 nm. Statistical analysis indicated that File B had significantly higher roughness parameters compared to File A and File C (P < 0.05).

Conclusion:

The surface topographies of rotary files vary significantly, which may impact their performance in root canal preparation. File B, with the highest roughness parameters, may pose a greater risk of canal wall damage and debris retention. These findings underscore the importance of selecting appropriate rotary files to optimize endodontic treatment outcomes.
Functions of nuclear factor Y in nervous system development, function and health
Authors: Moreira Pedro , Pocock Roger
Published: November 2024

Nuclear factor Y is a ubiquitous heterotrimeric transcription factor complex conserved across eukaryotes that binds to CCAAT boxes, one of the most common motifs found in gene promoters and enhancers. Over the last 30 years, research has revealed that the nuclear factor Y complex controls many aspects of brain development, including differentiation, axon guidance, homeostasis, disease, and most recently regeneration. However, a complete understanding of transcriptional regulatory networks, including how the nuclear factor Y complex binds to specific CCAAT boxes to perform its function remains elusive. In this review, we explore the nuclear factor Y complex’s role and mode of action during brain development, as well as how genomic technologies may expand understanding of this key regulator of gene expression.
Future global existence and stability of de Sitter-like solutions to the Einstein–Yang–Mills equations in spacetime dimensions $n\geq 4$
Authors: Liu Chao , Oliynyk Todd A. , Wang Jinhua
Published: November 2024

We establish the global existence and stability to the future of non-linear perturbation of de Sitter-like solutions to the Einstein–Yang–Mills system in

n\geq 4

spacetime dimension. This generalizes Friedrich’s Einstein–Yang–Mills stability results in dimension

n=4

[J. Differential Geom.
34
, 275–345 (1991)] to all higher dimensions.
Классификация трех семейств 5-конфигураций
Authors: Malyshev Fedor Mikhailovich
Published: November 2024

Исследуется строение трех известных на настоящий момент бесконечных серий 5-конфигураций на счетных множествах $X$. Конфигурации серий $\mathcal{A}$ и $\mathcal{B}$ строятся по так называемым ориентированным 2-графам, в которых каждая вершина имеет две входящие и две исходящие дуги, петель и параллельных дуг нет. Каждой вершине 2-графа соответствуют две точки множества $X$ для конфигураций серии $\mathcal{A}$ и четыре точки для конфигураций серии $\mathcal{B}$. Конфигурации серии $\mathcal{C}$ строятся по ориентированному 1-графу: каждая вершина имеет одну входящую и одну исходящую дугу, каждой вершине соответствуют три точки множества $X$. Доказывается, что конфигурации разных серий не изоморфны друг другу, что две конфигурации серии $\mathcal{A}$, как и две конфигурации общего положения серии $\mathcal{B}$, изоморфны, если только соответствующие 2-графы изоморфны.
О структурных особенностях пространства ключей криптосистемы Мак-Элиса - Сидельникова на обобщенных кодах Рида - Соломона
Authors: Vysotskaya Viktoriya Vladimirovna
Published: November 2024

В работе исследуются классы эквивалентности секретных ключей криптосистем типа Мак-Элиса - Сидельникова. Вводится понятие кодов с разложимым квадратом, получены соотношения, характеризующие классы эквивалентности, если криптосистема строится на таких кодах. Уточняются результаты для частного случая использования обобщенных кодов Рида - Соломона. Приведено несколько примеров кодов на основе обобщенных кодов Рида - Соломона с гарантированно неразложимым квадратом.