bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical and mediastinal emphysema in critically ill COVID-19 patients
Authors: Aljehani Yasser , Alkhunaizi Auday A. , Othman Sharifah A. , Alqumber Hassan Abdullah , Almubarak Yousif , Al-Musawi Tariq , Al Bazroun Mohammed Ibrahim , Alshaikhmohamed Khatoon 
Published: January 2022

INTRODUCTION:
Coronavirus illness 2019, commonly referred to as COVID-19, is a highly infectious disease brought on by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was declared a universal pandemic in March 2020 by the World Health Organization and is a severe health issue with unprecedented morbidity and mortality rates. Both surgical and mediastinal emphysema have been seen in cases of critically ill COVID-19 patients in several hospitals in the Eastern Province of Saudi Arabia.

METHODS:
This was a retrospective, cross-sectional, multicentric study involving several hospitals in the Saudi Arabian Eastern Province. Data were collected from intensive care units (ICUs) in these hospitals from March 2 to August 2, 2020. The inclusion criteria consisted of all patients who tested positive for SARS-CoV-2 and were admitted to a critical care unit.

RESULTS:
Thirty patients required thoracic consultation and management, including 26 males (81.3%) and 4 females (12.5%) (1:0.15) who developed surgical and mediastinal emphysema requiring thoracic surgery intervention. Most of the patients were on high ventilation settings, and the mean duration of ventilator support was 16.50 ± 13.98 days. Two patients (6.3%) required reintubation. The median positive end-expiratory pressure (PEEP) was 12 ± 2.80 cmH2O with a median FiO2 of 70% ± 19.73. On average, thoracic complications occurred on day 3 (±6.29 days) postintubation. Ten patients (33.33%) experienced a pneumothorax associated with surgical emphysema (SE), 1 patient (3.33%) presented with only mediastinal emphysema; 17 patients (56.66%) with only SE, and 1 (3.33%) had mediastinal emphysema associated with SE. We noted a correlation between the duration of ventilator support, the length of ICU stay (P < 0.001), and the total length of stay (LOS) in the hospital (P < 0.001). Total length of hospital stay showed significant association with the onset of complications (P = 0.045) and outcomes (P = 0.006). A significant association between PEEP and the duration of ventilator support was also evident with a P value = 0.009 and the onset of complications (P = 0.043). In addition, we found a significant association between the group with pneumothorax in combination with SE, and their outcomes, with a P = 0.002.

CONCLUSION:
Surgical and mediastinal emphysema in the critically ill patients are usually attributed to barotrauma and high ventilations settings. During COVID-19 pandemic, these entities were seen and the pathogenesis was revisited and some attributed its presence to the disease process and destruction on lung parenchyma. The associated with extended LOS and delayed recovery in addition to poor prognosis were seen. Their presence is an indicator to higher morbidity and mortality.
Impact of Anti-Diabetic Medications on Quality of Life in Persons with Type 2 Diabetes Mellitus
Authors: Baruah Manash P. , Bhowmick Ananya , Bhuyan Seema , Bhuyan Sonali B. , Deka Jumi , Bora Smriti Sikha 
Published: January 2022

Introduction:Type 2 diabetes mellitus (T2DM) has been found to be associated with poor quality of life (QOL). The aim of this study was to measure QOL in T2DM patients and examine if the patients’ socio demographic, diabetes-related clinical characteristics and insulin usage are associated with better quality of life.Materials and Methods:This clinic based cross-sectional study analyzed data from outpatients with T2DM attending a referral clinic between January and June 2016. Association between Diabetes Attitudes, Wishes and Needs (DAWN) QOL and few demographic, socioeconomic, clinical and biochemical predictors were examined using multivariate logistic regression model. A total of 518 patients completed the interview.Results:The HbA1c level of insulin ± oral anti-diabetic (OAD) cohort was significantly lower (7.89 ± 1.98) than the OAD cohort (8.79 ± 1.96),P< 0.001. Compared to their counterparts in the OAD cohort, patients on insulin were older with longer duration of diabetes mellitus. Co-morbid confounders like obesity, hypoglycemia, and blood pressure control or socio demographic confounders like income, education were almost similar in both the cohorts. The incidence of hypertension, coronary artery disease (CAD) and statin usage was significantly higher in the insulin cohort. The overall composite DAWN QOL scores of the insulin ± OAD cohort (25.42 ± 4.35) was marginally higher than that of the OAD cohort (23.62 ± 5.06) (P= 0.067). Analog insulin users were also found to have significantly higher composite DAWN QOL scores compared to human insulin users (25.77 ± 5.73 vs.24.13 ± 4.88,P= 0.037).Conclusions:The insulin cohort, despite being older and having longer duration of diabetes, had significantly higher diet compliance score, and enhanced QOL owing to better diabetes-related knowledge and treatment adherence characteristics than non-insulin users. Questionnaires-based evaluation of QOL can provide better understanding of the patient's experience of the illness, self-care, psychological and emotional functioning, and choice of therapeutic modality enhancing the quality of care.
Value of Combined Cytomorphological Parameters in Improving Diagnostic Accuracy of Papillary Thyroid Carcinoma on Cytology - The Five Dependable Features
Authors: Kumari Neha , Kalonia Tushar , Malik Akanksha , Kumar Arvind , Rao Shalinee 
Published: January 2022

Background:Fine-needle aspiration cytology remains the preliminary test for diagnosing papillary thyroid carcinoma (PTC). Numerous features are established to arrive at the diagnosis. However, few cases pose a challenge to correctly diagnose PTC. Our study aims to elicit the combination of features to aid in the diagnosis of such cases.Materials and Methods:Cytology smears of histologically proven cases of PTC and benign diagnoses were included as case (n = 36) and control group (n = 38), respectively. Features including papillae with cores, 3-D caps, nuclear grooves (NG), intranuclear cytoplasmic inclusions (INCI), giant cells, macrophages, cellular swirls, psammoma bodies, pale chromatin, nuclear overlapping, nuclear enlargement, and metaplastic cells were assessed. Statistic tests including Independent t test/Mann–Whitney Test and Chi-Square test/Fisher's Exact test were used. Receiver operating characteristic curve was used to assess the cut-off point of many cytological features to predict PTC. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of cytological features was calculated to predict PTC.Results:Presence of five or more cytological features (papillae with cores, cellular swirls, NG, INCI, and psammoma bodies) together could diagnose PTC (PPV) in 78.95% of the cases, with a NPV of 83.33%. Diagnostic accuracy of these five features combined was 81.08%. Papillae with cores and nuclear grooving were the most sensitive cytological features, whereas INCI followed by cellular swirls and NG were the most specific features.Conclusion:Relying on a combination of the most sensitive and specific features rather than any one cytological feature can help reduce the misdiagnoses in PTC.
Efficacy and Safety of Dulaglutide in Type 2 Diabetes Patients in Endocrinology Clinics of Islamabad, Pakistan
Authors: Kamin Matiullah , Khan Sajjad Ali , Raja Umar Yousaf , Ishtiaq Osama , Malik Asmara , Rehman Tejhmal , Wahab Muhammad Umar 
Published: January 2022

Objective:Our objective was to ascertain the efficacy and safety of once weekly Dulaglutide among patients with Type 2 diabetes of Pakistani origin.Methods:This prospective cohort study was conducted at the Endocrinology Clinics of Shifa International Hospital, Islamabad and Umar Diabetes and Foot Care Centre, Islamabad, Pakistan during the period from July 2020 to December 2020. Dulaglutide at the dose of 1.5 mg once weekly was initiated in patients with BMI >28 and suboptimal glucose control in the background of Type 2 Diabetes who were also taking one or more of oral anti-diabetic and/or insulin therapy.Results:Mean age of patient cohort (n = 148) was 49.51 years (SD +/- 12.15) with 53.5% (n = 85) having type 2 diabetes for a duration of over 10 years. Mean weight was 93.2 kg at baseline with end of study mean weight being 90.7 kg. Mean HbA1c at baseline was 9.2%, which improved to 8.05% at the end of study. The main side-effects were nausea in 32%, vomiting in 8%, and diarrhea in 7% with 19% discontinuation rate due to cost and side-effects.Conclusion:Dulaglutide as a therapy demonstrated favorable HbA1c and weight reduction in obese type 2 diabetes patients of Pakistani origin.
The impact of women violence on depression among female medical students at Imam Abdulrahman Bin Faisal University, Saudi Arabia
Authors: Al Sadah Zhra M. , Aldulijan Fajar A. , Aljamea Dana A. , Saleh Maan A. 
Published: January 2022

Aims:
The aim of this study was to evaluate the impact of domestic violence on depression among females’ students of Imam Abdulrahman bin Faisal University in the Kingdom of Saudi Arabia.

Settings and Design:
A cross-sectional study conducted from 2019 to 2020.

Methods and Material:
An electronic questionnaire containing biographical data, 2
nd
edition of Beck Depression Inventory (BDI), and The NorVold Abuse Questionnaire (NorAQ) was sent to the participants.

Statistical Analysis Used:
Data were analyzed using SPSS version 24 with a statistical significance set at P < 0.05. Tests of significance measured using independent t test and Chi-square test.

Results:
The study included 214 female medical students and 11 interns aged 18 to 26 with a mean of 20.66 ± 1.725 years. Most women (92.4%) were single, and the highest responders (30.2%) were second-year students. Based on The NorVold Abuse Questionnaire (NorAQ), the prevalence of violence was 56.9%. The most common form of violence was emotional abuse (50.2%) and the highest combined types of abuse were emotional and physical abuse (14.7%). Based on BDI scale, the prevalence of depression amongst our sample was 32.9%; it was mild in 14.2%, moderate in 15.6% and severe in 3.1%. None of the types of abuse were significantly associated with depression. However, severe depression was highest amongst students/interns with history of emotional or sexual violence.

Conclusion:
More than half of the participants were subjected to domestic abuse throughout their lives. Emotional abuse was the commonest type followed by physical, sexual, and healthcare abuses, respectively. However, the present study demonstrated no significant association between abuse and depression.
Neural tube defects
Authors: Ravi Kumar S. , Divasha  , Hassan Sameeullah B. , Pasi Rachna , Mittra Sangh , Kumar Raj 
Published: January 2022

Neural Tube Defects are the most typical congenital malformations, with almost 300,000 cases annually worldwide. The incidence varies amongst geographical ranges from 0.2 to up to 11 per 1000 live births. In India, incidence is reportedly higher in north than south and can be attributable to diet and genetic variances. Etiology is multifactorial. Severe forms of whitethorn are allied with syndromes. Primary neurulation and secondary neurulation are the most crucial steps in the formation and closure of the neural tube; any interruption can lead to mild to severe NTDs depending on the level of insult during embryogenesis. Various molecular and cellular events take place simultaneously for neural tube bending and closure of the neural tube. Neurological deficit in the newborn is contingent on the level of defect and severity of the structures affected. Survival of the newborn also depends on the severity of the lesion. Folic acid supplementation in all prospective mothers, preferably 4 weeks before conception and at least 12 weeks after conception, can prevent NTDs in folic responsive groups. But there is a significant number of other causes leading to neural tube defects apart from folic acid. Hydrocephalus is the commonest abnormality allied with NTDs in syndromic cases.

Conclusion:
NTDs are a frequent cause of stillbirths, infant mortality, and palsies in children. There are various reasons for NTDs, but the process of neurulation points towards some factors of NTC, which can be taken care of to lessen the burden of NTDs.
Prevalence of distal caries in the second mandibular molar among the general population in Mexico and its relationship with the position and angulation of the adjacent third molar
Authors: Flores-Orozco Elan Ignacio , Rogelio Diaz-Peña , Barron-Crespo Victor Melesio , Rovira-Lastra Bernat , Martinez-Gomis Jordi 
Published: January 2022

Aims:
This study aimed to estimate the prevalence of distal caries in the mandibular second molar (M2M) in a general population and to determine the strength of the association of several factors related to the adjacent mandibular third molar (M3M).

Subjects and Methods:
This retrospective cross-sectional study assessed digital panoramic radiographs of 753 individuals prescribed for screening and/or diagnostic purposes by different specialists. From these radiographs, 1358 M2Ms/M3Ms were included in the analysis. Age, sex, position, and inclination of the M3Ms with respect to the M2Ms and presence of distal caries in the M2Ms were assessed. Continuous variables were dichotomized using optimal cutoff values using receiver operating characteristic curve analysis.

Statistical Analysis Used:
A multivariate logistic regression model was performed.

Results:
In total, 8.2% (95% confidence interval 6.7 to 9.6%) of the M2Ms had distal caries. Multivariate logistic regression analysis showed that >22.5 years of age (odds ratio [OR] 3.42), >4.2 mm between the M2M and M3M (OR 2.67), >31.6° inclination of the M3M (OR 2.12) and the right side (OR 1.61) were positively associated with M2M distal caries.

Conclusions:
The prevalence of M2M distal caries can range from 6.7% to 9.6% in the general population. M3Ms separated more than 4.2 mm and mesioangulated more than 31.6° with respect to their adjacent M2Ms were 2.7- and 2.1-fold more likely to develop distal caries in their adjacent M2Ms.
Simulation-based Clinical Education Versus Early Clinical Exposure for Developing Clinical Skills in Respiratory Care Students
Authors: Al Khathlan Noor , Al Adhab Fadak , Al Jasim Hawraa , Al Furaish Sarah , Al Mutairi Wejdan , Al Yami Bashayer H. 
Published: January 2022

Background:
Early clinical exposure (ECE) has been shown to improve clinical skills, but several factors limit its implementation.

Objective:
To compare the use of simulation-based education (SCE) and ECE in improving respiratory care students’ clinical skills in laboratory settings.

Methodology:
This experimental prospective study was conducted among respiratory care students at Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Students from one batch were allocated to the ECE group, and students from another batch were allocated to the SCE group to concurrently undergo clinical training. On completion of the course, students completed the Clinical Learning Environment Inventory (CLEI), and their clinical practice course grades were evaluated.

Results:
A total of 72 students from the two batches completed the CLEI and clinical performance evaluation; 32 (45%) were female. The mean age was similar across both groups. Between the groups, there was no statistical difference in the mean clinical grade (95% CI) (ECE: 167.29 [164.74–169.84], SCE: 166.88 [164.12–169.65]; P = 0.837) and the CLEI score (ECE: 128.25 ± 3.9, SCE: 123.08 ± 4.2; P = 0.381). Multivariable linear regression analyses revealed no significant difference in the clinical performance grades (β = −0.09; 95% CI: −0.78–0.59; P = 0.788).

Conclusion:
The study found no significant difference in the performance between ECE and SCE in laboratory settings, indicating that SCE is a viable alternative to ECE in RC clinical training. Studies with larger cohorts are required to corroborate this finding.
Stieltjes interlacing of the zeros of
Authors: Frendreiss William , Gao Jennifer , Lei Austin , Woodall Amy , Xue Hui , Zhu Daozhou 
Published: January 2022

AbstractLet
$j_n$
be the modular function obtained by applying the nth Hecke operator on the classical j-invariant. For
$n>m\ge 2$
, we prove that between any two zeros of
$j_m$
on the unit circle of the fundamental domain, there is a zero of
$j_n$
.
Di(ver)sidades: fotoetnografía, coeducación y vulnerabilidad moral
Authors: Frutos Esteban Francisco Javier , López-San Segundo Carmen , Cerezo Prieto Marta , Montes López Estrella 
Published: January 2022

Cómo abordar la vulnerabilidad moral por razón de la orientación afectivo-sexual o la identidad de género en el contexto de la enseñanza superior? Di(ver)sidades afronta este reto como una acción coeducativa integrada en la experiencia de investigación e innovación responsable FotoC3: ciudadanía, creatividad y cuidado que se renueva anualmente desde el curso 2013/2014. Esta acción combina el uso de la fotografía colaborativa, la innovación docente, la indagación etnográfica, la creación cultural y la educación patrimonial y se apoya en tres prácticas metodológicas de investigación-acción participativa: Fotovoz, el Aprendizaje Basado en Proyectos y el Aprendizaje Servicio. Asimismo, promueve la mejora continua de sus procesos de gestión, adoptando la norma ISO 9000:2015, todo ello para insertarse en el contexto socioeducativo de la Universidad de Salamanca. En la actualidad, Di(ver)sidades obtiene resultados en tres dimensiones específicas: la puesta en marcha de buenas prácticas en innovación docente y responsabilidad social; la creación y difusión de contenidos culturales de carácter colectivo, y el desarrollo de la Colección Di(ver)sidades como parte de la Red de Colecciones Científicas de la Universidad de Salamanca.
AS CONTRIBUIÇÕES DA GEOGRAFIA PARA O ENSINO DE CIDADE E A FORMAÇÃO CIDADÃ
Authors: Alelaf Alice Silva Costa , Portela Mugiany Oliveira Brito 
Published: January 2022

As cidades têm grande importância econômica, cultural e política na vida das pessoas que as habitam, ou que, de algum modo dependem delas. Essa temática tem sido estudada e apresentada de diversas formas por pesquisadores de várias áreas do conhecimento, configurando-se como uma discussão bem expressiva na Geografia. São encontrados no meio acadêmico brasileiro trabalhos que visam um ensino de cidade com foco para munícipios específicos, o que tem aproximado os conceitos inerentes à temática à realidade dos alunos, possibilitando melhor compreensão e aprendizagem. Além disso, é um assunto a partir do qual os professores podem trabalhar diversos temas e conceitos geográficos. A Geografia, por meio do ensino de cidade, proporciona aos alunos riquíssimas discussões sobre o viver urbano, os processos de (re)produção, os agentes envolvidos nesse processo, as lutas e os conflitos expressos nesses espaços. Assim, o objetivo desse trabalho é apontar as contribuições do ensino cidade para a formação cidadã, expor encaminhamentos de assuntos que podem ser estudados nesse conteúdo e apresentar algumas produções referentes ao ensino de cidade e a relação com a Geografia, publicados no âmbito das pós-graduações e em alguns periódicos. Como resultados temos uma pesquisa bibliográfica sobre o tema em questão, além de encaminhamentos que contribuem para o ensino de cidade.
Palavras-chave
Geografia, Ensino de Cidade, Cidadania.

THE CONTRIBUTIONS OF GEOGRAPHY TO CITY TEACHING AND CITIZEN EDUCATION
Abstract
Cities have great economic, cultural and political importance in the lives of the people who inhabit them, or who in some way depend on them. This theme has been studied and presented in different ways by researchers from various areas of knowledge, configuring itself as a very expressive discussion in Geography. There are works in the Brazilian academic environment that aim at teaching the city with a focus on specific municipalities, which has brought the concepts inherent to the theme closer to the students' reality, enabling better understanding and learning. In addition, it is a subject from which teachers can work on various geographic themes and concepts. Geography, through city teaching, provides students with very rich discussions about urban living, the (re) production processes, the agents involved in this process, the struggles and conflicts expressed in these spaces. Thus, the objective of this work is to point out the contributions of city education to citizen education, expose subjects that can be studied in this content and present some productions related to city education and the relationship with Geography, published in the scope of graduations and in some journals. As a result, we have a bibliographic research on the subject in question, in addition to referrals that contribute to the teaching of the city.
Keywords
Geography, City teaching, Citizenship.
INDEPENDENT BENEFICIAL IMPACT OF SURGICAL REVASCULARIZATION ON ISCHEMIC LEFT VENTRICULAR DYSFUNCTION
Authors: Ahmed Taimur , Masood Arslan , Dastgir Noor 
Published: January 2022

Objectives: To assess the improvement in left ventricular ejection fraction (LVEF) after Coronary artery bypass grafting (CABG) among patients with severe LV dysfunction.
Methodology: This Quasi experimental study was conducted at Punjab Institute of Cardiology from January to June 2021. One hundred and thirty four patients of severe LV dysfunction with coronary anatomy suitable for CABG were included in the study. Assessment of LVEF was carried out with echocardiography at baseline. All patients underwent CABG under general anaesthesia and were followed-up on 15th day with repeat echocardiography. Pre-CABG and post-CABG EFs were compared and mean changes in EFs were checked for potential effect modifications with gender, diabetes, CAD duration, age and body weight.
Results: The mean LVEFs before and after surgery were 23.63 ± 1.17% and 32.11 ± 1.98% respectively. Mean improvement in LVEF after CABG was 8.5 ± 2.7 % (p < 0.001, 95% CI for difference 8.0 – 8.9) and did not different significantly according to gender, diabetes, CAD duration, age and body weight (P = 0.592, 0.167, 0.506, 0.138 and 0.458 respectively).
Conclusion: Patients of CAD who underwent CABG had improved post-operative LVEFs independent of evaluated potential effect modifiers.
Biopsy Proven Kidney Disease From A Rural Tertiary Care Centre — A Social And Epidemiological Perspective
Authors: Fatima Rana , Kumar Rakesh , Goud Amitesh , Muddhasani Srikanth , Reddy Satish , Swarnalatha Gouri shankar , Swain Meenakshi 
Published: January 2022

Abstract
The prevalence of chronic kidney disease (CKD) is rising in rural areas. Screening of high risk cases, early detection and referral by the physicians reduces the prevalence of kidney disease in the population. Hereditary disorders, Glomerular diseases, Obstructive nephropathies are common causes in CKD in rural areas. Kidney biopsy is an essential diagnostic tool in to diagnose glomerular diseases. This prospective study done at tertiary care teaching hospital between 2017 and 2020 to understand the profile of glomerular diseases in rural area. Forty patients were included in the Study. Primary glomerular disease (PGD) was present in 26 patients and Secondary glomerular disease (SGD) in 10 and primary tubulointerstitial pathology in 4 patients. The most common Secondary glomerular disease was lupus. Glomerular diseases are amenable to immunomodulatory therapy leading to change in clinical outcome of the disease. However, Kidney biopsy is underutilized particularly in elderly patients, hypertensive nephropathy patients, suspected non diabetic kidney disease and lupus patients.
Financial and social issues play dominant role in the treatment plan of chronic diseases in rural areas. Regional registry of kidney biopsy of urban and rural areas separately helps in paving a way of understanding the profile of glomerular diseases and its prevention.