bluuebunny/crossref_metadata_2025 huggingface dataset:
The Concept of Non-Residential Premises: Public Law Aspect
Authors: Verbitskaya Yu. O.
Published: May 2023

The paper deals with the concept of premises used by public branches of law from the point of view of urban planning law. The study is original in that that in literature premises are studied primarily considering the possibility to act as the subject of civil law transactions. This paper reveals the meaning invested by the legislator in the concept of premises from the point of view of administrative, urban planning, criminal legislation, norms on safety of buildings and structures, sanitary norms and rules. Can there be premises as part of non-permanent structures? How does this relate to the real estate regime? Can there be one-room premises? It depends, for example, whether a trade pavilion needs to be equipped with a fire alarm, whether it is possible to smoke on the summer veranda of a public catering facility, whether it is necessary to equip the pavilion with air recirculation systems, and much more. How to understand what is in front of us: a separate premises or part of other premises? The possibility of cadastral registration and the technical equipment of the premises depend on this. Can the premises be non-isolated, but passable? This issue has long been faced by the practice of law enforcement in terms of cadastral registration of non-residential premises. The author considers what role the purpose of the premises has: firstly, the possibility of independent use, and secondly, the presence of a functional purpose. So, as an illustration, the question is being investigated, what will happen if you place a nightclub in a warehouse, and a medical facility in a former shop? The paper also compares the legal regime of premises as an object of civil law with the legal regime of premises as an object of public law. The general legal features of non-residential premises, characteristic of many branches of public law, are revealed.
Trust and Communication: Cornerstones of Care
Authors: Marshall Laura H.
Published: May 2023

In this issue of the North Carolina Medical Journal, authors explore and debate the ways communication can influ­ence how North Carolinians access health care in our state. Articles illustrate the importance of increasing trust in health care providers and systems at a time when care is changing dramatically, and patients have more access to information than they ever have.
Matters of Faith and Trust: The Role of Institutions in Creating Communities that Flourish
Authors: Jones L. Gregory
Published: May 2023

Essential to solving some of the world’s most complex problems is the commitment of community institutions—especially hospitals, universities, churches, and businesses—to empowering their communities to grow and prosper. By establishing trust and supporting social drivers of health, institutions can make a direct impact on the overall health of our communities.
Understanding and Improving Trust Across the Health Care Ecosystem
Authors: Basnight L. Lorraine
Published: May 2023

Trust is critical for optimal outcomes in health care, including keeping a healthy and thriving workforce and providing high-quality care. Understanding the issues of trust in health care relationships and addressing threats can improve trust.
Philanthropy Profile : A Conversation with Laura Gerald, President of the Kate B. Reynolds Charitable Trust
Authors: Gerald Laura
Published: May 2023

Current issues of trust between health care insti­tutions and communities are rooted in generations of marginalizing behavior and system failures. In this interview, Kate B. Reynolds Charitable Trust President Laura Gerald emphasizes the hard truths about why trust is lacking and what must be done to build it.
Opioid Use Disorder Practice by Licensure Category in North Carolina
Authors: Hughes Phillip M. , Harless Chase , Ramage Melinda , Fusco Carriedelle , Ostrach Bayla
Published: May 2023

Background

Nurse practitioners, physician assistants, and certified nurse midwives, collectively known as advanced practice providers (APPs), are critical members of the opioid use disorder (OUD) treatment workforce. Few studies compare the OUD treatment practice patterns of APPs relative to physicians.

Methods

In this cross-sectional study, we distributed a survey examining general substance use disorder (SUD) and OUD-specific treat­ment practices to all licensed physicians and APPs in North Carolina, resulting in a sample of 332 respondents. Respondents were asked about screening, referrals, and Drug Enforcement Administration (DEA) X-waiver status. Waivered providers were asked about prescribing buprenorphine. Differences in practice patterns by provider type were examined using descriptive statistics and chi-squared tests.

Results

Practice patterns were similar between APPs and physicians; however, more APPs reported screening their patients for SUDs (83.3% versus 69.4%, p = .0045). Of the providers who were waivered to prescribe buprenorphine, APPs and physicians were equally likely to be currently prescribing buprenorphine (75.8% versus 77.1%, p = .8900).

Limitations

This was a descriptive cross-sectional study using self-report data from a purposive sample and may not be representative of all providers.

Conclusions

Our results describe practice patterns for APPs and physicians and differences that may be reflective of regulations and therapeutic approaches. Similarities in obtaining an X-waiver and prescribing buprenorphine suggest that reducing restrictions on APPs may result in a larger treatment workforce.
Evaluation the results of colon transit time in patients with chronic constipation resistant to treatment
Authors: Anari Hasan , Yazdanbod Abbas , Sadeghieh-Ahari Saeed , Rahimpourmiralilu Ali
Published: April 2023

Background: Determining colon transit time (CTT) is one of the simplest, reproducible, safe, inexpensive, reliable, patient-acceptable and fully applicable methods in the evaluation of patients with constipation. Objective was to determine the results of colon transit time (CTT) in patients with chronic drug resistant constipation.
Methods: In this study, 30 people with constipation for at least three months and had defecation at most twice a week and did not respond to basic treatments were studied from October 2019 to June 2021 at Ardabil city hospital. 20 metal markers were given orally. Abdominal x-ray was performed on the 6th day and the number and speed of markers were considered. Patients also discontinued their anti-constipation medications. According to the CTT pattern, the causes of refractory chronic constipation were identified.
Results: Of all 30 patients, 13 (43.3%) were male and 17 (56.7%) were female. The mean age of patients was 45.4 years with a standard deviation of 15.92. The greatest number of underlying diseases was related to blood pressure with 10 cases (33.3%). Of all patients, 19 patients (63.3%) had normal transit time colon despite chronic constipation. In terms of disorders; 5 patients (16.7%) had colon inertia, 3 patients (10%) had outlet obstruction and 3 patients (10%) had hindgut dysfunction. There was no significant relationship between colon transit time outcomes and patients’ gender and age.
Conclusions: Examination of transit time colon in patients showed that the finding was normal in most of cases.
Outcome of late preterm infants and the factors associated with neonatal intensive care admission
Authors: Alam M. Mahfooz , Alam Shahzad , Mazahir Rufaida
Published: April 2023

Background: Infants born between 34 0/7 and 36 6/7 weeks of gestation are referred to as late-preterm infants (LPI). The study’s objective was to examine the prevalence and course of LPI at our institution.
Methods: This single-center prospective observational study was conducted at the level 3 NICU from June 2018 to June 2019 and included LPIs born in the hospital. Both the prevalence of LPI and the reasons for premature births were evaluated. Infants were observed until discharge for complications and outcomes (mortality and NICU admission). The risk factors associated with NICU admission were analyzed using multivariate logistic regression analysis.
Results: LPI constitutes 2.94% of all live births and 40.45% of total preterm births. Pre-eclampsia (15.1%) and premature membrane rupture (9.4%) were the two main causes of preterm birth, while the majority of mothers (37.7%) experienced spontaneous labor. A total of 55 (51.9%) babies developed complications, with respiratory distress (33.9%) being the most common. Three infants died, and 65 infants needed admission to the NICU. NICU hospitalization was independently associated with the existence of maternal risk factors, gestational age of 35 weeks, the requirement for resuscitation, and children whose weight was out of proportion to their gestational age.
Conclusions: LPIs account for a large proportion of premature babies, are prone to complications, and have a high mortality and morbidity rate.
Efficacy of RBC histogram in the diagnosis of morphological types of anaemia compared with peripheral smear
Authors: Varghese Alina Mariam , Sankar S. , P. L. Jayalakshmy
Published: April 2023

Background: Anaemia constitutes an important diagnostic and clinical category of haematological disorders. Along with peripheral smear histogram is used to interpret the abnormal RBC morphology. The present study is to find out the efficacy of RBC histogram in diagnosis of morphological types of anaemia.
Methods: A total of 354 blood samples of adults >18 years, Hb <10 mg/dl included in the study conducted at Medical College, Kottayam. Peripheral smear evaluated for RBC morphology without referring to the histogram. RBC histogram from same sample analyzed separately. The results obtained, classified into 4 morphological types of anemia -Normocytic normochromic, microcytic hypochromic, macrocytic and hemolytic anemias. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.
Results: The major proportion of study is in the age group of 51-70. Major morphologic type in both, is normocytic. Concordant samples for normocytic - 161, microcytic- 97, macrocytic- 7, Hemolytic- 1. Histogram show more sensitivity and less specificity for normocytic. Microcytic has less sensitivity, more specificity. Macrocytic showed >90% sensitivity and specificity. Hemolytic has less sensitivity, more specificity. Overall sensitivity is 75%.
Conclusions: Histogram is efficient in detecting normocytic and microcytic anaemia. In macrocytic anaemia among 40 cases detected by histogram only 7 showed concordance because histogram may detect slight variation in morphology not appreciable on light microscopy. In haemolytic anaemia only one case detected by histogram. The discordance is due to low sample size.
Acute kidney injury in patients hospitalized with COVID-19 in HIMS, Hassan
Authors: R. M. Suresh , Kanchana  , Begum Kousar , B. S. Harsha
Published: April 2023

Background: There is a growing need to understand the risk factors and prevalence of AKI in COVID-19 patients to better manage and prevent the condition. HIMS, Hassan is a hospital in India that has been treating COVID-19 patients since the onset of the pandemic. This study aimed to determine the prevalence of acute kidney injury (AKI) in COVID-19 patients admitted to a hospital in HIMS, Hassan, and to identify the associated risk factors.
Methods: The study is a retrospective cohort study that investigates the clinical characteristics and laboratory parameters of hospitalized COVID-19 patients who met the inclusion criteria in HIMS teaching hospital, Hassan. 300 patients were included, and descriptive statistical analysis was performed using mean with standard deviation (SD) for continuous variables and proportions and percentages for categorical variables.
Results: Out of 300 patients, 68% had AKI. The age distribution was similar between the two groups, with the highest proportion of patients in the age group of 40-49 years. The proportion of AKI was higher among males than females, but the difference was not statistically significant. The need for ICU admission, mechanical ventilation, and dialysis was strongly associated with AKI. Patients with comorbidities such as DM and DM+HTN were at a higher risk of developing AKI. Laboratory parameters such as D-dimer, LDH, ferritin, urea, creatinine, SGOT, SGPT, Neutrophils / Lymphocytes ratio, and chloride levels were significantly different between the two groups.
Conclusions: These findings highlight the importance of monitoring patients with comorbidities closely and implementing preventive measures to reduce the incidence of AKI in COVID-19 patients.
Gasserian ganglion metastases of oral squamous cell carcinoma in the absence of loco-regional metastases masquerading as trigeminal neuralgia
Authors: Saxena Akriti , Singhal Niti , Rath Ashutosh , Singh Vivekanand , Shankar Ravi , Goel Madhu Mati
Published: April 2023

We presented an unusual case of a 43-year-old man presenting with symptoms of trigeminal neuralgia with a clinico-radiological diagnosis of maxillary nerve schwannoma. Surgical excision and histopathology revealed a diagnosis of metastases of squamous cell carcinoma to Gasserian ganglion. On further investigation, the primary tumour was detected in the right alveolar region of mandible. Our purpose of presenting this case was to make the clinicians aware that all cases presenting with trigeminal neuralgia may not be benign and may be the sole presentation of brain metastases of oral cancer without the loco-regional spread.
Role of slow decompression, injection carbetocin and Samarth Ram cannula for preventing postpartum haemorrhage in a patient of acute severe polyhydramnios
Authors: Meshram Pallavi S. , Kubde Ashish R. , Kothalkar Vijayalakshmi S. , C. M. Veerendrakumar
Published: April 2023

We presented a case of a 30-year-old woman G3P1L1A1 who was diagnosed with severe polyhydramnios at 29 weeks of gestation. The patient was managed conservatively with amnioreduction. However, after one week of conservative management showed a further increase in the AFI (54-55 cm) with severe breathlessness and abdominal pain. A decision to terminate pregnancy was taken in view of failed conservative management. Emergency LSCS done under general anaesthesia. Amniotomy was done by slow uterine decompression. Simultaneously injection carbetocin 100 mcg IV bolus over 1 minute given. Postpartum haemorrhage was prevented by using Samarth Ram cannula. Further recovery was uneventful and patient discharged on day 3 of surgery.
The versatile irrigation set tube: a case report of a frugal nephrostomy tube in a complex percutaneous nephrolithotomy irrigation tube as a nephrostomy alternative
Authors: Shah Abhijit , Choudhary Anupam , Gali Kasi V. , Singh Anshuman
Published: April 2023

Nephrostomy tubes were once the norm following a standard percutaneous nephrolithotomy (PCNL). Nowadays they are a rarity, since most PCNLs are performed without the use of a Nephrostomy tube in the post-operative period (tubeless PCNL). We present the use of a simple irrigation set tubing as a low-cost nephrostomy tube alternative in patients with post-PCNL hemorrhagic complications.
Rare occurrence of palatal perforation in a case of leprosy: a case report and literature review
Authors: Gonnuru Vinod Kumar , Dandala Sridhar Reddy , Albi Irene , Abbugari Rudrakshini , Bhaskar Jaya , Varma Varaprasada
Published: April 2023

The aim of the study was to demonstrate the rare occurrence of coexistent nasal septal and palatal perforations in a case of lepromatous leprosy. Nasal septal perforation is a full-thickness defect of the nasal septum which includes the bilateral mucoperichondrial flaps and structural middle layer. It occurs mostly on the anterior cartilaginous septum. Most of the patients are asymptomatic and the two-third of the people affected show no nasal complaints. Palatal perforation is said to have occurred when there is a development of communication between bilateral nasal cavities and the oral cavity. Whereas in our case, septal perforation was found to be co-existent with palatal perforation which is a rare condition. A 32-year-old, otherwise healthy patient presented with complaints of nasal regurgitation of food contents and shortness of breath while eating for 3 months. Septal mucosal biopsy, biopsy from the palatal perforation and the left ear nodule was taken without any complications, and tissue was sent for histopathological examination which showed features suggestive of lepromatous leprosy. The occurrence of coexistent septal and palatal perforation is rare and it is even rarer to be found in a case of lepromatous leprosy. Hence proper history should be elicited and adequate investigations such as histopathological examination should be performed in cases of coexistent nasal septal and palatal perforation.
Prospective analysis of pacing requirements following cardiac surgery
Authors: Sunil Kumar T. R.  , Karthigesan A. M.
Published: April 2023

Background: Post-operative conduction abnormalities are one of the complications occur after cardiac surgery, which can occasionally lead to significant morbidity and mortality. Conduction abnormalities can occur during and immediately after cardiac surgery, most commonly in valve operations. Possible mechanisms include injury to conduction apparatus during decalcification, injury from the sutures, needles and post-operative edema around the conduction system due to injury to surrounding tissues. Most of the pacing requirement is often temporary with only a small proportion of patients requiring permanent pacing. This study was conducted to study incidence of pacing requirements following cardiac surgery and to identify possible risk factors contributing to post-operative cardiac pacing.
Methods: In this study, all relevant data are collected from patients who met the criteria for the study which includes pre-operatively relevant history and routine investigations were done. Intra-operative data were collected and post-operatively – routine blood and cardiac investigations were done on the day of surgery and on alternate days thereafter. The onset of new arrhythmias and the need for pacing are recorded.
Results: In this study, of 350 patients who underwent various types of cardiac surgeries, only 79 (22.6%) patients required temporary pacing of the heart with the temporary pacing wire. Of these, only 1 (0.29%) patient was pacing dependent and requiring permanent pacemaker implantation.
Conclusions: In the study, the factors predicting post-operative pacing requirement were the presence of pre-operative atrial fibrillation, moderate to severe calcification of valves, surgeries performed using cardiopulmonary bypass with prolonged aortic cross-clamp time.
Effect of papain urea versus hydrogen peroxide in diabetic foot ulcer management
Authors: Maloth Rakesh  , Jomine Jose
Published: April 2023

Background: Diabetic foot ulcers are the most common complications in diabetic patients. Debridement of an ulcer play a vital role in the healing of diabetic foot ulcers. Medical methods of debridement have an advantage as it is also painless and can be done on OPD basis. Aim of this study was to compare the effectiveness of debridement using papain urea dressing as against hydrogen peroxide in diabetic foot ulcer management.
Methods: Patients who have a diabetic foot ulcer reporting to the hospital were studied using either hydrogen peroxide or papain urea dressings. All were brought under adequate glycemic control. Emperically oral antibiotics are started to all patients and changed according to culture and sensitivity reports after three days. Patients was randomly allocated to receive either H2O2 or papain urea dressings, 63 per set. Statistical analysis was done using the SPSS software. Significance level was fixed at p value of p<0.05.
Results: It was seen that PAPAIN UREA ointment is a better agent in debridement when compared to hydrogen peroxide. All 63 patients started showing features of reduction in ulcer size and area of slough. This difference was statistically significant.
Conclusions: In diabetic foot ulcer, papain urea dressings help in wound healing by decreasing the duration of healing time and by faster slough removal. It promotes granulation, without any complications. Hence papain urea dressings are a good option for debridement and wound healing in diabetic foot ulcer.
A novel approach to the treatment of type B aortic dissection and common iliac artery aneurysms in a patient necessitating redo renal transplantation
Authors: Khabaz Kameel , Subramanian Tanvi , Milner Ross
Published: April 2023

In patients with end-stage renal disease (ESRD), treatment of common iliac artery (CIA) aneurysm disease necessitates safe operative repair while simultaneously maintaining candidacy for future renal transplant. We present the case of a patient with a type B aortic dissection and aorto-biiliac aneurysmal degeneration who has a previously failed right kidney transplant. Initial operative planning was approached with three goals: 1) endovascular repair as possible; 2) minimize paraplegia risk; 3) maintain renal transplant candidacy. As such, a three-stage operation was planned. Endovascular repair of the R CIA aneurysm was followed by thoracic endovascular aortic repair (TEVAR). The third stage, repair of AAA and left CIA aneurysm, was performed open using an aorto-biiliac graft with a surgically modified prosthetic bypass to preserve the left internal iliac artery to reduce paraplegia risk and the left external iliac artery (EIA) for future kidney transplantation. This novel technique successfully allowed for surgical repair of the Type B aortic dissection and the CIA aneurysms, while maintaining the patient’s future redo transplant candidacy with minimal paraplegia risk.
Suburothelial hemorrhage masquerading as renal neoplasms: a case report of antopol Goldman lesion
Authors: Vijay Tanvi , Gyan Saurabh  , Singh Ranvir , Singh Smita
Published: April 2023

Renal cell carcinoma (RCC), which accounts for 2-3% of all adult malignancies, is one of the most lethal urologic cancers. They are sporadic in the majority of cases with 4-6% being familial. They are adenocarcinomas arising from renal tubular epithelial cells. They can present with symptoms of loin pain, palpable mass and haematuria. Another rare presentation is spontaneous perirenal haemorrhage which can be seen in up to 50% of these patients. These patients are also predisposed to increased risk of deep vein thrombosis (DVT) due to prevailing pro-thrombogenic state. Management requires radical nephrectomy for localised disease, targeted therapy and cytoreductive nephrectomy for metastatic RCC. Our patient is adult female who was referred to surgical OPD given her history of gross haematuria and right flank pain for 6 days. She is a known case of DVT on treatment with Warfarin for 4 years. A diagnosis of renal malignancy was made, contrast CT was suggestive of solid mass lesion of the upper pole of calyx likely transitional cell carcinoma (TCC)/papillary RCC. She underwent an urgent radical nephrectomy which showed a hard 5×5 cm lump in the upper pole of the kidney, revealing a clot on the cut section. Post-op HPE showed a large subcapsular hematoma in the upper pole with microscopy showing large areas of haemorrhage surrounded by chronic inflammatory infiltrate, likely Antopol Goldman lesion notorious for its similarity to renal malignancy.
Unusual coexistence: Allergic bronchopulmonary aspergillosis and pulmonary tuberculosis- A rare case report
Authors: Kumar Ankit , Devi Laxmi , Verma Yogendra Narayan , Sharma Parul , Ahmad Anees , Chandra Shubham
Published: May 2023

: Allergic Bronchopulmonary Aspergillosis (ABPA) is an allergic hypersensitivity reaction to the ubiquitous fungus Aspergillus that can cause inflammation and damage to the respiratory system. This condition predominantly occurs in individuals with long-standing airway disease, such as bronchial asthma or cystic fibrosis. While Acid-fast bacilli Mycobacterium tuberculosis causes tuberculosis (TB). ABPA and TB can coexist in the same patient. The coexistence of these two conditions can make the diagnosis and treatment more challenging. This is because some of the symptoms of ABPA, such as cough and wheezing, can be similar to those of TB, and both conditions can cause lung damage.

A 21-year young male was admitted with a six-month history of low-grade fever, cough with expectoration, atypical chest pain, and progressive breathlessness. On examination, the patient had bilateral diffuse rhonchi with coarse crepitation, and his chest X-ray showed bilateral heterogeneous opacities with cavities in the left upper and middle zone. Further evaluation revealed a total serum IgE of 3074 IU/L (Normal <100) and elevated levels of Aspergillus fumigatus-specific IgE and IgG. A high-resolution CT of the thorax revealed bilateral upper lobes with tree-in-bud opacities and centrilobular nodules, leading to a diagnosis of ABPA. A sputum sample was sent for an AFB smear, which was positive.

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus that most commonly affects people who have bronchial asthma or cystic fibrosis. However, diagnosis can be challenging as patients may not respond to standard treatment, and the symptoms can overlap with those of other respiratory diseases. Therefore, clinicians need to maintain a high index of suspicion for ABPA in at-risk patients and consider appropriate screening tests.

This case highlights the rare co-existence of active pulmonary TB and ABPA, which can make diagnosis and treatment challenging. However, with appropriate management, including anti-tubercular treatment and corticosteroid therapy, the patient showed marked improvement in his condition. Clinicians should consider the possibility of multiple comorbidities in patients presenting with respiratory symptoms, and appropriate evaluation and management should be undertaken to achieve optimal outcomes.
Mnemonic narrative method in the trilogy by Agota Kristof (“The Notebook”, “The Proof”, “The Third Lie”)
Authors: Sundukova Kseniya A.
Published: May 2023

The article analyzes three novels by the Hungarian-Swiss writer Agota Kristof through the poetics of memory. The trilogy is dedicated to the representation of the consciousness of the person whose life is destroyed by a series of historical cataclysms. Every novel presents a slightly different version of Lucas and Сlaus brothers life, their memories of the past traumatic events. In the hero's memories, the reality is distorted to such an extent that the very existence of the twin brother from the first novel is called into question. At the artistic level, the possibility of reconstructing the true course of events is constantly problematized. In this regard, the trilogy can be considered from the point of view of implementing the mnemonic narrative method in it - a special narrative method, which involves the creation of a novel hero character, whose inner life is turned to the past. This method is based on a conscious creative approach to description of the retracing mind and an approach to reflection about the process and description methods.
Women’s empowerment index for handloom weavers in assam, India
Authors: Basumatary Konita , Devi Mridula , Basumatary Sijousa , Mwchahary Sanswrang , Basumatary Iragdao Raja
Published: May 2023

The main purpose of this study is to construct a women’s empowerment index for handloom weavers by adopting the tools developed by the Oxford Poverty & Human Development Initiative (OPHI). Within Assam, India, 1000 sample respondents were selected for the study from five leading handloom production districts. For the study, individual-level data were collected by interviewing handloom weavers comprising seven domains and 25 indicators. A regression analysis was used in the study, and the results revealed that out of the five districts in Assam, the empowerment index of handloom weavers is highest for Kamrup (rural) (0.72), followed by Barpeta (0.64), Kokrajhar (0.61), Nagaon (0.58), and Chirang district (0.44). Overall, the women’s empowerment index for handloom weavers is less than the global standard empowerment weighted average of 0.80. It was also found that empowerment is linked to wages, education, availability of electricity, media exposure, and other household characteristics. Therefore, policies should set out a minimum wage structure for weavers that is fixed by the government and implemented properly as well as initiatives regarding other factors that encourage empowerment.
Spatial and temporal dynamics of the emergence of epidemics in the hybrid SIRS+V model of cellular automata
Authors:   Saratov State University, Shabunin Aleksej
Published: May 2023

Purpose of this work is to construct a model of infection spread in the form of a lattice of probabilistic cellular automata, which takes into account the inertial nature of infection transmission between individuals. Identification of the relationship between the spatial and temporal dynamics of the model depending on the probability of migration of individuals. Methods. The numerical simulation of stochastic dynamics of the lattice of cellular automata by the Monte Carlo method. Results. A modified SIRS+V model of epidemic spread in the form of a lattice of probabilistic cellular automata is constructed. It differs from standard models by taking into account the inertial nature of the transmission of infection between individuals of the population, which is realized by introducing a "carrier agent" into the model, which viruses act as. The similarity and difference between the dynamics of the cellular automata model and the previously studied mean field model are revealed. Discussion. The model in the form of cellular automata allows us to study the processes of infection spread in the population, including in conditions of spatially heterogeneous distribution of the disease. The latter situation occurs if the probability of migration of individuals is not too high. At the same time, a significant change in the quantitative characteristics of the processes is possible, as well as the emergence of qualitatively new modes, such as the regime of undamped oscillations.
Stability monitoring of patients with myasthenia gravis using a mobile-based application
Authors: Tafti Emad Alaei , Ghazisaeedi Marjan , Sarraf Payam
Published: May 2023

Background: Failure in early diagnosis of myasthenia gravis (MG) and the risks of taking certain medications and undergoing surgery and anesthesia can lead to severe respiratory disorders and death. However, there are therapeutic measures that significantly control the disease and improve individual’s functionality.
Methods: First, an expert panel was formed, and a needs assessment questionnaire was prepared for the information elements and the capabilities required for the application and provided to neurologists with a subspecialty fellowship in neuromuscular diseases. Then, based on the analyzed results, the application was designed and created in 2 versions (physician and patient), and in 2 languages (Persian and English). Eventually, a questionnaire for user interaction and satisfaction was provided to 5 relevant physicians to evaluate the application.
Results: The results showed that neurologists considered all items of the needs assessment questionnaire to be 100% essential. The capabilities of the application included registering the medication name and dose, recording symptoms and complaints by the patient, completing standard questionnaires, online chat, medication reminder, sending alerts to the doctor when the patient is unwell, and providing a variety of reports. The usability evaluation showed that neurologists evaluated the application at a good level with the average score of 8.23 ± 0.47 (out of 9 points).
Conclusion: In the long run, using this technology can reduce costs, improve patients’ quality of life (QOL) and health care, change health behaviors, and ultimately, improve individual’s health.
The relationship between retinal layer thickness and cognition in patients with multiple sclerosis: A systematic review of current literature
Authors: Moghadasi Abdorreza Naser , Mirmosayyeb Omid , Ebrahimi Narges , Sahraian Mohammad Ali , Mohammadi Aida , Ghajarzadeh Mahsa
Published: May 2023

Background: This study was conducted to evaluate the relationship between retinal layer thickness (RLT) and cognition in patients with multiple sclerosis (MS).
Methods: We searched PubMed, Scopus, Embase, Web of Science, and Google Scholar. The search strategy included the MeSH and text words as [“ora serrata” OR “retina” OR (“coherence tomography” AND “optical”) OR “OCT tomography” OR (tomography AND OCT) OR “optical coherence tomography” OR “OCT” OR “retinal thickness” OR “inner plexiform layer” OR “nerve fiber layer” OR “ganglion cell layer” OR “inner nuclear layer” OR “outer plexiform layer” OR “outer nuclear layer” OR “external limiting membrane” OR “inner segment layer” OR “outer segment layer” OR “retinal pigment epithelium”] AND [“cognition”* OR “cognitive function”* OR (function* AND cognitive)] AND [(sclerosis AND multiple) OR (sclerosis AND disseminated) OR "disseminated sclerosis" OR "multiple sclerosis" OR "acute fulminating"].
Results: The literature search revealed 1090 articles; after deleting duplicates, 980 remained. Finally, 14 studies were included. Totally, 1081 patients were evaluated. Mean age ranged from 31 to 55 years. In some studies, there was a correlation between cognition and retinal thickness, while others did not confirm this finding. Some authors found cognitive impairment (CI) in patients with MS with RLT.
Conclusion: The results of this systematic review show that there are discrepancies between the results of studies regarding the relationship between RLT and cognition status in patients with MS. Further studies with more included original studies and meta-analysis are recommended.
Comparison of One-Year Mortality Rates in Patients with Peritrochantric Hip Fractures during and Prior to the COVID-19 Pandemic
Authors: Khabiri Seyyed Saeed , Biglari Farsad , Jafari Kafi Aabadi Meisam , Sadighi Mehrdad , Ebrahimpour Adel , Sabaghzadeh Amir
Published: April 2023

Background: This study aimed to assess and follow up on patients who had peritrochantric hip fractures during the first wave of the coronavirus disease-2019 (COVID-19) outbreak in Iran. These patients were compared to patients from the previous year during the same period. Their prognosis and one-year mortality rates were also compared.
Methods: In this two-center, retrospective cohort study, patients aged over 60 years with a proximal femoral fracture admitted to the hospital between March 2019 and April 2020 were included. The primary outcome was one-year mortality.
Results: The patients counted 146, and we had access to all of them. Seventy-four were from the year 2019, and 72 were from the year 2020. There was no significant difference between the two groups regarding age, sex, type of fracture, or the American Society of Anesthesiology (ASA) score in the analytical investigation. Regarding patient mortality at this time, our one-year mortality rate in patients hospitalized before the COVID-19 era was 29.7%, compared to 51.5% in the COVID-19 period.
Conclusion: The one-year mortality rate for patients with hip fracture increased considerably during the COVID-19 pandemic. Comorbidity and ASA score were related to mortality in this patient population. This increase in mortality may be attributable to postoperative complications, including coagulopathy and proper health care limitation.
Wrist Extensor Tenosynovitides: A Case Report
Authors: Arabzadeh Aidin , Hamdilahzadeh Hosein , Zohrabi Kian , Farzan Mahmoud , Salkhori Omid
Published: April 2023

Background: Rice bodies can be found in rheumatic diseases, infectious diseases, and osteoarthritic joints. Rice bodies' most common locations include the subacromial bursa of the shoulder and the knee, while rice body synovitis of the wrist extensor tendons is uncommon. We have presented the case of tuberculous tenosynovitis with rice body formation in the extensor tendon sheaths of the hand and wrist.
Case Report: A 51-year-old man presented with swelling and mild pain in the dorsal side of left wrist, hand, and proximal phalanx of the second finger. He stated a history of traumatic injury to the proximal phalanx of the index finger. Radiographs showed a softtissue mass shadow, and magnetic resonance imaging (MRI) showed edema and soft tissue swelling around extensor tendons extending into the distal forearm and ulnar side of the second finger in favor of tenosynovitis. Laboratory test results were normal. The patient had a negative Mantoux test result and no history of mycobacterial exposure. Surgical exploration of the lesion revealed rice bodies in the synovial sheath of extensor tendons in the wrist, extending distally to the dorsal aspect of the hand, especially the radial side. Removal of the rice bodies and complete excision of the sheath and tenosynovectomy was performed.
Conclusion: As in our case, even in the absence of past tuberculosis (TB) infection or exposure, Mycobacterium TB (MTB) should be considered in the differential diagnosis of long-standing extensor tenosynovitis in the hand and wrist.
The Scope of Artificial Intelligence Applications in Medicine: A Review Article
Authors: Foroughmand-Araabi Mohammad-Hadi
Published: May 2023

Artificial intelligence (AI) is the high-tech discipline of employing computers to perform or potentially outperform human intelligence. With the deployment of AI systems, the traditional medical environment has already changed. For recent AI developments that have not yet been applied to medicine, as well as potential future developments, to be implementable in medicine, numerous considerations must be taken into account. In this article, we introduce fundamental AI-related concepts for researchers and administrators of healthcare systems. This article also discusses challenges with applications of AI in medicine, potential futures, and preparation strategies for the future of AI-enhanced medicine. In addition, a list of applications of AI in medicine is provided with a categorization that could help medical professionals to understand potential applications of AI systems in their fields of work.
Study of Contralateral Hip in Patients with Hip Fracture
Authors: Babu Surapaneni Suresh , Nanda Gopal Velagapudi , Ansari Shaik Waseem Raza
Published: May 2023

Background: This study was done to know whether patients with hip injury have pre-existing osteoporosis due to which, the patient sustained the fracture, subsequent fracture of the contralateral hip, any osteoarthritic changes of the contralateral hip at the time of index fracture, and ten-year probability of a major osteoporotic fracture by calculating fracture risk assessment percentage (FRAX%).
Methods: 34 patients were evaluated for age, gender, body mass index (BMI), fracture type, Singh index, bone mineral density (BMD), T-scores using dual-energy X-ray absorptiometry (DEXA) scan, and ten-year probability of fracture using FRAX%.
Results: Average age of the patients with hip fractures was 72.1 years. About 85% of patients were women. 67.6% of the patients were with BMI of 18.5-25 kg/m2 . The Singh index for osteoporosis fell in grades 2 and 3 in most patients. The mean interval between index fracture and contralateral hip injury was 4.25 years. Osteoarthritis of the contralateral hip was seen in 9%. The probability in ten years of hip fracture in 30 indexed patients using the FRAX% tool was 15%, and for 4 patients who were having bilateral hip fractures was 22.75%. There was a significant relationship between FRAX% with the Singh index and osteoarthritis of the contralateral hip. FRAX% was high in female patients.
Conclusion: Contralateral hip fracture in patients with osteoporosis was high in women and patients with low and high BMI. Fractures were also high in patients with low Singh index and T-scores. FRAX% increased with an increase in age and increased with a decrease in T-score.
Hemicorporectomy; Describing a Single-Stage Surgical Technique: A Case Report
Authors: Fallah Yousef , Shafiei Seyyed Hossein , Pourfakhr Pejman , Talebian Parham , Soleimani Mohammad , Pendar Ehsan
Published: May 2023

Background: Hemicorporectomy is a life-saving operation to maintain the survival of patients with severe and irreversible pelvis and lower extremities injuries. In the typical procedure, removing lower extremities and pelvic viscera in the two stages might result in hemodynamic instability, intraoperative and postoperative morbidities, and more deficient patients' survival. In this study, we aim to describe our experience with a new technique for one-stage hemicorporectomy, which minimizes surgical time and intraoperative bleeding
Case Report: A 77-year-old male patient with lower limb gangrene after previous vascular surgery for an abdominal aortic aneurysm in an unstable situation underwent hemicorporectomy in one step.
Conclusion: We believe that achieving a one-step procedure, especially in non-malignant cases or in the absence of severe trauma lesions, may be a viable option in emergency surgery cases or hemodynamic instability. However, there is still a need to modify the single-stage surgical technique in later experiments.
The Pattern of Morphine Necessity for Acute Renal Colic Patients in the Emergency Department; A Cross-Sectional Observational Prospective Study
Authors: Karimpour-Razkenari Elahe , Borhani Yasaman , Basiri Kamal , Honarmand Hooshyar , Safaei Arash , Najmeddin Farhad
Published: May 2023

Background: Renal colic is one of the most common urologic diseases that constitutes the majority of the emergency department (ED) patients. Intravenous ketorolac is usually prescribed for adequate pain control, but it is usually insufficient and morphine is required. The starting time and amount of morphine needed for acute renal colic is still under discussion.
Methods: This prospective, observational study was conducted for 6 months at ED of Sina hospital, Tehran, Iran. 44 patients were investigated. pain intensity with numeric rating scale (NRS) were observed at baseline and then continued every 5 min for 2hr. Patients were received ketorolac (30 mg) and if NRS>6 morphine loading dose (0.05mg/kg) initially if NRS>6. morphine rescue dose ordered if the NRS remain >6. Morphine consumption pattern was the primary outcome. Also total morphine dose, time to reach NRS<4, and adverse reaction were evaluated.
Results: At baseline, almost all patients had NRS>6, and about 65.8% had history of renal colic. The mean NRS was 8.98(±0.98), Therefore, all patients required a loading dose of morphine and 50% received at least one rescue dose. The patient with history of renal colic had higher NRS score at baseline, prolonged pain, higher total morphine dose and rescue dose. There wasn’t any significant side effect occurred.
Conclusion: Patients with acute renal colic have severe pain and should receive morphine primarily. In addition, patients with a history of renal colic had higher pain intensity scores, and required higher morphine doses.
Correlation between Root Nodule Characteristic and Growth Component of Jack Bean Intercropped with Aloe Plant in Calcareous Soil
Authors: Darini Maria Theresia , Zamroni - , Astuti Ari
Published: April 2023

This research aims to find out the correlation between root nodules and the growth of jack bean intercropped with aloe plants in calcareous soil. The research was carried out in Karangmojo, Gunung Kidul, Yogyakarta, Indonesia. A Randomized Complete Block Design with two factors and three replications was used. The first factor was the application of four rates of cow manure (10, 15, 20, and 25 t ha-1), and the second factor was the nitrogen fertilizer used, consisting of urea at a dose of 100 and150 kg ha-1 and ammonium sulfate at a dose of 200 and 300 kg ha-1. Control treatment of jack bean monoculture was also made. The variables observed were the number of nodules, percentage of plant height, number of leaves, active nodules, leaf weight, root weight, and fresh weight of the plant. Analysis of variance was used for statistical analysis, and Duncan's Multiple Range Test at the 5% significance level was used for means comparison. The best growth of nodules was obtained at the combination of 20-ton manure with urea of 100 kg ha-1, while the best growth of jack bean plants was gained at 15-ton manure combined with ammonium sulfate 200 kg ha-1, and better than the control. There were correlations between nodule number with a number of active nodules and root weight, but no significant correlation with growth components of a jack bean plant.
Increasing Precision of Water Sprout Detection based on Mask R-CNN with Data Augmentation
Authors: Areni Intan Sari , Maulidyah Nurul , Indrabayu - , Bustamin Anugrayani , Arief Azran Budi
Published: April 2023

This study evaluated the detection performance of four Mask R-CNN models trained in different scenarios. The first two scenarios are trained with a learning rate of 0.01 using data augmentation on the training data. The other two scenarios are trained with a learning rate of 0.001 and the same as previously, using augmentation on training data. These models are trained to detect water sprouts in cacao plants. The original data used are obtained from photographed pictures on the cocoa farm. As much as 150 images, the data is divided into 120 images for training data and 30 images for testing data. In previous studies, the model was trained without performing data augmentation, so that the amount of data trained was less than this study. Data augmentation is implemented to compromise the small amount of data and prevent over-fitting during the model training process. This process uses six augmentation parameters, namely horizontal flip, blur using Gaussian blur, contrast modification using linear contrast, color saturation alteration, cropping the sides of the image randomly by 50 pixels, and rotating the image. The test is carried out by varying the threshold value in the range of 0.6 to 0.9. The results obtained indicate that the model trained with a learning rate of 0.001 with data augmentation can detect objects better than other models with an F1score of 0.966 at a threshold of 0.8. This research will be developed to create a water sprout cutting robot in the future.
Study on the Behavior of a Simple House Partially Retrofitted Using Ferrocement Layers due to Earthquake Loads
Authors: Ismail Febrin Anas , Fauzan - , Hakam Abdul , Alfajri Aditya
Published: April 2023

Earthquakes are a serious threat in Indonesia. Large-scale earthquakes that have occurred, such as the Aceh earthquake (2004), the West Sumatra earthquake (2009), the Lombok earthquake (2018), the Mamuju earthquake (2021), and most recently, the West Pasaman earthquake (2022), which caused many fatalities and damaged infrastructure and building houses, especially houses of the economically weak community. These houses were generally built using adobe bricks using the Â½ brick masonry method without structural elements such as columns and beams that do not meet earthquake-safe house standards. In an effort to mitigate earthquake disasters, a strengthening method was developed in this study, namely by using ferrocement layers. In this research, a simple house model with adobe walls with a scale of 1:4 will be made, which will be partially strengthened using ferrocement layers tested on a vibrating table and given an earthquake load. Furthermore, numerical analysis was carried out to validate the results of experimental testing. The results of the tests show that the partial reinforcement has contributed significantly to increasing the shear capacity of the adobe brick walls. This is evidenced by the fact that there were no cracks in the reinforced walls up to the acceleration of the earthquake of 1.5 g, while the other walls of the house that were not reinforced experienced cracks and even collapsed.