bluuebunny/crossref_metadata_2025 huggingface dataset:
РОЗРОБКА УФ-СПЕКТРОФОТОМЕТРИЧНОЇ МЕТОДИКИ КІЛЬКІСНОГО ВИЗНАЧЕННЯ ЛЕВОЦЕТИРИЗИНУ В ТАБЛЕТКАХ З ВИКОРИСТАННЯМ ПРИНЦИПІВ “ЗЕЛЕНОЇ” ХІМІЇ
Authors: Михалків М. М. , Сіньковська В. О. , Івануса І. Б. , Горин М. М. , Демид А. Є.
Published: October 2024

Вступ. Левоцетиризин є R-енантiомером або активним iзомером цетиризину, який часто використовують для лікування алергічних реакцій. У наукових джерелах описано, головним чином, методики з використанням диференційної спектрофотометрії, високоефективної рідинної хроматографії, які вимагають дорогого обладнання, складних математичних обрахунків і не завжди відповідають екологічній безпеці. Тоді як спектрофотометрія в УФ-ділянці належить до фармакопейних методів аналізу, що має ряд переваг: експресність, економічність, незначна вартість аналізу, широке використання при аналізі лікарських засобів.
Мета дослідження – розробити просту, експресну, “зелену”, недорогу УФ-спектрофотометричну методику кількісного визначення левоцетиризину в таблетках.
Методи дослідження. Для виконання експериментальних досліджень було використано фармакопейний стандартний зразок левоцетиризину дигідрохлориду і таблетки “Алерзин” 5 мг (виробник “Egis”, Угорщина), серія № 3161С0722. Спектрофотометричні вимірювання проводили на двопроменевому сканувальному спектрофотометрі Shimadzu UV-1800 (Японія) з програмним забезпеченням UV-Probe 2.62.
Результати й обговорення. Етанольний розчин фармакопейного стандартного зразка левоцетиризину дигідрохлориду й етанольний розчин таблеток, що містить левоцетиризину дигідрохлорид, мали виражені максимуми поглинання в абсорбційному спектрі при 233 нм. Межа виявлення становила 1,02 мкг/мл, межа кількісного визначення – 3,39 мкг/мл. Представлено також рівняння регресії – у = 0,0261х – 0,0697, коефіцієнт кореляції – 0,9993. Лінійність спостерігали на всьому діапазоні застосування розробленої методики кількісного визначення (9,24–36,97 мкг/мл). Оцінка “зеленості” запропонованої методики вказує на те, що аналітична методика є відмінною відповідно до принципів “зеленої” хімії.
Висновки. Розроблено і валідовано УФ-спектрофотометричну методику кількісного визначення левоцетиризину в таблетках, яка є достатньо експресною та “зеленою”. Як розчинник було використано етанол Р. Вимірювання оптичної густини випробовуваного розчину та розчину порівняння необхідно проводити при довжині хвилі 233 нм.
Impaired Renal Function With Higher Remnant Cholesterol Related to Risk of Atherosclerotic Cardiovascular Disease: A Cohort Study
Authors: Elías-López Daniel , Vedel-Krogh Signe , Kobylecki Camilla Jannie , Wadström Benjamin Nilsson , Nordestgaard Børge Grønne
Published: October 2024

BACKGROUND:

Chronic kidney disease confers a high risk of atherosclerotic cardiovascular disease (ASCVD), partly due to hyperlipidemia. Although statins reduce the risk of ASCVD in chronic kidney disease, residual risk persists. We investigated whether higher remnant cholesterol is associated with an increased risk of ASCVD in statin users and nonusers with impaired renal function.

METHODS:

We included 107 925 individuals from CGPS (Copenhagen General Population Study) initiated in 2003 to 2015, of whom 10 427 had impaired renal function (estimated glomerular filtration rate, <60 mL/min per 1.73 m
2
). Remnant cholesterol was calculated from a standard lipid profile. ASCVD was myocardial infarction, coronary heart disease death, ischemic stroke, coronary artery bypass graft, or percutaneous coronary intervention extracted from Danish nationwide health registries from baseline through 2018; individuals with events before the start of follow-up were excluded from relevant analysis.

RESULTS:

In individuals with impaired renal function during up to 15 years of follow-up, 597 were diagnosed with myocardial infarction, 618 with ischemic stroke, and 1182 with ASCVD. In these individuals, a 1-mmol/L (39 mg/dL) higher remnant cholesterol level was associated with multivariable-adjusted hazard ratios of 1.22 (95% CI, 1.05–1.42) for myocardial infarction, 1.16 (95% CI, 0.97–1.38) for ischemic stroke, and 1.21 (95% CI, 1.08–1.36) for ASCVD. Corresponding hazard ratios for ASCVD were 1.40 (95% CI, 1.07–1.83) in statin users and 1.16 (95% CI, 1.01–1.34) in nonusers. Of the 1.36-fold excess risk of ASCVD in impaired versus normal renal function, elevated remnant cholesterol and elevated LDL (low-density lipoprotein) cholesterol explained 25% (95% CI, 2.5%–47%) and 0% in statin users and 8.3% (95% CI, 2.4%–14%) and 14% (95% CI, 6.4%–22%) in nonusers, respectively.

CONCLUSIONS:

Our results suggest that higher remnant cholesterol is a good marker of increased risk of ASCVD in individuals with impaired renal function, while higher LDL cholesterol may not be. Patients with chronic kidney disease who have high levels of remnant cholesterol are identifiable through higher non-HDL (high-density lipoprotein) cholesterol or apoB levels.
Performance of Atrial Fibrillation Burden Trends for Stroke Risk Stratification
Authors: Piccini Jonathan P. , Stanelle Evan J. , Johnson Cody C. , Hylek Elaine M. , Kanwar Rahul , Lakkireddy Dhanunjaya R. , Mittal Suneet , Peacock James , Russo Andrea M. , Soderlund Dana , Hills Mellanie True , Passman Rod S.
Published: October 2024

BACKGROUND:

Atrial fibrillation (AF) is associated with an increased risk of stroke, yet the limitations of conventional monitoring have restricted our understanding of AF burden risk thresholds. Predictive algorithms incorporating continuous AF burden measures may be useful for predicting stroke. This study evaluated the performance of temporal AF burden trends as predictors of stroke from a large cohort with insertable cardiac monitors.

METHODS:

Using deidentified data from Optum Clinformatics Data Mart (2007–2019) linked with the Medtronic CareLink insertable cardiac monitor database, we identified patients with an insertable cardiac monitor for AF management (n=1197), suspected AF (n=1611), and cryptogenic stroke (n=2205). Daily AF burden was transformed into simple moving averages, and temporal AF burden trends were defined as the comparison of unique simple moving average pairs. Classification trees were used to predict ischemic stroke, and AF burden significance was quantified using bootstrapped mean variable importance.

RESULTS:

Of 5013 patients (age, 69.2±11.7 years; 50% male; CHA
2
DS
2
-VASc, 3.7±1.9) who met inclusion criteria, 869 had an ischemic stroke over 2 409 437 days total follow-up. Prior stroke or transient ischemic attack (variable importance, 13.13) was the number 1 predictor of future stroke followed by no prior diagnosis of AF (7.35) and AF burden trends in follow-up (2.59). Temporal proximity of AF and risk of stroke differed by device indication (simple moving averages: AF management, <8 days and suspected AF and cryptogenic stroke, 8–21 days). Together, baseline characteristics and AF burden trends performed optimally for the area under the receiver operating characteristic curve (0.73), specificity (0.70), and relative risk (5.00).

CONCLUSIONS:

AF burden trends may provide incremental prognostic value as leading indicators of stroke risk compared with conventional schemes.
Using Atrial Fibrillation Burden Trends and Machine Learning to Predict Near-Term Risk of Cardiovascular Hospitalization
Authors: Peacock James , Stanelle Evan J. , Johnson Lawrence C. , Hylek Elaine M. , Kanwar Rahul , Lakkireddy Dhanunjaya R. , Mittal Suneet , Passman Rod S. , Russo Andrea M. , Soderlund Dana , Hills Mellanie True , Piccini Jonathan P.
Published: October 2024

BACKGROUND:

Atrial fibrillation is associated with an increased risk of cardiovascular hospitalization (CVH), which may be triggered by changes in daily burden. Machine learning of dynamic trends in atrial fibrillation burden, as measured by insertable cardiac monitors (ICMs), may be useful in predicting near-term CVH.

METHODS:

Using Optum’s deidentified Clinformatics Data Mart Database (2007–2019), linked with the Medtronic CareLink ICM database, we identified patients with >1 days of ICM-detected atrial fibrillation. ICM-detected diagnostic parameters were transformed into simple moving averages over different periods for daily follow-up. A diagnostic trend was defined as the comparison of 2 simple moving averages of different periods for each diagnostic parameter. CVH was defined as any hospital, emergency department, or ambulatory surgical center encounter with a cardiovascular diagnosis-related group or diagnosis code. Machine learning was used to determine which diagnostic trends could best predict patient risk 5 days before CVH.

RESULTS:

A total of 2616 patients with ICMs met the inclusion criteria (71±11 years; 55% male). Among them, 1998 (76%) had a planned or unplanned CVH over 605 363 days. Machine learning revealed distinct groups: (A) sinus rhythm (reference), (B) below-average burden, (C) above-average burden, and (D) above-average burden with decreasing patient activity. The relative risk was increased in all groups versus the reference (B, 4.49 [95% CI, 3.74–5.40]; C, 8.41 [95% CI, 7.00–10.11]; D, 11.15 [95% CI, 9.10–13.65]), including a 21% increase in CVH detection over prespecified burden thresholds of duration (≥1 hour) and quantity (≥5%). The area under the receiver operating characteristic curve increased from 0.55 when using hourly burden amounts to 0.66 when using burden trends and decreasing patient activity (
P
<0.001), a 20% increase in predictive power.

CONCLUSIONS:

Trends in atrial fibrillation were strongly associated with near-term CVH, especially above-average burden coupled with low patient activity. This approach could provide actionable information to guide treatment and reduce CVH.
The Institutionalisation of Power-Sharing in Zanzibar: Strengths and Challenges
Authors: Haji Moh’d J.
Published: October 2024

In 2010, Zanzibar presented a distinctive example of power-sharing in Africa. The introduction of power-sharing governance system was preceded by a referendum, which set the stage for a subsequent constitutional amendment to facilitate this governance approach on the Island. This model was adopted to address the region’s longstanding and entrenched political issues. Despite the strong base of its adoption, power sharing has shown ups and downs throughout its life, passing through the boycott from 2015 to 2020 and the 2020 electoral violence. This study examines the strengths and challenges of power-sharing in Zanzibar, focusing on its potential path for its institutionalization. The study used a qualitative research design, with interviews and documentary reviews as data collection methods. The findings indicate that while power-sharing in Zanzibar benefits from robust public support, which complicates efforts to eliminate or alter it, the system encounters various institutional and behavioral challenges that impede its full institutionalization.
Reflections on Forty Years of Muqarnas: The Broadened Range of Publication Venues for Islamic Art and Architectural History
Authors: Necipoğlu Gülru
Published: October 2024

On the occasion of the fortieth anniversary of Muqarnas, I examine the place of this groundbreaking publication in a changing scholarly landscape. Even though the field of Islamic/Islamicate studies has burgeoned—as evidenced by the establishment in recent years of many specialized series and journals—Muqarnas continues to fulfill the enduring need for a global perspective open to all subjects and critical methods. My “Reflections” combine a historiography of the journal with an overview of more specialized new publication venues, while highlighting the reasons for the revised title: Muqarnas: An Annual on Visual, Material, and Architectural Cultures of the Islamic World.
Stem and root anatomy of Zanonia indica L. (Cucurbitaceae) and significant adaptations of the aerial roots
Authors: Lekhak Manoj M. , Gondaliya Amit D. , Yadav S.R. , Ghane S.G. , Rajput Kishore S.
Published: October 2024

The physiological and ecological adaptions of higher plants are driven by anatomical changes that contribute to the evolution of the climbing habit. This not only makes them able to survive in a dry environment but also supports them to undergo secondary growth and complete their reproduction. Some plants even form aerial roots as a survival strategy. In the present study, the anatomy of both aerial and underground roots and stems in Zanonia indica L. (Cucurbitaceae) is investigated. In young stems, vascular bundles (VB) had sieve elements on the inner margin of the protoxylem elements (i.e., bicollateral VB). In stems as well as aerial and underground roots, the axial elements of the secondary xylem were arranged in radial plates separated by wide medullary rays. Aerial and underground roots shared similar features in having exarch protoxylem and distinct narrow piths. Structurally, the secondary xylem was composed of vessels, tracheids, fibres, axial and ray parenchyma cells while extra-fascicular sieve elements were observed only in stems and aerial roots. The formation of aerial roots is a survival mechanism whose significance is discussed with reference to the available literature.
Barbenigma Powell & Miller, a bizarre new genus and two new species of scale insects (Hemiptera: Coccomorpha: Ortheziidae) from the United States
Authors: POWELL ERIN C. , MILLER DOUGLASS R. , KELLER OLIVER
Published: October 2024

A strange new genus and two species of scale insect from the United States, Barbenigma Powell & Miller, gen. nov. and Barbenigma biza Powell & Miller, sp. nov. and B. boscus Powell & Miller, sp. nov. (Hemiptera: Coccomorpha: Ortheziidae) are described and illustrated, including the adult female and immature stages available. Barbenigma boscus was recently collected in Nebraska on the roots of grasses; B. biza is described from a series of undetermined specimens from Florida found in the Florida State Collection of Arthropods. These species, which have three-segmented antennae, no wax plates, conspicuous clusters of quadrilocular ducts on the abdomen, thoracic and abdominal spiracles set in a ring of pores, legs reduced in size, sparse ornate fimbriate dorsal setae, and very few capitate spines, stretch our current concept of the family Ortheziidae. The anal ring morphology, a fused trochanter and femur, presence of abdominal spiracles, large differentiated setae on the apex and subapex of the terminal segment of the antenna, a reduced number of ventral abdominal segments, and the presence of modified quadrilocular pores (most likely homologous to the ovisac band), support placement in Ortheziidae. We provide an updated phylogenetic analysis of Ortheziidae based on morphological characters with the new species included. The analysis demonstrates that the four species previously placed in the family Carayonemidae and the two new species of Barbenigma form a monophyletic group that should be placed within the Ortheziidae as the subfamily Carayoneminae Richard new synonymy and change of rank. The tribes Carayonemini Richard and Barbenigmini Powell & Miller tribe nov. are proposed as subunits within the subfamily. A revised key to the world species of Carayoneminae is provided.
New species, new records and complementary descriptions of two species of the genus Tenuipalpus Donnadieu (Acari: Tenuipalpidae)
Authors: ELGONI NASRELDEEN AHMED , KAMRAN MUHAMMAD , ALATAWI FAHAD JABER
Published: October 2024

A new species of Tenuipalpus (Acari: Tenuipalpidae), Tenuipalpus farasanensis sp. nov., is described and illustrated based on female and male specimens collected from Salvadora spp. (Salvadoraceae). The discovery of this species leads to the proposal of a new species group, farasanensis, under Tenuipalpus sensu lato, characterized by six pairs of opisthosomal setae. In addition, four Tenuipalpus species, T. combreti Meyer, T. emeticae Meyer, T. tamarixi Mahdavi and Asadi, and T. viticola Al-Gboory, are reported from Saudi Arabia for the first time. Complementary descriptions of T. combreti and T. emeticae are also provided.
A new species of Sphaeronemoura (Plecoptera: Nemouridae) from Guizhou, China with a revised key to males of this genus
Authors: ZHU YA-FEI , DU YU-ZHOU
Published: October 2024

A new species of the genus Sphaeronemoura, S. fanjingshana Zhu & Du, sp. nov., is described from Guizhou Province of southwestern China. The new species is described using color photography and is compared to other similar species in the genus. We also provide a revised key to the adult males of Sphaeronemoura.
On the Generating Mechanisms of Daily Precipitation in the Conterminous United States: Climatology, Trends, and Associated Marginal and Extreme Distributions
Authors: Alshehri Mohammed , Mascaro Giuseppe , Kunkel Kenneth E.
Published: October 2024

A critical task to better quantify changes in precipitation (P) mean and extreme statistics due to global warming is to gain insights into the underlying physical generating mechanisms (GMs). Here, the dominant GMs associated with daily P recorded at 2861 gauges in the conterminous United States from 1980 to 2018 were identified from atmospheric reanalyses and publicly available datasets. The GMs include fronts (FRTs), extratropical cyclones (ETCs), atmospheric rivers (ARs), tropical cyclones (TCs), and North American monsoon (NAM). Climatologies of the GM occurrences were developed for the nonzero P (NZP) and annual P maxima (APM) samples, characterizing the marginal and extreme P distributions, respectively. FRT is everywhere the most frequent (45%–75%) GM of NZP followed by ETC (12%–33%). The FRT contribution declines for APM (19%–66%), which are dominated by AR (50%–65%) in western regions and affected by TC (10%–18%) in southern and eastern regions. The GM frequencies exhibit trends with the same signs over large regions, which are not statistically significant except for an increase in FRT (TC) frequency in the northeast (central region). Two-sample tests showed well-defined spatial patterns with regions where 1) both the marginal and extreme P distributions of the two dominant GMs likely belong to different statistical populations and 2) only the marginal or extreme distributions could be considered statistically different. These results were interpreted through L-moments and parametric distributions that adequately model NZP and APM frequency. This work provides useful insights to incorporate mixed populations and nonstationarity in P frequency analyses.
National Trends in the Creation of Diverting Ileostomy at the Time of Ileal Pouch-Anal Anastomosis in Adults With Ulcerative Colitis
Authors: Adams Ursula C. , Agala Chris B. , Barnes Edward L. , Stem Jonathan M. , Charles Anthony G. , Phillips Michael R.
Published: October 2024

Introduction

The impact of diverting ileostomy in adults with ulcerative colitis (UC) undergoing ileal pouch-anal anastomosis (IPAA) is unclear. This study uses a novel approach with population-level data to identify patients with diverting ileostomy at the time of IPAA and determine the impact of diverting ileostomy on postoperative outcomes.

Methods

Using the International Business Machines (IBM) MarketScan® database, adults (18-64 years old) with a diagnosis of UC who underwent IPAA between 2000 and 2019 were examined. Patients were assigned to the diverting ileostomy (DI) cohort or no-DI cohort based on the presence of an ostomy closure code in the 1-year following their IPAA. Rates of ileostomy formation and readmissions were quantified and outcomes between cohorts compared.

Results

There were 540 patients in the no-DI and 2494 in the DI cohort. There were regional differences in the rate of ostomy creation, but the overall rate of ostomy creation remained stable across years. Patients with no-DI vs DI had a longer index length of stay (LOS) (7 vs 6 days, P = .001). Adverse postoperative outcomes did not differ between cohorts. Diversion did not independently affect the likelihood of a 30-day readmission, and since 2000, readmission rates have declined for all IPAA patients.

Discussion

This is the first study to capture population-level data on the effect of diversion at the time of IPAA for adult UC patients. This study demonstrates that the rate of fecal diversion at the time of IPAA has remained stable over time, but readmission rates have declined.
The “Green Persuasion Effect” of Negative Messages: How and When Message Framing Influences Tourists’ Environmentally Responsible Behavior
Authors: He Xuehuan , Ye Chengzhi , Huang Songshan (Sam) , Su Lujun
Published: October 2024

Tourist activities may harm the environment, making tourists’ environmentally responsible behavior particularly important in tourism research. This research investigates the persuasion effect of message framing in environmental protection reminders on environmentally responsible behavior. Through five studies employing both field and controlled experiments and different measures of environmentally responsible behavior across varied tourism scenarios, we demonstrate that negatively (vs. positively) framed messages more effectively increase environmentally responsible behavior. Specifically, negatively framed messages are more effective in enhancing tourists’ environmental awareness, which triggers more environmentally responsible behavior. Furthermore, we identify social class as a moderator of message framing effectiveness, showing that negatively framed messages are more persuasive for lower-class tourists, whereas positively framed messages are more persuasive for upper-class tourists. These findings advance knowledge on message framing and tourists’ environmentally responsible behavior, reconcile prior research, and offer practical guidance for destinations to encourage environmentally responsible behavior among tourists.
Mapping research trajectories in contemporary Hinduism through bibliometric analysis
Authors: Dash Bibhudatta , Jinde Priyanka , Narasimham G. Lakshmi
Published: October 2024

The concept of Hinduism, though, has been studied in religious studies for a long time; in recent years, publications on Hinduism have been a part of multidisciplinary studies. The present body of publication on Hinduism does not have a systematic literature review, which makes it challenging for the researchers to determine the research scope and know about the current trends, which can be resolved through Bibliometric analysis to obtain a structured overview of the development in this field in the last two decades. In total, 1193 published documents of various types were identified from 2004 to 2024 (excluded) in the Web of Science (WoS) database. The 1193 documents cover 1564 authors who have written documents in over 11 languages from 82 countries and 995 institutes. This research identifies the leading authors, countries, institutions, research areas, journals, and publishers based on the number of published documents. This study also analyses the current trends through keywords and several publications over the last twenty years to reveal how the field of Hinduism has advanced in the production of documents. The findings of this research aim to help researchers to understand the main concepts that define the new horizons of Hinduism.
Fault diagnosis of floating offshore wind turbine based on bidirectional long short-term memory networks with sliding window
Authors: Wu Ping , Huo Yifei , Ni Yuxuan , Wang Yixuan , Wu Zhenquan , Zhang Xujie , Wang Lin , Liu Yichao
Published: October 2024

Owing to its ability to harvest more power in deeper waters than other types of offshore wind turbines, the floating offshore wind turbine (FOWT) has attracted significant interest from both academics and industry. However, deterioration in system performance and unscheduled shutdowns will significantly increase operation and maintenance costs. To avoid system damage and ensure operation safety, there is a great demand for developing FOWT fault diagnosis to detect and identify faults as early as feasible. Due to the enormous complexity of FOWT including dynamics and nonlinearity, effective FOWT fault diagnosis poses a significant challenge. This paper develops a novel FOWT fault diagnosis method using bidirectional long short-term memory (BiLSTM) with sliding window. Firstly, the dynamics are embedded by stacking time-dependent measurements using the sliding window technique. Then, the augmented data is fed into a BiLSTM network to exploit the nonlinearity of FOWT. Consequently, a softmax classifier is used for fault diagnosis. A high-fidelity 10 MW spar FOWT benchmark based on the NREL Fatigue, Aerodynamics, Structures, and Turbulence (FAST) model is used to validate the capability and effectiveness of the proposed method. Experimental results show that the proposed method outperforms other related methods in diagnosing critical faults in FOWTs under various operating conditions.
Growth Beyond Borders: How Technological Innovation and Agricultural Competitiveness Propel Agri-venture Internationalisation
Authors: Tran My-Linh , Hong-Hue Trinh Hoang , Thai Huy-Cuong Vo
Published: October 2024

Amidst the challenges posed by the COVID-19 pandemic, global agricultural trade continued to grow, offering favourable business prospects. Nevertheless, despite its significance, the agricultural sector has received relatively scant attention in mainstream entrepreneurship research. This study addresses this gap by investigating the influence of technological innovations and industry competitiveness on international intensity in new agri-business ventures. To assess the impact of these factors, multilevel linear regression analysis was conducted using a multilevel dataset from the Global Entrepreneurship Monitor’s Adult Population Surveys and the World Bank (2014–2019). The results show that technological innovations—both process and product—and national agricultural competitiveness significantly enhance the international reach of new agri-ventures. Additionally, the effect of a firm’s technological innovations on international expansion is more substantial in countries with higher agricultural competitiveness. This suggests that a supportive industry environment amplifies the benefits of technological innovations in the agricultural sector. The study offers insights for firms aiming for global expansion and policymakers promoting entrepreneurship in agriculture while highlighting areas for future research on agricultural entrepreneurship.
A Study to Assess Personality, Psychological Distress, and Adjustment Difficulties Among Undergraduate Nursing Students in the National Capital
Authors: Anita  , Khakha Deepika C , Bhargava Rachna
Published: October 2024

Background

There has been growing concern about stress in nursing. It is acknowledged as a major part of the student experience and linked to psychological distress and other adverse consequences on student’s health and well-being. Psychological stress depends on students’ personality traits and may lead to adjustment issues.

Aim

To assess personality, psychological distress, and adjustment difficulties among nursing students at All India Institute of Medical Sciences (AIIMS), New Delhi.

Materials and Methods

This cross-sectional descriptive study included 292 participants enrolled in a BSc (Hons) nursing course at the College of Nursing, AIIMS, New Delhi. Data were collected using a questionnaire comprising the big five inventory, general health questionnaire, and adjustment inventory for college students. The reliability of the tools was 0.79, 0.82, and 0.94, respectively. Data were analyzed using descriptive and inferential statistics.

Results

Extrovert and neuroticism were found to be the most dominant type of personality trait among the nursing students. A high level of distress was experienced by 56.2% of the participants with a mean score of 4.8 ± 2.72 while a low level of psychological distress was experienced by 43.8% of the subjects with a mean score of 0.3 ± 0.48. No participant was in the excellent adjustment category while 2.1% of the participants were in the overall good adjustment category. Average overall adjustment was seen in 10.3% of the participants and unsatisfactory and very unsatisfactory overall adjustment was seen in 40.7% and 46.9% of the participants respectively. There was a significant association between neuroticism personality traits and psychological distress ( p < .05). There was a significant association between psychological distress and adjustment and between personality and adjustment ( p < .05). A significant association was also found between neurotic and conscientiousness personality traits with father’s education. Home, health, and educational adjustment were found to be positively correlated with mother’s education. Neuroticism and openness to experience personality traits and educational adjustment were found to have a statistically significant relationship with the duration of sleep. A significant relationship was also seen between psychological distress and health adjustment with the number of close friends.

Conclusion

Extrovert and neuroticism personalities are dominant among nursing students. Psychological distress and unsatisfactory adjustment categories are faced by the majority of the participants. Therefore, a student-friendly environment is needed in the colleges to decrease the level of distress faced by the students and to help them in easy adjustment.
Exercise-Associated Hyponatremic Encephalopathy, Rhabdomyolysis, and Acute Kidney Injury While Hiking in the Grand Canyon
Authors: Myers Thomas M. , Bennett Brad L. , Myers Weston
Published: October 2024

We present an unusual case of concomitant exercise-associated hyponatremic encephalopathy (EAHE), exertional rhabdomyolysis (ER), and acute kidney injury (AKI) in a Grand Canyon hiker. Our case patient, an adult 41-year-old male, consumed an excessive amount of water during his descent into the Canyon during hot weather. The next day, he was unable to hike out due to severe leg pain and disorientation, and ultimately evacuated by helicopter, having a grand mal seizure in flight. Despite having no serum sodium level, medics administered an intravenous (IV) bolus of 3% hypertonic saline (HTS) before transporting him to the hospital. There, he was diagnosed with EAHE (serum sodium, 114 mmol⋅L−1), ER, bilateral compartment syndromes, and mild AKI. The life-threatening EAHE was immediately corrected with more IV HTS, the limb-threatening compartment syndromes by surgical fasciotomies, and eventually, the AKI by oral and IV fluids. This case demonstrates the seriousness of overconsumption of water, as well as the potential complications of muscle damage when a deconditioned person does prolonged, strenuous exercise. Furthermore, it also illustrates the importance of considering EAHE within the differential diagnosis for acute alterations in level of consciousness. Lastly, it shows the importance to prioritize patient treatments for conditions that are an immediate threat to life or limb.
Narrowband Ultraviolet B Phototherapy for Generalized Granuloma Annulare: Real-Life Experience and Review of the Literature
Authors: Acer Ersoy , Kaya Erdoğan Hilal , Ağaoğlu Esra , Bilgin Muzaffer , Saraçoğlu Zeynep Nurhan
Published: October 2024

Introduction:

Generalized granuloma annulare (GA) is an uncommon noninfectious granulomatous dermatitis. Phototherapy is often considered first-line therapy, with more evidence for psoralen ultraviolet A than narrowband ultraviolet B (NB-UVB). We aimed to evaluate the effectiveness and safety of NB-UVB in generalized GA and to review the literature.

Materials and Methods:

In this observational, retrospective study, 11 patients with generalized GA who received NB-UVB between 2013 and 2023 were evaluated. Data from the patients were obtained from the phototherapy unit and clinical follow-up forms.

Results:

Eleven patients, 10 (90.9%) female and 1 (9.1%) male were included in the study. The mean age of the patients was 57.6 ± 7.9 years. The mean disease duration was 26.9 ± 27.9 weeks. Three (27.2%) of the patients had interstitial GA. All patients showed improvement: NB-UVB therapy resulted in complete response in 18.2% of the patients and partial response in 81.8%. The mean number of NB-UVB sessions was 36.4 ± 13.8. The mean cumulative dose was 37.1 ± 25.6 J/cm2. There was no significant difference in the mean number of sessions and cumulative dose according to clinical response ( P > .05). NB-UVB was extremely well tolerated. After phototherapy, patients were followed for at least 6 months; no relapses were observed.

Conclusion:

NB-UVB is an effective and safe treatment option in generalized GA.
Older Adults’ Needs and Wishes for Contact With the Outdoors at Residential Care Facilities: Implications for Theory and Practice
Authors: Liljegren Madeleine , Bengtsson Anna , Lindahl Göran , Wijk Helle
Published: October 2024

Aim: This qualitative study aimed to explore needs and wishes of older adults concerning their perceived need for contact with outdoor environments at residential care facilities (RCFs) and what implications it has for theory and practice. Background: There is increased awareness of the importance of health-promoting everyday environments for persons with special needs. Therefore, it is important to include the experiences of older adults at RCFs in research. Methods: Twelve older adults from three Swedish RCFs participated in semistructured walking interviews. Results: Two categories were identified concerning the needs and wishes of older adults for contact with outdoor environments. The first category, Outdoor environments as part of everyday life, describes aspects of normality linked to outdoor stays at RCFs. The second category, Getting outdoors in practice, describes supportive and hindering aspects of outdoor stays, as well as accessibility regarding different body positions and access to personal support. Conclusion: It was found in this study that the needs and wishes of older adults are important to consider to increase their opportunities for outdoor stays. Their needs and wishes could also be included in briefs and programs for the design and planning of new construction or refurbishment of RCFs. The results of the study can serve as the basis for further discussions concerning older adults’ outdoor stays and the accessibility of outdoor environments. Further, the results are intended to facilitate practical knowledge that is useful for care workers and managers at RCFs and to support decision makers, property developers, architects, and planners.
Explainable machine learning for modeling predictors of unintended pregnancy among married/in-union women in sub-Saharan Africa, a multi-country analysis of MICS 6 survey
Authors: Kebede Shimels Derso , Abera Kaleab M , Abeje Eyob Tilahun , Bekele Enyew Ermias , Daba Chala , Asmare Lakew , Demeke Bayou Fekade , Arefaynie Mastewal , Mohammed Anissa , Tareke Abiyu Abadi , Keleb Awoke , Kebede Natnael , Tsega Yawkal , Endawkie Abel
Published: October 2024

Introduction

Unintended pregnancy is defined as a pregnancy that is either mistimed (wanted at a later time) or unwanted (not wanted at all). It has been a concerning issue for reproductive health and public health, with significant negative effects on the mother, child, and the public at large. It is a worldwide public health issue that can have a major impact on the health of pregnant women and newborns.

Methods

The study was conducted using secondary data from IPUMS Multiple Indicator Cluster Surveys round 6. The analysis was based on a data merged from six sub-Saharan Africa countries such as Gambia, Ghana, Lesotho, Malawi, Nigeria, and Sierra Leone. A total weighted sample of 28,027married/in-union reproductive-age women was included in the study. Seven machine learning algorithms were trained and their performance compared in predicting unintended pregnancy. Finally, Shapley Additive exPlanations model explanation technique was used to identify the predictors of unintended pregnancy.

Results

XGBoost was the top-performing model, achieved the highest area under receiver operating characteristic curve (0.62) and accuracy (65.92%), surpassing all other models. SHAP global feature importance identified top predictors of unintended pregnancy, with women from Malawi, Ghana, and Lesotho, women having primary education and secondary education, with parity of more than three, have higher likelihood of unintended pregnancy. In the other hand, women from Nigeria and Sierra Leone, whose husband/partner has more wives or partners (polygamy relation), and women who owns mobile phone had lower risk of unintended pregnancy.

Conclusion

These findings highlight the importance of considering contextual factors, such as country-specific sociocultural norms and individual characteristics, in understanding and addressing unintended pregnancies. By strategically addressing the identified predictors, policymakers, and healthcare providers can develop impactful programs that address the root causes of unintended pregnancies, ultimately contributing to improved reproductive health outcomes worldwide.
Elder abuse in the transgender community of Pakistan: A clandestine issue
Authors: Mujahid Aleena , Rajab Fatima , Kazim Muhammad Subtain , Mehmood Qasim
Published: October 2024

Transgender is a broad term that includes people whose gender identity, gender expression, and behavior are discordant with those typically associated with the sex assigned at birth. They are subject to violence, poverty, human rights violations, socioeconomic inequalities, a lack of education, and unemployment. The struggle rises with increasing age, and the elderly community suffers abuse, financial exploitation, physical injuries, cognitive decline, and mental health issues and is denied healthcare. A fair system inclusive of the third gender calls for reforms by the state and society.
Arthrography for Sports Injuries
Authors: Setiawati Rosy
Published: October 2024

Arthrography is an X-ray examination using a contrast agent to examine a joint, such as the knee or shoulder.

In arthrography, serial X-rays are taken of the joint being examined in various positions after a contrast agent is injected into the joint. This examination is most often used to examine the knee and shoulder joints, but can also be used for other joints, such as the wrist, ankle, hip, or elbow.

Similarly, direct MR arthrography also involves the injection of contrast material into the joint. The contrast material used for MR evaluation is different from that used for x-rays; it contains the substance gadolinium, which affects the local magnetic field in the MRI channel and shows up on the MR image. As in conventional direct arthrography, the contrast material outlines anatomical structures within the joint, such as cartilage, labrum, ligaments, and bones, and allows them to be evaluated after the MR image is produced.

Direct CT arthrography uses the same type of contrast material as conventional direct arthrography using x-rays and can be supplemented with air to produce double-contrast CT arthrograms. CT creates cross-sectional images that are processed by a computer using x-rays.
Two Stages Management for Dislocation of Knee – A Case Report
Authors: Dibyosubroto A. Adityo , Achmad J Jachja , Wurarah Julia
Published: October 2024

Introduction:

Knee dislocation were defined as complete loss of tibiofibular articulation confirmed by radiography. The mean age at injury was 37.8 ± 15.3 years. Of the 303 patients included, 65% were male and 35% were female. We report a case of 37 years old women who comes to our ER. She complained pain at her right knee since 30 minutes after hit by motorcycle. Internal rotation of tibia could be seen in this patient. There were no damaged found on vascular and additional injuries. Knee radiography were carried out to confirm diagnosis.

Discussion:

According the Good and Johnson, they defined knee dislocation to include the grossly unstable knee, with a minimum of 2 of the 4 major knee ligaments injured. In this patient we performed operative immediately by closed reduction and cast fixation on knee with guidance of fluoroscopy. During the intraoperative we got the valgus test, varus test, Lachman’s test and anterior drawer test were positive. Every week, we follow up by radiography to check is there any shifting or loss reduction on the cast. After three weeks, we open the cast and found the negative result on valgus and varus test, but the anterior/posterior drawer test and Lachman’s test still positive. It confirmed by MRI with total tear on ACL, partial tear on PCL and partial tear on lateral meniscus. Then we planned to do two arthroscopy, first is ACL, second is PCL. During first arthroscopy we found many hematoma, then we performed harvest from the hamstring: semimembranosus and gracilis tendon as graft for ACL reconstruction.

Result:

Three weeks after the external fixation was removed, the result of valgus and varus test were negative. The outcome of ACL reconstruction is a stable ACL, it confirmed with the negative result of anterior drawer test.

Conclusion:

Delayed reconstruction may resulted resolution of swelling, less stiffness, better ROM of knee and some structures healed by itself, but more hematoma. This also support other studies about delay reconstruction could potentially yield equivalent stability outcomes compared with acute surgery.
Reconstruction of a Chronic Patellar Tendon Rupture: A Case Report
Authors: Fachri Dliyauddin , Utoyo Ghuna Arioharjo
Published: October 2024

Introduction:

A chronic patellar tendon rupture in adolescent is very rare but can happen in sport-related injury. Presentation at more than 6 weeks after injury might cause a significant disability. Prompt diagnosis and treatment are key factors to a good prognosis. In this case, we use an autologous semitendinosus tendon graft to repair the patellar tendon rupture.

Case Report:

A 17-year-old male presented with pain at left knee since 6 months ago. The pain started after he landed on his left knee, having jumped while playing volleyball. On physical examination of the left knee, edema and high patella were found. There was also a palpable gap at the inferior pole of the patella. The patient was unable to do active extension of the left lower leg. MRI evaluation of the left knee revealed a patellar tendon rupture, myositis ossificans and a partial ACL rupture. The patient was scheduled for an elective surgery, consisting of patellar tendon reconstruction using an autologous semitendinosus graft along with ossificans removal and debridement.

Discussion:

Risk factors of tendon rupture should be assessed with extensive evaluation to construct the appropriate surgical repair method. The decision on which method to use depends greatly on the patient's profile and nature of injury. Immobilization period and routine rehabilitation exercises are vital to an enhanced recovery and fully functional knee.

Conclusion:

An autologous semitendinosus graft provides a good result without the need of a steel wire, as demonstrated in our case. Immobilization period and routine rehabilitation exercises are vital to an enhanced recovery and fully functional knee.
Managing ACL Injuries: A Comprehensive Systematic Review and Meta-Analysis of Conservative vs. Operative Treatment Approaches
Authors: Wiksa Astrayana Gusti Agung , Wien Aryana Gusti Ngurah
Published: October 2024

Introduction:

ACL injuries from sports activities lead to substantial functional impairments and debates over optimal treatment (conservative vs. operative). We conducted a systematic review and meta-analysis focusing on IKDC score-based functional outcomes.

Objectives:

The aim of study is to review the management of ACL injuries.

Methods:

We identified relevant studies comparing ACL treatments, assessing IKDC-scored functional outcomes. Two reviewers independently performed data extraction and quality assessment. Random-effects models pooled effect sizes, generating forest plots. Heterogeneity and publication bias were assessed.

Results:

Five studies met inclusion criteria. Meta-analysis showed no significant correlation between non-operative and operative approaches regarding IKDC-scored functional outcomes. Forest plots revealed no significant differences.

Conclusion:

This systematic review/meta-analysis indicates no significant difference in IKDC-scored functional outcomes between non-operative and operative ACL treatments. IKDC scores were found to be higher in the operative treatment group when the follow-up period extended beyond 10 years. Individualized decisions, considering patient preferences and risks, are crucial. Further research is needed to explore additional outcome influencers and refine treatment guidelines.
The Association between Socio-demographics and Post-Reconditioning Physical Fitness of Athletes Undergoing ACL Reconstruction
Authors: Suriadiredja Siti S. , Lubis Andri M.T. , Kurniarobbi Jull , Reyhan Taufan F.
Published: October 2024

Introduction:

Meniscus and anterior cruciate ligament (ACL) are the most common knee sports injuries. During the injury and its management, there may be a decrease in the level of physical fitness. Athletes need good physical fitness to be able to return to sports optimally. Objective. The aim of this study is to determine the association between socio-demographics and post-reconditioning physical fitness of athletes undergoing ACL reconstruction in Indonesia.

Materials & Methods:

This is a cross-sectional study with analytic descriptive approach using secondary data from one hospital for two years. This study include athletes with ACL injury who underwent ACL reconstruction followed by reconditioning three times a week in six months. At the end of the reconditioning, they were tested for their level of physical fitness.

Results:

Forty-six athletes were obtained. Socio-demographics show that most of the subjects were male (87%) aged over 25 years (58.7%), have basic-middle level of education (65.2%), amateur athletes (54.3%) who play contact sports (73.9%), got injured during training (73.9%) with a non-contact mechanism (89.1%), had a single knee injury (60.9%), and good exercise compliance (73.9%). Most of the subjects achieved good post-reconditioning physical fitness, including cardiorespiratory endurance (65.2%), muscle strength (73.9%), muscle endurance (80.4%), and flexibility (87%). Multivariate analysis shows that exercise compliance was significantly associated with muscle strength (AOR=25.1; 95% CI:1.812-348.761) and muscle endurance (AOR=12.8; 95% CI:1.695-97.193).

Conclusion:

The reconditioning program following ACL reconstruction in athletes provide a good level of physical fitness and the most contributing factor is the good exercise compliance.
Predicting pathological complete response following neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer using merged model integrating MRI-based radiomics and deep learning data
Authors: Lu Haidi , Yuan Yuan , Liu Minglu , Li Zhihui , Ma Xiaolu , Xia Yuwei , Shi Feng , Lu Yong , Lu Jianping , Shen Fu
Published: October 2024

Background

To construct and compare merged models integrating clinical factors, MRI-based radiomics features and deep learning (DL) models for predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC).

Methods

Totally 197 patients with LARC administered surgical resection after nCRT were assigned to cohort 1 (training and test sets); meanwhile, 52 cases were assigned to cohort 2 as a validation set. Radscore and DL models were established for predicting pCR applying pre- and post-nCRT MRI data, respectively. Different merged models integrating clinical factors, Radscore and DL model were constituted. Their predictive performances were validated and compared by receiver operating characteristic (ROC) and decision curve analyses (DCA).

Results

Merged models were established integrating selected clinical factors, Radscore and DL model for pCR prediction. The areas under the ROC curves (AUCs) of the pre-nCRT merged model were 0.834 (95% CI: 0.737–0.931) and 0.742 (95% CI: 0.650–0.834) in test and validation sets, respectively. The AUCs of the post-nCRT merged model were 0.746 (95% CI: 0.636–0.856) and 0.737 (95% CI: 0.646–0.828) in test and validation sets, respectively. DCA showed that the pretreatment algorithm could yield enhanced clinically benefit than the post-nCRT approach.

Conclusions

The pre-nCRT merged model including clinical factors, Radscore and DL model constitutes an effective non-invasive tool for pCR prediction in LARC.