bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Arterial Lactate and Lactate Clearance in Risk Stratification of Patients with Upper Gastrointestinal Bleeding Presenting to the Emergency Department for use at Primary Health Care Level
Authors: Kaliparambil Binoy Xavier , Maprani Jobin Jose , Paulson Sandra
Published: March 2024

Background:

Upper gastrointestinal bleeding is a common presenting complaint in the emergency department (ED) and carries a small but significant mortality rate. In spite of the availability of various scoring systems, risk stratification for in hospital morbidity and mortality remains difficult. There is no single test that can reliably predict active bleeding from the upper gastrointestinal tract for use at primary health level.

Aims and Objectives:

To study the role of lactate clearance as a predictor of active bleeding and also to determine whether an ED arterial lactate can predict adverse outcomes like increased hospital length of stay, in hospital, 30-day and 60-day mortality.

Methods and Material:

Prospective single centre observational study at a tertiary hospital in north Kerala that included all stable adult patients who presented with the complaints of hematemesis, melena or both to the ED Arterial lactate was drawn at the bedside, a priori initial arterial lactate cut-off value of 2.2 mmol/L was selected and in patients with lactate value above the cut-off, a second lactate was measured to calculate lactate clearance.

Results:

Lactate clearance ≤13.39% was found to be associated with a high risk for active bleeding (odds ratio: 23.33; 95% CI = 4.337 to 125.512, P < 0.001). Optimal cut-off points for lactate as well as lactate clearance were derived using receiver operating characteristics curve.

Conclusions:

Lactate clearance can reliably rule in as well as rule out active bleeding in patients who might seem hemodynamically stable at the initial presentation to the ED.
Need of integrated care model for positive childbirth experience in Indian maternity care services
Authors: Leela Thaniya K. , Baboo Smitha
Published: March 2024

BACKGROUND:

Integrated care (IC) models are an emerging trend in healthcare reforms worldwide, especially in the maternal healthcare system. This research focuses on the scope of an integrated model for intrapartum care of women and explores the experience of birth under two intrapartum care models—biomedical and midwifery models, respectively. The term positive childbirth experience (PCE) is a concept defined by the World Health Organization (WHO) in the recommendations on intrapartum care for a PCE.

MATERIALS AND METHOD:

This study is convinced to employ a qualitative approach to explore how birth is experienced by women under maternity healthcare services in Kerala. A semi-structured interview was conducted to tap into the lived reality of birthing of sixteen first-time mothers (primipara) aged between 20 and 30 years under these two models. Furthermore, five participants have been specifically interviewed after their vaginal birth after a C-section (VBAC) experience. To achieve a systematic cross-case thematic analysis, systematic text condensation (STC) has been employed as a data analysis method.

RESULTS:

Four main categories were identified through the analysis as follows: (1) information and knowledge, (2) confidence, (3) quality of care, and (4) health-promoting perspective. These central themes evolved from 11 subthemes.

CONCLUSION:

The data analysis reveals both negative and positive experiences under two care models. It emphasizes the urgent need to reframe the biomedical-focused care model and adopt an integrated approach that aligns with the global intrapartum care model proposed by the World Health Organization (WHO) in 2018 and the definition of IC mentioned in the paper.
Relationship between reproductive health literacy and components of healthy fertility in women of the reproductive age
Authors: Ghavami Batool , Sohrabi Zahra , RaisiDehkordi Ziba , Mohammadi Fatemeh
Published: March 2024

BACKGROUND AND AIM:

One of the key factors affecting women’s behavior with fertility issues is their health literacy, but this topic has been less addressed in the existing studies. We aimed to determine the relationship between reproductive health literacy and components of healthy fertility in women of reproductive age.

MATERIALS AND METHODS:

This cross-sectional study was conducted from March 2019 to September 2014 on 230 married women who were referred to comprehensive health centers in Lordegan city. Data were collected using a reproductive health literacy questionnaire, demographic and fertility information checklist, and components of healthy fertility. Data analysis was done using SPSS software, version 20. Pearson, Spearman, and independent t-tests were used as appropriate.

RESULTS:

The mean ± SD reproductive health literacy score in the participants was 43.80 ± 18.99 depicting an average literacy level in more than half of the women. Also, the reproductive health literacy score had a statistically significant relationship with the use of low-failure contraceptive methods (P < 0.001) and planned pregnancy (P = 0.03). However, this relationship was not significant regarding pre-pregnancy care (P = 0.88) and observing the interval between pregnancies (P = 0.57).

CONCLUSION:

We found a relationship between the level of reproductive health literacy and the use of family planning methods with low failure and planned pregnancy. Hence, it seems that interventions to improve reproductive health literacy are effective in reducing the occurrence of high-risk pregnancies and unwanted and unplanned pregnancies. Therefore, it is suggested that the health system consider and provide education related to reproductive health literacy as a part of healthy reproductive services.
The practices of heat adaptation among elderly in Dezful: A qualitative study
Authors: Aghababaeian Hamidreza , Ostadtaghizadeh Abbas , Kiarsi Maryam , Sarfaraz Hossein , Ahvazi Ladan Aragi , Maniey Mohammad
Published: March 2024

BACKGROUND:

Useful experiences of the elderly in adapting to the environment may play an important role in formulating future policies. This study was conducted to explain the past experiences of the elderly in Dezful in adapting to heat.

MATERIALS AND METHODS:

This study was conducted with a qualitative research approach and a qualitative content analysis method in 2020 and 2021. The experiences of 18 elderly in Dezful were collected through semi-structured interviews via recording, face-to-face interviews, and data observation. Sampling was performed by the purpose-based method, and the data of this stage were analyzed using a content analysis approach using the Zhang and Wildemuth method.

RESULTS:

During the data analysis process, three main themes were extracted, including psychophysiological, socioeconomic, and environmental adaptation. Also, twelve subthemes including changes in physiological conditions, urban architecture, house architecture, diet, clothing, business conditions, mindset, life conditions, and the use of factors (spirituality, experience, and natural capacities) were extracted.

CONCLUSION:

Explaining the experiences of the elderly in Dezful, who have lived with heat for many years, can provide better identification of solutions and more tangible experiences of adaptation to heat for other communities. These experiences can be used in urban, cultural, and social planning.
Investigating the association between the lunar cycle and sleep, physiological, cognitive, and physical performance in children with Down syndrome
Authors: Lammouchi Zohra , Guelmami Noomen , Abedelmalek Salma , Saidane Mouna , Ghouili Hatem , Rebhi Mahmoud , Fessi Mohamed Saifedine , Aissa Mohamed Ben , Bedhioufi Hafsi , Saad Helmi Ben , Dergaa Ismail
Published: March 2024

BACKGROUND:

Children with Down syndrome (DS) offer a compelling context within the fieldof human biology for examining potential lunar influences. While the exact mechanisms governing lunar effects are still under investigation, a growing body of scientific inquiry suggests possible connections between lunar phases and physiological, physical, and cognitive parameters. This investigation holds promise for uncovering the intricate interplay between lunar cycles (LCs) and the unique biology of children with DS. This study investigated the potential influence of the LC on physiological, physical, and cognitive parameters in children with DS, focusing on sleep patterns, physical performance, and cognitive abilities.

MATERIALS AND METHODS:

Seventeen children with DS participated in this study. Sleep data, physical performance metrics, and cognitive test results were collected throughout the LC, including the new moon (NM), first quarter, full moon (FM), and third quarter. Statistical analyses were conducted to assess the differences in these parameters across lunar phases.

RESULTS:

Significant differences were observed in sleep patterns, with reduced total sleep time (P < 0.01) and sleep efficiency (P < 0.001) during the FM phase. Heart rates (HRs) before (P < 0.001) and after (P < 0.01) exercise also displayed pronounced changes during LC. Additionally, the reaction time (RT) exhibited a significant difference (P < 0.01) across the lunar phases. However, physical performance metrics, including squat jump (SJ), sprint, and 6-minute walk distance (6MWD), did not show significant variations.

CONCLUSION:

This study suggests that LC may have a moderating effect on sleep patterns, HR, and cognitive performance in children with DS. These findings have practical implications for caregivers and educators and highlight the importance of considering lunar-associated variations in planning schedules and interventions for children with DS.
Barriers to financial access of disabled people to health services in rural areas: A case study of Iran
Authors: Shams Lida , Nasiri Taha , Darvish Tahere , Hosseini-Shokouh Sayyed-Morteza , Amiri Mohammad Meskarpour
Published: March 2024

BACKGROUND:

People with disabilities (PWDs) account for a significant percentage of the world’s population, with a higher prevalence in less developed countries. Access to healthcare services is the main component of health systems performance, with lower access for PWDs living in rural areas. The current study aimed to investigate PWD’s access to healthcare services in rural areas of Iran and, secondly, factors that contribute to this issue.

MATERIALS AND METHODS:

Following a cross-sectional design, the current descriptive-analytical study is performed in the north of Iran. Using the quota sampling technique, 471 PWDs were recruited. Data were collected using a valid and reliable questionnaire, covering three dimensions of access, by face-to-face interview. Data analysis was administered using central tendency indicators and multiple regression by SPSS version 17. Statistical significance was considered when the P value <0.05.

RESULTS:

The mean score of PWD’s access to healthcare services for dimensions of utilization, availability, and affordability was 8.91 (±6.86), 14.54 (±2.3), and 51.91 (±8.78), indicating very low, low, and moderate levels of access. All three regression models were significant (P < 0.05), and variables of gender, age, marital status, education level, residence status, the income of the household head, receiving financial aid, and house area showed a significant effect (P < 0.05).

CONCLUSION:

This study demonstrated the seriousness of paying attention to PWD’s financial access to healthcare services, particularly in rural areas of Iran. Hence, policymakers should better focus on this problem, mainly regarding accessibility and utilization and factors that result in inequalities.
Evaluation of different taste sensations along with body mass index (BMI) in geriatric patients with and without complete dentures
Authors: Doddawad Vidya G. , Mehrin Farina , Raghavendraswamy K. N. , Chandrashekarappa Smitha M. , Shivananda S. , Vidya C. S.
Published: March 2024

BACKGROUND:

The purpose of this study was to investigate the effect of acrylic full removable dentures on the perception of four primary tastes (sweet, sour, salty, and bitter), as well as to determine if there is a correlation between changes in body mass index (BMI) and taste perception.

MATERIALS AND METHODS:

A total of 60 patients who wore acrylic removable dentures and 60 controls were included in the study as a convenient sample. Sixteen solutions for basic tastes were prepared, and the patients were asked to identify the taste of each solution from the lowest concentration. Anthropometric measures, such as height and weight, were measured and recorded in an MS-Excel sheet. The data were analyzed using SPSS version 23.

RESULTS:

The results showed that patients with complete removable dentures had lower taste scores for sourness (P < 0.001) and sweetness (P < 0.001) compared to the control group. However, there was no significant difference in salt taste scores (P = 0.218) and bitterness (P = 0.002) between the two groups. Additionally, the study found a correlation between lower BMI values and higher taste scores among denture-wearing patients, indicating an inverse relationship between total taste scores and BMI.

CONCLUSIONS:

The study suggests that geriatric patients with complete dentures have reduced taste sensations compared to those without dentures which can have a negative impact on their nutritional status. Therefore, it is crucial to provide adequate nutritional support and dietary counseling for geriatric patients based on health policy to maintain their overall health and well-being.
Acute neuromuscular disorders in critically ill children
Authors: Bansal Deepankar , Angurana Suresh Kumar , Suthar Renu , Bansal Arun
Published: March 2024

Acute neuromuscular disorders are a group of neurological emergencies characterized by rapid onset of motor weakness commonly involving the respiratory and bulbar muscles. These can be acute or an exacerbation of the chronic neuromuscular disease. An accurate and timely diagnosis allows for the timely institution of specific therapies, improving long-term functional outcomes. Landry–Guillain–Barre syndrome (LGBS), acute transverse myelitis, compressive myelopathy, traumatic spinal lesions, and anterior horn cell myelitis (due to viral infections) are some of the common causes of acute motor weakness in children. LGBS is the most common among all. The diagnosis relies on clinical presentation, signs, cerebrospinal fluid analysis, electrophysiological studies, and neuroimaging of the spine. Once compressive or traumatic spinal lesions are suspected, immediate neuroimaging of the spine is essential to plan early neurosurgical intervention. Pediatric intensive care unit (PICU) admission is often required for supportive management and immunomodulation. Supportive management typically includes endotracheal intubation to protect the airway, mechanical ventilation (MV) to support breathing, monitoring, management of autonomic dysfunction, control of pain, physiotherapy, adequate nutrition, prevention of pressure sores, bladder–bowel care, psychological support, and planning of long-term care. Autonomic dysfunction can cause hemodynamic instability, arrhythmias, sudden cardiac arrest, and death, requiring close monitoring and management in PICU. Tracheostomy is often needed in children who continue to have respiratory paralysis and are predicted to require long-term term mechanical ventilation. The outcome generally depends on the primary disease and long-term care.
The Impact of Gastric Juice on the Surface Roughness of Surface Sealant-Treated Provisional Restorations
Authors: Kuscu HY Yay , Kurkcuoglu I , Kucukesmen HC
Published: March 2024

Background and Aim:

Gastroesophageal reflux disease causes gastric acid to enter the oral cavity, leading to mucosal changes and deterioration of dental hard tissues and materials. The purpose of this in vitro study was to evaluate the impact of gastric juice on the surface roughness of two types of acrylics used in provisional restorations.

Materials and Methods:

Acrytemp ® and Temdent acrylic resin discs (10 × 2 mm) totaling 80 were manufactured and divided into eight groups (n = 10). Groups were prepared as follows: Group 1 (Temdent + Universal Polish) (control), Group 2 (Temdent + Universal Polish + Biscover LV), Group 3 (Temdent + Universal Polish + Resin Glaze), Group 4 (Temdent + Universal Polish + Fortify Plus), Group 5 (Acrytemp + Universal Polish) (control), Group 6 (Acrytemp + Universal Polish + Biscover LV), Group 7 (Acrytemp + Universal Polish + Resin Glaze), and Group 8 (Acrytemp + Universal Polish + Fortify Plus). The resin discs were immersed in distilled water for 24 h and in gastric juice (pH = 2) for additional 24 h. The initial and final roughness values of samples were measured and analyzed with non-parametric statistics including Mann–Whitney U-test for pairwise comparison, Kruskall Wallis test for comparing more than two groups, and Wilcoxon signed rank test for within-group comparison (P < 0.05).

Results:

Surface roughness did not differ significantly between control groups. It notably increased for all samples with surface sealants, both initially and after gastric juice immersion (P < 0.05).

Conclusion:

Surface sealants noticeably increased the roughness of two types of acrylic resins. After immersing in gastric juice, Group 4 (Temdent + Universal Polish + Fortify Plus) showed the highest roughness, while the untreated control groups remained the smoothest.
The Biomechanical Investigation of Osseointegration Levels in Titanium Implants Simultaniously Placed with Different Bone Grafts
Authors: Guler R , Dundar S , Bozoglan A , Ozcan EC , Ozupek MF , Acikan I , Gunes N , Bingul MB
Published: March 2024

Background:

Dental implant-supported prostheses have been scientifically accepted and have been a common treatment choice in the case reconstructing of partial or total tooth loss. In additon, bone grafts (alloplast, xsenograft, allograft) are frequently used in implant and sinus lift surgical procedures.

Aim:

The aim of this study is to investigate the bone–implant osseointegration levels of titanium implants simultaniously placed with different bone grafts.

Materials and Methods:

In the study, 32 female S. Dawley rats were divided into four groups. In the control group (n = 8), turned surface implants with a 2.5 mm diameter and a 4 mm length were placed in the tibia of the rats without the use of a graft material. In the experimental groups, bone cavities were opened in the tibias of the rats and a synthetic (alloplast) graft (n = 8), human allograft (n = 8), and bovine xsenograft (n = 8) were placed simultaniously with a 2.5 mm diameter and a 4 mm length turned surface titanium implants. The cavities in the experimental groups were opened with a 4 mm diameter and a 5 mm length. After 8 weeks of recovery, all rats were sacrificed at the end of the experimental period. The implants and surrounding bone tissue were removed. The removed tissue was subjected to biomechanical analysis in order to evaluate bone–implant osseointegration and peri-implant new bone formation. The Kolmogorov–Smirnov test, Kruskal–Wallis test, and Mann–Whitney U-test were used in the study. Significance was evaluated at the P < 0.05 level.

Results:

In the biomechanical analyses, it was determined that there was no statistically significant difference between the control group and the other three groups in which different graft materials were applied in terms of bone–implant osseointegration (P > 0.05). In other words, in the biomechanical analyses, no statistical difference was found between any of the groups.

Conclusions:

As a result of this study, it can be thought that different graft materials can be successfully used in peri-implant-guided bone regeneration and may be an alternative to autogenous grafts.
Serum Immunoglobulin E Level and Its Relationship with Eosinophil Count among Patients with Allergic Rhinitis in Tertiary Hospital in Bauchi, Northeastern Nigeria: A Cross-Sectional Study
Authors: Gwalabe SA , Adamu A , Kirfi AM , Dunga JA , Maigari IM
Published: March 2024

Background:

Allergic rhinitis is an immunoglobulin E-mediated hypersensitivity disease of the mucous membrane of the nasal airway. There is a paucity of information regarding serum immunoglobulin E level and its relationship with eosinophil count among patients with allergic rhinitis in our facility and Northeastern Nigeria.

Aim:

To determine serum immunoglobulin E level and its relationship with eosinophil count among patients with allergic rhinitis.

Methodology:

It was a cross-sectional study of consecutive patients diagnosed with allergic rhinitis that were recruited from the ear, nose, and throat surgery and respiratory medicine clinics of ATBUTH, Bauchi, Bauchi State, Northeastern Nigeria, from January 01, 2022, to May 31, 2023. Five milliliters of blood were analyzed for immunoglobulin E estimation using an immunoglobulin E ELISA kit and determination of eosinophil count using pack five hematologic autoanalyzer. Extracted data were analyzed using IBM SPSS version 23.0 software.

Result:

There were 61 patients studied comprising 22 (36.1%) males and 39 (63.9%) females with a male-to-female ratio of 1:1.7. Their ages range from 18 to 77 years old. The mean age, serum IgE level, and eosinophil counts of all three patients were 38.65 ± 14.34 years, 371.24 ± 82.63 IU/ml, and 3.35 ± 2.87%, respectively. All (100%) participants had raised serum IgE levels, and 88.5% had normal eosinophil count. There was no significant correlation between the serum IgE level and eosinophil counts (r = −0.206; P = 0.112).

Conclusion:

All of the participants had a high serum IgE level. There was no significant association between serum IgE and eosinophil count.
Association Between Articular Eminence Structure and Joint Spaces in Temporomandibular Joints with Anterior Disc Displacement
Authors: Etöz M , Çabuk D Soydan , Kütük N , Ercan I
Published: March 2024

Background and Aims:

The association among the joint spaces, articular eminence morphology, and disc displacement is not well documented in the literature. This study aims to evaluate and compare the joint spaces and the articular eminence structure (eminence height [Eh] and inclination [Ei]) using cone-beam computed tomography (CBCT) of temporomandibular joints (TMJs) with anterior disc displacements and joints with normal disc position.

Methods:

The study groups consisted of 75 TMJs of 39 patients. The disc status of TMJs was diagnosed with magnetic resonance imaging, and the measurements were performed on CBCT. Three groups, that is, normal disc position (NDP) group, anterior disc displacement with reduction (ADDWR) group, and anterior disc displacement without reduction (ADDWoR) group, were established. Anterior, superior, posterior joint spaces (AJS, SJS, and PJS, respectively), articular Eh, and articular Ei were measured. Statistical Package for the Social Sciences version 22 was used for statistical analysis. Shapiro–Wilk test was used to check the normality of data. Intergroup comparisons of categorical variables were assessed with Fisher–Freeman–Halton test. For comparison of continuous variables parameters, Mann–Whitney U test and Kruskal–Wallis test were used. Statistical significance level was determined as P < 0.05.

Results:

Significant differences were not found in intergroup comparisons for PJS. However, the difference between groups was found to be significant for AJS, SJS, Eh, and Ei. Intergroup comparisons were performed for these parameters. No significant difference was found between the NDP group and the ADDWR group for AJS, SJS, Eh, and Eİ. The mean AJS, SJS, Eh, and Ei values in ADDWoR were found to be significantly lower compared to the corresponding values in both NDP and ADDWR groups.

Conclusion:

Decreased AJS and SJS when TMJ is evaluated with CBCT may be an indicator of ADDWoR. Authors suggest that narrowed articular Ei and reduced articular Eh can be one of the predisposing factors for anterior disc displacement.
Dynamics of Gingival Indices and Microbiological Findings During Treatment of Plaque-Induced Gingivitis in Children Aged 10-14 Years
Authors: Tankova HI , Lazarova ZB , Mitova NG
Published: March 2024

Background:

The study analyzed the dynamics of the clinical periodontal status during the treatment of adolescents with generalized plaque-induced gingivitis.

Aim:

Assessment of the predominant subgingival microflora in the case of a diagnosed inflammatory process in the gingiva in childhood.

Methods:

Full-mouth periodontal assessment of plaque accumulation and bleeding on probing with an electronic periodontal probe was performed during the treatment of 34 adolescents with generalized plaque-induced gingivitis. The treatment protocol includes five visits (1, 3, 7, 14, and 30 days). Subgingival biofilm sampling was performed by real-time PCR testing to identify, follow-up in dynamics, and determine the quantities of main subgingival periodontopathogens during treatment. Three samples per child were taken from five teeth with the most severe inflammation.

Results:

For children aged 10-14 years with generalized plaque-induced gingivitis, two weeks after the start of treatment, the index values for bleeding on probing decreased twice from 53 to 27%. C. gingivalis was isolated before the start of treatment in all children, followed by P. intermedia, P. micros (70,4%) and T. denticola, T. forsythia (52,9%). Representatives of the red complex according to Socransky showing greater resistance to the therapy performed in terms of frequency and amount.

Conclusion:

The predominant subgingival microflora in adolescents with generalized plaque-induced gingivitis is representative of the orange and red Socransky complex, with index values decreasing smoothly at each subsequent visit during treatment.
Effect of Physical Performance Levels of Elderly Living in Urban and Rural Areas on Social Participation, Social Functioning, and Quality of Life: A Cross-sectional Study from the Mediterranean Region of Turkey
Authors: Parpucu Tİ , Keskin T , Başkurt Z , Başkurt F
Published: March 2024

Background:

Social interaction is a very important subject for the elderly, especially in the context of active aging.

Aim:

This study aims to investigate the effect of physical performance levels of the elderly living in rural and urban areas on social participation, social functioning, and quality of life.

Methods:

A total of 418 volunteer elderly aged 65 and over, living in rural (42.3%) and urban (57.7%) areas, participated in this study. The Mini-Mental State Examination, Short Physical Performance Battery, the World Health Organization Quality of Life Scale for Older Adults, Social Functioning Scale, and the Community Integration Questionnaire were applied to participants.

Results:

The scores of social functioning (P = 0.027) and the social network subscale of social participation (P = 0.001) were significantly higher among participants living in urban areas compared to those living in rural areas. Physical performance was positively correlated with social participation (r = 0.404) and social functioning (r = 0.324) at a moderate level (P = 0.000), and with quality of life at a low level (r = 0.158) (P = 0.001). Social participation was positively correlated with social functioning at a high level (r = 0.572) and with quality of life at a moderate level (r = 0.300) (P = 0.000). Social functioning was positively correlated with quality of life at a low level (r = 0.234) (P < 0.01).

Conclusion:

To increase social participation, social functioning, and quality of life among the elderly, it is necessary to keep physical performance levels higher. In addition, in the planning of social participation, it is crucial to take into account where the elderly live in.
The Effect of Different Ageing Protocols on the Shear Bond Strength of the Ceromer Indirect Composite on Two Different Substructure Materials
Authors: Kuscu HY Yay
Published: March 2024

Backround:

The evolution of restorative materials in prosthodontics has led to the emergence of indirect composite resins, including ceromers, as alternatives to traditional metal-ceramic restorations. However, research gaps exist regarding the impact of ageing protocols on the bond strength of ceromer composites to different metal substructures, necessitating further investigation in this area.

Aim:

This study aimed to determine the effect of five different ageing protocols on the shear bond strength (SBS) of ceromer indirect composites on two different substructures.

Methods:

In this in vitro study, 120 metallic discs (10 × 2 mm) were cast from cobalt-chromium (Co-Cr) alloy (n = 60) and spark erosion treated from grade V titanium (n = 60). Each sample was sandblasted. The M.L. primer (Shofu, Germany) and layers of opaque were applied to the surface following the manufacturer’s instructions. A special jig (6 × 2 mm) was placed on each disc. The ceromer was condensed in it and light-cured separately for 90 s. Following polishing, specimens were separated into five ageing groups: distilled water (as a control), thermal cycling, tea, coffee, and gastric acid immersion. All samples were placed in 37°C incubation for 28 days for distilled water, coffee, and tea, and 7 days for gastric acid immersion and thermal cycling for 5000 cycles (5-55°C). A universal test machine was used to measure the SBS. The samples were evaluated for failure modes using stereomicroscopy. Data were analyzed using one-way analysis of variance (ANOVA) (P < 0.05).

Results:

According to one-way ANOVA, the mean SBS (MPa) between the two groups was compared in each ageing protocol, and there were no significant differences between the Co-Cr-C and Ti-C groups (P > 0.05). The most frequent mode of failure in all groups was mixed.

Conclusions:

Applying the ageing protocols, the type of substructure material had no significant effect on the SBS of the ceromer indirect composite except for tea immersion.
Shockwave Intravascular Lithotripsy: The Future of Coronary Intervention?
Authors: Thirumurugan E. , Gomathi K. , Karthick R.
Published: March 2024

Aim:

The objective is to evaluate the safety, efficiency, and clinical outcomes of Intravascular Lithotripsy Systems for treating Calcified Coronary Artery Disease (CAC) during revascularization.

Methods:

Intravascular Lithotripsy (IVL) in India remains largely unexplored. Unfortunately, there is an alarming lack of sufficient data on this innovative technique, with only a handful of articles on IVL available in non-indexed journals that are not easily accessible online. This review aims to serve as a valuable source of information and promote further research on this innovative technique.

Results/Conclusion:

Intravascular lithotripsy systems have significantly impacted interventional cardiology, greatly improving the efficiency and safety of procedures. Coronary intravascular lithotripsy shows great promise in treating Calcified Coronary Artery Disease (CAC) during revascularization. IVL can be safely performed before stent implantation, with a high rate of procedural success and a low incidence of complications.
Étale motivic spectra and Voevodsky’s convergence conjecture
Authors: Bachmann Tom , Elmanto Elden , Østvær Paul Arne
Published: March 2024

We prove a new convergence result for the slice spectral sequence, following work by Levine and Voevodsky. This verifies a derived variant of Voevodsky’s conjecture on convergence of the slice spectral sequence. This is, in turn, a necessary ingredient for our main theorem: a Thomason-style étale descent result for the Bott-inverted motivic sphere spectrum, which generalizes and extends previous étale descent results for special examples of motivic cohomology theories. Combined with first author’s étale rigidity results, we obtain a complete structural description of the étale motivic stable category.
Social Demographic Characteristics Associated with Visceral Leishmaniasis in West Pokot, Kenya
Authors: Abdullahi Bulle , Mutiso Joshua , Gicheru Michael
Published: March 2024

Visceral leishmaniasis is a tropical disease with a significant global public health burden. This study aimed to determine the social demographic characteristics associated with visceral leishmaniasis in West Pokot of Kenya. A mixed-methods research design was adopted where household questionnaires and key informant interviews were administered. Quantitative data was analyzed using SPSS version 22, and qualitative data were analyzed to establish patterns for interpretation. Male children aged 10 years or younger were the most infected by Leishmania donovani in the community. The hospital record indicated that 60% of previously treated visceral leishmaniasis patients were severely malnourished during admission. Risk factors associated with the disease included low formal education (adjusted odds ratio [aOR] = 4.39; 95% CI = 1.66–11.59; P <0.05), peasant farming (aOR = 8.49; 95% CI = 2.77–26.00; P <0.05), and dog ownership (aOR = 4.86; 95% CI = 1.87–12.60; P <0.05). Social demographic risk factors for visceral leishmaniasis remain a major public health concern in West Pokot.
Implementation of a Randomized, Placebo-Controlled Trial of Live Attenuated Malaria Sporozoite Vaccines in an Indonesian Military Study Population
Authors: Indrihutami Khoriah , Chand Krisin , Fahmia Rizka , Rahardjani Mutia , Wulandari Fitria , Subekti Decy , Noviyanti Rintis , Soebandrio Amin , Mallisa Noch T. , Mardika I Made , Budiman Waras , Suriswan Irwan , Ertanto Yogi , Chen Mei-Chun , Murshedkar Tooba , Abebe Yonas , Sim B. Kim Lee , Hoffman Stephen L. , Richie Thomas L. , Chen Sky , Elyazar Iqbal R. F. , Ekawati Lenny L. , Baird J. Kevin , Nelwan Erni J.
Published: March 2024

Malaria eradication efforts prioritize safe and efficient vaccination strategies, although none with high-level efficacy against malaria infection are yet available. Among several vaccine candidates, Sanaria® PfSPZ Vaccine and Sanaria PfSPZ-CVac are, respectively, live radiation- and chemo-attenuated sporozoite vaccines designed to prevent infection with Plasmodium falciparum, the leading cause of malaria-related morbidity and mortality. We are conducting a randomized normal saline placebo-controlled trial called IDSPZV1 that will analyze the safety, tolerability, immunogenicity, and efficacy of PfSPZ Vaccine and PfSPZ-CVac administered pre-deployment to malaria-naive Indonesian soldiers assigned to temporary duties in a high malaria transmission area. We describe the manifold challenges of enrolling and immunizing 345 soldier participants at their home base in western Indonesia before their nearly 6,000-km voyage to eastern Indonesia, where they are being monitored for incident P. falciparum and Plasmodium vivax malaria cases during 9 months of exposure. The unique regulatory, ethical, and operational complexities of this trial demonstrate the importance of thorough planning, frequent communication, and close follow-up with stakeholders. Effective engagement with the military community and the ability to adapt to unanticipated events have proven key to the success of this trial.
Artificial intelligence for disease diagnostics still has a long way to go
Authors: Yang Jian-She , Wang Qiang , Lv Zhong-Wei
Published: March 2024

Artificial intelligence (AI) can sometimes resolve difficulties that other advanced technologies and humans cannot. In medical diagnostics, AI has the advantage of processing figure recognition, especially for images with similar characteristics that are difficult to distinguish with the naked eye. However, the mechanisms of this advanced technique should be well-addressed to elucidate clinical issues. In this letter, regarding an original study presented by Takayama et al , we suggest that the authors should effectively illustrate the mechanism and detailed procedure that artificial intelligence techniques processing the acquired images, including the recognition of non-obvious difference between the normal parts and pathological ones, which were impossible to be distinguished by naked eyes, such as the basic constitutional elements of pixels and grayscale, special molecules or even some metal ions which involved into the diseases occurrence.
Politicization of Ecology and Ecologization of Politics: Values and Interests
Authors: Avramenko A. A.
Published: March 2024

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“Nuclear Winter” Hypothesis Research and Responsibilities in Nuclear Policy
Authors: Ginzburg A. S. , Samoylovskaya N. A.
Published: March 2024

In the 1980s, one of the fundamental topics of scientific debate was the discussion of the global consequences of nuclear war. At that time, the hypothesis of “nuclear winter” emerged, in which scientists attempted to analyse the theoretical possibility of a sharp cooling of the Earth after mass fires, and to find natural analogues of a potential climatic catastrophe. In the following decades, the “nuclear winter” hypothesis went through various stages of criticism and reassessment. In the early 2000s, studies of the problem became regional in nature, focusing mainly on the possible consequences of local nuclear conflicts. In this article, the authors analyse the stages of development of research on the “nuclear winter” hypothesis, focusing on the Russian and American approaches, and conclude that the body of work produced by American and Soviet scientists in 1983–1985 represents the first attempts by the scientific community to conceptualise the problem of responsible nuclear policy.
“Neither Water, nor War:” the Problem of Fresh Water in International Relations of the First Quarter of the 21st Century
Authors: Likhacheva A. B.
Published: March 2024

In this article, the author compares the objective dynamics of changes in the state of the water problem since the beginning of the 21st century, which has continued to worsen in most regions of the world, and its foreign policy dimension, noting the transition from the global water alarmism of the 1990s to the challenges for small and medium powers, in solving the problems in which no major actor is yet actively interested. Fresh water, despite the slogans at the end of the last century about future water wars, the “blue oil” and the “new gold” of the 21ST century, has not become, and is unlikely to become, the cause of confrontation between great powers, while medium and small powers are still confine themselves to more traditional forms of conflict, including in the Tigris, the Euphrates and the Jordan basins, which have been seen for decades as a testing ground for future water wars. This does not negate the role of water bodies and ecosystems in promoting development or, conversely, in perpetuating the poverty and backwardness in entire regions. Waters remain in competition as an important source of water-intensive goods that can be converted into valuable assets – water-intensive goods, energy or the ability to achieve higher levels of the Human Development Index. And, of course, they can be used to exacerbate ethnic and political conflicts. This is where the potential of Russia, the world’s second water power, comes into play, both in terms of directly regulating regional water challenges and in influencing the approaches of international organizations and associations, in which Moscow plays a prominent role.
EU Climate Leadership: Contradictions Inherent in Carbon Regulation
Authors: Bolgova I. V. , Stolyarova E. A.
Published: March 2024

The article analyzes the EU Carbon Border Adjustment mechanism (CBAM) through the lens of the EU’s aspiration to strengthen its leadership in fighting climate change. The introduction of CBAM is viewed as another step toward achieving the EU's goal of climate neutrality, which has become a standard for global development. By studying the internal and external dynamics of CBAM's implementation, the article aims to analyze its role as a tool for diplomatic and exemplary leadership. On the one hand, the EU seeks to protect European producers from producers from countries with lower climate standards. On the other hand, the EU’s desire to involve other countries in creating CBAM-style mechanisms is supposed to strengthen the EU’s leadership, contributing to the formation of multilateral “climate clubs” and the gradual revision of the existing climate regime. However, the article suggests that there are inherent contradictions in the EU's approach. While it seeks to protect its economy through CBAM, it also frames these measures within the narrative of multilateral cooperation. This dual approach poses challenges to the EU's leadership potential. The protectionist nature of CBAM makes other global players, primarily the U.S., follow the same path of taking protective measures. China is not willing to give up its own framing of the climate agenda due to its importance for the construction of China’s international identity. Russia’s perception of the climate change problem is infl uenced by its national interests and the structure of economy. The projection of regulatory power beyond the EU’s borders also provokes resistance from developing and least developed countries, which can seriously damage the EU’s role as a normative power.
Collective dimension of social innovation projects: the contribution of relational chains
Authors: Ferru Marie , Omer Jade
Published: March 2024

Numerous projects, which today are described as social innovations, are being developed in response to the recent crises to meet various unsatisfied social needs (housing, climate, ageing, inequalities, etc.). Their highly collective nature implies a better understanding of the ways in which the partners involved in these projects are connected, which we propose to do using the relational chain method. The data collected using this method highlights the significant use of non-personal arrangements (circles and calls for projects) to obtain the support of institutions (local authorities) or organisations (foundations); interpersonal relationships—essentially professional—appear to be mobilised less frequently and mainly to access the world of research.

De nombreux projets qualifiés aujourd'hui d'innovation sociale se développent face aux crises récentes pour répondre à différents besoins sociaux non satisfaits (logement, climat, vieillissement, inégalités, etc.). Leur nature éminemment collective implique de mieux comprendre les modalités de mise en relation des partenaires impliqués dans ces projets, ce que nous nous proposons de faire en mobilisant la méthode des chaines relationnelles. Les données collectées grâce à cette méthode mettent en évidence le recours important aux dispositifs non personnels (cercles de l'ESS et appels à projets) pour obtenir le support d'institutions (collectivités) ou d'organisations (fondations) ; les relations interpersonnelles-essentiellement professionnelles-apparaissent quant à elles mobilisées plus rarement et principalement pour accéder au monde de la recherche.
The Influence of Accountability, Transparency and Community Participation on the Effectiveness of Cibungur Tasikmalaya Village Fund Management
Authors: Cahyandari Rini , Ibrahim Riza Andrian , Yuningsih Siti Hadiaty
Published: March 2024

This research investigates the influence of accountability, transparency, and community participation on the effectiveness of village fund management. This research was conducted in Cibungur, Parungponteng Subdistrict, Tasikmalaya Regency, the study adopts a quantitative approach, employing an associational research design with a sample of 100 households. Through multiple linear regression, the analysis reveals significant insights. The results indicate that accountability, transparency, and community participation individually and collectively impact the effectiveness of village fund management. Accountability exhibits a positive influence (t-value = 2.787, p-value = 0.001), as does transparency (t-value = 3.444, p-value = 0.001), while community participation also demonstrates a significant effect (t-value = -3.099, p-value = 0.003). The coefficient of determination (R²) indicates that 62.5% of the variance in village fund management effectiveness can be explained by these variables.The F-test reinforces the joint influence of transparency, accountability, and community participation, with a significant F-value of 53.392 and a p-value of 0.001. This study underscores the intricate dynamics between governance principles and community involvement for optimal village fund utilization, contributing to sustainable development and community welfare. Thus, this research not only fills knowledge gaps, but also provides a holistic view of efforts towards sustainable development and community welfare through optimizing village fund management.
Regional Autonomy in the Context of the Unitary State of Indonesia: Evaluation of Household Systems, Measurement Parameters, and the Rationality of Decentralization
Authors: Fadiah  , Suhaimi Nurnisaa , Laksito Grida Saktian
Published: March 2024

Regional autonomy in the context of the unitary state of Indonesia is a phenomenon based on constitutional foundations, especially Article 18 paragraph (1) of the 1945 Constitution. This discussion examines the regional household system, parameters for measuring regional autonomy, as well as the rationality and arguments supporting decentralization. The regional household system, consisting of material, formal and real, raises considerations regarding the granting of autonomous rights to regions. The measurement parameters involve authority quotas, supervision systems, methods for selecting regional heads, and the process of making regional regulations, but further clarification is needed. The rationality of regional autonomy includes efficiency, political education instruments, strengthening political stability, political equality, preparation for political careers, and accuracy of development planning. Arguments supporting decentralization highlight the prevention of accumulation of power, popular participation, government efficiency, adaptation to regional specificities, and direct assistance for development. Strengthening regional autonomy requires regulatory capabilities, adjustments to national regulations, local political support, financial resources, and human resource development. This research reflects efforts to understand, evaluate and strengthen regional autonomy systems to support regional development and national stability.
Analysis of Public Policy and Criminal Law in The Perspective of Consumer Protection for Online Loan Users in Indonesia
Authors: Kalfin  , Vimelia Willen , Haq Fadiah Hasna Nadiatul
Published: March 2024

The development of online loan services or pinjol in Indonesia raises new problems in consumer protection. Many cases of fraud and misuse of customer personal data are very concerning. The government has not had specific regulations regarding online loans. The existing regulations are merely appeals and suggestions for fintech pinjol to conduct business responsibly. In fact, stricter regulatory and enforcement steps are needed to address the increasing violations that harm consumers. This study aims to analyze public policies and criminal law in the perspective of protecting pinjol consumers in Indonesia. This research uses a normative legal approach with statute and conceptual approaches. The results are expected to provide recommendations for more effective legal protection for online lending consumers in Indonesia, as well as enriching academic literature on fintech and digital consumer protection. The conclusion is that firmer public policy and criminal law provisions are needed to protect consumer rights in using online loan services which currently have weak legal protection.