bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Austempering Parameters on Microstructure and Tensile/Impact Behaviours of Micro-Alloyed TRIP-Assisted Steel
Authors: Zurnadzhy Vadym , Efremenko Vasily , Halfa Hossam , Efremenko Bohdan , Azarkhov Alexander , Chabak Yuliia , Zaichuk Natalia
Published: September 2023

The article is aimed at studying the effect of austempering temperature below and above Ms temperature on the phase-structural state and mechanical properties of 0.2 wt.% C TRIP-assisted steel micro-added with Nb, V, Mo, Cr. The samples were austenitized at a temperature close to the Ac3 point (900 °C) and held at 300 °C (below Ms), 350 °C (close to Ms) and 400 °C (above Ms) for 5-20 min. The work was performed using optical microscopy (OM), transmission electron microscopy (TEM), X-ray diffraction, and tensile/impact testing. It was found that austempering at the aforementioned modes ensures the multiphase structure consisting of carbide-free bainite, tempered martensite, ferrite and retained austenite (in different combinations). The optimal was austempering at a temperature close to Ms which provided an advanced complex of tensile properties (PSE of 23.9 GPa×%) and V-notched impact toughness (95 J/cm2). TRIP-effect contributed to these properties while the strain hardening process tended to be prolonged with increasing the austempering temperature.
A Hybrid Pressureless Silver Sintering Technology for High-Power Density Electronics
Authors: Zhao Yuan , Tolla Bruno , Katze Doug , Castaneda Glenda , Wilson Jo-Anne , Brand David
Published: September 2023

Aerospace and defense applications present unique

challenges for material suppliers. As increasing adoption of advanced

semiconductor materials and Diverse Accessible Heterogeneous Integration

technologies, power density of defense and aerospace devices

increases rapidly. Traditional die-attaching technology is becoming

an increasingly limiting factor in microelectronics packaging for the

next generation aerospace and defense systems. Metal particle sintering

creates a porous metal foam, which can significantly enhance heat

transfer within the sintered material. However, the traditional silver

sintering requires very high sintering temperatures that cannot be tolerated

by typical microelectronics devices. In addition, the sintered

metal foam contains open-cell pores that can absorb/entrap moisture

and dusts, which poses a reliability risk. This article introduces an

advanced hybrid silver sintering material, which incorporates highperformance

silver sintering with high reliability and process-friendly

of epoxy-based die-attaching technology. This hybrid sintering paste

can be processed without applying any pressures in temperature

ranges that are normal in microelectronics packaging processes. Preliminary

experimental studies, including Scanning Electron Microscopic

study, volume resistivity tests, die shear strength tests, and

thermal resistance tests, were performed for developing a low temperature

sintering schedule that is compatible with normal assembly processes

of high-power density electronics devices. The results indicated

that the hybrid material could achieve silver sintering at 150 degrees C and

offer 36 enhancement on thermal performance comparing with a

widely used die-attach material.
Risk of Mortality Associated with Preexisting Chronic Diseases and Prior Year Diagnosis of a Mental Disorder in Survivors of a First Myocardial Infarction or Stroke
Authors: Ngueta Gerard , Blais Claudia , Foldes-Busque Guillaume , Hamel Denis , Poirier Paul
Published: September 2023

Background:

Chronic medical diseases and recurrent mental disorders are common and may lead to a negative prognosis in adults with cardiovascular diseases (CVDs). The impact of these overlapping morbidities is likely to be further increased in the critical years following a first acute CVD event such as a stroke or myocardial infarction (MI).

Objectives:

The objective of this study was to examine associations of preexisting chronic diseases and recent mental disorders with mortality in survivors of a first MI or stroke.

Methods:

Data from the 48,526 patients (59% men) aged ≥40 years with a first MI or stroke were extracted from the Quebec Integrated Chronic Disease Surveillance System. Cox regression models were used to assess the effect of preexisting cancer, renal disease, diabetes, chronic obstructive pulmonary disease (COPD), and recent mental disorders on the risk of recurrent fatal CVD events and all-cause mortality following the index MI or stroke.

Results:

An increased risk of CVD mortality was observed at 1, 3, and 4.5 years in women and men with coexisting mental disorders and at 4.5 years in those with chronic, preexisting renal disease. Inversely, cancer and COPD were associated with a lowered risk of CVD mortality during the study period. An increased risk of all-cause mortality at all time points was observed in adults with any of the assessed conditions.

Conclusions:

Adults with coexisting mental disorders are at increased risk of CVD mortality and all-cause mortality in the years following a first MI or stroke. This increased vulnerability is separate from the extra mortality attributable to preexisting chronic diseases.
An Integrated Perspective for Understanding the Psychosocial Impact of Acute Cardiovascular Events
Authors: Jackson Alun C. , Rogerson Michelle C. , Murphy Barbara M.
Published: September 2023

The psychosocial impact of acute cardiovascular disease (CVD) events, including cardiac and stroke events, is gaining increasing recognition, with recommendations regarding an integrated cardiovascular approach coming from organizations such as the European Society of Cardiology Council on Stroke. This study aims to document the similarities and differences between heart disease and stroke in the prevalence, predictors and consequences of, and treatments for, anxiety and depression. This scoping review provides an overview of the evidence of similarity and difference in the mental health impacts of cardiac events and strokes. It found that research into postevent anxiety and depression is generally more advanced in the cardiac area than in the stroke area, with research related to poststroke anxiety prevalence, predictors, and treatment being particularly sparse. Despite these limitations, the review reveals enough similarities in the psychosocial impacts of cardiac and stroke events to warrant investigation of the potential for integrated psychosocial services for CVD patients, paying particular attention to collaborative care models of intervention.
The Prevalence of Cancer in Patients with Multiple Sclerosis (MS) who were Under Treatment with Natalizumab (Tysabri): A Systematic Review and Meta-Analysis
Authors: Nasirzadeh Amirreza , Jahanshahi Reza , Ghajarzadeh Mahsa , Mohammadi Aida , Sahraian Mohammad Ali , Moghadasi Abdorreza Naser
Published: September 2023

Background:

To determine the pooled prevalence of cancer in subjects with multiple sclerosis (MS) who received Natalizumab.

Methods:

Two researchers systematically searched PubMed, Scopus, EMBASE, Web of Science, google scholar, and gray literature including references of the included studies. The search strategy which was used in PubMed was (“Disseminated Sclerosis” OR “multiple sclerosis” OR “MS” OR “Acute Fulminating”) AND (“Cancer” OR “Neoplasia*” OR “Neoplasm*” OR “Tumor*” OR “Malignancy” OR “Benign Neoplasm” OR “Malignant neoplasm”) AND (”Tysabri” OR “Antegren” OR “natalizumab” OR “Modifying Therapy”).

Results:

We found 1,993 articles by literature search, and 1,573 studies remained after removing duplicate studies. For metaanalysis, we used the extracted data of eight studies. The pooled prevalence of cancer in patients who received Natalizumab was 2% (95%CI: 1–3%; I
2: 99.4%, P < 0.001). The pooled prevalence of basal cell carcinoma in patients with cancer was 12% (95%CI: 5–20%; I
2:50.3%, P = 0.13).

Conclusions:

The main finding of this systematic review and metaanalysis is that the pooled prevalence of cancer in subjects who suffer from MS and received natalizumab was 2%.
Association of Adiponectin 45T/G (rs2241766) and Visfatin 4689G/T (rs2110385) Gene Polymorphisms with Susceptibility to Obesity
Authors: Ghazizadeh Foad , Afshari-Moez Sepideh , Alinaghian Nazila , Torab Mansour , Rahimi-Moghaddam Parvaneh
Published: September 2023

Background:

This study aimed to see whether the adiponectin 45T/G (rs2241766) and visfatin 4689G/T (rs2110385) gene polymorphisms in an Iranian population are linked to obesity and/or obesity-related traits in normal and obese individuals.

Methods:

230 obese individuals and 169 healthy controls had their genomic DNA taken. The alleles and genotypes of the rs2241766 and rs2110385 polymorphisms were determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.

Results:

Obese individuals had considerably greater frequencies of the G allele and GG genotypes of the rs2241766 polymorphism than healthy controls (35% vs 21%, Probability (P) <0.0001, odds ratios (OR): 1.99, 95% confidence intervals (CI): 1.45–2.75 and 21% vs 7%, P = 0.002, OR: 3.52, 95% CI: 1.81–6.85, respectively). In comparison to healthy controls, obesity patients had substantially lower frequencies of the T allele and TT genotype of the rs2241766 polymorphism (65% vs 79%, P < 0.0001, OR: 0.50, 95% CI: 0.36–0.69 and 51% vs 65%, P = 0.008, OR: 0.58, 95% CI: 0.39–0.87, respectively). Obese individuals had substantially higher frequencies of the G allele and GG genotype in the rs2110385 polymorphism than healthy controls (77% vs 69%, P = 0.01, OR: 1.47, 95% CI: 1.07–2.0 and 61% versus 51%, P = 0.047, OR: 1.5, 95% CI: 1.0–2.2, respectively). When compared to healthy controls, the frequency of the T allele in the rs2110385 polymorphism was considerably lower in obese individuals (23% vs 31%, P = 0.01, OR: 0.68, 95% CI: 0.5–0.93). Furthermore, these single nucleotide polymorphisms (SNPs) were shown to have a strong link to clinical data in obese individuals. In the case of adiponectin, 45T/G (rs2241766) genotypes, serum low-density lipoprotein, waist circumference, and diastolic blood pressure were substantially different among the rs2241766 genotypes (P = 0.007, P = 0.000, and P = 0.011, respectively). In the instance of the visfatin 4689G/T (rs2110385) gene polymorphism, serum triglycerides was substantially different among the rs2110385 genotypes (P = 0.039).

Conclusions:

In the Iranian population, our findings revealed a strong link between adiponectin and visfatin gene polymorphisms and obesity and several obesity-related clinical characteristics. These SNPs might be used to identify those who are at risk of becoming obese.
Behavioral Addictions: An Emerging Public Mental Health Crisis?
Authors: Das Subhash , Pandey Manoj K.
Published: September 2023

Mental disorders are a global public health concern, with India grappling with a high burden of mental health issues. Emerging among these challenges are behavioral addictions (BAs), encompassing behaviors such as gambling, internet, and gaming addiction. BAs, particularly prevalent among youth, pose significant mental health threats. Various countries are taking steps to address BAs, with initiatives including research, treatment centers, and policies. Efforts like the Behavior Resource Hub and SHUT Clinic offer interventions in India. Combining therapy and medication, technology-based interventions, and behavioral therapy have shown promise. Prevention strategies, including awareness, education, and early risk identification, are vital. Despite progress, India must increase awareness, conduct research, and establish effective frameworks to address BAs comprehensively. Collaboration, awareness campaigns, and preventive measures targeting youth are crucial to managing this emerging public mental health challenge.
Clinical and Social Correlates of Duration of Untreated Psychosis and Impact on Short-Term Outcome in Patients with First-Episode Psychosis
Authors: Sood Mamta , Sharan Pratap , Kattimani Shivanand , Sreenivas V , Arumugham Shyam Sundar
Published: September 2023

Background:

The duration of untreated psychosis (DUP) impacts symptomatic and functional outcome in patients with psychosis.

Objectives:

This study assessed DUP, its association with sociodemographic and clinical factors and its impact on short-term clinical and functional outcome in patients with first episode psychosis.

Methodology:

Sixty-nine first contact patients with first episode psychosis who had not received adequate treatment for psychosis (adequate treatment - antipsychotic medication of ≥3.5 mg haloperidol equivalents for ≥ 4 weeks) previously were assessed with Symptom Onset in Schizophrenia Inventory to determine DUP. They were followed up for 12 weeks. Positive and Negative Syndrome Scale and World Health Organization Disability Assessment Scale – II were used to assess symptoms and functioning at presentation and after 12 weeks.

Results:

The mean DUP for the sample (n=69) was 56.7 ± 89.1 weeks (13.2 ± 20.8 months). About three fifths (60.9%) of the subjects had DUP ≤ 3 months (short DUP) and two fifths (39.1%) had DUP > 3 months (long DUP). Univariate analysis found age, employment, mode of onset and diagnosis to be significant. At followup, treatment-related improvement in positive, general and total symptom scores was significantly negatively correlated with DUP and improvement in functioning was significantly greater in patients with DUP < 3 months. A step-wise multiple logistic regression model identified mode of onset, age, and history of prior attempts at treatment as independent predictors of membership to the two DUP categories; insidious onset led to a 20-fold and a history of prior treatment attempts indicated a 400% increase in the odds of belonging to the long DUP category. An average of 9% increase in odds of having long DUP was observed with every one-year increase in age.

Conclusion:

Early detection (short DUP) of psychosis was found to have a salutary impact on clinical and functional outcome.
Factors associated with osteoarthritis in menopausal women: A registry study of osteoporosis sarcopenia and osteoarthritis
Authors: Tsai Chia-Jen , Wang Yu-Wei , Chen Jung-Fu , Chou Chen-Kai , Huang Chung-Cheng , Chen Ying-Chou
Published: September 2023

ABSTRACT

Background:

Bone and muscle mass decline after menopause. The risk of osteoarthritis (OA), sarcopenia, and osteoporosis increases in later life. Our objective aimed to assess the possible factors affecting osteoarthritis in menopausal women.

Methods:

This is a registry study of osteoporosis, sarcopenia, and osteoarthritis. All subjects accepted bone mineral density (BMD) and body composition studies, and X-rays of both knees were performed. A medical history was taken and biochemical data were recorded. Logistic regression analyses were used to examine the associations between the presence of osteoarthritis and BMD, muscle mass, and other parameters.

Results:

A total of 139 patients were enrolled. The mean age of the patients was 73.86 ± 5.83 years in the osteoarthritis group and 74.53 ± 9.90 in the non-osteoarthritis group (p = 0.663). The mean body mass index (BMI) was 24.36 ± 3.64 kg/m2 in the osteoarthritis group, compared with 23.78 ± 3.61 in the non-osteoarthritis group (p = 0.366). The lumbar spine T score was -2.06 ± 1.33 g/cm2 in the osteoarthritis group, and -1.25 ± 1.76 in the non-osteoarthritis group (p = 0.006). There were no significant differences in smoking, alcohol consumption, diabetes, hypertension, cardiovascular disease, neurological disease, and chronic kidney disease between the two groups. When we used osteoarthritis as the outcome, we found that the lumbar spine T score had a significant association with osteoarthritis, with a high T score associated with less osteoarthritis formation (p = 0.024, odds ratio (95% confidence interval) 0.06 (0-0.69)).

Conclusions:

Knee osteoarthritis was associated with lumbar spine bone density. This study provides the initial information required to develop clinical algorithms for the early identification of potential high-risk populations, as well as essential information for the development of policies for the detection and prevention of osteoarthritis in menopausal women.
Quality in neonatal mortality audits: Results of pilot study from district of Dhule, Maharashtra
Authors: Pande Bhanupriya Shivshankar , Patel Aashutosh Ramkant , Patil Amit Jagannath , Patel Shraddha , Shaikh Mohammed Usman
Published: September 2023

ABSTRACT

Introduction:

As per WHO guidelines, it is important to have quality among mortality audit documents to improve outcome in health services.

Objective:

To assess quality of facility-based neonatal mortality audits implementation.

Methodology:

Mixed-method descriptive analysis was conducted. Totally, 96 death review documents were reviewed. The 25 healthcare workers were interviewed in depth. Observation analysis done for audit meetings using WHO modified checklist for quality in audit toolkit.

Results:

The observation of audit meetings highlighted that almost half of the members were not communicated regarding vision of audit and framework of audit and review meetings. In quantitative analysis, it was found that secondary care hospitals were not having accuracy and consistency in audit documentation.

Conclusion:

The quality of neonatal death audit was poor due to challenges faced by the hospitals in creating an enabling atmosphere, which can be overcome by sharing the vision of audit with the whole staff of the hospital. A standard operating procedure for audit committee to be adopted to implement action plans. Commitment, investment, and intentional leadership from everyone, including all healthcare workers, can make these ambitious goals attainable.
Dysmenorrhea and heavy bleeding as complications in COVID-19-positive women: An observational study
Authors: Deogade Meena Shamrao , Tahlan Nidhi , Anjum Sadaf , Parwati  , Jena Swarnakant , Bhati Deepak , Acharyya Amitava , Nesari Tanuja Manoj
Published: September 2023

ABSTRACT

Immunological dysregulation and inflammation may play a role in the nature of menstruation. Coronavirus disease 2019 (COVID-19) can produce a systemic inflammatory reaction that involves extrapulmonary organs and can also affect the immune system. This study aimed to analyze changes in the menstrual cycle in coronavirus (COVID)-positive women of reproductive age.

Methods:

The data of 35 women of reproductive age were collected telephonically from said patients admitted to the COVID Health Centre (CHC) ward of All India Institute of Ayurveda, New Delhi, during June 20, 2020, to October 31, 2020. Purposive sampling was used for data collection. Wyatt menstrual pictogram and Visual Analogue Scale (VAS) were used to assess the bleeding pattern and pain during menstruation, respectively.

Results:

Clinically, changes were noted in post-COVID menstruation such as irregularity, polymenorrhea, oligomenorrhea, clots, and menstrual flow in days. However, all results were statistically non-significant. But significant (P = 0.003) menstrual pain was reported.

Conclusion:

Menstrual changes were observed in COVID-19-positive women belonging to the reproductive age group.
Effect of collaborative care intervention on productivity losses among people with comorbid common mental disorders and cardiovascular disease in rural Karnataka
Authors: Fathima Farah Naaz , Selvam Sumithra , Heylen Elsa , Srinivasan Krishnamachari , Ekstrand Maria
Published: September 2023

ABSTRACT

Introduction:

Common mental disorders (CMD) and cardiovascular diseases (CVD), common health problems among patients seeking primary healthcare, contribute to high economic productivity losses. Collaborative care programs for CMDs and CVDs have shown improvement in clinical outcomes for both conditions; however, data on productivity outcomes are scarce. Objective: Effect of integrated collaborative care on productivity among people with comorbid CMD and CVD in rural Karnataka primary health clinics.

Methods:

Participants were recruited within a randomized trial in rural South India, where patients received either collaborative or enhanced standard care. In this substudy, 303 participants were followed for 3 months and assessed with the iMTA Productivity Cost Questionnaire (iPCQ).

Results:

We found a reduction in the proportion of individuals reporting productivity loss at 3 months (66%) compared to baseline (76%; P = 0.002). Productivity losses decreased from INR 30.3 per person per day at baseline to 17.7 at 3 months. Reductions were similar in the two treatment conditions.

Conclusion:

Medical intervention may foster reduced productivity losses among patients with CMD and CVD. Collaborative care did not translate into higher reductions in productivity losses than “enhanced standard care.”
To study ultrasound and chest X-ray findings and their role in the diagnosis of dengue fever in children
Authors: Lakra Mahaveer S. , Karotkar Sagar A. , Lakhkar Bhavana , Dhawan Vaishali , Lakra Ashwini
Published: September 2023

ABSTRACT

Introduction:

Dengue fever is a fatal viral illness affecting almost all age groups and is seen in almost all tropical countries. Ultrasonography (USG) can be a useful tool for the assessment and diagnosis of dengue fever.

Objectives:

The study aimed to evaluate X-ray and ultrasound findings in children with dengue fever.

Material and Methods:

This was a prospective and cross-sectional study that was carried out in a hospital in Mumbai for over one year. All relevant data were collected, validated, and analyzed statistically on the software Epi Info 7.

Results:

Abnormal X-ray findings noticed were pleural effusion, pneumonia, and bilateral nodular opacities. Pleural effusion and respiratory complications were more common in severe dengue (P < 0.05). Out of the 37 patients on whom USG was done, 33 (89.18%) had abnormal and 4 (10.81%) had normal USG findings. Of the 17 patients with dengue who showed warning signs, 16 (89.9%) had abnormal USG findings. Plasma leakage in the form of ascites and effusion was commonly seen. One hundred percent of patients with severe dengue had abnormal USG findings. The abnormal USG findings were more commonly detected between 5–7 days and were more commonly associated with IgG + IgM–positive serology.

Conclusion:

Ultrasonography is a good modality for the diagnosis and evaluation of dengue patients. Serial ultrasound should be done for the assessment and evaluation of said patients.
A study of modified Wells score for pulmonary embolism and age-adjusted D-dimer values in patients at risk for deep venous thrombosis
Authors: Singh Sweety , Goel Atul
Published: September 2023

ABSTRACT

Aims:

Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). This study was designed to evaluate the usefulness of modified Wells score combined with age-adjusted D-dimer cut-off levels as a clinical pre-test probability assessment for predicting PE in patients ‘at risk for DVT.’

Methods:

This was a cross-sectional study including 200 in-patients at risk for DVT. Patients were categorized as ‘pulmonary embolism unlikely’ or ‘pulmonary embolism likely’ using modified Wells score and underwent D-dimer testing. PE was considered excluded in patients classified as unlikely with normal D-dimer levels, whereas the rest of the patients underwent computed tomography pulmonary angiogram (CTPA).

Results:

Out of 200 patients, 163 patients (81.50%) were ‘pulmonary embolism unlikely,’ whereas 37 patients (18.50%) were ‘pulmonary embolism likely.’ Of 163 patients categorized as ‘pulmonary embolism unlikely,’ 67 patients (41.5%) had normal D-dimer values and were excluded from CTPA. PE was detected in 24.2% of the patients who underwent CTPA.

Conclusion:

The combined strategy using modified Wells score and age-adjusted D-dimer cut-off value has 100% sensitivity and a negative predictive value and can be used to safely exclude PE in in-patients.
Situational analysis of women empowerment in urban field practice area of Dr. M. K. Shah Medical College and Research Center, Ahmedabad
Authors: Shah Yash , Patel Hely , Oza Jasmin , Geriya Disha
Published: September 2023

ABSTRACT

Introduction:

Women empowerment in society and family are closely linked to decision-making. Empowerment of women is essentially the process of upliftment of economic, social, and political status of women, the traditionally underprivileged ones, in society. It involves the building up of a society wherein women can breathe without the fear of oppression, exploitation, apprehension, discrimination, and the general feeling of persecution which goes with being a woman in a traditionally male dominated society. The present study was conducted to assess women’s empowerment status and factors affecting it.

Material and Method:

Community-based cross-sectional study was carried out among 175 women residing in urban field practice area of Dr. M. K. Shah Medical College and Research Centre, Ahmedabad. A pre-designed questionnaire was used for data collection by interviewing the women through house to house survey. Data were entered in Microsoft Excel and analyzed using (Statistical Package for the Social Sciences (SPSS).

Result:

Around 85.71% of women were involved in decisions regarding trivial issues. A total of 17.72% of the women reported that they had suffered some form of domestic violence in their life. Around 23% of the women were not involved in any financial decisions of the family. Association between education of the women and involvement in decision-making was found statistically significant. Employment increases the participation of women in financial decision-making. 88.89% of employed women participated in financial decisions, while 71.42% of housewives were participating in these decisions.

Conclusion:

Education and employment were found to have impact on decision-making. So, education of girls should be given the priority.
Prevalence of diabetes distress and cross-cultural reliability of DDS-17 scale in rural Haryana
Authors: Ranjan Ravish , Rajput Meena , Sachdeva Aman , Saha Arup , Jyotsana  , Yadav Kapil
Published: September 2023

ABSTRACT

Background:

Diabetes distress associated with diabetes is an important under-appreciated domain of diabetes management. The aim of the study is to assess the prevalence of diabetes distress among T2DM patients in Jhajjar district of Haryana, using widely accepted DDS-17 scale along with testing the scale’s reliability through Cronbach’s α.

Material and Methods:

This observational study with cross-sectional design was carried out among 503 T2DM patients in district, Jhajjar, Haryana. DDS-17 scale was used for diabetes distress assessment. Data entry and analysis were performed using appropriate software.

Results:

37.97% subjects had diabetes distress either in moderate (DDS-17 Score ≥2) or severe (DDS-17 Score ≥3) form. English version of DDS-17 scale showed good internal consistency reliability (α = 0.79).

Conclusions:

This study conclusively showed that diabetes distress is very common among T2DM patients as more than one third of the T2DM patients had diabetes distress and diabetes distress scale (DDS-17) is an easy, well-accepted questionnaire with good reliability.
Barriers of household toilet utilization among toilet owners in a rural area of Northern India: An analytical cross-sectional study
Authors: Takhelchangbam Nilima D. , Saxena Deepanshi , Sachan Divyata , Jain Pankaj K. , Shukla Sushil K. , Srivastava Dhiraj K. , Bajpai Prashant K.
Published: September 2023

ABSTRACT

Background:

Open defecation continues to prevail among toilet owners despite effective implementation of the Swachh Bharat Mission (Gramin). We conducted this study to determine toilet utilization rates and learn about the barriers to toilet use in the rural areas. By understanding the barriers, physicians can provide targeted education and become better equipped to manage their patients’ conditions and advocate for their demands.

Materials and Methods:

We conducted a cross-sectional study on the households of the rural field practice areas of the department in central Uttar Pradesh by the census method. House listing was procured from the departmental records. The questionnaire was directed at both the household level and individual level.

Results:

The proportion of households with access to a toilet was found to be 91.1% of which 504 households were included in the study. Among the toilet owners, 115 (22.8%) households were not using toilets exclusively by all the members. At the individual level, age groups (of 20–59 years, and ≥60 years) and female gender were found to be significantly associated with open defecation. At the household level, government assistance for toilet construction and livestock keeping was found to be associated with open defecation. Major barriers to toilet use were childhood habits, dearth of toilets in the farming grounds/workplace, women during menstruation and having a non-functional toilet.

Conclusion:

This study indicates that merely installing a household toilet does not ensure exclusive utilization of toilet and the practice of open defecation might continue to be prevalent if corrective measures are not undertaken.
Stressors and coping strategies among medical students in Jazan, Saudi Arabia: A cross-sectional study
Authors: Salih Sarah , Mahmoud Samy S. , Abudeyah Manal Ahmed , Albeladi Fatimah Ibrahim , Mohsen Waad Mohammed , Hayyan Alanoud Ibrahim , Alfaifi Nada Ali Y. , Hakami Ghadah Mohammed , Alnamazi Noura Ali
Published: September 2023

ABSTRACT

Background:

Medical education is known to be stressful and demanding. Medical students face a various stressors, which include academic pressure, fear of not reaching goals, and difficulty integrating into systems. This study aims to assess levels of stress and coping strategies among medical students at Jazan University in Saudia Arabia.

Materials and Methods:

A descriptive cross-sectional study was conducted that comprised of 240 students at Jazan Faculty of Medicine using a self-administrated questionnaire to obtain data on socio-demographic characteristics, perceived stress, stressors, and coping strategies.

Results:

Respondents mean age was 22.08 ± 1.82 years and 52.7% were female. Of these, 51.9% were in preclinical years of study, 29.5% were in the second academic year, and 39.8% had a GPA greater than 4. Students stress level ranges from moderate to high. The most common causes were academic problems and frequency of examinations and work overload (92.1%), worrying about the future (61.8%), and lack of entertainment and time for recreation (58.9%). The most common coping strategy was recreational activity such as going to movies, watching TV, reading, sleeping, or shopping (36.5%). Mean perceived stress scale (PSS) and Brief-COPE scores were 24.1 ± 4.85 and 66.16 ± 10.71, respectively. Participant age and PSS score have significant positive correlation (P < 0.05).

Conclusion:

Stress level is moderate to high especially among students in preclinical years and among females. It is recommended to improve teaching and learning environment plus proper counseling and academic support. Also, active involvement of students in the educational process may help reduce academic stressors.

Plain Language Summery:

Medical students face a range of stressors due to the demands of study. This research found medical Students suffer stress level ranging from moderate to high. Most common causes of stress are academic problems, frequency of examinations, and work overload. Most common coping strategy performed by students was recreational activities like going to movies, watching TV, reading, sleeping, or shopping. It is recommended to improve teaching and learning environment plus proper counseling and academic support. Also, active involvement of students in the educational process may help reduce academic stressors.
Vaccine and malnutrition: A narrative review
Authors: Tripathy Saroj K. , Das Sarthak , Malik Archana
Published: September 2023

ABSTRACT

Nearly 45% of under 5 mortality is directly or indirectly linked to malnutrition. Infection adds to the increased mortality and morbidity in these groups. Vaccination is very important in these undernourished children protecting against life-threatening infections. The goal of vaccination is to produce long-term protection by generating memory cells and the generation of antibodies. Since malnutrition is a state of immunodeficiency, the immune response to vaccines in these children is a matter of concern. We did an exhaustive search to gather more recent studies and corroborated previous findings. Oral Polio Vaccine (OPV), Pneumococcal Polysaccharide Vaccine, Haemophilus influenza vaccine, rabies, and cholera vaccine showed normal response to immunization. Measles and rotavirus vaccines were found to elicit lower seroprotection and lower efficacy in undernourished children. Data regarding response to vaccination against BCG, DPwT, Hepatitis B, pneumococcal conjugate vaccine, and meningococcal vaccine was inconclusive. Although most of the studies show a normal immune response to different vaccines, excluding other confounding factors and effect modifiers had not been easy to interpret. However, with the advances in the understanding of vaccine physiology with newer immunological techniques, good-quality studies might explore the gray areas that remain untouched.
Prevalence of cardiac autonomic neuropathy in patients with type 2 diabetes mellitus
Authors: Karthikeyan Aditya , Manjunath PR , Latha A Tharuni , Sultana Sana
Published: September 2023

ABSTRACT

Introduction:

Cardiac autonomic neuropathy (CAN) is one of the microvascular complications of diabetes mellitus, which is due to the involvement of autonomic nerve fibers innervating the heart and blood vessels. CAN was found to have a greater degree of morbidity and mortality than their non-CAN counterparts as it is underdiagnosed. Hence, this study aims to determine the prevalence and severity of CAN in type 2 diabetics in the South Indian setting.

Materials and Methods:

Forty-two patients with type 2 diabetes mellitus were enrolled in the study. Patients underwent tests for CAN, with the severity of CAN estimated as a CAN score, which was the sum of the scores of the four cardiovascular autonomic function tests.

Results:

Out of the 42 patients, a total of 36 patients (85.7%) were diagnosed with CAN. Among those with CAN, 24 patients had early CAN (57.1%), and 12 were diagnosed with definite CAN (28.6%). Patients with any form of CAN (early and definite CAN) had higher HbA1c and mean glucose values than those without CAN. CAN was also found to be more severe among older patients with diabetes.

Conclusion:

In the present study, we found that more than 50% of the study population had early CAN and around 28.6% patients had definite CAN indicating higher prevalence of CAN in our population. Also, there was a positive correlation between the severity of CAN and the age of the patients. This study highlights the importance of understanding the importance of screening the diabetic patients for CAN to prevent adverse cardiovascular events.
Knowledge and perception regarding adverse drug reactions among undergraduate medical students of Bihar, Eastern India
Authors: Sidhu Gurcharan S. , Kumar Jatinder , Kumar Dharmendra , Dey Nakshatra , Ranjan Gyan , Sinha Tanay , Pal Ranabir
Published: September 2023

ABSTRACT

Background:

Adverse drug reactions (ADRs) have national and international monitoring and are part of teaching–learning of undergraduate medical course and curriculum.

Objectives:

To find the knowledge and perception of ADRs among undergraduate medical students in a tertiary care teaching institute in eastern India.

Materials and Methods:

This was an observational cross-sectional study conducted among the MBBS medical students by administration of pre-designed, pre-tested, semi-structured questionnaires. The data on their knowledge and candid reflections on ADRs were analyzed question by question using software and compared with peers.

Results:

The responses from the participants on knowledge and perception of ADRs varied widely. Final-year students had the most precise response on classification, filing an ADR report, national reporting centers, and the first step in monitoring ADRs; the majority accepted their first- hand experience and legal and professional responsibilities on ADRs. Third-year students responded well on objectives, methods, and scope of patients on direct reporting or drug overdose and monitoring; respect patient confidentiality while reporting; and expect feedback from monitoring centers, with special training on ADR. Second-year students responded well on definitions, pharmacovigilance programs in India, alertness of banned drugs because of ADR, and related capacity building.

Conclusions:

The awareness and insight on ADRs of the undergraduate medical students were quite reasonable. However, further reinforcement is needed in future to be updated to relevant issues to their practice as primary care physicians.
Awareness and utilization of social welfare schemes among elderly villagers of Mahabubnagar rural region in Telangana State of India – An interventional study approach
Authors: Bogam Rahul Ramesh , Chavan Vishwajeet Manohar , Rani C Usha
Published: September 2023

ABSTRACT

Introduction:

Demographic transition enhanced the proportion of geriatric population in India. Senior citizens experience progressive economic dependency for their daily survival. The Government of India provides economic assistance through social welfare schemes. However, inadequate awareness of schemes is the key reason for its low utilization. The present study was implemented to evaluate knowledge and utilization of social welfare schemes and also to assess the effect of educational intervention on awareness of elderly persons about welfare schemes.

Materials and Methods:

A community-based interventional study carried out from July to December 2022. A structured ‘TIV intervention’ comprised of ‘Training module’, ‘Interactive sessions’ and ‘Village Health Meeting’ was administered on 839 elderly persons in one of the rural blocks of Mahabubnagar district of Telangana State of India. Community health workers were actively involved in sensitization sessions. Pre- and postintervention questionnaires were completed through face-to-face interview with participants by trained social workers. The statistical analysis was performed using SPSS Version 20 Software.

Results:

There was a statistically significant improvement in awareness levels and utilization of social welfare schemes due to TIV intervention (P < 0.001, SD = 3.01vs 1.21). The awareness of schemes was significantly greater among males, literates, socioeconomic scale of classes 1 and 2 and with age group of 60-70 years.

Conclusions:

Simple, cost-effective intervention can make significant gain in awareness and utilization levels of social welfare schemes among elderly population. ‘Traditional Village Meetings’ can be used as a potential opportunity to sensitize community members about social welfare schemes.
Telehealth utilization among Egyptian population and health institutional readiness: An exploratory study
Authors: Osman Basma Mohamed , Mohamed Maaly Zayed , Ismail Shaimaa Ali Mohamed , Allah Lamiaa Saad Abd , Shaban Marwa Mamdouh
Published: September 2023

Objective:

This study aimed to assess the public’s perspectives and the health institutions’ readiness for telehealth utilization in Egypt.

Methods:

A cross-sectional study design was employed, and data were collected from a convenient sample of 800 Egyptian citizens and 26 nursing administrators and information technology personnel from 16 governmental hospitals and 10 private hospitals between January and March 2022. The Egyptian community utilization of telehealth questionnaire and the telemedicine hospital readiness assessment were used to collect the data.

Results:

The results revealed that 35.1% of the general Egyptian population used telehealth services and 43% expressed willingness to use them in future. As perceived by the general Egyptian population, the most prevalent barriers to telehealth utilization were communication barriers (97.6%), lack of confidence in health professionals (77.6%), technological limitations (72.5%), the need for physical examination (25%), and privacy concerns (10%). Regarding hospital readiness, 42% of governmental hospitals were not taking any initiative to implement telehealth services, and 15.4% were at the beginner level, meaning that some steps had been taken. However, the hospital was still far from being able to implement telehealth services. In contrast, private hospitals were either at the beginner or advanced level.

Conclusion:

Although the use of telehealth services in Egypt has increased, there is a need to address the barriers to public utilization and improve hospitals’ readiness to implement telehealth services to enhance public usage.
Intrathecal 1% 2-chlorprocaine for short gynecological day care procedures: Prospective, randomized, dose finding study
Authors: Choudhary Jaya , Bhojwani Priyanka , Agarwal Anshika , Mishra Amiya Kumar
Published: September 2023

Background and Aims:

Establishing the optimum dose of intrathecal 1% 2-chlorprocaine may reduce the discharge time and encourage more widespread use of spinal anesthesia for day care procedures. The aim of this study was to compare the efficacy and recovery characteristics of three different doses of intrathecal 1% 2-chlorprocaine for short gynecological day care procedures.

Material and Methods:

Fifty-one patients scheduled for elective day care gynecological procedures lasting less than 60 min and were randomly divided into three groups of 17 each to receive 35 mg, 40 mg, or 45 mg intrathecal 1% 2-chlorprocaine. Demographic data, time required to achieve readiness for surgery, time required to attain discharge criteria, maximum block height achieved, and adverse effects were recorded in each group.

Results:

The time required to achieve readiness for surgery was similar between the three groups (P = 0.306). However, 35 mg group required the shortest time to ambulate and there was a significant difference as compared with both 40 mg (P = 0.012) and 45 mg (P = 0.001). Voiding and the fulfillment of the discharge parameters were also attained more rapidly in the 35 mg group [133 (120,155) min] as compared with both 40 mg [164 (145,175) min, P = 0.000] and 45 mg [160 (150,175) min, P = 0.000]. None of the patients reported neurological symptoms during the follow-up.

Conclusion:

The 35 mg intrathecal 1% 2-chlorprocaine not only provides reliable anesthesia for short gynecological procedures but also facilitates faster achievement of the discharge parameters as compared with the 40 mg and 45 mg doses.
Chronic Obstructive Pulmonary Disease, Part 5: Clinical Pearls for Comorbid COPD
Authors: Clifford Kalin M. , Klein Mary S. , Courtney Lindsay A. , Van Dyke Alaina , Sigler Meredith , Basinger Rachel L.
Published: September 2023

Chronic obstructive pulmonary disease (COPD) is often diagnosed with other comorbid conditions. This can complicate therapy overall by contributing to adverse events leading to poor outcomes to not only COPD, but other comorbid conditions. This manuscript will discuss common comorbid
conditions often seen with COPD, update vaccination recommendations for COPD patients, and provide information regarding smoking cessation in COPD. The senior care pharmacist has an important role where they can recommend medication adjustments to potentially avoid these adverse events, immunize
their patients appropriately, and provide assistance with smoking cessation to improve not only COPD outcomes but outcomes associated with other comorbid conditions.
Artificial Intelligence Strategies for the Development of Robust
Virtual Sensors: An Industrial Case for Transient Particle Emissions in a
High-Performance Engine
Authors: Pulga Leonardo , Forte Claudio , Siliato Alfio , Giovannardi Emanuele , Tonelli Roberto , Kitsopanidis Ioannis , Bianchi Gian Marco
Published: September 2023

The use of data-driven algorithms for the integration or substitution of current
production sensors is becoming a consolidated trend in research and development
in the automotive field. Due to the large number of variables and scenarios to
consider; however, it is of paramount importance to define a consistent
methodology accounting for uncertainty evaluations and preprocessing steps, that
are often overlooked in naïve implementations. Among the potential applications,
the use of virtual sensors for the analysis of solid emissions in transient
cycles is particularly appealing for industrial applications, considering the
new legislations scenario and the fact that, to our best knowledge, no robust
models have been previously developed. In the present work, the authors present
a detailed overview of the problematics arising in the development of a virtual
sensor, with particular focus on the transient particulate number (diameter
<10 nm) emissions, overcome by leveraging data-driven algorithms and a
profound knowledge of the underlying physical limitations. The workflow has been
tested and validated using a complete dataset composed of more than 30 full
driving cycles obtained from industrial experimentations, underlying the
importance of each step and its possible variations. The final results show that
a reliable model for transient particulate number emissions is possible and the
accuracy reached is compatible with the intrinsic cycle to cycle variability of
the phenomenon, while ensuring control over the quality of the predicted values,
in order to provide valuable insight for the actions to perform.
NFT w muzeum – wyzwania i perspektywy w świetle art. 2 ustawy o muzeach
Authors: Rybak-Karkosz Olivia
Published: September 2023

This paper aims to analyse challenges and perspectives related to NFTs that Polish museums would need to consider regarding their activities, as described in art. 2 of the Act on Museums of 21 November 1996. These activities include collecting, maintaining, securing, and exhibiting artwork as well as conducting educational and research activities. Therefore, one must con-sider whether NFTs are a long-term opportunity for museums to fulfill their goals and activities or a temporary solution providing financial aid during the post-pandemic crisis. In this paper, the author describes the importance of NFTs for the art world and quotes examples of museums that already collect and exhibit NFTs or organise events about them. The paper also includes the results of a survey conducted among Polish museum professionals to obtain their opinions on this matter.
Instituições Educacionais e Educação não institucionalizada: relações para transformação das instituições
Authors: Moreira Nubia Regina
Published: September 2023

Resumo: Este texto discute a educação não formal como elemento gerador de aprendizagens situadas para além da escola. Considera as relações entre instituições educacionais e educação não institucionalizada como de complementariedade, não antagonismo. Aponta, especificamente, para um tipo de pedagogia que pulsa em ONGs, movimentos sociais, associações de moradores, entre outros grupos que constituem espaços que se organizam em torno de lutas sociais, no sentido político do termo, proporcionando aprendizagens sobre a organização da sociedade e sobre seu próprio grupo. O texto conclui apontando que a maternagem de mentes proporciona autonomia e reconhecimento do eu no coletivo.