bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hierarchical Structure of Small–Medium Enterprise Accidents Contributing to Legal Proceedings Resulting in Judicial Verdicts Using Interpretive Structural Modeling
Authors: Faraji Majid , Esmaeili Reza , Rismanchian Masoud , Shakerian Mahnaz 
Published: October 2024

Abstract

Aim:
The present study aims to identify and model factors influencing accidents in small–medium enterprises based on judicial orders.

Methods:
This study was conducted in two primary phases. The first phase involved analyzing legal documents related to work-related accidents to extract factors influencing accidents in SMEs. In the second phase, interpretive structural modeling (ISM) was employed to hierarchically model these factors and understand their relationships using ISM Excel base software. Ten experts from various Iranian universities and industrial companies participated in the study, contributing to the completion of matrices used in the ISM model.

Results:
In this study, 10 primary factors contributing to accident occurrences in SMEs were identified and categorized into three main groups: Individual factors related to the incident (comprising five subfactors), organizational factors (comprising three subfactors), and conditional factors (comprising two subfactors). The subsequent phase involved modeling the identified factors using the ISM technique. The results revealed that three factors – training, equipment-related factors, and hazardous processes or harsh environments – were placed at level 2, designating them as the key factors influencing accidents.

Conclusion:
The current research demonstrates that in SMEs, conditional and organizational factors like equipment shortcomings, hazardous processes, and insufficient training for workers are key factors in accident occurrences within these systems. Consequently, by controlling these factors, improvements in their safety conditions can be pursued.
Determining the Sound Absorption Coefficient of Bamboo Composites: Theoretical- and Laboratory-based Approaches
Authors: Irvani Hassan , Mahabadi Hassan Asilian , Khavanin Ali , Variani Ali Safari 
Published: October 2024

Abstract

Aim:
The use of natural fiber-based composites in various applications is increasing due to their cost-effectiveness, low density, nontoxicity, and environmental friendliness. Therefore, in this study, the acoustic performance of natural bamboo fiber composites was investigated using experimental and theoretical methods. The properties of these composites, which include affordability, low density, nontoxicity, and eco-friendliness, contribute to their growing popularity.

Methods:
In this study, three types of composites with a density of 200 kg/m3 and thicknesses of 50 mm were fabricated. The normal incidence absorption coefficient was directly measured using the impedance tube method based on the ISO 10534-2 standard. In addition, for predicting the sound absorption coefficient of the composites, the software COMSOL and the Miki and Attenborough models were utilized.

Results:
The results indicate that for samples F (fine fiber) and F-C (fine coarse fiber), the average sound absorption above 1000 Hz is 0.8. The sound absorption values in sample C (coarse fiber) were lower than those in samples F and F-C. In addition, the mathematical models of Miki and Attenborough can predict the acoustic behavior of the samples to some extent, with the Attenborough model providing higher accuracy in its predictions.

Conclusion:
The results of this study demonstrate that a composite composed of natural bamboo fibers can be used as a sound-absorbing material for noise control purposes, while also contributing as a green technology replacing natural fibers with synthetic fibers.
Effect of Multi-Walled Carbon Nanotubes, Salicylic Acid, and Drought Stress on Mazut Biodegradation Efficiency in a Pb- and Zn-Polluted Soil Under Cultivation of the Pinto Bean Inoculated with Piriformospora indica
Authors: Baghaie Amir Hossein , Khosravi-Dehkordi Ardeshir 
Published: October 2024

Abstract

Aims:
Today, remediation of soils contaminated with heavy metals and petroleum compounds is one of the major environmental problems. This research was done to investigate the effect of multiwall carbon nanotubes (MWCNs) and foliar application of salicylic acid (SA) on biodegradation of mazut in the Pb- and Zn-polluted soil under cultivation of the pinto bean inoculated with Piriformospora indica (P.indica).

Methods:
Treatments included applying MWCNs (0 and 2 % (W/W)) in the soil that was naturally polluted with Pb and Zn, foliar application of salicylic acid at the rate of 0 and 1.5 mmol/lit on the plants inoculated with P.indica under drought stress. In addition, the studied soil was polluted with mazut at the rate of 0% and 6% (w/w). After 3 months, plants were harvested and the plant Pb and Zn, the soil Pb and Zn, and the biodegradation of mazut in the soil were also measured.

Results:
Addition of MWCNS and foliar application of salicylic acid at the rate of 1.5 mmo/lit significantly decreased the soil Pb by 14.3 and 13.3%, respectively. Plant inoculation with P. indica significantly increased the biodegradation of mazut in the Pb- and Zn-polluted soil by 15.9%. However, drought stress had a negative effect on degradation of mazut in the soil.

Conclusion:
Regardless of plant expose to drought stress, using MWCNs and foliar application of SA has a positive effect on biodegradation of petroleum hydrocarbon in the soil.
Consequence Analysis and Safety Assessment of an Ethylene Oxide Unit in a Petrochemical Complex
Authors: Esmaeili Sayed Vahid , Esmaeili Reza , Mohsenian Ali , Alboghobeish Ali 
Published: October 2024

Abstract

Aim:
This study focuses on the consequence analysis and safety assessment of an ethylene oxide (EO) unit in a petrochemical complex. This study evaluates the potential consequences of process accidents in the tankage, tank truck loading, and cylinder filling areas of an EO unit.

Methods:
The analysis was conducted using DNV’s PHAST software (2023), which models and quantifies the consequences of chemical releases by considering various factors such as material characteristics, storage tanks, weather conditions, and the number of people at risk. This study considers scenarios such as fire, flammable and toxic gas dispersion, and vapor cloud explosion.

Results:
The results provide insights into the safety measures and precautions required in different areas of the petrochemical complex. The analysis of hazard zones allows for the prioritization of protective measures and ongoing monitoring of operational hazards.

Conclusion:
This study provides a comprehensive assessment of the consequences and risks associated with the use of the EO unit in a petrochemical complex.
Creation and evaluation of a three-dimensional-printed synthetic vas deferens for microsurgical training
Authors: Joshi Parth , Jacobsohn Tamar , Polis Andrew , Shah Darshi , Gillette Brian , Schoor Richard 
Published: October 2024

ABSTRACT

Introduction:
Individuals choose to undergo vasectomy reversal for a variety of reasons, including remarriage or due to the death of a child. To be proficient in this procedure, the surgeons need to be high volume and the trainees require a safe environment to develop their microsurgical skills. To overcome this challenge, we used three-dimensional (3D) printing to create a synthetic model of the vas deferens with properties similar to the human vas deferens. We distributed this model to experienced microsurgeons for evaluation.

Methods:
The vas deferens model was created using thermoplastic polyurethane filament. The filament was then infused with a foaming agent to allow for temperature-dependent tuning of the material’s stiffness. The model’s outer diameter was 1 mm and the inner lumen was 0.5 mm. Fellowship-trained male reproductive urologists were recruited from the Society for the Study of Male Reproduction website. They used our model and judged it on several factors by completing a 13-question survey.

Results:
We received completed evaluations from five microsurgeons. Eighty percent of the surgeons were able to complete a full anastomosis on the model using 9-0 and 10-0 sutures. The majority of the completed anastomoses were performed using the one-layer technique. The average responses for the model’s usefulness as a practice tool, a training tool, and overall assessment ranged from 72 to 79 out of 100. Comments for the improvement included the need for a more flexible and softer model.

Conclusions:
We created a 3D-printed synthetic vas deferens that serves as a valuable training and practice tool.
The reused-disposable scope in flexible ureteroscopy for stones as a cost-conscious approach: Reporting the outcomes of a real-world practice multicenter study of 2183 patients by the team of worldwide endourological researchers group
Authors: Gauhar Vineet , Traxer Olivier , Sabnis Ravindra B , Fong Khi Yung , Gharia Parimalsinh , Grover Rishi , Ragoori Deepak , Lim Ee Jean , Tanidir Yiloren , Mehta Amish , Gökce Mehmet Ilker , Lakmichi Mohamed Amine , Soebhali Boyke , Gadzhiev Nariman , Chew Ben H. , Somani Bhaskar Kumar , Castellani Daniele 
Published: October 2024

ABSTRACT

Introduction:
We aimed to assess complications and stone-free rate of flexible ureteroscopy (FU) reusing disposable scopes (RDS) after repeated sterilization.

Methods:
Data from adults from 11 centers were retrospectively reviewed (January 2020–December 2022). Inclusion criteria were proximal ureteral/renal stone(s). All cases were performed using an RDS to save costs for patients who come from economically challenged environments. Residual fragments (RFs) were defined as single fragment ≥4 mm or multiple fragments of any size within 3 months. Continuous variables are presented as median and interquartile range.

Results:
Two thousand one hundred and eighty-three patients were included, of whom 67.0% were male. Median age was 48.0 (36–59) years. The median stone diameter was 10.2 (9–14) mm. Flash sterilization was used in 90.2% (plasma in 60.5%). Approximately, 88% had FU with an RDS used ≤2 times (12%: 3–5 times). RDS needed to be changed intraoperatively in 3.9% of cases due to its malfunction. Commonly, defects in RDS function were reported in upward (1.6%) and downward deflection (6.5%) and image quality on white balancing (4.7%). Fever >38C was seen in 13.7% of cases, and sepsis in 0.5%. RFs were found in 31.4% of cases. Lower pole (odds ratio [OR] 5.63) or pelvis stone (OR 4.67), faulty scopes (OR 12.8), and total operation time (OR 1.05) were factors associated with higher odds of RFs. Stone size (OR 1.09), positive urine culture (OR 1.67), interpolar stone (OR 1.68), and prestenting (OR 1.37) were factors associated with higher odds of fever/sepsis.

Conclusions:
RDS was used as a cost-conscious approach with a low rate of serious infections but with a high rate of RFs.
Can artificial intelligence aid the urologists in detecting bladder cancer?
Authors: Hengky Antoninus , Lionardi Stevan Kristian , Kusumajaya Christopher 
Published: October 2024

ABSTRACT

Introduction:
The emergence of artificial intelligence (AI)-based support system endoscopy, including cystoscopy, has shown promising results by training deep learning algorithms with large datasets of images and videos. This AI-aided cystoscopy has the potential to significantly transform the urological practice by assisting the urologists in identifying malignant areas, especially considering the diverse appearance of these lesions.

Methods:
Four databases, the PubMed, ProQuest, EBSCOHost, and ScienceDirect were searched, along with a manual hand search. Prospective and retrospective studies, experimental studies, cross-sectional studies, and case–control studies assessing the utilization of AI for the detection of bladder cancer through cystoscopy and comparing with the histopathology results as the reference standard were included. The following terms and their variants were used: “artificial intelligence,” “cystoscopy,” and “bladder cancer.” The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A random effects model was used to calculate the pooled sensitivity and specificity. The Moses–Littenberg model was used to derive the Summary Receiver Operating Characteristics (SROC) curve.

Results:
Five studies were selected for the analysis. Pooled sensitivity and specificity were 0.953 (95% confidence interval [CI]: 0.908–0.976) and 0.957 (95% CI: 0.923–0.977), respectively. Pooled diagnostic odd ratio was 449.79 (95% CI: 12.42–887.17). SROC curve (area under the curve: 0.988, 95% CI: 0.982–0.994) indicated a strong discriminating power of AI-aided cystoscopy in differentiation normal or benign bladder lesions from the malignant ones.

Conclusions:
Although the utilization of AI for aiding in the detection of bladder cancer through cystoscopy remains questionable, it has shown encouraging potential for enhancing the detection rates. Future studies should concentrate on identification of the patients groups which could derive maximum benefit from accurate identification of the bladder cancer, such as those with intermediate or high-risk invasive tumors.
Assessment of systemic immune-inflammatory index and other inflammatory parameters in predicting mortality in patients with acute cholecystitis: A retrospective observational study
Authors: Korkmaz İbrahim , Peri Burak , Karaali Rezan 
Published: October 2024

Objective:
To investigate the effectiveness of the systemic immune- inflammatory (SII) index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis (AC).

Methods:
279 Patients presented to the emergency department with abdominal pain and diagnosis of AC between September 2021 and September 2023 were included in the study. Demographic data, laboratory parameters, clinical follow-ups, and outcomes of the patients were recorded.

Results:
The mean age of the patients was (55.0±16.3) years and 36.6% were male. 63.8% Had gallbladder/choledochal stones and 49.5% underwent surgery. The mortality rate was 6.1%. Advanced age (P=0.170) and prolonged hospitalization (P=0.011) were statistically significant risk factors for mortality. Decreased lymphocyte count (P=0.020) and increased C-reactive protein (CRP) levels (P=0.033) were found to be risk factors for mortality. According to the mortality predictor ROC analysis results, the cut-off for SII index was 3 138 (AUC=0.817, sensitivity=70.5%, specificity=84.7%), the cut-off for neutrophil count was 15.28×103/ mm3 (AUC=0.761, sensitivity=52.9%, specificity=95.0%), the cut-off for leukocyte count was 19.0×103/mm3 (AUC= 0.714, sensitivity=52.9%, specificity=98.0%), cut-off for CRP was 74.55 (AUC=0.758, sensitivity=70.5%, specificity=79.0%), cut-off for aspartate transaminase (AST) was 33.0 IU/L (AUC=0.658, sensitivity=82.3%, specificity=50.3%).

Conclusions:
The SII index may be a good predictor of mortality with high sensitivity and specificity. Elevated levels of neutrophils, leukocytes, CRP, and AST are other inflammatory parameters that can be used to predict mortality associated with AC.
Opioid-free General Anesthesia and Awake Fiberoptic Intubation with Dexmedetomidine in a Class IV Obese Patient with Cervical Spondylosis
Authors: Gaiwal Sucheta , Prasad Nimitha , Palep Jaydeep 
Published: October 2024

Abstract
Patients with Class IV obesity (C4O) (body mass index [BMI] >50 kg/m2) are at a particularly high risk of anesthesia-related complications during the postoperative period, e.g., critical respiratory events (CREs) including respiratory arrest and oversedation, leading to problems with maintaining open airway, hypoxia, and hypercapnia. We present the case of a 67-year-old C4O (BMI 57.2 kg/m2) female patient with cervical spondylosis, scheduled for laparoscopic sleeve gastrectomy. Preanesthesia evaluation revealed hypertension, type 2 diabetes mellitus (DM), nonalcoholic steatohepatitis, and obstructive sleep apnea as comorbidities. Awake fiberoptic intubation was planned because of a high potential for difficult intubation (neck circumference of 45 cm, cervical spondylosis, reduced neck mobility, and type 2 DM), using topical anesthesia and dexmedetomidine (Dex) infusion. General anesthesia was given with desflurane and muscle relaxant. “Opioid-free anesthesia,” wherein use of systemic, neuraxial, or intracavitary opioids is completely eliminated, was maintained with Dex infusion for sedation and analgesia. Reversal of anesthesia was done in Fowler’s position (FP), and after extubation, nasopharyngeal airway connected to high-flow oxygen (10 L/min) via tubing was used, which facilitated spontaneous breathing, maintaining oxygen saturation and uneventful recovery. Postoperatively, intravenous paracetamol alone was adequate for effective pain relief. The patient remained hemodynamically stable throughout the perioperative period. This case underscores the benefits of “opioid-free anesthesia” using intraoperative Dex infusion and efficacious use of nasopharyngeal airway in FP postoperatively, avoiding requirement of ventilator, in supermorbidly obese patients, reducing CREs and optimizing postoperative outcomes.
Utilisation of Atlanta Classification for Local Complications and Severity Detection of Acute Pancreatitis – A Narrative Review
Authors: Singh Varun , Mishra Gaurav Vedprakash , Tapadia Shreya 
Published: October 2024

AbstractAcute pancreatitis (AP) is one of the most common acute abdominal pathologies, having varying grades of severity and presentation ranging from mild self-limiting pain in the abdomen and vomiting to severe category which consists of multiple organ failure, sepsis, fever, and severe abdominal pain and vomiting making the patient hospital-bound. Over the years, many radiological and clinical classification systems have emerged to categorize the patient severity and associated local complications to assess their prognosis and help the clinicians decide the treatment plan. Patients suffering from mild pancreatitis are treated with conservative management, whereas those with moderate-to-severe pancreatitis are dealt with minimally invasive or surgical procedures hence making it necessary to classify the patients according to their severity which further helps the clinicians and surgeons decide on treatment plans. The revised Atlanta’s (2012) classification has made a milestone change in the way we classify AP and its complications by including the presence of organ failure and local fluid collections as an essential component of severity grading. In this review article, we will be reviewing past literature and discussing the efficacy of the revised Atlanta classification (2012) in evaluating the type of pancreatitis, the presence or absence of organ failure, local complications, and its role in assessing the prognosis of the patient.
A Preexperimental Study to Find the Effectiveness of Structured Simulation-based Training on Basic Life Support among Dental Doctors, in Uttarakhand
Authors: Jelly Prasuna , Aggarwal Pradeep , Sharma Rakesh 
Published: October 2024

Abstract

Background:
Improving skills to provide high-quality cardiopulmonary resuscitation (CPR) among health-care professionals is vital and may lead to a reduction in unexpected deaths due to cardiac arrest.

Aim:
The aim of the study is to evaluate the impact of basic life support (BLS) training among dental physicians.

Materials and Methods:
A preexperimental study was conducted among 97 dental doctors selected using universal sampling at the center for Professional Education (CPD), All India Institute of Medical Sciences, Rishikesh. The participants included faculty and postgraduate students from Seema Dental College, Rishikesh, after obtaining informed consent. A pretested, semi-structured questionnaire on BLS techniques and a feedback form was used to assess knowledge of CPR. A structured simulation-based training was given to the participants for 2 days about BLS after conducting a pretest. The training was given in small groups (10 members), and all the participants were given mandatory participation to practice the procedures before the posttest, followed by feedback on the quality of the training. Data analysis was done using statistical software.

Results:
There was a significant difference in mean scores of awareness between the pretest (13.69 ± 4.37) and posttest (22.01 ± 1.86) of the participants (P = 0.001). The majority of the participants (89.7%) felt that overall, the quality of the module was most satisfactory, intellectually stimulating, and relevant research based.

Conclusion:
There is a need for BLS training for the different cadres of health-care professionals, public volunteers, ambulance drivers, schoolteachers, students, and the general public at regular intervals. The feedback about the present training was favorable.
Insulin Resistance and Its Detection
Authors: Manwani Tamana , Wanjari Anil , Acharya Sourya 
Published: October 2024

Abstract
Insulin resistance is a characteristic of adiposity, metabolic disorders, and several heart disorders, and it correlates to the diabetic state. As a result, determining insulin responsiveness in animals and humans is critical for an observational study, fundamental medical and preclinical research, and therapeutic application. Directly and indirectly, approaches of varied intricacy are now employed for this purpose. Several approaches use constant glucose and insulin analysis while others use dynamic testing. Every approach has its own set of pros and cons. As a result, the best strategy to utilize and choose is determined by the nature of the current research. The sources of primary data for evaluating insulin sensitivity in vivo that has been developed were rather complicated. The hyperinsulinemic-euglycemic glucose clamps and insulin-suppressing tests assess insulin-dependent sugar consumption in constant circumstances which need effort and time. The indirect technique depends on a basic pattern recognition of regularly selected intravenously glucose tolerance testing, which is significantly less complicated. Furthermore, basic substitute measures for insulin sensitiveness/resistances are known, which are calculated from blood insulin and glucose levels in fasted (stable conditions) or just after taking sugar by mouth (dynamics). Thus, quantifiable control index of insulin sensitiveness, in an instance, has now been thoroughly verified against the gold standard of glucose clamping. Quantifiable glycemic control check indicator’s quantitative insulin-sensitivity check index an easy, reformable methodology for measuring reforms in insulin sensitivities as a result of therapeutic protocols and the onset of diabetics. Researchers address the benefits, limitations, and correct implementation of established in vivo insulin sensitivity/resistance testing in this Frontier article.