bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Weight Control Intervention on Body Mass Index among Adolescents with Overweight: A Systematic Review and Meta-Analysis
Authors: Narmkul Piyanan , Songserm Nopparat , Woradet Somkiattiyos
Published: March 2024

Background:

Due to the dramatic rise in overweight and obesity, adolescent weight management interventions are required. Therefore, this study aimed to study the components and the effect size of weight control programs for adolescents with overweight and obese.

Materials and Methods:

Following the PRISMA 2020 guidelines, we systematically searched electronic databases (PubMed, Google Scholar, ThaiJo, ThaiLis, and Embase) through December 2021 published in English and Thai, samples aged 15–22 years, and presenting the mean, SD a sample size of both experimental and control groups. However, we excluded articles other than full-text articles. In addition, a risk of bias assessment was performed according to the Cochrane Collaboration’s quality assessment tool. Finally, this meta-analysis included six studies that met the criteria. The meta-analysis used a fixed-effects model with a forest plot to compute effect sizes and Cochran’s Q and I2 statistics as measures of heterogeneity.

Results:

We found six primary studies which included 721 overweight adolescents. The analysis of the effectiveness of weight control programs for overweight adolescents revealed that 360 adolescents with overweight and obese (49.93%) who underwent the weight control programs changed body weight and body mass index values with the effect size of -0.80 (-1.03, -0.56) and I2 was 56.00%.

Conclusions:

The results indicate further studies should focus on constructing programs that consider adolescents’ changes in technology and lifestyles. Additionally, social and mobile tools should motivate and educate adolescents about body weight control to help them adapt to a healthy lifestyle and maintain weight control over time.
Evaluation of the effect of mechanical alteration of enamel surface on shear bond strength of self-adhering composites utilizing different adhesive modalities
Authors: Tarun Gangala Srinivas , Naik Kundapur Supreetha Shankar , Prakash Karanam Apoorva , Shetty Mitha , Sanketh Archana K , Patil Netra
Published: March 2024

Background:

Self-adhering flowable composite (SAC), which has currently been launched, is said to be postoperatively responsive and less technique-reactive than previous materials. Clinical demands for bonding to undamaged, modified, or prepared enamel surfaces—which may attach differently with adhesive resins—often accompany restorative demands. Very little information was available for SAC.

Aim:

This study was carried out to determine the impact of mechanical enamel surface modification on shear strength properties in various bonding procedures.

Materials and Methods:

The three groups of prepared enamel surfaces (group A, n = 60), unprepared enamel surfaces (group B, n = 60), and prepared enamel surfaces plus etch-and-rinse (group C, n = 20), which served as the control group, were randomly assigned to the 140 constructed samples. Subgroups A1, B1 (nanohybrid composite + self-etch), A2, B2 (self-adhering composite), and A3, B3 (self-adhering composite + self-etch) were created from groups A and B, respectively (n = 40). Composite resin cylinders with the unique bonding protocols of each group were created using Teflon ring molds. Testing for shear bond strength was done, and information was examined.

Results:

The control group C was found to have the highest mean shear bond strength (29.77 MPa), whereas subgroup B2 had the lowest mean shear bond strength (8.4 MPa). For all adhesive techniques, shear bond strength values for prepared enamel surfaces were considerably greater than those for unprepared enamel surfaces (P < 0.01). The following were the mean shear bond strength values: C > A1 > A3 > A2 > B1 > B3 > B2.

Conclusions:

Shear bond tensile properties on prepared enamel surfaces were higher than those of unprepared enamel surfaces. Higher shear bond strength values of the self-adhering composite in prepared and unprepared enamel surfaces were produced by using a self-etch agent first.
A survey on functional constipation and its risk factors in older people in Shahreza, Iran
Authors: Amiri Mina , Hassanzadeh Akbar , Rahimi Majid
Published: March 2024

BACKGROUND:

Functional constipation is prevalent among older people. It has major effects on the quality of life of them, as well as the high costs of treatment. This study investigated functional constipation and risk factors affecting older people living in Shahreza, Iran.

MATERIALS AND METHODS:

This cross-sectional study was performed on 200 older people in Shahreza. They were selected by simple random sampling. We used the Rome III Criteria, the Elderly Physical Activity Questionnaire (PASE), and related questions from the SIB system (integrated health system). After completing the questionnaires, the data were analyzed using the mean and standard deviation, Chi-square test, independent-samples t-test, Fisher’s exact test, and Mann–Whitney test.

RESULTS:

The prevalence of functional constipation was 45%. There are significant relationships between functional constipation with dental problems (P = 0.02), intake of fluid (P = 0.001), fruits (P = 0.001), and vegetables (P < 0.001), polypharmacy (P = 0.003), and antidepressants (P = 0.008), history of colon (P = 0.003) and anal (P = 0.001) diseases, stroke or mobility disabilities (P = 0.002), the level of physical activity (P = 0.002), and gender (P = 0.04) in older people living in Shahreza.

CONCLUSIONS:

According to the high prevalence of functional constipation in the studied older people, it is necessary to focus on controlling risk factors and planning to prevent the destructive effects of social restrictions on older people during the coronavirus disease 2019 (COVID-19) pandemic.
Prevention of White Spot Lesion during Orthodontic Treatment: A Novel Bioactive Glass Nanobioadhesive
Authors: Parihar Ajit , Swaraj Sadhna , Upadhyay Chandan , Nethivalavan Mohana , Maiti Pralay , Vishwakarma Ajit
Published: March 2024

Objectives:

The objective of this study is to evaluate the ability of the bioactive glass (BAG)-Bonds to inhibit the demineralization surrounding the orthodontic brackets when being exposed to an in vitro caries challenge and also simultaneously evaluate the physical and mechanical properties in order to be accepted as an orthodontic bonding agent.

Materials and Methods:

Preparation of mesoporous bioactive glass (MBG) used an improved sol-gel method, combining with sacrificial liquid template to MBGs with controllable particle size. Tetraethyl orthosilicate, triethyl phosphate, calcium nitrate tetrahydrate, ethanol absolute, ethyl acetate, hexadecyltrimethylammonium bromide, deionized water, and ammonium hydroxide were used. The microstructure was analyzed using a field emission gun-based scanning electron microscope (SEM). The debonding and adhesion characteristics were analyzed using an Instron Universal Testing Machine.

Results:

SEM analysis shows that the prepared MBG particles possess spherical morphology with generally uniform size. Novel orthodontic bonding material (BG) provides adequate mechanical and physical properties in order to be accepted as an orthodontic bonding agent since its bond strength both at the time of bonding and after 6 months in simulated salivary conditions is significantly higher than conventional bonding resin (TBXT). The bond strength was also evaluated both initially at the time of bonding as well as 6 months after being kept in simulated salivary conditions.

Conclusion:

These novel adhesives result in reduced demineralization surrounding orthodontic brackets and possess optimal physical and mechanical properties to be accepted as an orthodontic adhesive.
Knowledge, Attitude, and Practice of COVID-19 among the Exposed Frontline Police Workers in Eastern Uttar Pradesh Region: An Exploratory Study
Authors: Singh Jaya , Singh Shruti , Jain Trupti , Raja Dinesh , Chandra Akhilesh , Khairnar Mahesh , Naveen P. G. , Agrawal Rahul
Published: March 2024

Background:

The world has been hit by an unknown obstacle in the form of the COVID-19 pandemic. India also faced a never seen before situation in trying to contain the spread of COVID-19 by enforcing one of the most stringent lockdowns in the world. The billion-plus population of the country throws a severe challenge at the operational level in enforcing the measures. The frontline workers in these trying times such as the Police, Central Industrial Security Force, health-care workers, volunteers, and essential service workers have done a praiseworthy job under exceptionally hard conditions.

Aim:

The study aimed to investigate the awareness of COVID-19 among the frontline police workers who were posted during lockdown in our state.

Materials and Methods:

A questionnaire comprising 25 questions was randomly distributed among the police personnel who were on COVID-19 duty. The knowledge they had was assembled, assessed, and scrutinized.

Results:

A total of 150 police officers took part in the study. Mean age of 39.91 ± 9.96 years was seen. The majority of them had enough knowledge about the ongoing pandemic and they were seen to be taking good precautions to fight the virus.

Conclusion:

The joint effort of public and the frontline workers was the mainstream reason to bring our country back on track. Police had put their best efforts into controlling the spread of this contagion by maintaining a strict lockdown. They did immensely well and we as citizens should be grateful to them for protecting us from this pandemic.
Effectiveness of Egg Carton Simulation Model as a Method of Teaching Tooth Brushing in School going Children – A Quasi Experimental Study
Authors: Polapala Sugeethika , Praharsh Anakapalli Sai , Reddy L. Vamsi Krishna , Sivakumar Pydi , Nagarjuna Pottem , Pichika Swathi
Published: March 2024

Background:

The majority of oral diseases, which are among the most common illnesses worldwide, can be avoided. Adequate oral health depends on establishing significant tooth brushing routines to prevent gingivitis and dental caries and controlling the consumption of sugared foods. Elementary schools are a potential target for these interventions to support children in developing healthy behaviors independently. Large scale school-based programs are effective in reducing preventable diseases through cost-effective interventions.

Objectives:

To establish and assess a new activity-based approach for teaching schoolchildren regarding tooth brushing, by using egg cartons as models for teeth.

Materials and Methods:

Two methods of teaching tooth brushing technique to school children of age group of 8–12 years were compared: (i) Conventional method (n = 15): Instructions on study model (ii) egg carton simulation method (n = 15): Hands-on activity on egg cartons as simulated models. The outcome assessed was the plaque index (Silness and Loe, 1964). Gender-wise comparisons were done using a Chi-square test for comparing the categorical variables.

Results:

Plaque scores compared using an independent t-test showed significant improvement in the egg carton group after the teaching sessions (P < 0.01 for the egg carton method).

Conclusion:

The egg carton simulation method is an effective method for plaque removal compared to the conventional approach as there is significant plaque score reduction in children after the teaching session.
Awareness of Patients Regarding Restorative and Endodontic Treatment during COVID-19: A Survey
Authors: Shetty Suneeth , Gupta Maruthi , Ambikatanya U. K. , Maurya M.
Published: March 2024

Objective:

The aim of the study was to assess the awareness of patients visiting the dental Outpatient Department of JSS Dental College Hospital regarding coronavirus symptoms and their willingness to get dental treatment done during this period.

Materials and Methods:

Five hundred and twenty-five patients in the age group of 25–65 years who reported to the department of conservative dentistry and endodontics during 6 months were assessed for coronavirus symptoms using a questionnaire of descriptive statistics and analysis.

Results:

Patients were willing to undergo treatment during the pandemic (97%).

Conclusion:

Irrespective of the coronavirus, patients seem to be keen to get either their restorative or endodontic treatment done, which shows that the patients are not completely aware of the spread of COVID-19 infection and awareness programs have to be conducted to educate people.
Knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter
Authors: Halemani Kurvatteppa , Dhiraaj Sanjay , Kumar Basant , Hussan Saadhat , Pawan Premalata Prerna , Gupta Priyanshi Raviraj
Published: March 2024

Objectives:

The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.

Materials and Methods:

This cross-sectional study was conducted from June 1, 2021, to September 11, 2021, in a tertiary hospital in north India. Purposive sampling was used to select 50 participants. Three instruments were employed for data collection after fulfilling sample criteria; for baseline information demographic tool, knowledge questionnaires, and a practice checklist. Data were analyzed using descriptive and inferential statistics.

Results:

On assessment of 50 participants, the majority of parents aged above 30 years (74%). Most of the participants were male (82%), graduated (38%), and working in the private sector (58%). Similarly, two-thirds of participants were residing in a nuclear family (64%) with a single child 32 (64%) and family income <5000 rupees per month (60%). The mean score of knowledge was 1.94 ± 0.81 and that of practice skills was 1.98 ± 0.85 on home-based care. Regression analysis showed that knowledge of parents was significantly associated with qualification (β: 1.821,P= 0.002). Similarly, association of practice skills of parents with gender (β: 1.235,P= 0.050) and qualification (β: 1.889,P = 0.00) was significant.

Conclusion:

The general findings of our study showed that parents’ education and occupation played a significant role in a child’s care. Parental education and catheter care skills positively affect the child and reduce readmission rates.
Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients
Authors: Zaky Mohammed Elsayed , Farghaly Shimaa Magdi , Ramadan Osama Mohamed Elsayed , Abdelkader Rehab M. , Shaban Mostafa
Published: March 2024

Objective:

Rheumatoid arthritis (RA) requires comprehensive management. Structured nursing protocols may enhance outcomes, but evidence is limited. This study evaluated the effect of a structured nursing protocol on RA outcomes.

Materials and Methods:

In this one-group pre-post study, 30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education, psychosocial support, and self-management promotion. Assessments included clinical evaluation of joint counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and patient-reported Arthritis Self-Efficacy Scale (ASES), Health Assessment Questionnaire (HAQ), Visual Analog Scale (VAS) for pain, and Hospital Anxiety and Depression Scale (HADS).

Results:

The study demonstrated significant improvements in both clinical- and patient-reported outcomes. Joint count decreased from 18.4 ± 4.2 to 14.2 ± 3.8 (P < 0.001), ESR from 30.1 ± 6.8 mm/h to 25.5 ± 6.8 mm/h (P < 0.01), and CRP levels from 15.2 ± 3.6 mg/L to 11.8 ± 2.9 mg/L (P < 0.01) postintervention. Patient-reported outcomes showed a marked increase in ASES score from 140 ± 25 to 170 ± 30 (P < 0.001) and reductions in HAQ from 1.6 ± 0.4 to 1.3 ± 0.3 (P < 0.01), VAS pain score from 7.8 ± 1.7 to 6.2 ± 1.2 (P < 0.001), and HADS anxiety and depression scores from 11 ± 3 to 8 ± 2 (P < 0.05) and 10 ± 2 to 7 ± 1 (P < 0.05), respectively.

Conclusion:

A structured nursing protocol significantly improved clinical disease activity, physical functioning, pain, self-efficacy, and emotional well-being in RA patients. A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.
Longitudinal axis approach versus longitudinal oblique axis approach for ultrasound-guided radial artery cannulation in adult patients: A comparative study
Authors: Kumar Rakesh , Gupta Madhu , Kaushik Parul , Mohanan Shyam , Dabas Manisha
Published: March 2024

Background and Aims:

Ultrasonography (USG)-guided arterial cannulation is a frequently performed procedure in the operating room and intensive care unit. Conventionally, longitudinal/in-plane and transverse/out-of-plane approaches are used for cannulation. Recently, a longitudinal oblique approach has been described with the advantage of wide visualization area. Hence, the present study was designed to compare the success of USG-guided radial artery cannulation in longitudinal oblique axis (LOA) and longitudinal axis (LA).

Material and Methods:

Seventy patients requiring radial artery cannulation were randomly allocated into two groups: group L (USG-guided radial artery cannulation in LA) and group O (USG-guided radial artery cannulation in LOA). Primary outcome was to assess cannulation success in the first attempt, while the secondary outcomes were to assess the number of attempts, failure rate, total cannulation time, and associated complications.

Results:

First-attempt success was higher in group O (80%) compared to group L (54.3%), with a P value of 0.022. In group L, 31.4% required two attempts and 5.7% had three attempts, while in group O, 14.3% had two attempts and 2.9% required three attempts. Group L failure rate was 8.6%, while it was 2.9% in group O. The mean total cannulation time (sec) for group L was 146.83 ± 89.37 and group O was 63.89 ± 26.277. No complication was observed with group O, while in group L, 9% had hematoma formation.

Conclusion:

The LOA approach for USG-guided radial artery cannulation has higher first-pass success rate, total success rate, and requires less cannulation time compared to the LA approach.
Exploring the Perceptions and Challenges of Teenage Pregnancy and Motherhood with Its Way Forward: A Phenomenological Study among the Tribal Population in a Rural Area of Udaipur, Rajasthan, India
Authors: Sharma Meena , Engti Raktim , Mittal Deepak
Published: March 2024

Background:

Teenage pregnancy and motherhood are one of the global public health problems. In India, 6.8% of women aged 15–19 years began childbearing between 2019 and 2021 and this is more common in rural areas and socioeconomically disadvantaged states. During the National Family Health Survey-5, it was seen that 4.2% of 15–19 years were already pregnant or had children. Thus, this study aims to explore the various challenges faced by teenage mothers with the barriers in service delivery and solutions to tackling the issue from their perspective.

Materials and Methods:

A qualitative study with a phenomenological approach was conducted from October to November’ 2023 in the tribal hamlets of Udaipur, Rajasthan. In-depth interviews of 21 purposively selected with snowball sampling teenage mothers were conducted. Audio recording and note-taking were done during the interview. Thematic analysis was done

Results:

The teenage mothers were subjected to various types of medical problems, lack of unawareness, lack of parental and spousal support, as well as psychosocial stressors and social constraints as the major challenges being faced. The major themes for its solutions were parental and spousal cooperation, education, and ownership taken by the village head

Conclusion:

Lack of unawareness, medical problems, and familial issues probably due to socioeconomic factors are the major challenges for teenage mothers, whereas the prime solution, as suggested, is parental support and cooperation. Regulation on the sale of alcohol was also cited as a factor in curbing the problems of teenage pregnancy.
Deep Learning Framework for Liver Tumor Segmentation
Authors: Gupta Khushi , Aggarwal Shrey , Jha Avinash , Habib Aamir , Jagtap Jayant , Kolhar Shrikrishna , Patil Shruti , Kotecha Ketan , Choudhury Tanupriya
Published: March 2024

INTRODUCTION: Segregating hepatic tumors from the liver in computed tomography (CT) scans is vital in hepatic surgery planning. Extracting liver tumors in CT images is complex due to the low contrast between the malignant and healthy tissues and the hazy boundaries in CT images. Moreover, manually detecting hepatic tumors from CT images is complicated, time-consuming, and needs clinical expertise.
OBJECTIVES: An automated liver and hepatic malignancies segmentation is essential to improve surgery planning, therapy, and follow-up evaluation. Therefore, this study demonstrates the creation of an intuitive approach for segmenting tumors from the liver in CT scans.
METHODS: The proposed framework uses residual UNet (ResUNet) architecture and local region-based segmentation. The algorithm begins by segmenting the liver, followed by malignancies within the liver envelope. First, ResUNet trained on labeled CT images predicts the coarse liver pixels. Further, the region-level segmentation helps determine the tumor and improves the overall segmentation map. The model is tested on a public 3D-IRCADb dataset.
RESULTS: Two metrics, namely dice coefficient and volumetric overlap error (VOE), were used to evaluate the performance of the proposed method. ResUNet model achieved dice of 0.97 and 0.96 in segmenting liver and tumor, respectively. The value of VOE is also reduced to 1.90 and 0.615 for liver and tumor segmentation.
CONCLUSION: The proposed ResUNet model performs better than existing methods in the literature. Since the proposed model is built using U-Net, the model ensures quality and precise dimensions of the output.
Association of decreased estimated glomerular filtration rate with lung cancer risk in the Korean population
Authors: Shin Soonsu , Kim Min-Ho , Oh Chang-Mo , Chun Hyejin , Ha Eunhee , Lee Hyo Choon , Moon Seong Ho , Lee Dong-Young , Cho Dosang , Lee Sangho , Jung Min Hyung , Ryoo Jae-Hong
Published: March 2024

OBJECTIVES: Inconsistent results are available regarding the association between low estimated glomerular filtration rate (eGFR) and lung cancer risk. We aimed to explore the risk of lung cancer according to eGFR category in the Korean population.METHODS: We included 358,293 adults who underwent health checkups between 2009 and 2010, utilizing data from the National Health Insurance Service-National Sample Cohort. Participants were categorized into 3 groups based on their baseline eGFR, as determined using the Chronic Kidney Disease Epidemiology Collaboration equation: group 1 (eGFR ≥90 mL/min/1.73 m2), group 2 (eGFR ≥60 to <90 mL/min/1.73 m2), and group 3 (eGFR <60 mL/min/1.73 m2). Incidences of lung cancer were identified using the corresponding codes from the International Classification of Diseases, 10th revision. Multivariate Cox proportional hazard models were employed to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for lung cancer incidence up to 2019.RESULTS: In multivariate analysis, group 2 exhibited a 26% higher risk of developing lung cancer than group 1 (HR, 1.26; 95% CI, 1.19 to 1.35). Furthermore, group 3 demonstrated a 72% elevated risk of lung cancer relative to group 1 (HR, 1.72; 95% CI, 1.58 to 1.89). Among participants with dipstick proteinuria of 2+ or greater, group 3 faced a significantly higher risk of lung cancer than group 1 (HR, 2.93; 95% CI, 1.37 to 6.24).CONCLUSIONS: Low eGFR was significantly associated with increased lung cancer risk within the Korean population. A particularly robust association was observed in individuals with severe proteinuria, emphasizing the need for further investigation.
Renormalization in one-dimensional dynamics
Authors: Skripchenko Alexandra Sergeevna
Published: March 2024

The study of the dynamical and topological properties of interval exchange transformations and their natural generalizations is an important problem, which lies at the intersection of several branches of mathematics, including dynamical systems, low-dimensional topology, algebraic geometry, number theory, and geometric group theory. The purpose of the survey is to make a systematic presentation of the existing results on the ergodic and geometric characteristics of the one-dimensional maps under consideration, as well as on the measured foliations on surfaces and two-dimensional complexes that one can associate with these maps. These results are based on the research of the ergodic properties of the renormalization process - an algorithm that takes an original dynamical system and builds a sequence of equivalent dynamical systems with a smaller support set. For all dynamical systems considered in the paper these renormalization algorithms can be viewed as multidimensional fraction algorithms.
Bibiliography: 74 titles.
Is there a need for universal double reflex testing of HBsAg-positive individuals for hepatitis D infection?
Authors: Abbas Zaigham , Abbas Minaam
Published: March 2024

Hepatitis D virus (HDV) can infect HBsAg-positive individuals, causing rapid fibrosis progression, early decompensation, increased hepatocellular carcinoma risk, and higher mortality than hepatitis B virus (HBV) mono-infection. Most countries lack high-quality HDV prevalence data, and the collection techniques employed often bias published data. In recent meta-analyses, HDV prevalence in HBsAg-positive patients reaches 5%-15% and is even significantly higher in endemic areas. Since HBV vaccination programs were implemented, HDV prevalence has decreased among younger populations. However, owing to immigrant influx, it has increased in some Western countries. The current practice of HDV screening in HBsAg-positive individuals is stepwise, based on physician’s discretion, and limited to at-risk populations and may require numerous visits. Double reflex testing, which includes anti-HDV testing in all HBsAg-positive individuals and then HDV RNA testing for anti-HDV-positive ones, is uncommon. Reflex testing can identify more HDV infection cases and link identified patients to further care and follow-up. Moreover, laboratory-based double reflex screening is less biased than physician-led testing. Therefore, healthcare providers should learn about reflex testing, and federal and provincial hepatitis control programs should implement laboratory-based double reflex testing to obtain reliable HDV prevalence estimates. The test’s cost-effectiveness depends on the number of HBV-positive patients screened to identify one HDV-positive patient. Such testing may be viable in areas with low HBsAg but high HDV prevalence. However, its economic impact on areas with low HDV prevalence needs further study.
Non-alcoholic fatty liver disease and sleep disorders
Authors: Bu Lu-Fang , Xiong Chong-Yu , Zhong Jie-Yi , Xiong Yan , Li Dong-Ming , Hong Fen-Fang , Yang Shu-Long
Published: March 2024

Studies have shown that non-alcoholic fatty liver disease (NAFLD) may be associated with sleep disorders. In order to explore the explicit relationship between the two, we systematically reviewed the effects of sleep disorders, especially obstructive sleep apnea (OSA), on the incidence of NAFLD, and analyzed the possible mechanisms after adjusting for confounding factors. NAFLD is independently associated with sleep disorders. Different sleep disorders may be the cause of the onset and aggravation of NAFLD. An excessive or insufficient sleep duration, poor sleep quality, insomnia, sleep-wake disorders, and OSA may increase the incidence of NAFLD. Despite that some research suggests a unidirectional causal link between the two, specifically, the onset of NAFLD is identified as a result of changes in sleep characteristics, and the reverse relationship does not hold true. Nevertheless, there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD. Further research is needed to establish a clear relationship between NAFLD and sleep disorders. This will lay the groundwork for earlier identification of potential patients, which is crucial for earlier monitoring, diagnosis, effective prevention, and treatment of NAFLD.
Comparison of fungal vs bacterial infections in the medical intensive liver unit: Cause or corollary for high mortality?
Authors: Khan Sarah , Hong Hanna , Bass Stephanie , Wang Yifan , Wang Xiao-Feng , Sims Omar T , Koval Christine E , Kapoor Aanchal , Lindenmeyer Christina C
Published: March 2024

BACKGROUND

Due to development of an immune-dysregulated phenotype, advanced liver disease in all forms predisposes patients to sepsis acquisition, including by opportunistic pathogens such as fungi. Little data exists on fungal infection within a medical intensive liver unit (MILU), particularly in relation to acute on chronic liver failure.

AIM

To investigate the impact of fungal infections among critically ill patients with advanced liver disease, and compare outcomes to those of patients with bacterial infections.

METHODS

From our prospective registry of MILU patients from 2018-2022, we included 27 patients with culture-positive fungal infections and 183 with bacterial infections. We compared outcomes between patients admitted to the MILU with fungal infections to bacterial counterparts. Data was extracted through chart review.

RESULTS

All fungal infections were due to Candida species, and were most frequently blood isolates. Mortality among patients with fungal infections was significantly worse relative to the bacterial cohort (93% vs 52%, P < 0.001). The majority of the fungal cohort developed grade 2 or 3 acute on chronic liver failure (ACLF) (90% vs 64%, P = 0.02). Patients in the fungal cohort had increased use of vasopressors (96% vs 70%, P = 0.04), mechanical ventilation (96% vs 65%, P < 0.001), and dialysis due to acute kidney injury (78% vs 52%, P = 0.014). On MILU admission, the fungal cohort had significantly higher Acute Physiology and Chronic Health Evaluation (108 vs 91, P = 0.003), Acute Physiology Score (86 vs 65, P = 0.003), and Model for End-Stage Liver Disease-Sodium scores (86 vs 65, P = 0.041). There was no significant difference in the rate of central line use preceding culture (52% vs 40%, P = 0.2). Patients with fungal infection had higher rate of transplant hold placement, and lower rates of transplant; however, differences did not achieve statistical significance.

CONCLUSION

Mortality was worse among patients with fungal infections, likely attributable to severe ACLF development. Prospective studies examining empiric antifungals in severe ACLF and associations between fungal infections and transplant outcomes are critical.
Palliative long-term abdominal drains vs large volume paracenteses for the management of refractory ascites in end-stage liver disease
Authors: Kaur Senamjit , Motta Rodrigo V , Chapman Bryony , Wharton Victoria , Collier Jane D , Saffioti Francesca
Published: March 2024

BACKGROUND

Long-term abdominal drains (LTAD) are a cost-effective palliative measure to manage malignant ascites in the community, but their use in patients with end-stage chronic liver disease and refractory ascites is not routine practice. The safety and cost-effectiveness of LTAD are currently being studied in this setting, with preliminary positive results. We hypothesised that palliative LTAD are as effective and safe as repeat palliative large volume paracentesis (LVP) in patients with cirrhosis and refractory ascites and may offer advantages in patients’ quality of life.

AIM

To compare the effectiveness and safety of palliative LTAD and LVP in refractory ascites secondary to end-stage chronic liver disease.

METHODS

A retrospective, observational cohort study comparing the effectiveness and safety outcomes of palliative LTAD and regular palliative LVP as a treatment for refractory ascites in consecutive patients with end-stage chronic liver disease followed-up at our United Kingdom tertiary centre between 2018 and 2022 was conducted. Fisher’s exact tests and the Mann-Whitney U test were used to compare qualitative and quantitative variables, respectively. Kaplan-Meier survival estimates were generated to stratify time-related outcomes according to the type of drain.

RESULTS

Thirty patients had a total of 35 indwelling abdominal drains and nineteen patients underwent regular LVP. The baseline characteristics were similar between the groups. Prophylactic antibiotics were more frequently prescribed in patients with LTAD (P = 0.012), while the incidence of peritonitis did not differ between the two groups (P = 0.46). The incidence of acute kidney injury (P = 0.014) and ascites/drain-related hospital admissions (P = 0.004) were significantly higher in the LVP group. The overall survival was similar in the two groups (log-rank P = 0.26), but the endpoint-free survival was significantly shorter in the LVP group (P = 0.003, P < 0.001, P = 0.018 for first ascites/drain-related admission, acute kidney injury and drain-related complications, respectively).

CONCLUSION

The use of LTAD in the management of refractory ascites in palliated end-stage liver disease is effective, safe, and may reduce hospital admissions and utilisation of healthcare resources compared to LVP.
Penjadwalan Pembelajaran Narapidana: Penerapan Algoritma Genetika di LPKA Kelas I Tanjung Gusta Medan
Authors: Siagian Yun Betry , Santoso Heri , Irawan Muhammad Dedi
Published: March 2024

Penjadwalan pendidikan merupakan masalah umum yang sering dihadapi, terutama terkait ketidaksesuaian antara jam belajar dan ketersediaan guru. Untuk mengatasinya, diperlukan ketelitian yang hati-hati dan waktu yang cukup untuk menyusun jadwal pelajaran. Algoritma genetika muncul sebagai pilihan yang tepat untuk menangani penjadwalan mata pelajaran di sekolah karena kemampuannya menyelesaikan masalah multi-kriteria dan multi-objektif yang terinspirasi dari evolusi biologis. Konsep algoritma genetika dapat diterapkan secara efektif dalam konteks penyusunan jadwal di institusi pendidikan. Penelitian ini menggunakan metodologi kuantitatif dan menerapkan metode pengembangan sistem Rapid Application Development (RAD). Penggunaan algoritma genetika dalam penyusunan jadwal mata pelajaran, seperti yang ditunjukkan dalam penelitian ini, dapat memberikan manfaat bagi lembaga pemasyarakatan yang sebelumnya melakukan proses penyusunan jadwal secara manual. Hasilnya menunjukkan kesuksesan pendekatan algoritma genetika dalam menyelesaikan masalah penjadwalan sekolah dengan mencari kombinasi penjadwalan optimal, yang terbukti dengan mencapai nilai kecocokan maksimal dan kesalahan minimal (dalam kasus ini, kesalahan bernilai 0), menunjukkan tidak adanya bentrok jadwal pelajaran.
Ultrasound-guided percutaneous nephrostomy: Analysis of early complications in a prospective descriptive cross-sectional study at a tertiary care center
Authors: Pandey Bishnu , Katwal Shailendra , Bhandari Sushmita , Ansari Mukhtar Alam
Published: March 2024

Background: Percutaneous nephrostomy (PCN) is a crucial intervention for urinary obstruction. Understanding indications, complications, and materials used enhances its clinical application.
Objective: This study aims to identify PCN indications, assess tube types/materials, evaluate early complications, and determine PCN success rates, fostering improved outcomes and procedural refinement.
Materials and Methods: This study was carried out in the interventional radiology suite of the Department of Radiodiagnosis and Imaging, Tribhuvan University Teaching Hospital (TUTH) on 74 patients for one year. Patients of all age groups who underwent PCN were included in the study. Indications for PCN were identified before the procedure using various imaging modalities like Ultrasonography (USG), Computed Tomography (CT) scan, and more. The type of approach, calyx punctured, the size of the tube chosen, and the type of the drain material were all recorded during the procedure or in the post-procedure note. The patients were evaluated daily, and USG was done in every patient after 48 hours of the procedure to evaluate in terms of any complications.
Results: Ninety-eight PCNs were done on 74 patients, of whom 58 were males and 40 were females. The main reasons for PCN were calculus disease with hydronephrosis (44.9%), calculus disease with pyonephrosis (22.4%), and obstructive uropathy due to bladder or cervix carcinoma. The success rate for PCN on the first attempt was 89.8%, while 6.1% required two attempts and 4.1% needed more than two attempts. Complications included tube dislodgement (8.2%), urinoma (5.1%), major bleeding (3%), and retroperitoneal hematoma (1%). No new cases of sepsis occurred post-procedure.
Conclusion: Percutaneous nephrostomy is a safe and simple procedure with low morbidity and no life-threatening complications.
Faecaloid like material in the urinary bladder: A radiological finding in a patient with urinary tract fungal bezoar infection
Authors: BAHRIN Abdul Hadi Shamsul , Jamali Ahmad Aizuddin Mohamad , Sayuti Khairil Amir , Haron Juhara , Ismail Zul Khairul Azwadi , Puteh Othman , Daud Mohamed Ashraf Mohamed
Published: March 2024

Fungal colonization or infection of the urinary tract system is caused by Candida species. Fungal intravesical bezoars, however, are extremely rare. Radiological features may mimic the appearance of emphysematous cystitis, which makes the radiological diagnosis challenging. We present an unusual case of urinary bladder fungal bezoar caused by Candida tropicalis.
Responsibility of the Radiologists as a Clinician: RCRT Perspective and Short Message of the ESR International Forum 2023, Vienna, Austria
Authors: Kaewchur Tawika
Published: March 2024

The European Society of Radiology (ESR) internal forum is held in the European Congress of Radiology (ECR) every year and this year, under the theme "Responsibility of the Radiologists as a Clinician", on March 3, 2023. The representatives of twenty-two international societies were invited to present their perspectives and discussions as ESR's global society stakeholders.
Polychlorinated biphenyls (PCBs) in sediments and fish from dredged tributaries and creeks of river Ethiope, South-South, Nigeria: sources, risk assessment and bioaccumulation
Authors: Eyenubo B. O. , Peretomode V. O. , Egharevba F. , Osakwe S. A. , Avwioro O. G.
Published: March 2024

Polychlorinated biphenyls (PCBs) are persistent organic pollutants that are ubiquitous in nature. In this study, the levels of PCBs were evaluated in sediments and fish samples obtained from dredged tributaries and creeks of River Ethiope. The work also assessed the possible relationship between the parameters and risks posed by polychlorinated biphenyls via several pollution indices. The mean concentrations of \sum PCBs on the sediments spanned from 645 – 3,977 µg/kg (wet season) to 252 – 1,219 µg/kg (dry season) dry weight. The concentrations of PCBs in fishes were 1,688 µg/kg (wet season) and 557 µg/kg (dry season). Higher bioaccumulation factors were observed with lower molecular weight PCBs than the higher ones (9 – Hexa – PCB, 8- Tetra- PCB). The results of the ecological risk (160 \leq Eri < 320), and human health risk (\geq 10-4 to 10-3-\leq 10-6), showed moderately to very high contamination and also moderately to very high cancer risk for children and adults. The strong positive correlation between PCB-114 and PCB-77, PCB-81, PCB-105 (r2 = 1.00, 0.99 & 1.00, p < 0.01) and the risks assessment values which ranged from 6.10 × 10-3 to 1.47 × 10-2 for children and 6.30 × 10-4 to 1.11 × 10-3 for adults (wet season), 1.04 × 10-3 to 2.99 × 10-2 for children and 7.80 × 10-5 to 5.61 × 10-1 for adults (dry season), showed rarely to adversely high potential ecological risk, biological effect and human health risk across the environment. The data show that higher levels of PCBs were observed in sediments and fish samples when compared with available standards. Considering the ILCR, hazard index, toxic equivalent, the sediments and fish obtained from these sites would be considered risky for humans. Dredging activities are majorly responsible for the high levels of PCBs across the sites. These have contributed significantly to the environmental status of the studied area.
DESAFIOS E POSSIBILIDADES PARA O ENSINO DA TABELA PERIÓDICA EM TURMAS DO 1º ANO DO ENSINO MÉDIO EM UMA ESCOLA PÚBLICA CEARENSE
Authors: Araújo Fábio José de , Ferreira Ana Paula Freitas , Fonteles Antonia Jane Cleide Sampaio , Santos Flávia Maria Matos Santos dos , Nascimento Maraléia Silva Nogueira do
Published: March 2024

Este estudo investigou as estratégias mais eficazes de ensino de química e da tabela periódica. A vivência foi realizada em uma escola pública do interior do Ceará em três turmas de 1º ano do Ensino Médio. Os resultados mostraram que as dificuldades no ensino desses temas estão relacionadas à falta de interesse dos alunos, bem como do baixo rendimento escolar, falta de recursos didáticos e problemas de indisciplina. Por outro lado, as possibilidades encontradas estão relacionadas à utilização de metodologias ativas e contextualizadas, uso de recursos audiovisuais e experimentais e formação continuada dos professores. A conclusão é que é necessária uma mudança de paradigma no ensino de química e da tabela periódica, de forma a torná-los mais atrativos e significativos para os alunos, tornando o aprendizado mais efetivo e satisfatório.
ANÁLISE DA PIORA NA QUALIDADE NUTRICIONAL DA POPULAÇÃO BRASILEIRA
Authors: Passos Luiz Marcelo , Silva Glyciane Vieira da , Lima Junior Izaias Nunes de , Krohling Joana Paula Ramos , Dill Thaís Freitas
Published: March 2024

Neste artigo, o objetivo é promover uma reflexão sobre a relação entre os hábitos alimentares e os alimentos industrializados. Com base na leitura de textos, pretende-se trazer à tona informações pertinetes sobre a influencia alimentar nociva à saúde coletiva, conhecer o processo de identificação de componentes presentes nos alimentos industrializados, evidenciando assim os malefícios de sua ingestão exagerada para nossa saúde. Fatores como inflamação crônica a nível celular muitas vezes induzida por alimentos processados, pobres em nutrientes e ricos em carboidratos refinados e gorduras Trans, desempenham um papel crítico para a saúde humana. O consumo de alimentos ultraprocessados é responsável por aproximadamente 57 mil mortes prematuras de pessoas entre 30 e 69 anos por ano no Brasil. No Brasil, em 2022, a média nacional apontou que 31,2% dos adolescentes estavam com excesso de peso, quase o dobro da média global (18,2%).
O PAPEL DO DESIGN INSTRUCIONAL NA EDUCAÇÃO A DISTÂNCIA
Authors: Ricardo Fabiana Pereira de Aguiar , Silva Ana Walquíria Souza da , Lima Antonio Guilherme da Cruz , Costa Elionides José da , Figueirôa Lindalva Mendonça de
Published: March 2024

Este trabalho tem objetivo de apresentar a nova perspectiva da educação a distância em uma sociedade em constante crescimento na era da tecnologia da informação e comunicação. A Educação é uma das áreas que vem experimentando essas mudanças de forma significativa, e diante desse cenário surgiu uma nova área de atuação, o Design Instrucional com foco no desenvolvimento de cursos e treinamentos de forma estruturada e sistemática. Outro item importante apontado neste estudo é as vantagens e desvantagens da aprendizagem autogerida dos cursos da educação a distância. A reflexão proposta deste estudo ocorreu por meio de uma revisão de literatura, tendo como fonte de dados a Biblioteca Digital, bem como a revisão bibliográfica realizada a partir do referencial teórico apresentado na disciplina “Princípios do Design Instrucional”. O trabalho exprime a integração da tecnologia na educação a distância, mediante a participação efetiva de um profissional da área de design instrucional na arquitetura dos cursos e treinamentos.
AS DIFICULDADES ENFRENTADAS POR PROFESSORES DENTRO DO ESPAÇO ESCOLAR NUM PONTO DE VISTA DA EDUCAÇÃO ESPECIAL E INCLUSIVA COM ALUNOS DO ENSINO FUNDAMENTAL E MÉDIO
Authors: Mungo Wesley Schulz , Costa Elionides José da , Pereira Filomena Alves , Meroto Monique Bolonha das Neves , Oliveira Nivaldo Pedro de
Published: March 2024

O texto aborda a importância da inclusão de crianças com deficiência no ensino fundamental e médio, ressaltando as vantagens e desvantagens dessa prática. Destaca-se a necessidade de formação continuada para os professores, visando à adequação das práticas pedagógicas às necessidades dos alunos. Aponta-se que a inclusão escolar deve garantir o acesso de qualidade, respeitando a personalidade e dignidade de cada criança. São mencionadas as diversas barreiras enfrentadas pelos professores, como formação insuficiente, falta de apoio pedagógico e infraestrutura inadequada, que comprometem a efetividade da inclusão. vA reflexão sobre os obstáculos em sala de aula não se restringe aos professores, mas envolve a sociedade como um todo, destacando que a promoção da inclusão é um investimento na construção de uma sociedade mais justa e igualitária. A educação inclusiva é vista como um caminho para a transformação social, garantindo o acesso de todos a uma educação de qualidade.
An Intelligent E-Pharmacopoeia Retrieval System Using Responsive Web Design
Authors: Tian-Hsiang Huang  , Wan-Ling Chao  , Kao-Shing Hwang  , Yao-Mei Chen  , Wen-Hsien Ho
Published: March 2024

To develop an e-pharmacopeia retrieval mobile system aimed at assisting medical personnel in efficiently assessing precise drug information and ensuring patient safety, this study utilized responsive web design. The research framework incorporated the convergence of the technology acceptance model (TAM) and the information systems success model (ISSM) to investigate user satisfaction and continuance intention. A survey was administered to 151 pharmacy students who had utilized the system for over 30 minutes. The findings revealed that the TAM-ISSM model significantly influenced user satisfaction, surpassing the individual impacts of TAM and ISSM. Furthermore, user satisfaction exhibited a positive and significant impact on continuance intention, which, in turn, demonstrated a positive and significant influence on both individual and organizational performance. This suggests that the proposed system is proficient in accurately identifying and processing drugs, thereby mitigating the pain induced by diseases in patients.
Closed-House Biofilter Design and Performance Evaluation for Mitigating Environmental Odor Disturbances
Authors: Adinda Rizki Virginia  , Arief Sabdo Yuwono  , Chusnul Arif
Published: March 2024

Broiler-closed houses typically lack reduction technology, leading to environmental issues, namely odor. Processing technology can be used, namely biofilters. This study aims to design and construct a closed-house biofilter and perform a test on the biofilter to reduce odors. Odors are measured by the odor gas concentration (ammonia and hydrogen sulfide) and hedonic scale by the panel method. The biofilter consisted of an odor source (closed house), a humidifier, and a biofilter reactor. Factors that influence the size of the biofilter reactor from gas removal activities include air flow rate, retention time, and air volume. The proposed biofilter can reduce the odor from the broiler. Reactor temperature, relative humidity, and bacterial activity affect odor reduction. This successful implementation of a biofilter significantly mitigates odors in a closed-house broiler, addressing a critical environmental concern.