bluuebunny/crossref_metadata_2025 huggingface dataset:
O ACORDO DE BASILÉIA III E O IMPACTO NA CARTEIRA DE CRÉDITO DOS BANCOS PÚBLICOS ESTADUAIS DO BRASIL
Authors: Silva José Carlos Farias , Alencar Douglas Alcântara , dos Santos Ricardo Bruno Nascimento
Published: September 2024

O artigo apresenta a análise em relação a implantação do Acordo de Basiléia III e seus impactos na carteira de crédito dos Bancos Públicos Estaduais no Brasil (BPEB)no período de 2010 a 2018, com objetivo de mostrar se a implantação desses requerimentos de capital impactou de forma restritiva a carteira de crédito desses bancos. Para tanto, desenvolveu-se uma pesquisa de caráter quantitativo e exploratório, a partir de fontes primárias e secundárias, que permitiu a construção de modelos econométricos com base em Mínimos Quadrados Ordinários, que mostraram que a implantação do Acordo de Basiléia III no Brasil não impactou de forma restritiva o volume de crédito dos Bancos Públicos Estaduais.
Fatores monetários em Hicks e sua influência no debate Harrod-Solow
Authors: BRIGANTE PAULO
Published: September 2024

Baseado no debate da teoria do crescimento econômico sobre o problema do crescimento equilibrado a pleno emprego, inaugurado por Harrod (1939;1948) e sequenciado por Solow (1956), este artigo tem como objetivo analisar como a comportamento da taxa de juros afeta a solução de crescimento equilibrado, conforme os argumentos keynesianos. Para isso, apóia-se na contribuição de Hicks (1950). Aspectos construtivos e teóricos presentes no modelo deste autor permitiram compreender como os desequilíbrios monetários ameaçam as condições de equilíbrio, em particular, a igualdade entre a taxa natural e a taxa garantida, além de agravarem o potencial de instabilidade do sistema.
Duas décadas do Tripé Macroeconômico: Uma análise da sua atuação na Economia Brasileira
Authors: Dos Santos Deivid Jorge , De Andrade Leandro Quintino , Infante Ana Luiza
Published: September 2024

Em 1999, no segundo governo do ex-presidente Fernando Henrique Cardoso, foi instituído o tripé macroeconômico, que consistia no trinômio metas de inflação, câmbio flutuante e superavit primário. Seu objetivo foi estabelecer um regime macroeconômico estável, aos moldes do Novo Consenso Macroeconômico que iniciará na década de 90 (NASSIF, 2015). O presente trabalho visa analisar seu desempenho na economia brasileira nas últimas duas décadas, se apoiando na literatura sobre o tema e avaliando seu papel na economia brasileira. Analisando sua base teórica, considerações presentes na literatura especializada, dados empíricos e atuação no período, conclui-se que o tripé foi ineficaz para a economia brasileira, sendo seu legado composto de uma política monetária fortemente recessiva, política fiscal pró-cíclica e política cambial prejudicial ao setor industrial brasileiro.
Structure and Magnetic Properties of Fe3O4/C Composites Synthesized from Wheat Straw
Authors: Bordun Ihor , Malovanyy Myroslav , Nahurskyi Nazar , Borysiuk Anatoliy , Szymczykiewicz Ewelina
Published: September 2024

The porous structure and magnetic properties of nanostructured Fe3O4/C composites based on wheat straw were investigated in this work. The synthesis was carried out by a one- and two-step method using FeCl3 and ZnCl2 as activating agents. X-ray diffraction methods have shown the presence of an additional phase of magnetite Fe3O4 in both synthesized composites, along with the amorphous carbon phase. Magnetic measurements have shown that the composite synthesized in one step has better magnetic properties, in particular, a higher specific saturation magnetisation. However, the samples of the composite synthesized in two steps are characterised by a higher content of micropores and mesopores, which causes an increase in the specific surface area to 884 m2/g compared to 405 m2/g for the samples synthesized in one step. Based on the dependence of the coercive force on the particle diameter in Fe3O4 dispersions, it was found that the average size of the magnetite particles is ~25 nm for both synthesized magnetoresponsive composites.
Awareness of middle ear pathologies in South Africa: Towards a primordial preventive audiology
Authors: Sebothoma Ben , Baloyi Naledi
Published: September 2024

Background: Public awareness of auditory pathologies, has been explored in the literature. However, there is limited evidence regarding public awareness of middle ear pathologies and their risk factors in South African communities.Objectives: The aim of this study was to describe public awareness regarding middle ear pathologies and their associated risk factors in the community of Giyani, Limpopo province, South Africa.Method: A quantitative cross-sectional survey design was conducted among 94 adults aged 18 years and older living in Giyani, Limpopo province. A questionnaire was used to collect data. Descriptive statistics was used to summarise the data, while a Chi-squared test was used to determine if there is any association between awareness and independent variables with categorised outcomes.Results: Adults aged between 18 and 65 years participated in this study. Most participants were aware of aural itchiness (71.3%) and pain (35%) as symptoms related to middle ear pathologies. The use of cotton buds (51.1%) and other illnesses (35.5%) were primarily reported as risk factors for middle ear pathologies. There were varied responses with regard to awareness of which professionals manage middle ear pathologies, indicating a general lack of awareness. No statistically significant association was found between the dependent and independent variables (p  0.005).Conclusion: The study indicated a general lack of public awareness regarding middle ear pathologies and their associated risk factors among Giyani community.Contribution: The study raises implications for public awareness campaign that educates communities about middle ear pathologies, risk factors and social determinants of health associated with these pathologies.
Arm Length and Height Relationship in Young Indian Adults: A Correlation and Regression Analysis
Authors: Joshi Aparna Milind , Thorat Shweta Shankarrao
Published: September 2024

Introduction:

Anthropometric studies on body proportions such as arm length (AL) and height (Ht) are essential for understanding physical growth patterns and health indicators, particularly amongst young adults. However, limited research exists on this relationship in the Indian population.

Materials and Methods:

This study examined the correlation and regression between AL and Ht in 500 healthy Indian adults aged 18–23 years. Standard anthropometric tools were used to measure AL and Ht, and statistical analyses were conducted to determine the relationship between these variables.

Results:

The results showed varying degrees of correlation between AL and Ht across different age groups and genders. Males generally exhibited higher AL to Ht ratios compared to females, with significant gender differences observed in younger age groups.

Conclusion:

These findings contribute to our understanding of human growth patterns amongst young Indian adults and have important implications for clinical assessments and anthropological research. Further, longitudinal studies are recommended to better understand the dynamics of growth and body proportions over time in this population.
Assessment of academic stress and its association with academic achievement among health science students
Authors: Kaphle Maheshor , Karki Rajesh , Khanal Sudip , Aryal Dipsikha , Adhikari Kishor
Published: September 2024

Background:

Excessive stress may cause serious psychosocial and emotional health consequences. Academic stress influences the academic achievement of students.

Aim:

This study aimed to assess academic stress and its association with academic achievement among health science students in Kathmandu.

Methodology:

A cross-sectional study was conducted among 268 health science students. Data were collected using the Scale for Assessing Academic Stress, to measure academic stress, academic activity-related questions, and academic Grade Point Average (GPA) from the previous semester which were used for academic performance. We selected students by systematic random sampling. We used a self-administered questionnaire method for data collection. Data were entered into EpiData software and transferred to IBM SPSS (version 25) for analysis. Descriptive analysis was performed by percentages and median (interquartile range). We used Pearson’s correlation and Chi-square tests to measure the association between academic stress, performance, and related factors.

Results:

A total of 31.7% and 35.4% of respondents had moderate and high academic stress, respectively. The correlation between academic achievement and academic stress was found to be negative (r = −0.201 and P = 0.001), but statistically significant. The association between sex (P = 0.008), academic environment at home (P = 0.041), teaching–learning materials at home (P = 0.022), and academic stress was found to be statistically significant.

Conclusion:

More than two-thirds of respondents had moderate and high academic stress. The relationship between stress and academic achievement is negatively correlated, which suggests that students do not need high academic stress to achieve substantial academic performance.
Occupational Health Problems among Workers of Cashew Processing Units in Kollam District, Kerala
Authors: Nair Devika G. , Francis Paul T. , Olickal Jeby J. , Thankappan Kavumpurathu R.
Published: September 2024

The cashew processing industry plays a vital role in supporting the livelihoods of a large number of individuals in southern Kerala. Therefore, this study aimed to determine the prevalence of occupational health problems and associated factors among cashew workers. This cross-sectional survey was conducted among 360 cashew workers. Socio-demographics, musculoskeletal disorders (MSDs), respiratory symptoms, and dermatological problems were collected through a scheduled interview. Log binomial regression analysis was done. The prevalence of MSDs, chronic lung diseases (CLDs), and dermatological problems were 55.8%, 18.9%, and 47.5%, respectively. Female workers and workers with a lower education level were significantly more likely to report MSDs. Male workers and those with more years of employment were significantly more likely to report CLDs. Workers in the shelling and peeling section were significantly more likely to report dermatological problems. Targeted interventions to improve the occupational health of cashew workers are needed.
Histopathologic Perspective of Combined Liver–kidney Transplant: In Primary Hyperoxaluria Type 1 Patient
Authors: Gore Charusheela Rajesh , Iqbal Banyameen , Chhablani Nikita Ghanshamdas
Published: September 2024

Primary hyperoxaluria (PH) type 1 is a rare autosomal recessive disorder of glyoxylate metabolism. Its prevalence is 1–3 cases/million people. Glyoxylate is the precursor of oxalate which is believed to be produced by oxidation in liver peroxisomes. Serine-pyruvate aminotransferase/alanine-glyoxylate aminotransferase is an enzyme involved in the metabolism of glyoxylate. In the absence of this enzyme, oxalate and glycolate are overproduced leading to hyperoxaluria. This causes urolithiasis or nephrocalcinosis, which are conditions caused by the deposition of calcium oxalate. Due to its rarity and heterogeneous phenotype, it remains unrecognized due to which diagnosis is delayed, ending up in end-stage renal disease (ESRD) and ultimately death. Hence, early diagnosis and simultaneous hepatorenal transplant remain the mainstay to avoid systemic oxalosis. Here, we discuss a case of a 43-year-old female who underwent combined liver–kidney transplant with a history of multiple episodes of renal calculi since childhood ultimately landing into ESRD in view of PH type 1.
Multiple Level Anterior Cervical Discectomy and Fusion with PEEK Cage without Plating: Clinical Outcomes
Authors: Jacob Adrian Jamesraj , Mangaleswaran Balamurugan , Saranraj M. K. , Jadhav Darshil
Published: September 2024

Background:

Anterior cervical discectomy and fusion is a common procedure done to treat cervical disk disease. The role of plating in the treatment of multilevel disc disease in the absence of instability has been debated with some claiming no difference in the clinical outcomes.

Objective:

The aim of the study was to assess the long term clinical outcomes of patients who underwent two or three level discectomies with PEEK cage placement without plating.

Material and Methods:

We collected the required data of all patients. Patients were contacted and completed clinical outcome questionnaires including NDI and VAS-Neck. All data was tabulated and statistical analysis was done.

Results:

Data of 72 patients was collected. The average age of the patients was 52.73 years. The mean follow-up was 62.4 months. 37 patients presented with Myelopathy (51%), 24 with radiculopathy (33%), 11 with myeloradiculopathy. The average VAS scores for neck pain preoperatively was 6.29 (Range: 4–9) and postoperatively improved to an average of 3.18 (Range: 0–7). The average neck disability index preoperatively was 37.86 (Range: 28–47) and the average postoperative NDI score being 19.02 (Range: 9 to 28). Our patients had a preoperative mean mJOA score of 11.68 (Range:3–17) and a mean postoperative mJOA score of 14.66 (3–17) with a mean difference of 3 points.

Conclusion:

The clinical outcomes of multiple-level cervical fusion without plating and with plating are similar. The best surgical option is one that requires minimal disruption of normal tissue, simple in technique and provides the patient with immediate- and long-term relief.
Unveiling the hoarseness of voice: a case report of laryngeal paraganglioma
Authors: Kar Sonali , Mohapatra Debahuti , Dash Subhashree S.
Published: September 2024

Voice hoarseness is a common clinical symptom, often resulting from underlying laryngeal pathologies, which can be either non-neoplastic or neoplastic. Laryngeal paraganglioma, a neuroendocrine tumor with a rare occurrence, originating from the parasympathetic paraganglia of the larynx, typically presents with nonspecific symptoms such as hoarseness, making it difficult to diagnose. The authors present a case of a 19-year-old male with a 5-month history of hoarseness who visited the outpatient department. Laryngoscopy revealed a supraglottic submucosal lesion involving the right aryepiglottic fold. Histopathology suggested potential diagnoses such as a neuroendocrine tumor, carcinoid, paraganglioma, or medullary thyroid carcinoma. Immunohistochemistry ultimately confirmed the diagnosis of paraganglioma. This case report highlights the importance of considering paraganglioma as the differential diagnosis of laryngeal lesions despite its rare occurrence in the larynx. Early identification is crucial for developing an effective treatment strategy and achieving optimal patient outcomes. Our case report adds to the growing literature on the clinical presentation and diagnostic evaluation of laryngeal paragangliomas.
Comparison of sodium and potassium values in arterial and venous blood samples
Authors: Mikun M. , Sivakumar K. , Thangaraj Prabha , Thamarai R.
Published: September 2024

Background:

In routine practice, electrolytes are measured in serum using an electrolyte analyzer, which takes approximately 30 min. In contrast, electrolyte measurements from arterial blood using an arterial blood gas (ABG) analyzer can be completed within 5–10 min. However, limited information compares electrolyte values between venous and arterial samples. This study aims to determine if sodium (Na) and potassium (K) test results from arterial blood and venous serum samples can be used interchangeably.

Materials and Methods:

An observational cross-sectional study was conducted over 2 months (July and August 2019) at a tertiary care teaching hospital and research center. Data were collected from 50 intensive care unit patients, including their ABG analysis and serum electrolyte reports. The ABG samples, collected in heparinized syringes, were processed immediately using GEM Premier 3500 Blood gas analyzer. Serum electrolytes were measured with the Roche 9180 analyzer after centrifugation. Data analyses were performed using IBM Statistical Package for the Social Sciences version 21, and Bland–Altman plots were used to compare the results.

Results:

The mean sodium levels in venous samples and arterial blood were statistically insignificant (P < 0.17). In contrast, a significant difference was observed in potassium measurements between the two sample types (P = 0.000, null hypothesis rejected). The mean difference in sodium (Na+) results was 2.01 mEq/L, with a limit of agreement ranging from −17.98 to 22 mEq/L. The bias in arterial potassium was 0.99 mEq/L, with a 95% limit of agreement from 0.01 to 1.97 mEq/L.

Conclusions:

While sodium results from arterial and venous samples were similar, potassium results differed significantly. Therefore, potassium measurements from ABG and serum electrolyte analyzers should not be used interchangeably and must be interpreted cautiously.
Application of Ward Noise Management in Perioperative Hepatobiliary Surgery: A Retrospective Study
Authors: Zhou Shaobi , Huang Ling , Zhong Xiaying
Published: September 2024

Objective: To explore the application effect of ward noise management during the perioperative period of hepatobiliary surgery. Methods: The clinical data of 295 patients undergoing hepatobiliary surgery admitted to People’s Hospital of Zunyi City Bo Zhou District from March 2020 to March 2023 were retrospectively analyzed. In accordance with different perioperative management programs, patients were divided into the control (implementation of perioperative routine management) and observation (implementation of perioperative routine management + ward noise management) groups. Patients’ general data were matched through propensity score matching, and 55 cases were allocated to each group. After matching, the clinical indicators of the two groups were compared to evaluate the effect of ward noise management on patients undergoing hepatobiliary surgery. Results: No significant difference in general data was found between the two groups (P > 0.05). After management, the postoperative recovery indicators, such as feeding time, exhaust time, defecation time, first time to get out of bed, and incidence of postoperative complications, did not significantly differ between the observation and control groups (P > 0.05). The Hamilton Anxiety Scale, Hamilton Depression Scale and Pittsburgh Sleep Quality Index scores of the observation group were lower than those of the control group (P < 0.05). The average noise decibel values during the day, night, and over 24 hours of the observation group were lower than those of the control group (P < 0.05). Conclusions: Ward noise management can improve the negative emotions of patients undergoing hepatobiliary surgery, enhance sleep quality, and promote recovery. Therefore, it has a certain clinical promotion value.
Application of Music Therapy in Improving the Sleep Quality and Mental Health of Nurses with Circadian Rhythm Sleep Disorders Caused by Work Shifts
Authors: Wang Xuan , Feng Ting , Liu Shuhua , Ruan Jingjing
Published: September 2024

Objective: To analyze the impact of using music therapy to improve the sleep quality and mental health of nurses who suffer from circadian rhythm sleep disorders. Methods: Our retrospective analysis included 360 nurses with circadian rhythm sleep disorders from 20 different departments who worked in Wuhan Third Hospital for more than 1 year from May 2022 to May 2023. A total of 180 nurses with circadian rhythm sleep disorders were classified as the control group (received melatonin receptor agonist Melatonin Receptor Type 2 [MT2]). The other 180 cases were classified into the observation group (received melatonin receptor agonist MT2 + music therapy). After six courses of treatment, the clinical efficacy, Self-Assessment Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index Scale (PSQI) score of the two groups of nurses were compared. Results: Before treatment, no statistically significant differences in baseline treatment and SAS, SDS, and PSQI scores were found between the two groups. After treatment, the total effective rate of treatment in the observation group was 85.56%, which was significantly higher than the 50.56% in the control group (P < 0.001). After treatment, the SAS, SDS and PSQI scores of the observation group were lower than those of the control group (P < 0.05). The SAS, SDS and PSQI scores of both groups were lower after treatment than they were before treatment (P < 0.05). Conclusion: Implementing music therapy for nurses with circadian rhythm sleep disorders caused by shifts can improve sleep quality and reduce negative emotions. It is a clinical strategy with clinical application value and a certain promotion value.
Effect of Implementing Guided Music Management Strategies on the Psychological State of College Students of Science and Technology During Their Graduation Reply
Authors: Li Jin
Published: September 2024

Purpose: To study the effect of guided music management strategies on the psychological state of college students of science and technology during their graduation reply. Methods: A retrospective analysis was conducted on the relevant data of 107 college students of science and technology who underwent graduation defense in 2022. These students returned to school 1 week before their graduation reply. On the basis of whether they received guided music management strategies, the students were divided into a control group (no management strategy) and an observation group (received guided music management strategies). Among the students, 50 were included in the observation group after excluding two who did not meet the inclusion criteria. A total of 53 students were included in the control group after excluding 2 who did not meet the inclusion criteria. General demographic information and Self-Rating Anxiety Scale (SAS), Test Anxiety Scale (TAS) and Chinese Perceived Stress Scale (CPSS) scores were collected. Results: No significant differences in SAS, TAS and CPSS scores were found between the two groups before management (P > 0.05). After management, the SAS score of the observation group was lower than that of the control group (P < 0.05). The TAS and CPSS scores of the observation group after management were lower than those of the control group (P < 0.05). Conclusion: Implementing guided music management strategies can effectively alleviate anxiety and stress in college students of science and technology during their graduation reply and has a certain utility and promotion value.
Assessment of Noise Exposure and Risk of Hearing Loss for Young People in Amusement Arcades
Authors: Zou Nengsong , Wang Hongwei , Huang Zhixuan , Wang Qiaochu
Published: September 2024

Background: Amusement arcades are one of the most popular entertainment venues for young people, but excessive noise levels inside them could harm young people’s hearing. The aim of this study is to assess the characteristics and risk of noise exposure for young people in amusement arcades and understand their knowledge of and attitudes towards safe listening. Methods: In this study, noise measurement was conducted in five large amusement arcades to collect 40 noise samples. At the same time, questionnaires were used in each amusement arcade to investigate young players’ social information, subjective perception, and cognition of noise-induced hearing loss (NIHL). Results: The level of the noise samples ranged from 83.05 to 89.4 dBA. There are significant differences in noise levels between amusement arcades (P < 0.05), but there is no significant difference in noise levels between different games (P > 0.05). The subjective questionnaire survey shows that 61.9% of young people feel that the sound of video games is noisy or very noisy, but it is worth noting that 63.5% of them do not know or think that noise will not cause hearing loss, and 39.7% of people will choose to do nothing to help them endure the noise in such an environment. For safe listening, young people are more inclined to choose measures to stay in quiet areas and reduce the volume of game devices. Conclusions: The noise levels in most amusement arcades have exceeded the exposure limits recommended by the Environment Protection Agency (EPA); subjective questionnaires also indicate that internal noise levels may cause hearing loss, and young customers did not know enough about safe listening. For young people’s hearing safety, these issues need more attention.
Observations on the Clinical Effects of Music Therapy on Premature Infants in Neonatal Intensive Care Units
Authors: Xiao Wenjun , Luo Xingfang
Published: September 2024

Objective: This study aimed to explore the clinical effects of music therapy (MT) on premature infants in neonatal intensive care units (NICUs). Methods: A total of 78 premature infants in NICUs admitted from January 2021 to January 2022 in Wuhan Children’s Hospital, Tongji Medical College, and Huazhong University of Science and Technology were selected as the reference group and received routine management. Wuhan Children’s Hospital implemented MT from February 2022 to February 2023, and 74 premature infants in NICUs admitted during the same period were selected as the observation group. The corresponding management mode was implemented on the second day of NICU admission for premature infants. Amplitude-integrated electroencephalogram (aEEG) and neonatal behavioral neurological assessment (NBNA) were adopted to evaluate the brain function, specifically the neurological function of neonates, after the end of management. The degree of parent–child attachment was measured using the pictorial representation of attachment measure (PRAM) in a nonverbal (visual) manner. The temperature, pulse, respiratory rate (RR), the number and duration of crying, and incidence of complications were all compared between the two groups. Results: SPSS showed that no difference existed in the aEEG and NBNA scores between the two groups (P > 0.05). The distance of PRAM self-baby-distance was smaller in the observation group compared with the reference group (P < 0.05). Furthermore, there was no significant difference in temperature between the two groups (P > 0.05). The observation group had significantly lower pulse and RR values than the reference group (P < 0.05). Finally, no significant difference existed in the incidence of complications between the two groups (P > 0.05). Conclusion: MT has a certain application value for premature infants in NICUs and can thus be applied to newborns in other NICUs. However, further studies are required to completely verify the research results.
Morphology of Perforated Cervicothoracic Ganglion in Indian Cadavers
Authors: Rajmohan Lavanya , Sakthivel Sulochana
Published: September 2024

Background:

Cervicothoracic ganglion (CTG) has surgical significance for the diagnosis and treatment of chronic regional pain syndromes, herpes zoster, refractory angina, vascular occlusive disorders, etc. Rarely, CTG could be perforated by the vertebral artery (VA), which might lead to complications during the ganglionic block. The present study describes the morphology of perforated CTG in Indian cadavers.

Methodology:

The present study included 25 formalin-embalmed cadavers (male – 18, female – 7) that were utilized for undergraduate teaching in the department of anatomy from 2017 to 2021. Out of 25 cadavers, two specimens on the right side were excluded from the study due to adhesion and damage to the ganglion. A total of 48 specimens (right – 23; left – 25) were included in the study and analyzed for the perforated CTG.

Results:

CTG was observed in 87.5% of the specimens and the inferior cervical ganglion in 12.5%. Perforated CTG was observed in four specimens (9.52%) exclusively on the left where the VA pierced at its superior pole or middle. The perforated CTG was found exclusively on the left, and in all four specimens, the VA was a branch from the subclavian artery.

Conclusion:

An analysis of the morphology of perforated CTG in Indian cadavers revealed its significant occurrence in the present study. It is crucial to consider the risk of injuring the VA during a CTG block. Understanding this variation could aid anesthetists, neurosurgeons, and surgeons in preventing complications during the therapeutic and diagnostic ganglionic blocks.
The Prevalence and Predictors of Burnout Among Resident Doctors in Enugu State, South East Nigeria: A Mixed Method Study
Authors: Okeke TA , Kassy CW , Chime OH , Ogugua IJ , Shu EN
Published: September 2024

Background:

Burnout in the health care industry is a potential hazard that has reached epidemic proportions mostly among doctors in practice and training. Burnout has enormous consequences on doctors, patients, and health care institutions.

Aim:

This study aimed to determine the prevalence and predictors of burnout among resident doctors in Enugu State, Nigeria.

Methods:

This was a mixed-method study of 420 resident doctors in tertiary hospitals in Enugu State, Nigeria. Data were collected using Oldenburg Burnout Inventory and in-depth interviews of chief resident doctors of selected departments. Data were analyzed using IBM statistical package 23.0 and Nvivo 11. Test of significance was set at 0.05.

Results:

The mean age of participants was 34.11 ± 5.08 years. The prevalence of burnout groups among resident doctors was 84.3% in the burnout group, 4.8% in the disengagement group, 6.9% in the exhaustion group, and 4.0% in the non-burnout group. Gender (OR = 1.861, C.I = 1.079–3.212), duration of training (OR = 1.740, C.I = 1.008–3.005), and working hours (OR = 2.982, C.I = 1.621–5.487) were the predictors of burnout; only working hours (OR = 0.279, C.I = 0.091–0.0862) was the predictor of disengagement; and gender (OR = 0.248, C.I = 0.107–0.579) was the predictor of exhaustion. Heavy workloads, long working hours, migration, poor working environment, job insecurity, poor remuneration, and management style were identified factors of burnout.

Conclusion:

There was high prevalence of burnout among resident doctors, predicted by gender, duration of training, and working hours. Interventions are needed to reduce burnout, prevent the “brain drain”, and improve resident doctors’ overall well-being.
Integration of Primary Preventive Care of Cardiovascular Disease in a Retroviral Clinic in an adult retroviral clinic in Ibadan: A retrospective study
Authors: Kuti MA , Kuti KM , Awolude OA , Ogundeji OA , Moradeyo DM , Feinstein MJ , Taiwo BO
Published: September 2024

Background:

A consequence of improved survival of people living with human immunodeficiency virus (HIV) (PLHIV) is an aging population with an increased risk of developing atherosclerotic cardiovascular diseases (ASCVDs). International guidelines recommend primary preventive strategies which should be integrated into routine care of PLHIV.

Aims:

This study audited the ASCVD preventive practices offered to PLHIV at the adult antiretroviral clinic in Ibadan.

Methods:

This was a retrospective review of clinical records of all persons who were recruited into the antiretroviral therapy clinic between January 1 and December 31, 2018. Cardiovascular disease (CVD) preventive practices were audited against recommendations of the American Heart Association for PLHIV.

Results:

The records of 568 persons with a mean (standard deviation) age of 39.95 (11.77) years were reviewed. There were 365 (64.26%) females and 203 (35.74%) males. Only 364 (64.08%) patients had the required parameters for the calculation of the low-density lipoprotein cholesterol (LDL-C) by the Friedewald formula. Ten-year ASCVD risk was not calculated for any of the patients during their clinic visits. Thirty-seven (6.51%) patients had either an LDL-C ≥4.91 mmol/L or an age between 40 and 75 years with diabetes mellitus or ASCVD risk score (when calculated) ≥ 7.5%. Only one of these persons was referred for specialist care of lifestyle modification. Fifty (8.80%) persons had an eGFR <60 mLs/min, but only 11 (1.94%) were referred for nephrology care.

Conclusion:

The integration of primary preventive cardiovascular practices into routine care for PLHIV is suboptimal. A revision of the recommendations of the Nigerian National Guidelines for HIV may be a useful first step addressing this.
Assessment of Prevalence of Otitis Media with Effusion and Correlation Between Otoscopic Findings with Jerger’s Diagnostic Tympanograms Among Pupils in Calabar Municipality
Authors: Onwughalu BC , Adekanye AG , Mgbe RB , Anisi CO , Umana AN , Somefun OA
Published: September 2024

Background:

OME is an accumulation of serous or mucoid fluid in the middle ear cavity with an intact tympanic membrane and without any sign of acute infection.

Aims:

This study aimed to determine the prevalence of otitis media with effusion among preschool and school-age children aged 1-10 years in private and public schools in Calabar municipality and the correlations between otoscopic findings and Jerger’s diagnostic criteria among study participants.

Methods:

This school-based descriptive cross-sectional study used a multistage sampling technique to recruit participants. The Institutional Ethical Committee approved the study. Consent and assent were obtained from parents/guardians of children aged < 6 years and >7 years, respectively. A structured questionnaire was used to obtain sociodemographic characteristics, symptoms, and possible risk factors for otitis media with effusion. In addition, ear, nose, and throat (ENT) examinations and tympanometry were performed for each participant. Jerger’s type B and C tympanograms were the diagnostic criteria for otitis media with effusion. The data were analyzed using IBM SPSS version 25, and the threshold for statistical significance was set at P < 0.05.

Results:

The overall prevalence of OME was 13.8%, with P values ≤ 0.001, P = 0.597, and P = 0.007 for daycare (45.85%), public schools (14.7%), and females, respectively. Jerger type B tympanograms had a strong positive correlation with middle ear fluid (r = 0.777) on otoscopy, Jerger type C tympanograms with dull TM (r = 0.687), and retracted TM (r = 0.774).

Conclusion:

Otitis media with effusion was more prevalent among preschool children aged 1-2 years in public schools and among female children in Calabar municipalit. The otoscopic results of otitis media with effusion were consistent with Jerger’s diagnostic criteria in our study.
Repeater F-waves: Clinical Importance and Distinction from A-waves
Authors: Mercan Metin , Yayla Vildan
Published: September 2024

ABSTRACT

Aim:

The aim of this study was to distinguish repeater F-waves (Frep) from A-waves by measuring the amplitude and ratio and investigating their relationship with neuromuscular diseases (NMDs).

Materials and Methods:

We retrospectively reviewed and compared the Frep records of 414 patients with different NMDs and 162 control subjects with normal electrophysiologic findings. Optimal cutoff points were determined using receiver operating characteristic curves, yielding >99% specificity versus A-waves.

Results:

The sensitivity at each derived cutoff point for the median, ulnar, peroneal, and tibial nerves were 58.5% for ≥340 uV, 46.2% for ≥350 μV, 13.1% for ≥560 μV, and 50.1% for ≥410 μV, respectively. However, the Frep/M-response amplitude ratio demonstrated very low sensitivity. The occurrence of repeater F-waves (Freps) was similar in patients with primary demyelination and axonal degeneration (P > 0.05); however, it was higher than that in control subjects (P < 0.017). The Frep amplitudes in patients with primary demyelination were significantly lower than in patients with axonal degeneration and control subjects (P < 0.017). The M-response amplitude negatively correlated with the occurrence of Freps and positively correlated with the F-wave persistence (P < 0.001).

Discussion:

The amplitude parameter appears to be an essential criterion for assessing late potentials, which may help differentiate Freps from A-waves, thereby facilitating the accurate detection of Freps. The increased occurrence of Freps indicates dysfunction of lower motor neurons, independent of the pathophysiologic process.
Electrophysiological Insights: Using Repetitive Nerve Stimulation to Monitor Clinical Status and Remission in Myasthenia Gravis
Authors: Tunç Abdulkadir , Güngen Belma Doğan , Öncel Samet , Sivaci Ali Özhan
Published: September 2024

ABSTRACT

Objective:

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder with a variable course that complicates the prediction of remission. This study aimed to evaluate the utility of repetitive nerve stimulation (RNS) in monitoring clinical status through the assessment of decremental response rates in the nasalis and trapezius muscles during treatment.

Subjects and Methods:

A prospective study was conducted with 52 patients diagnosed with generalized MG. Patients underwent clinical assessments, including tests for anti-acetylcholine receptor and anti-muscle-specific kinase antibodies, and were classified according to the Myasthenia Gravis Foundation of America classification. Electrophysiological testing through RNS and single-fiber electromyography was performed. Data analysis involved comparing the RNS decrement rates with clinical and demographic variables. Follow-up for assessing remission spans 2 years.

Results:

Among the 52 patients, 53.8% achieved clinical remission. In the remission group, 14.3% of the patients exhibited a decremental response compared with 70.8% in the nonremission group, particularly in the nasalis and trapezius muscles, in the follow-up RNS conducted 2 years after the initial assessment (P < 0.05). The remission group presented significantly lower rates of antibody positivity and less bulbar involvement. Interestingly, initial clinical severity did not correlate significantly with remission.

Conclusion:

This study demonstrated the usefulness of RNS in assessing the clinical status of MG patients and evaluating the effectiveness of current therapeutic strategies. These findings suggest that focusing on specific muscle responses in RNS can provide valuable information for patient management.
Ocular sequelae following snakebite envenomation
Authors: Joshy Susmitha , Chaitra M. C.
Published: September 2024

We report the case of a 33-year-old male patient who developed ophthalmoplegic symptoms following a viper snakebite. The patient presented with complaints of ptosis, blurred vision, and diplopia following a snakebite on his left lower limb. Clinical examinations revealed signs of envenomation, including local swelling and tenderness, alongside ocular manifestations such as limited extraocular movements and alternating exotropia. Blood investigations showed elevated white blood cell count and urinary abnormalities. The objective of this case report is to present the characteristic findings and management of this rare manifestation of a viper snakebite.
Global Mental Health: The View from Social Medicine and Medical Anthropology
Authors: Kleinman Arthur
Published: September 2024

Background:

This article explores the interplay between social medicine and medical anthropology in shaping global mental health perspectives.

Methods:

In this review, the author has reviewed pertinent topics about the interplay between social medicine and medical anthropology as reflected in his professional work presented in a 2023 special issue of Daedalus and a special lecture delivered to the Taiwanese Society of Psychiatry in June 2024.

Results:

How societal factors such as economic disparity, gender norms, ethnic conflicts, and global cultural shifts significantly influence mental health outcomes are highlighted. The discussion extends to the mental health repercussions of COVID-19 pandemic, the implications of aging populations, and the growing prevalence of dementia. In addition, the article critiques current mental health strategies, advocating for a broader approach that integrates social, cultural, and economic interventions. The role of community-based care is emphasized, with a particular focus on the effectiveness of community health workers in delivering mental health services. This piece calls for a reevaluation of psychiatric practices to more comprehensively address the complexities of global mental health, urging a move toward structurally and culturally sensitive care solutions.

Conclusion:

Psychiatry needs to change and will change, owing to global forces and new research that are creating a different kind of mental health-care system for the future.
Performances of Large Language Models in Detecting Psychiatric Diagnoses from Chinese Electronic Medical Records: Comparisons between GPT-3.5, GPT-4, and GPT-4o
Authors: Chien Chien Wen , Tai Yueh-Ming
Published: September 2024

Objectives:

As a type of artificial intelligence (AI), the large language model (LLM) is designed to understand and generate human-like fluent texts. Typical LLMs, e.g., GPT-3.5, GPT-4, and GPT-4o, interact with users through “prompts” and some internal parameters, like “temperature.” Currently, some AI models have been widely used in the field of psychiatry, but systemic reports examining the capacity and suitability of LLM in detecting psychiatry diagnoses are still lacking. In this study, we intended to explore the performances of different generations of LLMs with different levels of temperature in detecting mental illnesses from electronic medical records (EMRs).

Methods:

We collected 500 Chinese EMRs from one mental hospital in northern Taiwan, with the “current medical history” section as corpuses. We used the GPT-3.5-turbo-16K, GPT-4, and GPT-4o models provided by Microsoft’s Azure OpenAI service (www.portal.azure.com) to generate AI-based predictions (the probability) for the diagnoses of major depressive disorder (MDD), schizophrenia (SCZ), attention-deficit/hyperactivity disorder (ADHD), and autistic spectrum disorder (ASD). Clinic diagnoses made by qualified psychiatrists were treated as gold standards (target) of receiver operating characteristic curve analysis. Then, their area under the ROC curve (AUCs) were compared using the DeLong test.

Results:

Among 500 recruited Chinese EMRs in this study, 56.6% were primarily diagnosed with MDD, as well as 22.4% with SCZ, 11.2% with ADHD, and 9.2% with ASD. In general, our LLMs achieved AUCs of 0.84 to 0.98 for detecting four different diagnoses. There were no significant differences between versions, but newer versions (GPT-4o models with AUCs of 0.98–0.97 for SCZ, ADHD, and ASD) performed better than older versions (GPT-3.5 models with AUCs of 0.88–0.96) except for MDD (AUC of 0.95 for GPT-4 and AUC of 0.93 for GPT-4o). Although DeLong tests showed nonsignificant differences between the AUCs of models with different levels of temperature, models with zero temperatures generally represented the best performances in magnitudes.

Conclusion:

To the best of our knowledge, this study is the first to demonstrate that LLMs performed excellently in distinguishing some mental illnesses. Nevertheless, the diagnostic capabilities of LLMs differed from other diagnoses such as MDD. We hypothesize that this phenomenon may partially result from the complexity of symptomology and/or the content filtering rules of OpenAI. Therefore, more advanced models, e.g., GPT-5, or private training models, e.g., Llamma 3, with the relevance generative answering technique, are expected to answer our questions.
Understanding Barriers to STEM: Teachers' Insights on African American Underrepresentation
Authors: Ndiangui Peter , Koklu Onder
Published: September 2024

This study focuses on the development of a measurement instrument to identify Middle and High School mathematics and science teachers’ beliefs about the main factors of underrepresentation of African American students in STEM (Science, Technology, Engineering, and Mathematics) fields. The research method using the stages of instrument development were (1) test design which involved construction of initial item pool by conducting extensive review of literature and coding of participating teachers personal statements (2) determination of validity which involved expert review process to confirm construct and face validity of items, (3) pilot testing which involved collecting data from a second set of participants, (4) determination of reliability which involves conducting a reliability analysis based on data collected from pilot testing and (5) determination of factorial structure which involved Exploratory Factor Analysis (EFA) to identify underlying factors in participating teachers’ belief structures. First, to obtain trustworthy information, voluntary middle and high school mathematics and science teachers were asked to write personal statements where they explain their main reasons for choosing teaching as a career. Secondly, qualitative data obtained from participating teachers’ personal statements were coded. Coding was applied to identify and to group the phrases or sentences that convey the same or similar reasons. Then results from an extensive literature review on this topic were blended in teachers’ common expressions which were determined because of coding procedure. Then 8 content experts assessed content validity and face validity. Finally, the survey was piloted to African American middle and high school mathematics and science teachers. Fifty-three (53) surveys were completed and received back from teachers. Then, exploratory factor analysis was conducted to identify any underlying factors in the scale. Reliability analyses were also conducted for both the entire survey and for each of the factors. Results of the study suggested four underlying components: (1) Access and Resources, (2) Role Models and Representation, (3) Bias and Discrimination, (4) Curriculum and Pedagogy.
Consistency of Youth Identity Construction in Media Texts: Development and Adaptation of Actor-Network Theory for Empirical Media Research (Сase Study)
Authors: Sosnovskaya Anna M.
Published: September 2024

The formation of youth identity in communication is on the agenda of many areas of humanitarian knowledge. We analyzed communication within the framework of an educational media project, which resulted in the construction of the expected identity. In the course of the analysis, we used a conceptual model of communication that combines the stages of identity construction in interaction with the environment and the actions of actors from the standpoint of the methodology of actor-network theory. A three-dimensional model of communication is presented for the first time, where actors and actants change the communicative process by their affordances and resistance. The obtained results allow to delineate the necessary actions of human and non-human actors at each stage of communication and identity integration, giving the opportunity to justify a new theoretical direction in the study of the problems of identity construction through media communication. The methodology requires further testing, but there are already positive results. The tendency of actualization of urban identity of young people depending on the focus on interaction with the heritage of the city and according to the stages of communication, according to the conceptual model, has been established. The article is intended for specialists in mass communication and journalism, and will also be useful for those interested in the ontological turn in humanitarian knowledge, actor-network theory, discourse and media text analysis.