bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving access block in emergency department: An audit cycle
Authors: Rijal Suraj , Adhikari Sunil
Published: March 2023

Introduction: Emergency department crowding is a major problem worldwide and has been associated with a variety of deleterious patient care and outcomes. 1Crowding has also been implicated in increased work load, burnout and staff turnover. ED is the common entry point to hospitals for nearly all patients with acute problems. Prolonged length of ED stay is the most common cause of patient dissatisfaction.

Method:  Plan-Do-Study-Act (PDSA) cycle will be used. The barrier identified for first cycle was delay in access is due to delay in consultation, evaluation by admission team, and delay in transfer of patient to ward. There are two cycles of data collections. In first cycle. we identified a barrier and set an indicator to measure it. We did a first cycle, analysed and evaluated the data and did necessary interventions. Then did second cycle to see the improvement and consistency for various departments.

Result: In first cycle, average of length of overall ED stay of all admitted patients is 401.95mins (Median time-368.5min). Total numbers of patients analyzed were 165. 63.63% of patients were transferred to respected admitting departments within 8 hours of ED stay. In second cycle, average of length of overall ED stay of all admitted patients is 375. 01mins (median time-341.5min). Total patient analyzed were 161. 67.5% of patients were transferred to respected admitting departments within 8 hours of ED stay.

Conclusion:  Delay in access is due to delay in consultation, evaluation by admission team, and delay in transfer of patient to ward.
COVID-19 Preparation at a Rural District Hospital in Nepal: The days following the lockdown
Authors: Aryal Prayush
Published: March 2023

Since the beginning of 2020 AD, the world is grappling with the COVID-19 pandemic and in Nepal, the first case was seen in the month of January itself. The second case, however, was detected only after 2 months and this gave the country an opportunity to upgrade the health system, especially for the pandemic. It also imposed a nationwide lockdown to contain the spread of the disease.

Myagdi, a rural district of Nepal and its district hospital in Beni also prepared for the disease with the resources it had. The incoming route to the district was sealed off and people were asked to stay indoors unless there was an emergency. The regular OPD services of the hospital was also closed and a fever clinic was established where all the fever and suspected COVID-19 cases were seen.

An isolation building was set up where the strong suspected cases were admitted and kept there until their PCR reports came out. Similarly, quarantine facilities were also made outside the hospital premises for those who had returned to the district from abroad. The hospital staffs were given Personal Protective Equipment, but they were scarce and had to be re-used. The whole scenario had appeared to put a mental toll on the hospital staffs as many of them were anxious and scared.

At the same time, Dengue and Scrub Typhus cases also emerged in the district, adding to the health woes. However, the hospital staffs and the local bodies are stepping up to the challenge and are toiling hard to plan and execute for the containment of the disease in the district.
Introducing an efficient alternative technique to optional quantitative randomized response models
Authors: Azeem Muhammad , Salam Abdul
Published: March 2023

In social surveys on sensitive characteristics, optional randomized response models give the respondents the option to either report the true response or report the scrambled response. If any respondent finds that the question being asked does not feel sensitive, he/she reports the true response. In the existing variants of optional randomized response models, the researcher doesn’t know whether the respondent opted for the correct response or for a scrambled response. In practice, some of the respondents may have no problem in disclosing to the researcher that they are giving the true response and hence not opting for scrambling. This paper presents an alternative procedure to optional scrambling randomized response models, where each respondent has the choice whether or not to disclose to the researcher that he/she is giving the true response. Alternative modified versions of three existing scrambling randomized response models are presented. It is found that the efficiency of the quantitative randomized response models improves if the exact number of respondents who are opting for scrambling, is known to the researcher. Besides improvement in efficiency, the level of the respondent-privacy is the same as that of the existing models, thus resulting in an improvement in the overall quality of the existing models.
De tônico para idosos a melhorador de desempenho em crianças: os usos da Ritalina e as explicações cerebrais para transtornos mentais
Authors: Brzozowski Fabíola Stolf
Published: March 2023

O objetivo deste artigo é analisar em perspectiva histórica os diferentes usos atribuídos à Ritalina (metilfenidato), desde a sua descoberta, na década de 1950, até hoje. Analisamos também como as explicações sobre supostos substratos neurais para os transtornos mentais possibilitou e legitimou o atual uso da droga para “tratar” problemas de comportamento e para melhorar o desempenho acadêmico. São abordados o diagnóstico do Transtorno de Déficit de Atenção com Hiperatividade (TDAH), que permitiu o uso de metilfenidato e de outros estimulantes em crianças; como esse medicamento foi usado ao longo do tempo, desde sua entrada no mercado na década de 1950; o papel das explicações biológicas cerebrais na consolidação do TDAH como diagnóstico psiquiátrico tratável com medicamentos; e como tudo isso resulta no metilfenidato como um medicamento prescrito e utilizado para melhorar o desempenho cognitivo. Argumentamos, ao final, que a crença nos substratos neurais de transtornos mentais pode gerar consequências sociais relevantes: a relativização da influência de questões sociais nos sofrimentos; a tentativa de prevenção de “perigos” por meio do tratamento e estigmatização de indivíduos considerados em risco; danos físicos e neurais decorrentes do uso exagerado e/ou a longo prazo de medicamentos psicotrópicos, dentre outras.
Palynological Sampling in Western Jutland 2021-22: Anthea Work Package #2
Authors: Løvschal Mette , Ombashi Havananda
Published: March 2023

A palynological sampling programme was carried out in three areas of Western Jutland in 2021-22. Our goal was to collect new sediment samples from archaeological excavations and peat deposits to reconstruct patterns in past heathland use and development. The location of the case areas was determined by the potential of the sites for combination with existing palynological data (Solsø Hede) and/or archaeological data (the Vejen area). At Solsø Hede, a pollen core was obtained near Solsø. At Vejen, two separate sediment collections took place. To the north of Vejen, in Gammelby Mose, peat sediments were collected. To the south of Vejen, at Kongehøj, 15 samples were collected from a Bronze Age house floor plan. The sampling programme formed part of the research project called ANTHEA (Løvschal 2021), which focuses on the deep history of anthropogenic heathlands. The project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 853356).
Writing with New Journalism and Portraiture
Authors: Høyen Marianne
Published: March 2023

To explain broader social phenomena through human perspectives, sociologists closely analyse their qualitative data. As individuals’ actions and embeddedness into society may be subject to inquiry, biographical and narrative approaches can enable access to the other’s world, its social and material contexts. Yet sensitivity is seldom evident when communicating research findings. Traditionally researchers address a uniform, neutral academic readership, one at odds with current reality. Just as the researcher seeks to understand the interviewee, similar effort is needed to accommodate the reader. Good communication needs to consider complexity and address the human experience through multi-faceted but meaningful lenses. It requires creative thinking. I suggest that New Journalism and Portraiture, in combination, provide a good starting point for communicating the human experience and its surrounding conditions: New Journalism as it introduces devices from fiction into the field; Portraiture because it encourages the writer to bring creative aspects into the text. The article explores the considerations around writing up such a text from biographical research and demonstrates how this can be done.
A Method Off the Beaten Track
Authors: Pilegaard Nathali H. S. , Philipsen Heidi
Published: March 2023

How can you improve your writing processes and your creative projects by examining your own working conditions? In this article, we address this question and the possibilities and challenges of the method called ‘practice-led research’, which is a method off the beaten track in media production studies. We examine assignments by students from the educational program of ‘Screenplay Development’ at the University of Southern Den-mark. Our purpose is to clarify how the students have used practice-led research to enhance their screenwriting, and whether this method has contributed to their talent development. The theoretical framework in the article is constituted by Donald Schön’s (2013) practice epistemology. As our analytical lens we use Robin Nelson’s (2013) modes of thinking, as well as talent development theories by Anders Ericsson (Ericsson & Pool, 2016) and Mihalyi Csikszentmihalyi (1996). Based on our findings, we suggest how to get started you’re your creative writing and improve your writing processes.
Life pushing through
Authors: Gripsrud Birgitta Haga
Published: March 2023

As a researcher, three of my fields of interest have been the breast, breast cancer and death. In 2020, life interrupted as my mother phoned to say that a CT-scan had revealed a small growth in her left breast. Having just published an article on policy guidelines for the integrated breast cancer pathway, I was thrown into this pathway as next of kin, accompanying my mother through diagnosis and treatment. With life pushing through in this way, I started writing about the experience. In 2021, life interrupted again: the tumor in my mother’s breast had metastasized, her cancer is incurable. Increasingly, the writing became a lifeline for me. In this text, I develop a “creatography” to bring forth and give form to, by way of an assemblage of fragments, the struggles I’ve had with writing about this experience, as well as the pleasures I’ve had going off the beaten track. I highlight how we often have personal stories to tell about our relationships with professional research fields, yet we hesitate to give them substance or credit in our academic writing. I reflect on how we could and why we should engage in such emotional labour, while sharing my own process of coming to writing. I see this writing as an opening: to begin mining my own fields for deeper reflexivity.
Lists for Many Occasions in Qualitative Research Writing
Authors: Kuecker Elliott
Published: March 2023

This article proposes many ways qualitative scholars can use the list as a writing form when composing their academic texts. Given that so many people already write lists in daily life, the list as a form contains a democratic quality unmatched by many other forms of experimental research writing, which are more often garnered from other disciplinary contexts or elevated writing practices. Embracing the simplicity of form and complexity of interpretation that the list offers, the author describes different styles of lists—such as the to-do and the catalog—particularly emphasizing how they may serve qualitative researchers in their writing process or textual expression. In addition, the author analyzes existing lists written by children, poets, and researchers in the context of qualitative inquiry. Each section is accompanied by prompts and pedagogical advice for researchers wishing to practicing composing lists.
Critical Reflections on Collaborative Writing
Authors: McIntosh Shona , Kang Sarah Ruth Lillo
Published: March 2023

Drawing on our experience of creating an innovative co-edited book form, we consider the risks and possibilities of experimentation in high-stakes writing and editorial work. Writing and editing conventions that value parsimony, individuality and objectivity can result in sparse writing styles that disconnect authors from their texts. In applied disciplines, such as Education, academic writing can be a barrier to communication with practitioners and fail to connect research to practice. To foster a connection, academics, educators, practitioners and alumni were grouped to undertake dialogue-centred collaborative writing about equitable engagement in global citizenship education. We found that “critical and liberating dialogue” (Freire, 1993, p. 39) in this third space (Bhabha, 1994) challenged dominant writing conventions, and invited critical consideration of liminalities beyond the self as writing became linked to knowing differently. With large parts presented in dialogue format, our article reflects on the editorial challenges and pleasures of fostering dialogic, collaborative writing for equity.
Banksy’s Street Art
Authors: Jabeen Farrah , Carter Susan
Published: March 2023

Internationalization of doctoral study means more doctoral writers working across language and cultural borderlands. How can their access to a self-reliant understanding of English language be enabled? How can they acquire the confidence to find their textual voice? How can academics supporting these writers help them to adapt to western cultures of thinking, learning, and communicating? Behind this article sits an extensive investigation into how to support international doctoral candidates to make such crossings pleasurably: eight doctoral candidates from across disciplines at the University of Auckland, Aotearoa New Zealand, collectively close-read literary items, and Banksy’s street art. The purpose was to deepen understanding of argumentation, critical analysis, rhetoric that persuades, voice and creative positioning. Two interactive classroom sessions used Banksy’s street art to promote creative thinking about powerful communication. Here, we explain how Banksy’s graffiti gave a good foundation for the development of analytical skill, socio-political confidence, and cultural learning—and doctoral participants found the courage to be more creative thinkers and thesis writers.
QUALITY OF LIFE OF PATIENTS WITH POSTOPERATIVE HYPOTHYROID AND HASHIMOTO THYROIDITIS
Authors: FELEK Duygu , DUMAN Gülhan
Published: March 2023

Purpose: The symptoms and findings resulting from thyroid dysfunctions display a picture similar to mood disorders such as depression and anxiety, which are the most common psychiatric disorders in the community. Therefore, this study aims to examine patients with Hashimoto thyroiditis receiving L-thyroxine therapy and euthyroid patients with postoperative hypothyroidism receiving L-thyroxine therapy in terms of their susceptibility to anxiety and depression and the change in their quality of life, as well as determine the role of the thyroid gland in psychosocial life.

Material and method: For evaluating anxiety, depression, and quality of life, Beck depression and Beck anxiety inventories and SF-36 were administered to 120 people (20-80 years old) who were applied to the Department of Endocrinology of XXXX University. 40 of them had developed hypothyroidism after thyroid surgery, 40 were diagnosed with Hashimoto thyroiditis at some point in their life and are now in a euthyroid state after L-thyroxine treatment, and 40 were healthy people in the control group. Data were analyzed on SSPS.

Results: The reasons for these psychosocial effects on individuals were evaluated in multiple ways, such as thyroid dysfunction, having a chronic disease, the idea of constant drug use, the effect of autoimmunity, and endogenous hormone secretion. Thyroidectomy patients' anxiety and depression were higher, and their quality of life was poorer than both Hashimoto thyroiditis patients and the control group (p
El control externo de la administración pública: análisis del caso brasilero
Authors: Valencia Tello Diana Carolina
Published: March 2023

En los Estados modernos, el poder debe estar limitado y controlado conforme estructuras y competencias bien establecidas en los ordenamientos jurídicos para evitar el abuso del poder y garantizar el respeto por los derechos de todos los individuos. Las Entidades de Fiscalización Superior (EFS) son las encargadas de ejercer el control externo y cuando evidencian infracciones graves al ordenamiento jurídico por parte de las administraciones públicas, deben actuar en consecuencia para sancionar conductas ilegitimas y recuperar los recursos públicos perdidos. A nivel internacional, la Organización Internacional de Entidades Fiscalizadoras Superiores INTOSAI, establece lineamientos a las EFS sobre el control externo del Estado. En este contexto, el presente artículo analizará primero el control fiscal del Estado y los lineamientos de la INTOSAI, para después estudiar el caso brasilero, teniendo en cuenta que los Tribunales de Cuenta fueron establecidos desde el gobierno provisional en 1890 y han perdurado hasta la actualidad como el principal organismo de control externo a la administración pública, permaneciendo sin mayores modificaciones internas y adaptándose a los cambios de régimen político.
The Multi-Functional Modelling Shear Lag Method for Accurate Calculation of Static Response and Accordion Effect of Improved Composite Box Girders
Authors: Gan Ya-Nan , Zhang Zi-Chen , Wang Gen-Hui
Published: March 2023

The composite box girder with corrugated web and steel bottom plate (CW-SBS) is a kind of improved steel-concrete structures. The design of CW-SBS box girders needs the accurate method to calculate the working response and accordion effect in consideration of the self-stress equilibrium condition of shear lag warping stress and shear deformation. This study proposes the multi-functional modelling shear lag (MFMSL) method which adopts the four longitudinal displacement difference functions to model the variation of shear lag in the CW-SBS box girders with different wing slab widths and thicknesses. Therefore, MFMSL is a method to calculate the static response and accordion effect of the CW-SBS composite box girders. Structural differential equations based on the energy-variation principle present that the MFMSL method effectively improves the calculating accuracy of the CW-SBS box girder static response, which can be verified by both experimental and simulative results. Also, the MFMSL method demonstrates that the accordion effect of the CW-SBS box girder is stronger than that of the traditional composite box girder and closely relates to the load distribution. Hence, the proposed method further lays the foundation for the analysis and design of CW-SBS box girders.
Use of Marble Waste as A Road Base Material in Different Size Ranges
Authors: Ural Nazile , Kahveci Ahmet Neim
Published: March 2023

Along with the economic loss caused by the non-use of waste worldwide, uncontrolled storage also brings an additional cost. Today, the rapid increase in the population and the rapid depletion of natural resources in nature lead us to research the recycling possibilities of waste materials. In this context, using marble waste in road pavements is one of the best areas of use. This study investigated the suitability of substituting the marble waste obtained from a marble quarry in Bilecik, Turkey, in the road base layer instead of the aggregate, which was used all the time in the base layer in highway construction at different intervals. The physical tests carried out in this context have met the base material limit conditions of the Turkish Highways Technical Specification (THTS). Mixtures obtained in modified Proctor experiments, and optimum water contents (wopt) and maximum dry unit volume weight (rdmax) were determined for each mixture. California bearing ratio (CBR) values remained above the limit value of all mixtures for 0 days and 7 days of curing according to the specifications for THTS. In addition, CBR values were obtained after freezing-thawing at 4, 12, and 20 cycle numbers. According to the freeze-thaw test results, there was an increase in CBR values in the first 4 cycles and a decrease in the following cycles. Still, all the test results obtained remained above the limit value according to the specifications for THTS. Aggregate unit cost constitutes approximately twice the unit cost of marble waste. Besides, this difference has created an economic equality distance of 18.9 km. Therefore, a marble quarry, a road construction site within the calculated economic equality distance and marble waste material will provide a financial gain for our country. With the evaluation of quarry waste all over the world, we can leave a liveable world with rich raw material resources and a strong economy for future generations.
Driving Cycle for Passenger Cars on Urban Roads in Pristina, Kosovo
Authors: Salihu Flamur , Demir Yusuf Kağan
Published: March 2023

The driving cycle is a significant input for the micro-scale analysis of vehicle emission. Several cities around the world have developed driving cycles based on their driving behaviours, while Pristina still has a lack of studies on this issue. Thus, the first objective of this study was to represent the proper driver behaviour of passenger cars in Pristina by obtaining a driving cycle from real-time measurements on the road. The driving cycle was developed by extracting the micro-trips from 53 491 s of data using a “3-sequential points” algorithm, where 780 micro-trips were detected. Using the K-means method from 780 micro-trips, we selected only 25 to develop the final driving cycle. The second objective was to analyse the effects of different intersections on the final driving cycle parameters. We found that the final driving cycle had significant differences from driving cycle of other cities. Driving habits in Pristina are more aggressive compared to other European cities. Also, we found that the average speed of roundabouts and un-signalized intersections was statistically different from signalized intersections.
Road Safety Development and Economic Growth in China From 1979 to 2018
Authors: Kang Liangguo
Published: March 2023

Road safety development is affected by both motorization rates and economic growth. This phenomenon is studied using the Kuznets curve model, which uses data such as the number of road fatalities, the population, the number of vehicles, and the gross domestic product (GDP) per capita, all of which are verified by applying the data envelopment analysis (DEA) model. The results showed that there were strong links between road safety development and economic growth in China. As GDP per capita rose from 1979 to 2018, the number of vehicles per person increased and the number of fatalities per vehicle decreased, producing a relationship that followed an N-shaped curve. However, in 2002, the relationship between the road mortality rate and GDP per capita followed an inverted U-shaped curve; the point at which this happened in the Kuznets curve was the turning point for road safety performance in China. Thus, road mortality rates increased as GDP per capita increased, but declined once GDP per capita exceeded 17 187 CNY. The analysis that stems from the results of the Kuznets curve model is consistent with the performance evaluation derived from the DEA-based road safety model. The findings could provide an important reference for policymakers to improve road safety under harsh economic conditions.
A Development Model for Identifying the Uncertainty Sources and Their Impacts on Bridge Construction Projects
Authors: Atashgah Kayvan Mohammadi , Ghousi Rouzbeh , Abbasi Armin Monir , Nasrabadi Abbasali Tayefi
Published: March 2023

Bridge construction projects are rife with uncertainty because of their unique features, from execution of the work, time estimation, inspection and assessment to fund allocation. Therefore, a critical step is recognise and categorise the uncertainties associated in bridge building in order to meet project objectives in terms of quality, cost, schedule, environmental, safety, and technical indicators. Various models, however, have been created to detect and prioritise the uncertainty. One of the most commonly used approaches for dealing with uncertainty is the spherical fuzzy set. To formulate an issue, this technique uses a mathematical procedure. The analytic hierarchy process (AHP), on the other hand, is a computer technique that solves a complicated problem by breaking it down into numerous basic problems. A hybrid model based on spherical fuzzy sets and AHP (SAHP) can benefit from both approaches. This study proposes a SAHP based on group decision making (GSAHP) to prioritise the sources of uncertainty in bridge construction projects. Likewise, a modified algorithm is proposed for checking the consistency of the spherical fuzzy matrices. To show the model potential, a real case study is illustrated and evaluated. The model demonstrates its capabilities in modelling uncertainty under an environment with a number of unknown components. The findings reveal that the “delays” factor is of the highest, and the “project team conflicts” parameter is of the least importance. The research findings could be used by decision makers and managers to develop preventive measures.
The Implementation of Green Logistics in Road Transportation
Authors: Jarašūnienė Aldona , Bazaras Darius
Published: March 2023

The article presents an analysis of academic literature in an attempt to identify the importance of the implementation of green logistics in road transportation. Areas of concern as well as solution and implementation opportunities are presented. A research of transportation companies was conducted in an attempt to understand the real situation regarding the implementation of green logistics measures. The research results are presented in the article. Solutions are provided in the form of a conceptual model for the implementation of green logistics measures in transportation organisations. Nowadays the interest in ecology, minimization of fossil fuel usage, and mitigation of harmful road transportation consequences is rapidly increasing. Eco-friendly vehicles, effective transportation system, application of advanced technologies and innovations should become the main factors in promoting the implementation of green logistics in the transportation sector to mitigate negative effects on the environment. In order to maintain their competitive advantage and customer satisfaction, transportation organisations should begin implementing the concept of green logistics in their businesses. The significance of the concept of green logistics can be observed on global, regional, and national levels. Business is still seen as the leader, responsible for initiation and implementation of ecological logistics principles. The implementation of green logistics is critically important; however, lack of funding and collaboration between the public and the private sectors prevent companies from adopting green logistics measures. Economic driving classes, employee education, electric and hybrid cargo-handling vehicles are some of the possible green logistics measures.
Humour in the classroom
Authors: Weisi Hiwa , Mohammadi Vahid
Published: March 2023

The present study was conducted with the purpose of investigating the use of humour by EFL teachers in a private language institute in the context of Iran. In so doing, the study made an attempt to identify the forms of humour EFL teachers opt to use more frequently in relation to the students’ teaching in the classroom through observing their classroom teachings. Moreover, an interview was held with the EFL teachers to seek their perceptions with regard to the functions humorous language can serve in the process of language teaching and learning and their suggestions as to the implementation of humour in the classroom. The findings of the study demonstrate that Iranian EFL teachers show the inclination to use jokes, physical humour and riddles more frequently than other forms of humour. Moreover, the results of the interview reveal that EFL teachers assign some more commonly functions to the humorous language in the classroom such as creating a cheerful and friendly atmosphere, acting as a relaxing, comforting, and tension reducing device, increasing student interest and enjoyment, increasing learners’ concentration and motivation, and finally improving the quality of learning. Finally, the suggestions for appropriate use of humour and implications of the study are discussed in the result and conclusion sections, respectively.
multimodal analysis of humour as an engagement strategy in YouTube research dissemination videos
Authors: Bernad-Mechó Edgar , Girón-García Carolina
Published: March 2023

Science popularisation has received widespread interest in the last decade. With the rapid evolution from print to digital modes of information, science outreach has been seen to cross educational boundaries and become integrated into wider contexts such as YouTube.  One of the main features of the success of research dissemination videos on YouTube is the ability to establish a meaningful connection with the audience. In this regard, humour may be used as a strategy for engagement. Most studies on humour, however, are conducted solely from a purely linguistic perspective, obviating the complex multimodal reality of communication in the digital era. Considering this background, we set out to explore how humour is used from a multimodal point of view as an engagement strategy in YouTube research dissemination. We selected three research dissemination videos from three distinct YouTube channels to fulfil this aim. After an initial viewing, 22 short humoristic fragments that were particularly engaging were selected. These fragments were further explored using Multimodal Analysis - Video (MAV)[1], a multi-layered annotation tool that allows for fine-grained multimodal analysis. Humoristic strategies and contextual features were explored, as well as two main types of modes: embodied and filmic. Results show the presence of 9 linguistic strategies to introduce humour in YouTube science dissemination videos which are always accompanied by heterogeneous combinations of embodied and filmic modes that contribute to fully achieving humoristic purposes.
[1] Multi-layer annotation software used to describe the use of semiotic modes in video files. By using this software, researchers may analyse, for instance, how gestures, gaze, proxemics, head movements, facial expression, etc. are employed in a given file.
A 3D-printed passive exoskeleton for upper limb assistance in children with motor disorders: proof of concept through an electromyography-based assessment
Authors: Sanchez Cristina , Blanco Laura , del Río Carmina , Urendes Eloy , Costa Vanina , Raya Rafael
Published: March 2023

The rehabilitation of children with motor disorders is mainly focused on physical interventions. Numerous studies have demonstrated the benefits of upper function using robotic exoskeletons. However, there is still a gap between research and clinical practice, owing to the cost and complexity of these devices. This study presents a proof of concept of a 3D-printed exoskeleton for the upper limb, following a design that replicates the main characteristics of other effective exoskeletons described in the literature. 3D printing enables rapid prototyping, low cost, and easy adjustment to the patient anthropometry. The 3D-printed exoskeleton, called POWERUP, assists the user’s movement by reducing the effect of gravity, thereby allowing them to perform upper limb exercises. To validate the design, this study performed an electromyography-based assessment of the assistive performance of POWERUP, focusing on the muscular response of both the biceps and triceps during elbow flexion–extension movements in 11 healthy children. The Muscle Activity Distribution (MAD) is the proposed metric for the assessment. The results show that (1) the exoskeleton correctly assists elbow flexion, and (2) the proposed metric easily identifies the exoskeleton configuration: statistically significant differences (p-value = 2.26 ⋅ 10−7 < 0.001) and a large effect size (Cohen’s d = 3.78 > 0.8) in the mean MAD value were identified for both the biceps and triceps when comparing the transparent mode (no assistance provided) with the assistive mode (anti-gravity effect). Therefore, this metric was proposed as a method for assessing the assistive performance of exoskeletons. Further research is required to determine its usefulness for both the evaluation of selective motor control (SMC) and the impact of robot-assisted therapies.
Micro-shear bond strength of different calcium silicate materials to bulk-fill composite
Authors: Falakaloğlu Seda , Yeniçeri Özata Merve , Plotino Gianluca
Published: March 2023

Introduction

This study aimed to compare the micro-shear bond strength (µSBS) performances of two resin-based calcium silicate-based cement (CSC) (TheraCal PT and TheraCal LC), Biodentine, and two modified-MTA CSC materials (NeoMTA 2 and BioMTA+) to bulk-fill restorative material.

Materials and Methods

Fifty 3D printed cylindrical resin blocks with a central hole were used (2 mm in depth and 4 mm in diameter). CSCs were placed in the holes (per each group n = 10) and incubated for 24 h. Cylindrical polyethylene molds (2 mm in height and diameter) were used to place the bulk-fill restorative materials on the CSCs and polymerize for 20 s. Then, all specimens were incubated for 24 h at 37 °C at a humidity of 100%. Specimen’s µSBSs were determined with a universal testing machine. Data were analyzed with one-way ANOVA (Welch) and Tamhane test.

Results

Statistically higher µSBS was found for TheraCal PT (29.91 ± 6.13 MPa) (p < 0.05) respect to all the other materials tested. TheraCal LC (20.23 ± 6.32 MPa) (p > 0.05) reported higher µSBS than NeoMTA 2 (11.49 ± 5.78 MPa) and BioMTA+ (6.45 ± 1.89 MPa) (p < 0.05). There was no statistical difference among TheraCal LC, NeoMTA 2 and Biodentine (15.23 ± 7.37 MPa) and between NeoMTA 2 and BioMTA+ (p > 0.05).

Conclusion

Choosing TheraCal PT as the pulp capping material may increase the adhesion and µSBS to the bulk-fill composite superstructure and sealing ability.
A Retrospective Cross-sectional Study of Paediatric Dermatoses during the COVID-19 Pandemic in a Tertiary Care Hospital in Bengaluru, Karnataka, India
Authors: Rajeswari KA , Geetha M
Published: March 2023

Introduction: Dermatologic conditions constitute at least 30% of all outpatient visits to paediatricians and 30% of all visits to dermatologists involve children. Skin conditions that manifest themselves during childhood and adolescence are referred as paediatric dermatoses and make up their own unique category of skin conditions. Aim: To identify the dermatological conditions which were prevalent during the Coronavirus Disease 2019 (COVID-19) pandemic in a tertiary care hospital in Bangalore. Materials and Methods: This retrospective cross-sectional study was conducted by reviewing records of Outpatient Department (OPD) of Dermatology and Paediatrics in our tertiary care center, Bengaluru from February 2020 to February 2022. The demographic details and diagnosis are recorded. The diagnosis was made according to ICD-10 (International Classification of Diseases 10th Revision) and the prevalence of different dermatoses was calculated. Mean and standard deviation was calculated for descriptive statistics. Data were statistically evaluated with IBM Social Package for Statistical Analysis (SPSS) Statistics for Windows version 26.0., IBM Corp., Chicago, IL. Results: The total number of paediatric cases attended dermatology OPD during the two year pandemic was 558. The prevalence of paediatric dermatoses in the present study was 193 (34.58%). There were 283 girls and 275 boys with Male : Female is 1:1.02. There is a female preponderance of 50.7% against 49.28%. The majority was infectious lesions 153 (27.41%), congenital dermatoses 9 (1.61%), Papulosquamous disorders 23 (4.12%), Pilosebaceous disorders 111 (19.89%), dermatitis 193 (34.58%) followed by Miscellaneous 69 (12.36%). Conclusion: This study was conducted during COVID-19 pandemic which in comparison to the other studies shows a similar distribution of dermatoses. But there was a significant shift of age group affected which can be well explained by the lockdown and social isolation.
Estimating the Frequency of Hanifin and Rajka’s Minor Criteria among Paediatric Atopic Cases at a Tertiary Care Hospital in Western Tamil Nadu, India- A Cross-sectional Study
Authors: Gopalakrishnan K , Sivanandam S , Aithal Sowmya S , Sakkaravarthi Vinupriya , Vikash R Prabhu , Rajendran K , Jeevithan S
Published: March 2023

Introduction: Atopic Dermatitis (AD) is a common relapsing inflammatory disorder, among the paediatric population clinically, characterised by pruritus and recurring eczematous skin lesions and a host of other cutaneous changes. Diagnosis is done on the basis of clinical findings with the usage of Hanifin and Rajka’s criteria which includes 4 major and 23 minor criteria. Geographical, climatic factors and other population factors have been reported to influence the occurrence of minor criteria. Aim: To estimate the frequency of Minor criteria among paediatric atopic dermatitis in Western Tamil Nadu, India. Materials and Methods: This cross-sectional observational study was done by including 110 atopic children attending Paediatric and Dermatology Outpatient Departments (OPD) of KMCH IHSR, Coimbatore, Western Tamil Nadu, India, between March 2022 to August 2022. The clinical and ophthalmological findings were documented. Categorical variables were presented as frequency and percentages, Continuous variables were presented as Mean±Standard deviation. The data was entered in excel and was analysed using statistical package for social sciences (SPSS) version 27. Results: Among the total study population of 110, 53 (48.2%) were males and the rest 57 (51.8%) were females. The mean age was 24.73±5.18 years with a range of 2-15 years. Early age of onset was seen in 73.6% of study population. Hyperlinear palms were found in 70% of the study patients. 68.2% had Dennie Morgan infraorbital fold, 64.5% had xerosis, 61% had pityriasis alba and 60% had a family history of atopy. Conclusion: Certain minor manifestations of AD like xerosis, icthyosis, hyprerlinear palms, and perifollicular accentuation were more common in the present study. Western Tamil Nadu having a tropical semi-arid climate tempered by higher altitude could explain the differences noted in the frequency of certain minor criteria.
Knowledge, Attitude and Practice Regarding Medication use among Pregnant Women Attending Antenatal Clinic: A Cross-sectional Study
Authors: Sen Rohan , Mandal Ananya , Chattopadhyay Suman , Mondal Supreeti Biswas
Published: March 2023

Introduction: Medication use during pregnancy is a major concern in India and poor awareness is driven by non scientific information sources. Primary care providers play a role in providing information on risk of teratogenic and folate deficiency birth defects. Aim: To assess Knowledge, Attitude and Practice (KAP) of pregnant women attending antenatal clinic regarding medication use and self-medication during pregnancy. Materials and Methods: This cross-sectional study was conducted on 100 pregnant women attending the antenatal clinic in a tertiary care teaching hospital of Eastern India from August to October 2021. The study looked at sources of drug information, attitudes regarding medication use and practice of medication use and self-medication among pregnant mothers attending antenatal clinic of the hospital. Consenting women were enrolled in the study and the qualitative data gathered from the women were analysed using tools of descriptive statistics. Results: This study included 100 pregnant women with mean age of 22±2.0 years of which 42% were primigravida. Of the participants 80% had atleast high school education. Two third of the mothers 66% cited their family members as source of their drug information and 76% were aware of the risks of selfmedication during pregnancy. Self medication practice was seen in 25% pregnant women mainly with Paracetamol use for pain or over-the-counter drugs to control acid reflux and morning sickness symptoms. All the participants (100%) took their iron and folic acid supplements as advised. Conclusion: The pregnant women attending the hospital showed adequate knowledge and satisfactory practices regarding medication use. Counselling of the mothers attending the clinic regarding drug use and possible harms to the mother and baby can help reduce long-term risks.
Comparison of Three Different Calcium Channel Blockers on Gingival Overgrowth in Hypertensive Patients
Authors: Katuri Kishore Kumar , Jannu Suresh , Duddu Aparna , Chennu Swetha , Cheruvu Shivani , Boyapati Ramanarayana
Published: March 2023

Introduction: Calcium Channel Blockers (CCBs) like Nifedipine is the most widely used drug in many countries in the management of hypertension, with other drugs also in use like Amlodipine, and Felodipine. Gingival hyperplasia is the common adverse effect of the three classes of CCBs used commonly as dihydropyridine calcium antagonists. Aim: To compare the effect of three different CBCs on gingival overgrowth in hypertensive patients. Materials and Methods: The present cross-sectional study was carried out in the Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh. The study was conducted between September 2020 and February 2022. A total of 206 patients with hypertension taking CCBs, were enrolled and divided into three groups based on the patient’s medication as Group-I (nifedipine; n=83), Group-II (amlodipine; n=71) and Group-III (felodipine; n=52). Gingival Overgrowth (GOG) was graded and periodontal parameters like Plaque Index (PI), Gingival Index (GI), and Probing Pocket Depth (PPD) were recorded. One-way analysis of variance and Tukey’s post-hoc test were done to evaluate and compare between the groups. Results: Mean age of the patients in group-I was 60.81±4.13 years, in group-II was 62.70±4.19 years, and in group-III was 59.54±3.42 years. No significant difference in PI scores and GI scores was seen between the groups. The mean score for PPD in group-I was 5.91±0.14 mm, in group-II score was 5.76±0.14 mm and in group-III the score was 5.13±0.22 mm. A statistically significant difference (p<0.001) was observed in group-I when compared with group-II and group-III. The mean GOG scores in group-I, group-II, and group-III were 3.49±0.22, 2.98±0.3, and 2.74±0.16. A statistically significant (p=0.001) increase in GOG scores was observed in group-I followed by group-II and group-III. Conclusion: Nifedipine was the most prescribed drug with high amount of gingival overgrowth in patients with hypertension, compared with amlodipine and felodipine.
An Elusive Case of Pleural Effusion
Authors: Ziaullah Nazia Banu , Raja Koushik Muthu , Vinod Venkatachalam Govindasaami , Thangaswamy Dhanasekar , . Rathish
Published: March 2023

The incidence of distant metastasis in head and neck Squamous Cell Carcinoma (SCC) is relatively low. The most frequently involved sites for distant metastasis are lungs, followed by bone and liver. The most important predictive factors for distant metastasis appear to be site of the primary tumour (hypopharynx), advanced T- and N-classification, locoregional control and histologic grade. A 61- year-old male, chronic smoker, presented with complaints of grade 4 mMRC (Modified Medical Research Council) dyspnoea. He had left-sided buccal mucosal SCC (locally advanced) and was on palliative chemotherapy. He had undergone treatment for pulmonary tuberculosis seven years back. He was tachypneic and clinical examination revealed absent breath sounds in the left hemithorax. Chest radiograph showed a massive left pleural effusion which was found to be exudative after therapeutic thoracocentesis. Cytology tests were negative for malignant cells. Positron Emission Tomography (PET) scan showed uptake along the left pleura (SUV Max-5.06) and left buccal mucosa (SUV Max -4.1). Thoracoscopic frozen section pleural biopsy revealed metastatic squamous cell carcinomatous deposits in the pleura. On table pleurodesis was done with doxycycline. The patient was continued on palliation with no recurrent effusion. However, he succumbed to the disease after eight months. This case report describes a rare case of malignant pleural effusion from a primary buccal mucosal SCC without any concurrent lung involvement.
Spatial Distribution of Noise from Religious Houses in Rumu-Okwachi Community, Rivers State, Nigeria
Authors: Udeh N. U. , Amah V. E. , Amadi R. C.
Published: March 2023

Noise from 12 religious structures was mapped in the Rumu-Okwachi community. Religious noise in residential settings is a growing concern. Noise levels for daytime religious activity were monitored before, during, and after religious sessions at 15 sample sites defined by superimposing 150-by-150-meter gridlines. The findings showed that during religious activities, the highest equivalent noise level (Leq) was 75.5 (dBA) at sampling point 13, whereas during religious non-activities, it was 63.3 (dBA) at point 7. A two-way analysis of variance (ANOVA) showed p<0.05 that the average daily noise level differed across sample sites. The highest peak noise level (L10), intermediate noise level (L50), and background noise level (L90) were recorded on Sundays during religious events. The geographical distribution of Leq values at all sample sites verified the noise map's prediction of higher Leq values during religious occasions, with Sunday having the highest Leq values of 69.2054 to 75.544. (dBA). The noise indices were compared to the WHO's recommended noise exposure limit, which showed that during religious events, the Leq values were higher than the WHO's recommended noise standard, with the maximum noise pollution level (NPL) being 96.17 (dBA). This suggests that residents of this neighborhood may experience bothersome noise levels.