bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends of endometrial cancer incidence in Sri Lanka from 2011 to 2020: An analysis of annual national cancer incidence data reports
Authors: Wijesinghe Rajitha D. , Hapuachchige Chinthana 
Published: July 2024

ABSTRACT

Introduction:
The incidence of endometrial cancer in low-income countries is rising at a rapid rate. This could be due to changes in risk factors and socio-economic transitions occurring in developing countries. The main aim of this study was to assess the changes in endometrial cancer incidence in Sri Lanka.

Materials and Methods:
Incidence data for uterine corpus cancer and endometrial cancer between 2011 and 2020 were extracted from the National Cancer Register of Sri Lanka. This included the crude rate, age standardised incidence rate, and age-specific incidence. Joinpoint trend analysis software was used to analyse the temporal pattern of incidence. The estimated annual percentage change of incidence (EAPC) was calculated

Results:
A total of 8332 patients with uterine corpus cancer were reported with the highest incidence in the 60–70-year-old age group. The EAPC of uterine corpus cancer was 9.26%, while it was 8.26% for endometrial cancer. The highest rise of age-specific incidence was observed in the 70 years plus age group (EAPC 13.3968%, 95% confidence interval (CI): 9.6916–17.1994).

Conclusion:
There is a clear rise in endometrial and uterine cancer incidence in Sri Lanka. While part of this could be due to better reporting of new cases, a true increase in incidence should have occurred due to different rates of EAPC among age categories. Studies to evaluate the factors leading to the rising incidence of endometrial cancer are recommended.
Serum 25(OH) vitamin D deficiency among young adults in the East Khasi Hills district of Meghalaya and its influence on bone mineral density: Investigating the involvement of the RANKL/RANK/OPG system
Authors: Ruram Alice A. , Chutia Happy , Bhattacharyya Himashree , Handique Akash 
Published: July 2024

ABSTRACT

Introduction:
Vitamin D’s precise role in bone mineral density regulation remains elusive. Nevertheless, its deficiency is linked to increased bone turnover through the upregulation of RANK ligands by osteoblasts. This study aimed to (i) evaluate vitamin D status in young adults and (ii) assess the association between vitamin D deficiency and bone turnover markers receptor activator of nuclear factor-κB ligand (RANKL), RANK, and the osteoprotegerin (OPG) in determining bone mineral density.

Materials and Methods:
This cross-sectional study involved 474 participants from the East Khasi Hills district, Meghalaya. Vitamin D levels were measured using the UniCel DxI 800 system, while OPG, RANK, and RANKL were assessed through enzyme-linked immunosorbent assay (ELISA). Additionally, a whole-body dual X-ray absorptiometry (DEXA) scan determined bone mineral density. Vitamin D deficiency was categorised as <20 ng/ml, insufficiency as 20–29 ng/ml, and sufficiency as ≥30 ng/ml.

Results:
Findings indicated 54.6% vitamin D deficiency and 35.4% insufficiency in young adults. Osteoporosis affected 26%, and 67% exhibited osteopenia. A weak positive correlation was found between vitamin 25(OH) D and bone mineral density T score (r = 0.16, r2 = 0.02, P = 0.44). Additionally, moderately weak correlations were observed between serum vitamin D and OPG (r = –0.42, r2 = 0.18, P < 0.001) and between vitamin D and RANKL (r = –0.13, r2 = 0.01, P = 0.18).

Conclusion:
The study suggests that vitamin D deficiency diminishes bone mineral density by promoting RANKL-RANK osteoclastogenesis and upregulating OPG expression. As young adults form a significant workforce, creating awareness is crucial for maintaining optimal health.
Carbon monoxide-related fatalities: A fifteen-year single institution experience
Authors: Kumar Rajesh , Sheikh Nishat A. , Vasudeva Abhimanyu , Kumar Adarsh , Yadav Abhishek , Gupta Sudhir K 
Published: July 2024

ABSTRACT

Introduction:
The winter climate in Delhi is severe, with temperatures dropping below 10°C. As a result, individuals often resort to utilizing diverse heat sources such as electrical heating appliances, coal and gas geysers. Unfortunately, these sources are commonly associated with the emission of carbon monoxide (CO) which can accumulate in inadequately ventilated spaces. Exposure to this noxious gas can lead to acute lethargy and debilitation, leaving individuals in a state of helpless distress.

Materials and Methods:
The present study utilized a retrospective descriptive analysis to examine cases of fatal carbon monoxide exposure retrieved from the Department of Forensic Medicine archives at the esteemed All India Institute of Medical Sciences, New Delhi. Autopsy records were thoroughly examined with respect to various parameters including age, gender, seasonality of the incident, circumstances surrounding the death, source of carbon monoxide generation, post mortem observations, as well as toxicological analysis reports.

Results and Discussion:
This study entailed an analysis of 56 individuals who fell victim to carbon monoxide poisoning, with a staggering 95% of fatalities occurring during the winter season. The majority of the individuals affected belonged to the age bracket of 21–30 years. The most common sources of carbon monoxide exposure were linked to the use of coal-burning earthen or iron vessels for room heating, as well as structural fires. With the exception of one case, all incidents were accidental in nature. Additionally, nearly all of the victims were discovered in enclosed spaces with heating equipment in close proximity, and evidence of a struggle was noted on the crime scene or with the deceased.

Conclusion:
The findings of this study indicate that the principal contributor to the inadvertent build-up of lethal concentrations of carbon monoxide gas is the utilization of heating appliances within inadequately ventilated, enclosed spaces. Due to the scentless and non-irritating properties of this gas, individuals who are asleep may be unable to detect its presence in their surroundings, thereby leading to a silent death. To mitigate such risks, the installation of carbon monoxide detectors is crucial. Additionally, it is of utmost importance to raise public awareness regarding the perils associated with using fire pots, coal burning and electrical heating appliances in areas with insufficient ventilation.
Prevalence of urinary incontinence in nulliparous Indian sportswomen
Authors: Syeda Fizzia , Pandit Unnati 
Published: July 2024

ABSTRACT

Introduction:
A common gynaecological problem among women that leads to a negative impact on quality of life and causes distress is the involuntary loss of urine which is addressed as urinary incontinence (UI). Females involved in playing various types of sports perform high-intensity activities which can serve as risk factors for UI and pelvic organ prolapse. According to the available literature, there is a scarcity of information regarding data on the prevalence of UI in Indian female athletes. Therefore, the purpose of the present study was to evaluate the prevalence of UI in nulliparous Indian sportswomen.

Methodology:
For a duration of 6 months, a cross-sectional study was carried out in various sports centres across the states of Telangana, Maharashtra, Gujarat, and Delhi. A total of 560 nulliparous Indian female sportswomen were involved based on the selection criteria. The various sports involved were malkhamb, kabaddi, kushti, weightlifting, gymnastics, basketball, badminton, and athletics. All the participants were provided with a questionnaire for female UI diagnosis (QUID), which was the primary outcome measure

Results:
Out of 560 women enrolled in the study, the highest prevalence was found for stress urinary incontinence (SUI), consisting of 126 (22.5%) women, followed by mixed urinary incontinence (MUI), involving 49 (8.8%) women, and urge urinary incontinence (UUI), including 47 (8.4%) women. Additionally, the prevalence of UI was highest in obese and overweight Indian sportswomen. Moreover, the highest prevalence of SUI among women was for weightlifting, whereas for UUI and MUI, malkhamb and kushti sports were the most prevalent, respectively.

Conclusion:
The present study concluded that the highest prevalence among nulliparous Indian sportswomen was for SUI, followed by MUI and UUI. Additionally, weightlifting sport showed the highest prevalence for SUI, followed by malkhamb for UUI and kushti for MUI. The prevalence of UI in Indian sportswomen is important as it imparts knowledge and awareness among women and benefits professionals in designing appropriate preventive and rehabilitative protocols for curtailing such problems in the near future.
Burden of depression and anxiety among caregivers of children having structural epilepsy
Authors: Pahwa Kumud , Acharya Rohan , Bhalla Kapil , Yadav Dinkar 
Published: July 2024

ABSTRACT

Context:
Epilepsy is one of the most common chronic neurological disorders in childhood. Structural malformations of the cerebral cortex are an important cause of developmental disabilities and epilepsy; this leads to a significant amount of psychological burden on parents of such children. Despite being a common and debilitating neurological illness, there is a paucity of data on the burden of stress and depression in parents of such children.

Aims:
The objective was to find out the burden of these illnesses on caregivers of such children.

Settings and Design:
This was a hospital-based cross-sectional, questionnaire-based study conducted in the Department of Pediatrics (both inpatient and outpatient), PGIMS Rohtak, during the period of June–September 2023. Parents of children with structural epilepsy (age: 2–14 years) were study subjects.

Methods and Material:
A cross-sectional study involving parents of 100 children with structural epilepsy (aged 2–14 years) was conducted using Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HAM-A).

Statistical Analysis Used:
Data were recorded in Microsoft Office Excel. Statistical analysis was performed using Statistical Package for Social Sciences v22. Statistical significance was checked by P value (two-tailed) considering value < 0.05 as significant

Results:
Higher levels of anxiety and depression were seen in parents of children having structural epilepsy. Relatively higher levels were seen in parents of such children who were receiving polytherapy (HDRS (P = 0.002); HAM-A (0.001))

Conclusions:
This study shows a higher prevalence of anxiety and depression among caregivers of children having structural epilepsy. Parents of such children require extra support as they appear to be a population prone to illnesses that will hinder the proper care of children with structural epilepsy and their quality of life. This circle has to be broken for better upbringing and treatment compliance for such children. Preventive and therapeutic interventions need to be taken to reduce the burden of such psychiatric illness at the community level.
Impact of multidisciplinary management via special clinic for the outcome of diabetic foot disease: A prospective observational study
Authors: Meena Satya P. , Badkur Mayank , Lodha Mahendra , Rodha Mahaveer S. , Chaudhary Ramkaran , Sharma Naveen , Kala Prakash C. , Gaur Ravi , Bishnoi Sumit 
Published: July 2024

ABSTRACT

Introduction:
Diabetic foot is a common complication of diabetes mellitus, affecting approximately 15–20% of individuals with diabetes. It is a comorbid condition that significantly impacts the routine life of patients. This study aimed to assess multidisciplinary management strategies and their impact on the outcomes of patients with diabetic foot.

Methods:
A prospective observational study was conducted on 56 patients with diabetic foot. Outcome measures included the type of surgery, frequency of surgery, morbidity, mortality, patient satisfaction, return to work, and the number of patients using prostheses

Results:
The majority of the patients (87%) received surgical treatment. The most common type of surgery performed was debridement (55%), followed by minor amputations (toes amputation/forefoot amputation) (28%) and major amputations (below-knee (B/K) or above-knee (A/K)) (15%). More than 70% of patients had multiple surgeries. The mortality rate was low (7%), and 71% of surviving patients were satisfied with their treatment. Sixty-seven percent of patients had an early return to work. The number of patients using prostheses was also high (73% of major amputation cases).

Conclusion:
Multidisciplinary management is the most effective approach for diabetic foot patients. These patients may experience less morbidity and an early return to work. A specialized care clinic for diabetic foot patients is essential to prevent treatment failure, loss of follow-up records, permanent limb loss, and economic burdens on society.
Role of augmented reality and virtual reality from the Indian healthcare education perspective – A systematic review
Authors: Mondal Ramkrishna 
Published: July 2024

ABSTRACTAugmented reality (AR) and virtual reality (VR), are upcoming technologies with considerable potential to revolutionizing healthcare education, enhancing patient safety, and improving healthcare quality particularly in the Indian context. This review is conducted to view the current scenario of Indian context considering the impact of COVID-19. The current systematic review study was done following PRISMA 2020 guidelines using the key terms “Augmented Reality,” “Virtual Reality,” “Healthcare,” and “India.” Only the PubMed database was selected based on its reputation and authenticity, which is the only limitation of this study and strength. Both qualitative and quantitative methods are used for synthesis of results. In Indian context, 12 (1.7%) and 36 (2.2%) articles related to AR and VR were found, respectively. Six abstracts could not be retrieved, and after screening abstracts, three were found not suitable in VR and eight were found duplicate. A total of 30 articles were considered for this review. 18 (50%) were original, 12 (33.3%) were review, and 6 (16.7%) were other articles. 03 (8.3%), 21 (58.3%), and 12 (33.3%) articles were related to AR, VR, and both AR and VR, respectively. Considering the single database search and six unretrievable abstract, AR, VR, mixed reality (MR), soft e-skin, and extended reality (XR) technologies have the potential to revolutionize healthcare education and training, reducing real-life errors and improving patient safety. Although the Indian healthcare sector only contributes 1.7–2.2% to PubMed publications related to AR and VR.. The review was not registered.
Sarcopenia and frailty among the elderly population in the community: An observational study
Authors: Gupta Nalina , Kumar Palani G. , Patel Divya J. 
Published: July 2024

ABSTRACT

Context:
There are few studies on the prevalence of sarcopenia and frailty in India.

Aims:
The aim of this study was to assess sarcopenia and frailty using simple clinical tools among the elderly population in the community.

Settings and Design:
This was an observational study. The elderly population with an age group of >60 years residing in villages within 10–15 km of Sumandeep Vidyapeeth, Vadodara, formed the sampling frame of the study.

Methods and Material:
A total of 785 participants were approached, of whom 556 were included in the study based on inclusion criteria. Participants were assessed for grip strength, muscle mass, gait speed, and frailty.

Statistical Analysis Used:
The data were analyzed using STATA-IC statistical software version 13. A nonparametric Chi-square (χ2) test was used for categorical variables, and an independent-samples t-test was used to analyze the difference between various variables. Statistical significance was considered at P < 0.05 with a 95% confidence interval (CI).

Results:
Based on the Indian criteria, 205 participants (36.1%) were diagnosed as having sarcopenia, and 351 participants (63%) were diagnosed as having “no sarcopenia.” 5.6% of participants were found to be frail, 19.2% to be pre-frailty, and 75.2% to be no frailty. The χ2 analysis showed a significant association of sarcopenia with gender and different age groups (P value < 0.001).

Conclusions:
In this study, 36.9% of the elderly participants were found to have “sarcopenia,” and 5.6% of the participants had frailty. Simple clinical tools used were easy to administer and suitable for field screening.
Distribution of non-thyroid neck swellings and their clinicopathological correlation
Authors: Chaturvedi Himani Tiwari , Patel Bhupesh , Chaturvedi Chandrashekher , Damor Paresh Kumar , Patel Varsha , Vasava Rahul 
Published: July 2024

ABSTRACT

Background:
Neck swellings are frequently found and can present the vast pathological spectrum from simple benign to highly malignant, which sometimes can pose a diagnostic dilemma. They are broadly classified as developmental, inflammatory, and neoplastic on the basis of etiology. The aim of the study is to assess the distribution of neck swelling according to etiology and its relation to age groups, as well as to assess their clinicopathological correlation as benign and malignant.

Materials and Methods:
The study was conducted from January 2020 to February 2023 on the basis of retrospective and prospective sampling. All the patients with neck swellings, except thyroid, who had undergone an excisional or incisional biopsy, were included in this study. Data was collected from in-patient records for retrospective sampling, and fine-needle aspiration cytology (FNAC), radiological investigation, and excisional or incisional biopsy were performed for prospective sampling after proper history and examination. Cytological and pathological correlation was analyzed as benign and malignant. Sensitivity and specificity were calculated. (P value <0.001 considered significant)

Results:
Out of the 74 patients, 16% were categorized as developmental, 31% as inflammatory, and 53% as neoplastic (benign 64%, malignant 36%). The most common cause was an epidermoid cyst (50%) among developmental swellings, reactive lymphadenitis (48%), and tuberculosis (35%) among inflammatory, pleomorphic adenoma among benign neoplasm and metastasis to lymph node among malignant swelling. Malignant lesions mainly occur in the older age group, more than 40 years of age. The overall sensitivity, specificity, and accuracy of FNAC, to differentiate from benign to malignant, is very similar to histopathological examination.

Conclusion:
Different age groups breed different etiology, so age needs to be the prime demographic factor to be established. Pediatric and younger generations of neck swelling are usually inflammatory and developmental, in contrast to the older category, in which malignancy is far more prevalent, hence demanding more caution in evaluation. FNAC is a diagnostic tool that has become highly sensitive for malignant lesions; though in no sense can it replace histopathology, it can still be valuable in diagnostic and screening dilemmas of neck swelling.
Підводні телекомунікаційні кабелі в контексті безпеки Європейського Союзу
Authors: Зернецька O.В. 
Published: July 2024

У статті вирішується проблема функціонування підводних телекомунікаційних кабелів в контексті безпеки Європейського Союзу. Стверджується, що важливість підводних кабелів зменшена у масовій свідомості, але зараз підводні телекомунікаційні кабелі несуть 99% інформації і даних, починаючи від дипломатичних, політичних, фінансових до економічних, соціальних, культурних сфер життя.
Метою статті є дослідження проблем безпеки пов’язаних з розвитком і експлуатацією підводних кабелів в ЄС, що константуює одну з головних геополітичних проблем.
Доводиться, що Інтернет повністю залежить від підводних кабелів. Глобальна комунікація, яка існує зараз, неможлива без підводних кабелів. Її безпека повністю залежить від них. Тому що кабелі прокладені на дні морів і океанів, пролягають через національні кордони і часто закопані у землю, про них часто забувають і політики, надаючи їм замало уваги.
Увага політиків до безпеки підводних кабелів почала збільшуватися з 2014 р., коли російські підводні човни почали свої розвідки у Північній Атлантиці, де прокладені підводні кабелі. Геополітичні хвилі посилилися у 2022 р., коли розпочалася російсько-українська війна, і уразливість морських інфраструктур почала привертати як громадську увагу, так і увагу політиків. У статті висвітлено важливість підводних кабелів через їх глобальну пов’язаність, роль у диджитальній економіці та воєнних операціях.
Зроблено висновок, що Україна як морська держава після повернення Криму та інших приморських територій матиме доступ до підводних телекомунікаційних кабелів, які будуть покладені по дну Чорного моря. Це ще більше наблизить Україну до співпраці з ЄС та приєднання до цієї регіональної організації.
Політика Австралії у сфері оборони (2020-2024 рр.)
Authors: Пошедін О.І. 
Published: July 2024

У статті досліджується оборонна політика австралійського уряду протягом 2020-2024 р. З’ясовано, що в цей період політика Австралії у сфері оборони зазнала суттєвого перегляду. Визначено, що десятирічний термін стратегічного попередження про напад на Австралію вже не може бути основою для оборонного планування. Це має значні наслідки для управління стратегічними ризиками і потребує термінових дій, включно з підвищенням рівня військової готовності, прискореним розвитком спроможностей, збільшенням витрат на оборону, відмовою від звичайного підходу до розробки політики та управління ризиками. Негайні дії уряду щодо зміни пріоритетів спроможностей сил оборони включали: інвестування в атомні підводні човни зі звичайним озброєнням завдяки партнерству AUKUS; розвиток здатності сил оборони точно вражати цілі на великій відстані та виробляти боєприпаси в Австралії; покращення здатності сил оборони діяти з північних баз Австралії; збільшення спроможності швидко переводити нові революційні технології в можливості сил оборони у тісному партнерстві з австралійською промисловістю; інвестування у зростання та утримання висококваліфікованої робочої сили; поглиблення дипломатичного та оборонного партнерства з ключовими союзниками в Індо-Тихоокеанському регіоні.
Встановлено, що тристороннє партнерство в галузі безпеки AUKUS має важливе значення для Австралії в контексті отримання асиметричних спроможностей. AUKUS надаватиме розширені можливості австралійським силам оборони в таких сферах як штучний інтелект, гіперзвукова техніка та обізнаність про ситуацію на морі. Партнерство AUKUS набуває особливого значення на тлі розробки Китаєм нового покоління атомних підводних човнів, які будуть тихішими і які буде важче виявляти.
Запропоновано у наукових дослідженнях в Україні зосередити увагу на питаннях прискорення інтеграції нових революційних технологій в оборонні спроможності, інвестування у розвиток та утримання висококваліфікованої робочої сили в оборонній сфері, а також розробки оборонних промислових пріоритетів. З огляду на проблеми у сфері українських оборонних закупівель, особливу увагу варто звернути на дослідженнях досвіду реформування австралійської системи оборонних закупівель.