bluuebunny/crossref_metadata_2025 huggingface dataset:
A semi-automatic approach for doline mapping in Brazilian covered karst: the way forward to vulnerability assessment
Authors: Fernandes Ferreira Cristiano , Yawar Hussain  , Uagoda Rogério
Published: December 2022

Doline mapping is paramount in the vulnerability and risk assessment of the underground karst environment by identifying cave-ground connectivity points at the surface. However, manual mapping is labour-intensive, slow and subjective, especially on a large scale. Therefore, the present study adopted a GIS-based semi-automatic approach for mapping large and medium-sized depressions/dolines in the Corrente river basin in Brazil, with a particular focus on the environmentally preserved areas of river Vermelho (APANRV Portuguese abbreviation) using remote sensing (DEM and Google Earth imagery) and field-based observations. Seven typical dolines forms (e.g., cockpit with drain insertion, collapse, collapse with river capture, suffosion, solution, cover collapse, and buried) are found from extensive field surveys. As an outcome of the proposed approach, two hundred and thirty-two medium to large-sized dolines have been identified and categorised into three main groups based on the cave density and local geology G1, G2, and G3. The high density of identified dolines (164 known caves) in G1 provides reconnaissance for future speleological works in the preserved areas. Additionally, the presence of a considerable number of dolines in the adjoining areas (G2 and G3) stresses the need to revise the existing boundaries of the APANRV. Results correlate well with the dolines sites marked using field surveys and Google Earth images. This doline mapping may help researchers in the groundwater vulnerability assessment and the protection of speleological heritage preserved in the caves.
Microplastic pollution in vulnerable karst environments: case study from the Slovenian classical karst region
Authors: Valentić Lara , Kozel Peter , Pipan Tanja
Published: December 2022

Since the start of mass production of plastic materials more than a century ago, the problem of accumulating plastic waste in the environment has reached epic proportions. Recently, the problem of smaller plastic particles (microplastic, MP) in the environment has become a widely studied topic, but the amount and types of MP in karst environments are still poorly known. Thus, the objective of this study was to collect and analyse samples from various karst habitats and to try and determine the scope of pollution in karst springs that are in part used as sources for drinking water. Of the potential pollution sources, we sampled rainwater, two discharges from wastewater treatment plants, and a leachate from a landfill. We conducted polymer analyses of potential MP particles using FTIR-ATR. The results showed that eight samples from the Postojna region (Postojna–Planina Cave System, rainfall sample and surface streams) contain up to 444 MP particles per m3. However, 32 samples taken from the Škocjan–Kačna–Jama 1 v Kanjaducah Cave System contain up to 60,000 MP particles per m3, with the bulk of particles found in the sediment samples from Škocjan Caves – Kačna Cave System. Samples from Postojna region contained mostly PET, PU and PA polymers, with a minor inclusion of polymers of plastic sponge used for cleaning. Samples from Škocjan region contained mostly PP, PET and PE polymers, with some of PA and PU polymers. Sediment samples contained much less MP particles compared to water samples, which indicates fast transport through karst aquifer.
Sensor Based Algorithm for Self-Navigating Robot Using Internet of Things (IoT)
Authors: Helshani Laurik , Qarkaxhija Jusuf , Prevalla Blerta
Published: December 2022

Abstract— The purpose of this paper is to show the design technique and programming of an autonomous robot prototype that can go to a predetermined location and return to its starting place utilizing the Global Positioning System (GPS). An HD camera along with an ultrasonic sensor and two IR sensors is used to provide necessary data from the real world to the robot to avoid obstructions, by following GPS Waypoints. A smart algorithm was introduced for path planning and re-planning. The robot can modify its direction using a digital compass reading and input from sensors by computing the heading angle from the current GPS point. This self-navigation mobile robot's accuracy was evaluated in several locations and is quantified in terms of heading angle and path length from the starting point to the goal point.
Un nouveau centenaire pour le Brésil et pour son Musée National
Authors: Duarte Luiz Fernando Dias
Published: December 2022

Le Musée National [Museu Nacional] brésilien a
fêté son second centenaire en 2018, l’année où la plus grande partie
de son siège et de ses collections a été détruite par un incendie. La
date précédait de quatre années la commémoration du second centenaire
de l’indépendance du pays. Le musée aurait dû accompagner – en
première ligne – la réflexion et les fêtes suscitées pour l’occasion.
Dans le contexte de la restauration du palais de São Cristóvão et de
la reconstitution générale de l’institution, un intense travail de
révision de la signification de son traditionnel caractère
« national » et de sa responsabilité en tant que plus ancien musée du
pays s’est imposé. Il a permis une prise de conscience des changements
du contexte social et culturel national, notamment pour un musée
d’histoire naturelle et d’anthropologie. Les débats en cours sur les
nouvelles installations, les collections et les futures expositions
constituent un moment stratégique de cette révision apportant des
contributions durables pour le service de l’institution à la
nation.
Musée Paulista : du théâtre de la mémoire au musée-laboratoire. Autour de l’indépendance du Brésil
Authors: Schiavinatto Iara Lis , Lima Junior Carlos
Published: December 2022

Le projet muséologique d’Afonso Taunay pour le
Musée Paulista, rattaché à l’Université de São Paulo depuis 1963, a
consacré ce musée historique à l’indépendance du Brésil (1922). Notre
objectif dans cet article est de montrer les formes d’élaboration d’un
contrat civique entre l’institution et cette date nationale. L’arrivée
d’Ulpiano Bezerra de Meneses à sa direction, en 1989, imprima un
tournant avec, notamment, la mise en place de nouvelles orientations
sur le plan muséal à partir d’une révision critique de son fonds
(matériel et visuel) et du bâtiment-monument qui en est le siège.
Après avoir donné quelques repères dans l’évolution du musée, à partir
de la caractérisation des phases institutionnelles antérieures à
Bezerra de Meneses, nous montrons que les postulats de ce dernier
– dans son effort pour passer d’un Musée « théâtre de la mémoire » à
un « laboratoire de l’histoire » – inspirent le plan de restauration
puis l’inauguration du musée de l’Ipiranga (nouvelle dénomination) en
2022, ainsi que les reformulations des manières d’appréhender le
concept dans le chef-d’œuvre de Pedro Américo, « L’Indépendance ou la
mort ! ».
Régimes d’écriture et de scientificité de l’histoire brésilienne au XIXe siècle : Varnhagen et le plagiat de son História geral do Brasil par Handelmann
Authors: Bentivoglio Julio
Published: December 2022

Cet article analyse les nouvelles pratiques
historiographiques liées à la recherche empirique, à l'écriture de
l'histoire et à l'émergence d'un nouvel ethos pour les historiens brésiliens au
cours du XIXe siècle. Il
dissèque la genèse des nouveaux régimes d’écriture et de
scientificité, prenant comme objet d'enquête l'accusation de plagiat
que Francisco Varnhagen porte en 1860 contre Heinrich Handelmann, à
l'Institut historique et géographique brésilien (IHGB). D’après lui,
l'historien allemand aurait plagié des extraits de la première partie
de son História geral do
Brasil.
« Objets Etc. » : pratiques autres dans l’art brésilien des années 1960
Authors: Caspary Gabriela
Published: December 2022

Le but de cette étude est d’analyser le réseau
formé entre les artistes, les marchands, les institutions et la
critique d’art au Brésil entre les années 1965 et 1969. La production
d’objets en dehors des normes traditionnelles – notamment de
« boîtes » (caixas) – et
les processus de légitimation découlant de cette nouvelle pratique
sont observés dans le but d’étudier le fonctionnement du système de
l’art. Les productions d’artistes aux vocations et aux désirs variés,
notamment d’artistes ne faisant pas partie des grands noms de
l’avant-garde de l’époque, sont analysées.
Removal of Methyl Orange Using Hybrid Spherical Silica Adsorbents
Authors: Hassan Boushara Reham Salah , Hassani Nabila Balqis , Abdul Rahim Abdul Rahman , Johari Khairiraihanna , Rabat Nurul Ekmi , Mohd Amin Khairatun Najwa , Shaharun Maizatul Shima , Song Show Tien
Published: December 2022

This study investigated the potential of adsorption behaviour of methyl orange onto hybrid spherical silica adsorbent. Removal of dye has been a problem worldwide and the study of removing dye through adsorption method is quite limited. This study aims to synthesize and characterize spherical silica (SSi) adsorbent and evaluate its adsorption capacity of it. The spherical silica adsorbent (SSi) was prepared using oil-in-water (o/w) emulsion polymerization modification where Tetraethyl Orthosilicate (TEOS) acts as the silica precursor. The physicochemical properties of SiNs were characterized using Fourier transform infrared (FTIR), field emission scanning (FESEM), nitrogen adsorption/desorption analysis (NAD), and transmission electron microscopy (TEM). The batch adsorption study for the methyl orange removal parameters such as pH (2-10 ) and agitation time (0-180 minutes). The experimental adsorption data were further evaluated using several adsorption kinetic models, namely pseudo-first-order, pseudo-second-order and Elovich kinetic models. The diffusion kinetics model includes the Weber-Morris plot, Fick’s Law equation and Boyd plot. The result shows that the spherical silica (SSi) adsorbent at pH 2 has the highest adsorption capacity amongst another adsorbent towards methyl orange which is 45.05 mg/g. Furthermore, the equilibrium time for methyl orange adsorption onto SSi was 120 min. The data fitted into a pseudo-second-order kinetic model indicating chemical adsorption, limited by film diffusion.
Evaluation of the Corrosion, Microstructural and Mechanical Characteristics of Cu-Al-Zn-Sn High Entropy Alloys
Authors: Samuel Ayuba Ushe , Fayomi Ojo Sunday Isaac , Omotosho O.A.
Published: December 2022

In a search for solutions to minimize the problem of aluminium cookware leaching, pitting, wear and cracking off due to thermal stress, high entropy alloys (HEAs) have become profitable materials. Cu-Al-Zn-Sn HEAs were produced, ad properties compared with that of the existing aluminium cookware material. The ASTM G102 standard was followed to investigate the corrosion rate (CR) of these materials in 3.65 wt.% NaCl (potentiodynamic polarization technique). Following ASTM A-370 standard, Vickers hardness (VH) of the materials were examined using a nanoindenter. The CETR reciprocating sliding tribometer was used to investigate the wear rate (WR) in line with ASTM G99 procedure. With the aid of a thermo-gravimetric analyzer, the MTS (maximum temperature of stability) of the materials was examined. The microstructural analysis of the materials was conducted using scanning electron microscope (SEM) and X-ray diffractometer (XRD). For the existing aluminium cookware material sample, the CR, VH, WR and MTS of the were 0.9327 mm year-1, 56.25 mN mm-2, 1.888 × 10-5 mm3 N-1 m-1 and 610 °C, respectively. For the HEA samples, the CR, VH, WR and MTS ranged from 0.1708-0.4080 mm/year, 159.99-398.18 mN mm-2, 1.565 × 10-5-1.944 × 10-5 mm3 N-1 m-1 and 680-690 oC, respectively. The microstructural examination of the HEA samples revealed the existence of better morphology, higher texture quality and enhanced microstructural homogeneity compared to the aluminium (Al) sample. The dendrites observed on the HEA samples on the surface are indications that the samples exhibited superior mechanical properties, and could be employed for advanced applications. Key words: Corrosion; Wear; Thermo-gravimetric; Wear; Microstructure; Temperature
Effect of Synthetic Materials in Reinforcement of Aluminium Matrix Composites
Authors: Joseph Olufunmilayo Oluwabukola , Aluko Micheal Olalekan
Published: December 2022

Aluminium matrix composite is a type of innovative technical material that have applications in aerospace, automotive, biotechnology, electronics, and a lot more. Non-metallic reinforcements can be injected into an aluminium alloy to provide advantages over base metal (Al) alloys. Better mechanical properties, improved microstructure, and corrosion resistance are the benefits that have been noticed upon reinforcements. The proportion of reinforcement, kind, size, and forms of aluminium matrix are all important factors in improving mechanical and tribological properties. Investigation in the creation of highly advanced tailored materials using liquid and solid-state processes and the impact it has on the properties and application are the subject of this work. The current research summarizes recent breakthroughs in aluminium-based composites and other particle reinforcement effects. The experiment findings revealed that strengthening the aluminum matrix with reinforcements increased mechanical properties and improves the microstructure. Also, stir casting was seen to be the most popular liquid metal approach because of its cost effectiveness and processing parameters which could easily be adjusted and monitored. It is concluded that aluminum matrix composites have greater mechanical characteristics, microstructure, and corrosion resistance than unreinforced aluminum alloys.
Feasibility of the novel ‘Tobacco-Free Hospital’ model and its compliance assessment at a tertiary care hospital of New Delhi, India
Authors: Kapoor Surbhi , Mohanty Vikrant R. , Balappanavar Aswini Y. , Kapoor Shivam , Rijhwani Kavita , Chahar Puneet , Malhotra Sneha
Published: December 2022

BACKGROUND:

Tobacco is one of the biggest threats to the public health. Tobacco harms not only human health but also the environment. The Cigarette and Other Tobacco Products Act (COTPA) was implemented in India in 2003. Compliance of these laws in public places is mandatory. This study presents an innovative model to make hospitals tobacco-free. The aim is to assess the effectiveness of implementation of tobacco-free hospitals among security guards, tobacco users, and key observers visiting a tertiary care dental hospital through a comprehensive strategy.

MATERIALS AND METHODS:

An exploratory study was conducted in three phases. Structured training was organized for all security guards (n = 25) along with pre- and post-assessment using a validated questionnaire. All the patients and attendants entering the hospital were screened for tobacco products by security guards. Those patients who were carrying tobacco products to the hospital (n = 107) were interviewed using a validated questionnaire. Opinions of key observers (n = 223) who witnessed the event were also recorded. Descriptive statistics (means, frequency distribution) and inferential statistics (Chi-square test) were calculated.

RESULTS:

At the baseline, only 20% security guards were aware about tobacco legislations, whereas after 1 month, more than 80% security guards were aware about the laws. Around two-third of study participants of both the groups were aware of COTPA Section 4. Approximately 33.6% of tobacco users and 58.4% of key observers were aware of COTPA Section 6b. Forty tobacco users in the study availed tobacco cessation services of the hospital.

CONCLUSION:

Every staff should be a torch bearer of tobacco control. The study highlights a comprehensive approach of integrating hospital staff and linking vital cessation services by implementing Sections of COTPA.
Comparison of the level of critical thinking skills of faculties and medical students of Ahvaz Jundishapur University of Medical Sciences, 2021
Authors: Shakurnia Abdolhussein , Khajeali Nasrin , Sharifinia Reza
Published: December 2022

BACKGROUND:

One of the main tasks of educational institutions, in addition to developing students' professional competencies, is to develop decision-making and problem-solving skills, which are themselves influenced by critical thinking that should be developed by instructors at the university. The aim of this study was to compare the level of critical thinking skills in students and faculties of Ahwaz Jundishapur University of Medical Sciences.

MATERIALS AND METHODS:

In this cross-sectional descriptive study, the sample consisted of 81 medical students and 52 faculty members of the medical school who were teaching and studying in 2021. The research method was descriptiveanalytical and the data collection tool was the California Critical Thinking Questionnaire Form B. SPSS-18 software and t-test were used to analyze the data.

RESULTS:

The mean score of students' critical thinking skills was 12.49 ± 4.43 and that of faculties was 12.44 ± 3.76 and no significant difference was observed between the scores of the two groups (P = 0.94).

CONCLUSION:

The findings of the study show that the level of critical thinking skills in both faculties and students is below the standard and poor. The results of the study indicate the weakness of critical thinking in students and faculties in all dimensions, which indicates the need to teach critical thinking skills at the university level. Therefore, educational planners and faculty officials should pay more attention to developing critical thinking skills in their educational programs.
Identifying the preparedness components in COVID-19
Authors: Maziar Pooneh , Maher Ali , Alimohammadzadeh Khalil , Jafari Mehrnoosh , Hosseini Seyed Mojtaba
Published: December 2022

In 2019, the COVID-19 pandemic posed a major challenge to the world. Since the world is constantly exposed to communicable diseases, comprehensive preparedness of countries is required. Therefore, the present systematic review is aimed at identifying the preparedness components in COVID-19. In this systematic literature review, PubMed, Scopus, Web of Science, ProQuest, Science Direct, Iran Medex, Magiran, and Scientific Information Database were searched from 2019 to 2021 to identify preparedness components in COVID-19. Thematic content analysis method was employed for data analysis. Out of 11,126 journals retrieved from searches, 45 studies were included for data analysis. Based on the findings, the components of COVID-19 preparedness were identified and discussed in three categories: governance with three subcategories of characteristics, responsibilities, and rules and regulations; society with two subcategories of culture and resilience; and services with three subcategories of managed services, advanced technology, and prepared health services. Among these, the governance and its subcategories had the highest frequency in studies. Considering the need to prepare for the next pandemic, countries should create clear and coherent structures and responsibilities for crisis preparedness through legal mechanisms, strengthening the infrastructure of the health system, coordination between organizations through analysis and identification of stakeholders, culture building and attracting social participation, and service management for an effective response.
Knowledge, Anxiety, and practice during the COVID-19 crisis among HCWs in Saudi Arabia
Authors: Alshagrawi Salah , Alhowti Sultan
Published: December 2022

BACKGROUND:

The rapid and widespread of COVID-19 has caused distress and havoc among people in all walks of life. Such impact has been more pronounced among HCWs. We sought to examine how health care workers (HCWs) knowledge about COVID-19 and perceived anxiety can influence preventive practices.

MATERIALS AND METHODS:

In this cross-sectional study a multiple regression analysis was applied to examine the relationship between knowledge, anxiety, and preventive practices among 267 participants work in different settings in a variety of health care organizations in different regions in Saudi Arabia. To estimate potential associations, a multiple regression analysis was applied. Standardized beta-coefficients and their 95% confidence intervals were estimated to examine the outcome variable and the predictors' associations.

RESULTS:

Our findings shows that HCWs had high levels of knowledge about COVID-19, perceived anxiety, and preventive practices. In examining the relation between HCWs characteristics and their knowledge about COVID-19, older HCWs have been shown to have higher knowledge compared to younger HCWs. Finally, the model to estimate the impact of knowledge about COVID-19 and perceived anxiety on preventive practice showed that both have a significant impact.

CONCLUSIONS:

HCWs tendency to adhere to preventive practices is related to their levels of knowledge and perceived anxiety. Such a relationship can inform administrators and policymakers in the health care field to design health promotion campaigns to ensure all HCWs are aware of the nature of communicable diseases and the risk they might entail.
Social networks
Authors: García-Méndez Carmen , García-Padilla Francisca María , Romero-Martín Macarena , Sosa-Cordobés Elena , Domínguez-Pérez María del Mar , Robles-Romero José Miguel
Published: December 2022

BACKGROUND:

Social networks are integrated in our lives and, amongst other functions, they are a means of dissemination. There are numerous social network accounts dedicated to health that could be used as an educational resource. The aim of this study was to evaluate the quality of accounts dedicated to health in different social networks, assessing their content and didactic and technological effectiveness and accessibility.

MATERIALS AND METHODS:

Observational cross-sectional descriptive study in which an analysis of social networks related to health was carried out from April to June 2021 in Spain. Twenty-eight accounts were analysed using a mixed qualitative-quantitative methodology. Content analysis of the speeches disseminated through the selected accounts was performed. In addition, the quality of the accounts was assessed with the Instrumento de Evaluación de Recursos Educativos Digitales (#IE_RED) (Digital Educational Resources Evaluation Instrument [#IE_RED]).

RESULTS:

Four categories were identified according to the content: student-focused profiles, specific professionals' profiles, current health issues and profiles promoting a healthy lifestyle. In addition, the quality of the accounts obtained a score that indicates they meet the requirements to be validated as a good educational digital resource but could be improved. Instagram social network accounts and those managed by nurses scored significantly higher.

CONCLUSIONS:

The analysed accounts were revealed as a quality tool for health dissemination, with varied content and applicable to teaching. Their use could be applied both to the training of health professionals and to the promotion of the population's health.
Prevalence of depression, anxiety and stress among private medical college students in South India
Authors: Raja Sangeetha , Balasubramanian Gayathri , Jamuna Rani R
Published: December 2022

BACKGROUND:

Medical education is competitive across the globe. The long duration of the medical and paramedical courses and exposure to clinical settings potentially causes mental health issues. The aim of this study was to estimate the prevalence of depression, anxiety and stress among undergraduate students in a private medical college in South India.

MATERIALS AND METHODS:

This cross-sectional study was conducted among paramedical and medical students at a private medical college hospital and research center in South India in the year 2021. The required sample size was calculated as 783 with an expected prevalence of 53%, 95% confidence interval (CI), design effect 2.0, and non-response of 10%. The study participants were selected based on simple random sampling. After obtaining informed consent, the data was collected using an email questionnaire. Standard data collection tools such as the Perceived Stress Scale (PSS); and the Depression, Anxiety and Stress Scale - 21 (DASS-21) questionnaire were used. The investigator computed the odds ratio (OR) and adjusted odds ratio (aOR) with a 95% CI.

RESULTS:

Out of 1200 students, 1015 (85%) responded to the email questionnaire. Among them, 639 were females (63%), and 925 were paramedics (91%). Prevalence of depression, anxiety and stress were 59%, 43% and 11%, respectively. Almost 95% of students experienced moderate-to-severe stress in the last one month. Prevalence was higher among females and students of medical courses. Students of final year of college (aOR = 2.0; 95% CI = 1.2–3.5) and students of medical course (aOR = 1.5; 95% CI = 1.1–2.4) were independently associated with stress among the study participants.

CONCLUSION:

There is high prevalence of depression, anxiety and stress among medical college students in south India. The final year of study and medical course were independently associated with higher stress than others. We recommend periodic assessment of mental health status and additional mental health care for final year students and medical students.
Effectiveness of reinforcement program on adherence toward short peripheral catheter (SPC) care guidelines among registered nurses working in pediatric wards of a tertiary care hospital
Authors: Shivani S , Joseph Hepsi Bai
Published: December 2022

BACKGROUND:

Short peripheral catheterization is the common procedure performed in every hospital with patients' admittance. It becomes challenging when it comes to children and requires more knowledge and skills. The aim of the current study was to assess the effectiveness of the reinforcement program on adherence to short peripheral catheter (SPC) care guidelines among registered nurses.

MATERIALS AND METHODS:

A quasi-experimental study was conducted among 44 registered nurses by observing 96 SPC care events before and after the reinforcement program in pediatric wards of a tertiary care hospital in Eastern India. The study was conducted in a tertiary care public hospital in Eastern India in 2019, and the data collection tool included children's and nurses' socio-demographic data and an observation checklist on intravenous catheterization care. Descriptive statistics were used to explain the participant characteristics, and McNemar's test was used to identify the adherence to SPC care guidelines.

RESULTS:

There was a statistically significant improvement in most steps, such as hand washing, gloving, tray preparation, documentation initiation, maintenance, and removal (P = 0.001). A statistically significant reduction in the early stage of phlebitis was found from 66.7% in pre-intervention to 37.5% in post-intervention (P = 0.027).

CONCLUSIONS:

The majority of nurses adhered to SPC care guidelines after the reinforcement program. From the study findings, it is recommended that regular reinforcement related to peripheral catheter care acts as a stimulant to adhere to SPC care guidelines. The nursing administration should take initiative by conducting in-service training for the nurses, which motivates them toward practicing quality nursing care.
Application of Berlin questionnaire in obstructive sleep apnea syndrome through soft palate morphology types
Authors: Saluja Imit P. , Bhargava Ananya , Bhargava Apoorva , Hiremutt Darshan R. Prasad , Saxena Shobhit , Agrawal Anagha
Published: December 2022

BACKGROUND:

Obstructive sleep apnea (OSA) is a sleep disorder characterized by intermittent complete and partial airway collapse, resulting in frequent episodes of apnea and hypopnea. The Berlin questionnaire (BQ) is a simple, inexpensive instrument used to screen for OSA, which is about risk factors for sleep apnea, namely, snoring behavior, daytime sleepiness or fatigue, and the presence of obesity or hypertension. This 10-question test has since then become well known for its accuracy in predicting the presence of sleep apnea in patients. Cephalometry is a relatively inexpensive method and it permits a good assessment of the soft tissue elements that define the soft palate and its surrounding structures. Therefore, the present study aims to study the morphology of the soft palate using lateral cephalometry and classify it into various types. And to identify the individuals with OSA syndrome through a particular type of soft palate and correlate it with the BQ.

MATERIAL AND METHODS:

This prospective study was conducted in the Department of Oral Medicine and Radiology of D.Y.Patil Dental College, Pune. About 150 subjects for the study were selected by random sampling from the outpatient department of Oral Medicine and Radiology and the patients were referred from the orthodontics department. Lateral cephalograms were assessed for soft palate morphology types, and all participants filled the BQ. A Chi-square test was applied. The level of significance was set at P < 0.05.

RESULTS:

Among six types of the soft palate, the maximum number of participants had type 2 (rat-tail type) of the soft palate (26.0%). A highly significant association was found between the BQ (positive and negative response) and soft palate morphology types (i.e., P < 0.01). A maximum number of participants who responded to the BQ had type 5 (S type) of the soft palate (76.47%).

CONCLUSION:

The type 2 (rat-tail) soft palate was the most frequent type, while the type 4 (straight-line) shape was the least common among all the six types. The persons with type 5 (S-shape) soft palate responded more positively to the BQ as compared to other types of soft palate. This shows that a particular type of soft palate could be responsible for causing OSA syndrome.

Clinical Significance:

Lateral cephalogram and BQ, which are relatively inexpensive and widely available, can be used in resource-limited and thickly populated countries like India to correctly identify patients with OSA syndrome.
Competency-based medical education (CBME) curriculum and its effect on prevalence of anxiety, depression and stress amongst medical undergraduates
Authors: Goel Ashish , Sethi Yashendra , Moinuddin Arsalan , Deepak Desh , Gupta Priyanka
Published: December 2022

BACKGROUND:

A growing body of literature now identifies higher levels of anxiety, depression, and stress among medical students as a distinct mental health domain. The competency-based medical education (CBME) curriculum was introduced to revamp the existing curriculum with an aim to garner constructive impact on the mental health of undergraduate medical students. As such, we sought to draw comparisons between the mental health of medical students, studying the old (2018 batch) and the new (2019 batch) medical education systems in India.

MATERIALS AND METHODS:

We designed a survey that contained structured questions pertained to anxiety (HAM-A, GAD-7), depression (HAM-D, BDI), and stress (PSS) amongst medical undergraduate students of 2018 and 2019 batches at the Government Doon Medical College (GDMC), Dehradun, India.

RESULTS:

Contrasting the 2018 and 2019 batches, the introduction of CBME resulted in a significant two-fold decrease in moderate anxiety, as exhibited by both HAM-A (6.0 vs 3.0, P = 0.016) and GAD-7 (3.5 vs 1.0, P = 0.037) scales, although no significant change in mild and severe anxiety, and overall depression (BDI: P = 0.05, HAM-D: P = 0.05) or stress (PSS: P = 0.86) was found.

CONCLUSION:

The CBME system has made a significant impact on the mental health of undergraduate medical students for anxiety, albeit its effect on depression and stress remains equivocal. Future studies are warranted to compare the effect of CBME in other undergraduate and postgraduate courses across the country to help predict the psychological impact of the newfangled CBME education system.
Do different positions during a non-stress test affect the maternofetal physiological parameters and comfort in pregnant women?
Authors: Patel Rukmani , Smitha M. V. , Jena Saubhagya K. , Jacob Jaison , John Joseph
Published: December 2022

BACKGROUND:

A non-stress test (NST) is an essential diagnostic test performed during pregnancy to assess fetal well-being. It is a recording of fetal movements besides fetal heart rate, indicating fetal biophysiological well-being. As maternal physiology is altered in various positions, apt positioning during the NST is essential for accurate results while ensuring maternal comfort. This study aims to evaluate the effect of different maternal positions, left lateral and semi-fowler's, on NST reactivity, maternal blood pressure, heart rate, and comfort in pregnant women while performing the NST.

MATERIALS AND METHODS:

This crossover study evaluated 50 healthy pregnant women between 32 and 40 weeks of gestation with no obstetric complications for the effect of maternal positions on maternofetal physiological parameters and comfort. The NST was performed for 20 min in each position with a washout period of 10 min. The maternofetal physiological parameters were recorded by a calibrated sphygmomanometer and the electrocardiograph interpretations. The maternal comfort was assessed using a maternal comfort rating scale (MCRS) for each position after the NST. Relevant descriptive and inferential statistics are applied to compute the results.

RESULTS:

Statistically, there was a significant difference in the mean maternal blood pressure and heart rate between the left lateral and semi-fowler's positions at 0 and 20 min (P = 0.001), whereas within the groups, in the same position at 0 and 20 min, no significant difference was found. There was no significant difference in NST reactivity (P = 0.79) in different positions. There was no significant difference between the MCR scores of women in either of the positions (Z = −1.64, df = 49, P = 0.100).

CONCLUSION:

Semi-fowler's position demonstrated favorable maternal blood pressure and heart rate during the NST in the third trimester of pregnancy, though it was clinically not significant. There was no significant difference in the comfort of women in both positions. Hence, either of the positions can be implemented in practice as an alternative position while performing the NST, based on the women's preference.
Factors affecting nonadherence to treatment among type 2 diabetic patients with limited health literacy
Authors: Pourhabibi Nasrin , Sadeghi Roya , Mohebbi Bahram , Shakibazadeh Elham , Sanjari Mojgan , Tol Azar , Yaseri Mehdi
Published: December 2022

BACKGROUND:

Treatment adherence is one of the behaviors associated with type 2 diabetes that predicts whether it will be successfully treated or develop complications and become uncontrolled. This study aimed to determine factors affecting nonadherence to treatment among diabetic patients with limited health literacy from the perspectives of patients, their families, and healthcare providers.

MATERIALS AND METHODS:

This qualitative study with a content analysis approach was conducted on 84 eligible type 2 diabetes patients with limited health literacy and poor adherence to treatment, as well as their families and healthcare providers using a purposive sampling method, in Kerman city in 2021. Interviews were conducted using a semistructured interview guide with a broad, open-ended question to provide a general history of the disease separately. The interviewer asked participants to identify the perceived barriers to treatment nonadherence. Each interview lasted 45–60 min. MAXQDA version 20 and inductive content analysis were used to code and analyze extracted data.

RESULTS:

Four major themes emerged from the patients' perspectives as “financial problems,” “individual factors,” “problems related to medication availability,” and “healthcare providers' poor practices.” Two major themes were classified from the perspective of patients' families as “financial problems” and “Individual factors,” and four major themes were identified from the viewpoint of healthcare providers including “financial problems,” “individual factors,” “scarcity and medication availability,” and “poor practice of the healthcare provider.” These mentioned barriers were confirmed regarding treatment nonadherence among study participants.

CONCLUSION:

Study findings revealed different factors of treatment nonadherence among diabetic patients with limited health literacy. Therefore, these factors should be considered in tailoring promotive educational and supportive interventions. Considering the importance of adherence to treatment patients, planning empowerment family-based interventions focusing on health literacy improvement seems necessary.
Reproducibility of Cytomorphological Diagnosis and Assessment of Risk of Malignancy of Thyroid Nodules Based on the Bethesda System for Reporting Thyroid Cytopathology
Authors: Panda Sasmita , Nayak Mamita , Pattanayak Lucy , Behera Paresh Kumar , Samantaray Sagarika , Dash Sashibhusan
Published: December 2022

Introduction:

The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was introduced for unifying the terminology and morphologic criteria along with the corresponding risk of malignancy, leading to more consistent management approaches. The aim of this study was to study the utility and reproducibility of TBSRTC in reporting thyroid cytology in a referral cancer center.

Methods:

The fine-needle aspiration (FNA) of all thyroid nodules were included for a period of 5 years, from January 2016 to December 2021, in this cancer center. They were retrospectively reviewed and recategorized according to TBSRTC by two experienced pathologists. Cytohistopathological correlation was done for the cases which underwent surgical resection.

Results:

522 fine-needle aspiration cytology (FNAC) of thyroid swellings were evaluated and categorized according to TBSRTC. There was agreement in the cytological diagnosis of 512 cases, of which 260 (50.78%) were benign lesions, 189 (36.91%) were malignant, 5 (0.97%) were unsatisfactory/nondiagnostic, 41 (8.01%) were follicular neoplasm/suspicious for neoplasm, 13 (2.53%) were suspicious for malignancy, and 4 (0.78%) cases were reported as atypia of undetermined significance. Two cytopathologists were in agreement in 512 cases (98%) of cases. Almost complete concordance was noted in the malignant (99%) and benign categories (98%). Disagreement was seen in 10 cases. Histological follow-up was available in 201 cases with an overall malignancy rate of 62.68% (126/201).

Conclusion:

TBSRTC proved to be a very simple and effective reporting system for thyroid FNAC, especially in the setting of a cancer center. This enables proper triaging of cases with thyroid masses into those who require surgical intervention and those who can avoid it, thereby preventing unnecessary morbidity.
Peripheral Blood Smear
Authors: Garg Neha , Gupta Rashmi Jain , Siroha Alka , Kumar Sunil
Published: December 2022

The incidence of nosocomial infections has been reported as 12%–18% in various studies from India, with bloodstream infections amounting 15%. Fungal pathogens have become a major cause of nosocomial bloodstream infections. Detection of fungemia by blood culture often requires 2 or 3 days of incubation. Few studies have reported the detection of Candida species (Candida albicans, Candida glabrata, and Candida parapsilosis) by review of routinely stained blood smears, often days earlier than diagnosis being possible by culture. These can be seen as round–oval extracellular as well as intracellular budding yeast organisms which show pink-magenta staining with periodic acid Schiff stain. We report here the detection of Candida spp. in the peripheral blood smear.
Comparative Morphological and Morphometric Study between Medial and Lateral Menisci in Aged Male and Female Human Cadavers
Authors: Aggad Waheeb Sami , El-Aziz Gamal S. Abd , Hamdy Raid M. , Saleh Hamid A. , Alyazidi Anas S.
Published: December 2022

Background:

The meniscal cartilages are fibrous discs that are important for knee structures and have the ability to bear weight and stabilize joints. However, morphological and standard data for the meniscus are limited. Therefore, this work will compare anatomical and histological parameters of meniscal cartilages. The results will be important for the different measurements that are necessary for knee joint surgery.

Materials and Methods:

A total of 24 aged cadavers (12 males and 12 females) were included. Knee joints were dissected and the menisci were excised and labeled as medial or lateral, right or left, male or female. Then, the menisci were kept in 10% formalin solution. Morphological variations of the meniscal shapes were macroscopically categorized. Different measurements, including the distance between anterior and posterior horns, outer and inner circumferences, width (breadth), and thickness, were done using a digital Vernier caliper and recorded manually.

Results:

48 medial menisci (MMi) cartilages were studied, they were 54.6% crescent-shaped, 34.6% V-shaped, and 10.8% U-shaped. 48 lateral menisci (LMi) cartilages were studied, 41.6% were crescent-shaped, 56.4% were C-shaped, and 2% were disc-shaped articular cartilage. Findings included differences in their lengths and thickness.

Conclusion:

The findings of this study were significant in providing new information on various morphological and morphometric parameters of the MMi and LMi in aged males and females, which are necessary to require more precise and comprehensive fundamental data that will be helpful for many specialists for better diagnostic and therapeutic approaches; aiming to restore normal joint conditions in senile people complaining of different meniscal pathologies.
Posterior Iris-Claw Lens – A Boon to Budding Cataract Surgeons
Authors: Vidhya C , Shreeshruthi N
Published: December 2022

Aim:

The aim was a retrospective comparative study on visual outcomes and complications of retro-pupillary fixated iris-claw lens (RPICL) with respect to the experience level of the operating surgeons.

Methods and Materials:

A retrospective study in which records of 126 patients who had RPICL implanted following cataract surgery between January and December 2020 at our hospital were analyzed. Patients were categorized into two groups: (a) RPICL done by a consultant (with experience of a minimum of 25 RPICL done) and (b) RPICL done by a resident (less than two RPICL done, with assistance). Visual outcome (best-corrected visual acuity in logMAR) and postoperative complications (on the first postoperative day and one month) were analyzed in the two groups.

Results:

There was a total of 126 eyes in 126 patients, of which primary RPICL was implanted in 45 eyes by the consultants (group A) and 81 eyes by the residents (group B). Overall ocular risk factors warranting a difficult surgery were significantly higher in the consultant group when compared with the resident group (P = 0.001). Mean preoperative vision was 0.899 and 1.137 in group A and group B, respectively. The final postoperative vision (postoperative period 1 month) was 0.246 and 0.332 in group A and group B, respectively. There was no statistically significant difference in preoperative and postoperative vision between both groups. Postoperative complications on day 1 were more in group B (71.6%) than in group A (55.6%) (P = 0.054). However, most of them resolved within 1 month postoperative period.

Conclusion:

Primary RPICL implantation is an effective modality of visual rehabilitation in complicated cataract surgery with deficient capsular support and is a boon for young budding cataract surgeons.
Retinal Artery Macroaneurysm − An Uncommon Manifestation of Radiation Retinopathy
Authors: Mishra Divyansh , Shanmugam Mahesh , Lomte Sonali , Ramanjulu Rajesh , Pal Surendra
Published: December 2022

To describe two cases of radiation retinopathy (RR) presenting with clinical and imaging characteristics of retinal artery macroaneurysm (RAM). The first case had radiotherapy to the right side of the brain 17 years prior to ocular manifestation, developed vitreous hemorrhage secondary to RAM in the right eye (RE) was managed with intravitreal anti-vascular endothelial growth factor. Second case had radiotherapy to right side of neck 6 years back, developed multiple tributary vein occlusions in RE, and was treated with sectoral laser. One year later, developed premacular and subretinal hemorrhage with RAM and managed with pars planavitrectomy and anti-VEGF. on subsequent follow up second patient had persistent cystoid macular edema which was managed with intravitreal triamcinolone acetonide and focal laser to RAM.
Prevalence of Visual Impairment Among Primary School Pupils in the Ga West Municipality, Ghana
Authors: Ceesay Winston , Abaidoo Benjamin , Braimah Imoro Z
Published: December 2022

Objective:

To determine the prevalence and pattern of visual impairment (VI) among primary school pupils in the Ga West Municipality of Ghana.

Methods:

A descriptive cross-sectional survey among primary school pupils at the Ga West Municipality. A cluster sampling technique was used to select 765 pupils from 12 primary schools (six public and six private schools). All pupils had presenting visual acuity (VA) testing and pupils with VI (presenting VA <6/18 in the better eye) had detailed ocular examination to determine the cause of VI. Binary logistic regression was used to determine the association between independent variables and prevalence of VI.

Results:

Four hundred and forty-eight (58.6%) of the pupils were males and their mean age was 10 ± 2.4 years. The prevalence of VI was 4.3%. Refractive error, 17 (51.5%), was the most common cause of moderate VI. Other morbidities associated with moderate VI were ocular surface abnormalities secondary to vernal keratoconjunctivitis, five (15.2%), amblyopia, four (12.1%), cataract, two (6.1%), and albinism, two (6.1%). The causes of severe VI were corneal opacity, chorioretinal scars, and glaucoma, each accounting for 3.0% of VI. Increasing age of pupils (P = 0.04) and private school attendance (P = 0.01) were found to be significantly associated with a higher prevalence of VI.

Conclusion:

Refractive error was the most common cause of VI in the primary school pupils. Annual eye examination and provision of affordable spectacles to school pupils with refractive error is recommended to reduce the impact of VI on their educational achievement.
Enterococcal Ulcerative Keratitis in a 32-Year-Old Nigerian
Authors: Ezeh Ernest I. , Okonkwo Sunday N. , Bassey Bassey O. , Ezeh Roseline N. , Etiowo Nkama , Egbe Ekama
Published: December 2022

Globally, most cases of microbial ulcerative keratitis are bacterial in origin. The most common causative organisms in bacterial keratitis are Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, and Pseudomonas aeruginosa. Ocular infections by enterococci are rare. Only a few cases of keratitis and endophthalmitis caused by enterococci have been reported worldwide. To the best of the authors’ knowledge, no case has been reported in Nigeria. We present a case of ulcerative keratitis due to Enterococci specie, to highlight the occurrence of this unusual ocular pathogen. A case of a 32-year-old male trader is presented with a 4-week history of severe painful red left eye, associated whitish discharge, sticky eyelids, tearing, profound visual loss, and whitish patch on the eye. Examination revealed paracentrally located 4.0 × 3.0 mm epithelial defect with an iris plugged 2 mm corneal perforation and an underlying dense, well-defined, white stromal infiltrate. Cultures yielded growth of E. specie, verified by biochemical tests (the Analytical Profile Index system Approach). He was managed on intensive antibiotics and made remarkable improvement. This highlights the need for Eye care practitioners to be mindful of the potential risk of unusual pathogen such as E. specie, causing cornea infection in our environment.