Alsaegh, Ali

Darawsheh H., Alsaegh A., Nikolenko V., Bakieva S., Smilyk I., Panin A., Kheygetyan A., Troitskiy V., Leonov D., Vasil’ev Y.

Background and Objectives: the mandibular foramen is an essential anatomic landmark in performing various dental and surgical procedures, including inferior alveolar nerve block (IANB). However, its position may vary based on the individual morpho-functional features of the skull and face. This study aims to conduct a personalized assessment of the location of the mandibular foramen in various shapes of skulls, faces, and mandibles. Materials and Methods: this anatomic morphometric cross-sectional study was performed using one hundred and six (n = 106) certified human cadaver heads of both sexes. The cranial index (CI) and Izard’s facial index (FI) were calculated, the linear anatomic parameters of the skull and mandible were measured, the location of the mandibular foramen was identified, and the shapes of the skulls and mandibles were determined. Quantitative statistical data were obtained based on the location of the mandibular foramen, considering different shapes of skulls and faces. Results: there is a significant correlation between the location of the mandibular foramen, the high lengthy index (HLI) of the mandible, and the longitudinal latitude index (LLI) of the mandibular process. Conclusions: personalized assessment of the mandibular foramen based on a comprehensive analysis of craniometric characteristics can contribute to preventing unwanted dental and surgical complications, such as inferior alveolar nerve damage.

Darawsheh H., Alsaegh A., Kanukoeva E., Saleev R., Saleeva G., Volel B., Kireeva N., Rebrova E., Vasil’ev Y.L.

Inferior alveolar nerve block (IANB) is one of the most common procedures in operative dentistry, and a deep understanding of the normal anatomical variation of the pterygomandibular space (PM) is essential for its safe and successful administration. This cadaveric anatomical study aimed to use A-silicone injections to evaluate the volume of the PM. This study was conducted using 46 human cadaver heads (25 males and 21 females). A craniometric analysis was performed using the cadavers’ ages, the number of silicone cartridges (carpules) used to fill the pterygomandibular space, Izard’s Facial Index (FI), and the Cranial Index (CI). A Halstead mandibular block was performed by injecting 1.7 mL A-silicone cartridges (as an equivalent to standard local aesthetic carpules volume) into the PM. The cured silicone was extracted from the dissected mandibles. The volume (length, width, and thickness) of the extracted silicone and the number of silicone cartridges used to fill the space were evaluated. The results showed that there are statistically significant positive correlations between the CI and the width of the right PM, as well as the width and length of the left PM. A statistically significant correlation was found between the width of the left PM and the age of the cadaveric heads; the higher the age, the thicker the space on both sides. The volume of the PM corresponded to 1.5 cartridges on average.

Kashtanov A., Molotok E., Yavorovskiy A., Boyarkov A., Vasil’ev Y., Alsaegh A., Dydykin S., Kytko O., Meylanova R., Enina Y., Troitskiy V., Kapitonova M., Vaits S., Vaits T., Saleev R., et. al.

Working in intensive care units (ICUs) is stressful and potentially leads to various psycho-emotional disorders. Today, this issue represents a serious concern to the healthcare sector and affects the quality of healthcare provided. This study aimed to assess and compare the psycho-emotional state in COVID-19 and non-COVID-19 hospitals’ ICU healthcare workers (HCWs). From January to July 2021, we conducted an anonymous cross-sectional web survey of ICU physicians and nurses (N = 1259) of various hospitals in a metropolis with a population of over 10 million people. The statistical distributions of non-COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 14.6%, average 30.8%, and high 54.6%); depersonalization levels (low 11.6%, average 16.5%, and high 71.9%); and reduced personal accomplishment levels (low 23.5%, average 40.3%, and high 36.2%). The statistical distributions of COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 16.5%, average 31.5%, and high 52%); depersonalization levels (low 7.4%, average 9.4%, and high 83.1%); and reduced personal accomplishment levels (low 25.4%, average 45.4%, and high 29.1%). This study found a strong correlation between emotional exhaustion, aggression, and depersonalization in non-COVID-19 ICU HCWs and also found a correlation between their age, aggression, emotional exhaustion, and occupational stress.

Kytko O.V., Meilanova R.D., Sankova M.V., Smilyk I.M., Zavodilenko L.A., Yartseva A.V., Alsaegh A., Ivanov A.A.

Alsaegh A., Belova E., Vasil’ev Y., Zabroda N., Severova L., Timofeeva M., Dobrokhotov D., Leonova A., Mitrokhin O.

The novel coronavirus (COVID-19) outbreak is a public health emergency of international concern, and this emergency led to postponing elective dental care procedures. The postponing aimed to protect the public from an unknown risk caused by COVID-19. At the beginning of the outbreak, for public health authorities, the aerosol-generating procedures and the close proximity between dental care workers and patients in dentistry represented sufficient justification for the delay of dental visits. Dental care is a priority, and for many years, studies have proven that the lack and delay of dental care can cause severe consequences for the oral health of the general population, which can cause a high global burden of oral diseases. Safety is necessary while resuming dental activities, and risk assessment is an efficient method for understanding and preventing the COVID-19 infectious threats facing the dental industry and affecting dental care workers and patients. In this study, for safe dental care delivery, we adapted risk assessment criteria and an approach and an occupational classification system. Based on those tools, we also recommend measures that can help to minimize infectious risk in dental settings.

Reshetnikov V., Mitrokhin O., Belova E., Mikhailovsky V., Mikerova M., Alsaegh A., Yakushina I., Royuk V.

The novel coronavirus (COVID-19) outbreak is a public health emergency of international concern, and as a response, public health authorities started enforcing preventive measures like self-isolation and social distancing. The enforcement of isolation has consequences that may affect the lifestyle-related behavior of the general population. Quarantine encompasses a range of strategies that can be used to detain, isolate, or conditionally release individuals or populations infected or exposed to contagious diseases and should be tailored to circumstances. Interestingly, medical students may represent an example of how the COVID-19 pandemic can form new habits and change lifestyle behaviors. We conducted a web-based survey to assess changes in lifestyle-related behavior of self-isolated medical students during the COVID-19 pandemic. Then we analyzed the sanitary-hygienic regulations of the Russian Federation to determine the requirements for healthy buildings. Results showed that during the pandemic, the enforcement of isolation affects medical students’ lifestyle-related behavior and accompanies an increase in non-communicable diseases (NCDs). Indoor environmental quality (IEQ) and healthy buildings are cutting-edge factors in preventing COVID-19 and NCDs. The Russian sanitary-hygienic regulations support improving this factor with suitable requirements for ventilation, sewage, waste management, and disinfection. Herein, assessing isolation is possible through the hygienic self-isolation index.

Mitrokhin O., Belova E., Alsaegh A., Ermakova N., Leonova A.

Self-isolation is a preventive measure that started in January 2020 as a response to the spread of the coronavirus COVID-19 infection, and it has no precedents in human history. During this pandemic, governments forced billions of people to self-isolate for several months, and the sanitary-hygienic assessment of self-isolation became an essential issue. It is possible to assess self-isolation using several methods: We proposed a sanitary-hygienic definition of self-isolation. We developed a hygienic self-isolation index point score (HSIPS) which determines that the optimal mode is directly proportional to the coefficients of a person’s physical activity (D), indoor area (air cubic capacity) per isolated (S), time spent in fresh air (T) and inversely proportional to the calorie intake. The self-isolation index point score (HSIPS) determines if self-isolation is (1) optimal, (2) favorable, or (3) unfavorable. We determined methods to assess the level of functional reserves of the body. We identified the leading risk factors for the health of the self-isolation population. We proposed sanitary-hygienic criteria for assessing self-isolation based on the sanitary-hygienic standards of the Russian Federation. The sanitary-hygienic assessment of self-isolation can ensure the prevention of cardiovascular, alimentary-dependent diseases, and pathologies of the musculoskeletal system. Besides, self-isolation accompanies a decrease in motor activity and unbalanced nutrition.

Mitrokhin O., Belova E., Alsaegh A., Filin A., Severova L., Timofeeva M.

Novel coronavirus (SARS-COV-2) was identified in December 2019 in the People's Republic of China, and it started emerging as an international healthcare emergency. COVID-19 pandemic might represent the tip of the iceberg and is the responsibility of all public healthcare authorities and experts to develop an adequate response using the right protocols and instruments to ensure public safety. To ensure safety and to improve public health, we developed a risk assessment criteria (RAC) that combine all the necessary preventive elements (sanitary, hygienic, and organizational). RAC is a reliable assessment method based on the following sanitary-hygienic criteria: distance from the infectious source, contact time, and the magnitude of the contact hazard. Furthermore, we suggested an occupational classification system according to the coronavirus COVID-19 infectious risk (high risk, medium risk, and low risk). To reduce the spread of coronavirus infections, we also proposed the use of the following sanitary-hygienic principles: time protection (the shorter the time of contact with potential carriers of a mild form of a disease, the lower the infectious risk), distance protection (compliance with social distancing), and impact scale protection (the fewer the contacts with possible asymptomatic carriers, the lower the infectious risk). To minimize the spread of mass epidemics and infectious diseases, we believe that it is essential to implement a preventive action plan (PAP) that includes the following measures: reconsidering architectural standards; designing and building modular hospitals and modular equipment; mandatory self-isolation; and preparing a professional workforce. This action plan can be used to improve the readiness of public health authorities on countering biological threats in the short, medium, and long terms.

Lee Y., Dai J., Li X., Chiang M., Chen P., Lin Y., Wang C.

Burnout is a global concern, and critical healthcare professionals have been identified as a high-risk population of burnout. Early identification is crucial, but the prevalence of burnout and its risk factors demonstrate significant geographical variations. This study aims to investigate the prevalence of burnout among critical healthcare professionals and explore potential risk factors during the post-pandemic era in Taiwan. A web-based questionnaire survey was conducted from December 1, 2023, to January 31, 2024, targeting critical healthcare professionals employed in selected medical institutions affiliated with the Chang Gung Memorial Hospital Foundation, one of Taiwan’s largest healthcare organizations. Demographic information, the Subjective Happiness Scale (SHS), current work stressors and self-reported general health data were collected. The study utilized the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-MP). Univariate and multivariate logistic regression were employed to investigate the association between risk factors and each burnout subscales. A systematic review of Asian literature concerning burnout among critical care practitioners was also conducted. In our study, 254 participants were enrolled, with an overall burnout rate of 35.4%. The prevalence of high emotional exhaustion (EE) was 70.9%, high depersonalization (DP) was 56.3%, and low personal accomplishment (PA) was 60.6%. Young, unmarried populations, individuals with limited work experience, longer working hours, and night shifts are potential vulnerable groups susceptible to burnout. The top three stressors identified were excessive workload, the burden of administrative tasks, and a shortage of vacation time. Our systematic review included 20 Asian studies on the same issue, with variable burnout prevalence ranging from 16.3 to 82.1%. The prevalence of burnout was high among critical healthcare professionals in post-pandemic Taiwan, particularly affecting younger, unmarried populations and individuals with limited work experience, longer hours, and more night shifts. The influence of pandemic-related factors has decreased. Regional variations in burnout have been observed across Asia, highlighting the need for further research to identify local risk factors and protect the well-being of professionals and healthcare quality.

Kashtanov A.D., Stetsyk E.O., Dydykin S.S., Kytko O.V., Trunin E.M., Aleshkina O.Y., Lavrentieva A.N., Andreeva A.N., Alekseeva D.S., Muratova A.A., Kharina A.Y., Tatarkin V.V., Sokolova A.S., Filatov V.N., Samodova I.L., et. al.

The introduction of digital technologies into the learning process for medical university students represents a new paradigm in medical education since high level of criteria for assessing the quality of learning of a medical student require the application of modern technologies in training fundamental disciplines and, in particular, anatomy. Thanks to virtual technologies, conditions are created for modeling and integrating the student into conditions close to real ones, which increases the interest and involvement of students in the educational process and, as a result, a subjective improvement in the process of assimilation of the material. Traditional education based on dissection materials cannot fully provide for the massive training of students, as biological materials cannot be restored or preserved and are quickly damaged. 3D models are devoid of these limitations.Aim: to evaluate the effectiveness of digital dissection in the educational trajectory of clinical anatomy using interactive anatomical tables and the need of students for the active use of these aids.Materials and methods. Four groups of students were formed: three groups were studying the material using various anatomical tables and one group used the traditional method. To control the effectiveness of the educational process, before the start of training, entrance testing was conducted in all groups. At the end of classes on individual topics, participants completed exit testing, as well as a questionnaire.Results. The analysis of learning outcomes shows a significantly higher level of absorption of the material among students in groups where 3D anatomical models were used during classes. This indicates that students’ subjective experience of the learning process has improved due to their increased involvement in the class and their interest in innovative teaching methods.Conclusion. We plan to study learning outcomes in more detail to identify any differences in the formation of general and professional competencies among students. This information will help us make informed decisions about the widespread use of anatomical models in educational practice.

Darawsheh H., Alsaegh A., Nikolenko V., Bakieva S., Smilyk I., Panin A., Kheygetyan A., Troitskiy V., Leonov D., Vasil’ev Y.

Background and Objectives: the mandibular foramen is an essential anatomic landmark in performing various dental and surgical procedures, including inferior alveolar nerve block (IANB). However, its position may vary based on the individual morpho-functional features of the skull and face. This study aims to conduct a personalized assessment of the location of the mandibular foramen in various shapes of skulls, faces, and mandibles. Materials and Methods: this anatomic morphometric cross-sectional study was performed using one hundred and six (n = 106) certified human cadaver heads of both sexes. The cranial index (CI) and Izard’s facial index (FI) were calculated, the linear anatomic parameters of the skull and mandible were measured, the location of the mandibular foramen was identified, and the shapes of the skulls and mandibles were determined. Quantitative statistical data were obtained based on the location of the mandibular foramen, considering different shapes of skulls and faces. Results: there is a significant correlation between the location of the mandibular foramen, the high lengthy index (HLI) of the mandible, and the longitudinal latitude index (LLI) of the mandibular process. Conclusions: personalized assessment of the mandibular foramen based on a comprehensive analysis of craniometric characteristics can contribute to preventing unwanted dental and surgical complications, such as inferior alveolar nerve damage.

Rusu M.C., Toader C., Tudose R.C., Grigoriţă L.O.

The lateral pterygoid muscle (LPM), a critical component of the masticatory muscles, typically comprises upper (SLPM) and lower (ILPM) heads. However, it is essential to note that the LPM’s structure is not a constant feature, as the number of bundles and their topography can vary. Moreover, additional heads, such as medial and middle heads, and unique-headed configurations of the LPM have been reported. Several studies have demonstrated the penniform structure of the LPM, which is further supported by its diverse pattern of innervation. Anatomically, the LPM originates from the greater wing and lateral pterygoid plate of the sphenoid bone, with variations in these origins being common. For instance, the presence of a broad lateral pterygoid plate or extensions from it can enlarge the origin area of the LPM. Equally variable are the insertions of the LPM, which can include attachments to the mandibular condyle and the temporomandibular joint disc. In some cases, aberrant LPM bundles may attach to the mandibular condyle outside the mandibular notch. Rarely encountered muscles like the pterygoideus proprius, pterygospinosus, and pterygofacialis further add to the diversity of this muscle. The anatomy of the LPM is subject to modification due to factors like atrophy or hypertrophy. Therefore, it is imperative to recognize that a one-size-fits-all anatomical pattern for the LPM does not exist. Instead, a personalized therapeutic approach should be based on a case-by-case determination of the LPM’s specific anatomical configuration. This nuanced understanding challenges the simplistic view of the LPM and underscores the need for individualized clinical considerations.

de Yong S., Rachmawati M., Defiana I.

"Theorizing security-pandemic aspects and variables for post-pandemic architecture" refers to creating propositions and theory systems for the security-pandemic aspects and variables in the presence of pandemic and health issues and the consequences of changing hybrid activities within living-working space. COVID-19 has caused changes in architecture, especially in the context of the security pandemic. Architecture needs different strategies to help prevent disease in the future. A theorizing theory involves classification and interpreted terms, network analysis, and creating propositions and theories based on aspects and variables. The findings are 3 new interpretations of aspects, 14 sub-aspects of security-pandemic theory, and 23 security-pandemic variables that can be used as strategies in architecture design. The interconnection between aspects (dynamics, distancing, and living-working pattern), sub-aspects, and variables are connected regarding control, prevention, and deterring patterns for disease spread through person-to-person and media/surface-to-person. These findings will support future research in preventive measures in post-pandemic architecture, creating innovative building and green code certifications for security-pandemic theory or modifying the existing codes and green certifications. © 2017 Elsevier Inc. All rights reserved.

Quesada-Puga C., Izquierdo-Espin F.J., Membrive-Jiménez M.J., Aguayo-Estremera R., Cañadas-De La Fuente G.A., Romero-Béjar J.L., Gómez-Urquiza J.L.

The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction. Sustained stress in the workplace leads to the development of burnout, a syndrome characterised by three dimensions: emotional exhaustion, depersonalisation and perceived lack of personal fulfilment. To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel. The PubMed, CINAHL and Scopus databases were used. A systematic review and meta-analysis. The study sample consisted of 18 quantitative primary studies conducted in the last five years. Validated questionnaires were used to assess burnout in ICU healthcare workers, the most commonly used being the Maslach Burnout Inventory. The search equation applied was: “job satisfaction AND nurs* AND burnout AND (ICU OR intensive care units)”. The search was performed in October 2022. The search returned 514 results. Only 73 articles met the eligibility criteria. After reading the title and abstract, 20 articles were selected. After reading the full texts, 12 articles remained and after the reverse search, 18 articles were finally selected. The studies reported a 50% prevalence of burnout, all three dimensions of which were heightened by the COVID-19 pandemic. Analysis of the study findings revealed an inverse association between burnout and job satisfaction. Job dissatisfaction of ICU nurses depends on lack of experience, working conditions or working environment among others. ICU nurses with lower job satisfaction have higher levels of burnout. This meta-analysis shows the potential value of job satisfaction on improving health outcomes related to burnout syndrome for nursing professional in Intensive Care Units. Different factors that could increase job satisfaction and consequently protect them from suffering high levels of burnout, such as salary, permanence in the service, mental health care are the responsibility of the hospital supervisor and, finally, of the own Health System. Knowledge of a risk profile based on the factors influencing job dissatisfaction would enable the implementation of effective workplace interventions to reduce or prevent the risk of burnout. Health policies should focus on protecting the worker, so in addition to improving working conditions, it would be interesting to promote coping skills in order to improve the quality of care and patient safety.

Zaman S., Ahammed T.

COVID-19 is an international emergency public health concern that poses significant challenges. Intake of adequate immune-boosting nutrients from natural sources, proper hygiene practices, and ideal lifestyle practices must be adhered to during this condition, along with the discovery of protective vaccines. The purpose of the current study was to evaluate the dietary, hygiene, and lifestyle practices among adult residents during the COVID-19 pandemic situation in the Jashore district, Bangladesh. This cross-sectional study was conducted through face-to-face interviews with 500 adult respondents of both genders (age ≥ 18 years). A structured and validated questionnaire was used to collect data on socio-demographic information, dietary diversity, hygiene, and lifestyle practices. Multivariate logistic regression was employed to evaluate and predict factors that influence the study variables. The study found that about 44.60% had medium, 27% had low, and 28.40% had high dietary diversity. Regarding the dietary practices, age (p = 0.001), education (p = 0.005), occupation (p = 0.015), and COVID-19 experience (p = 0.001) of respondents were significantly associated with both residential. Hygiene practices such as using a face mask, hand sanitizer use, covering the face during coughing, and hand shaking were significantly associated (p < 0.05) with respondents in both residential areas. In logistic regression analysis, factors associated with poor hygiene practices were being male, illiterate, > 40 years of age, smokers, malnourished respondents in rural areas, obese, > 40 years of age, and having income < 10000 BDT in urban areas. About 40.4% of urban and 45.6% of rural respondents were found to be engaged in physical activity. The study found that the respondents mostly had access to medium dietary diversity, and rural residents maintained a better lifestyle while urban respondents practiced better hygiene. Based on the findings, the study suggests increasing public awareness regarding dietary diversity, hygiene, and lifestyle practices in both rural and urban areas to mitigate the consequences of COVID-19.

Alonso C., de Frutos F., Martín-Consuegra F., Oteiza I., Frutos B.

Housing energy rehabilitation is currently a priority in Europe. In vulnerable neighbourhoods, improving energy efficiency and comfort conditions has an important impact on people living conditions. Rehabilitation strategies are usually designed according to standard scenarios, without taking into account variations related to the users or the type of building. Monitoring this type of housing offers valuable information to be able to select the best strategies based on a diagnosis of their real performance. In this paper we present one year data on energy consumption, hygrothermal comfort and CO2 monitored for 22 dwellings in Madrid, located in six different vulnerable locations. In addition to normal periods, the monitoring campaign includes periods of extreme heat and cold, and two exceptional situations, the "Filomena" snowfall and the COVID pandemic period. The results report poor indoor environmental quality in these dwellings, both in the main rooms and in the bedrooms. Also poor building quality is observed. The recorded energy consumption is lower than that given as a reference in the standards or models, at the cost of a worse indoor environment. The analisys supports the importance of retrofit strategies that take into account the composition of the household, such as single-person households or those with children, the higher vulnerability of dwellings with higher demand, the subjective perception and the role of users, and the need to incorporate improvements in indoor air renewal.

Pakou V., Tsartsalis D., Papathanakos G., Dragioti E., Gouva M., Koulouras V.

This study explored the associations between personality dimensions, burnout, and psychopathology in healthcare professionals in intensive care units (ICUs). This study further aimed to discern the differences in these relationships when considering the variables of critical care experience (less than 5 years, 5–10 years, and more than 10 years), profession (nurses versus intensivists), and the urban size of the city where the ICU is located (metropolitan cities versus smaller urban cities). This cross-sectional investigation’s outcomes are based on data from 503 ICU personnel, including 155 intensivists and 348 nurses, in 31 ICU departments in Greece. Participants underwent a comprehensive assessment involving a sociodemographic questionnaire, the Eysenck Personality Questionnaire (EPQ), the Maslach Burnout Inventory (MBI), and the Symptom Checklist-90 (SCL-90). To analyze the interplay among critical care experience, burnout status, and psychopathology, a moderation analysis was conducted with personality dimensions (i.e., psychoticism, extraversion, and neuroticism) serving as the mediator variable. Profession and the urban size of the ICU location were considered as moderators influencing these relationships. Male healthcare professionals showed higher psychoticism levels than females, aligning with prior research. Experienced nurses reported lower personal achievement, hinting at potential motivation challenges for professional growth. Psychoticism predicted high depersonalization and low personal achievement. Neuroticism and psychoticism negatively impacted ICU personnel’s mental well-being, reflected in elevated psychopathology scores and burnout status. Psychoticism appears to be the primary factor influencing burnout among the three personality dimensions, particularly affecting intensivists. In contrast, nurses are more influenced by their critical care experience on their mental health status.

de Yong S., Rachmawati M., Defiana I.

PurposeThis paper aims to identify aspects of how work-life interaction has changed in the post-pandemic situations and propose strategies of the security concept for living-working patterns in the post-pandemic interior as future disease prevention.Design/methodology/approachWe conducted a systematic literature search and review to select previous research systematically and relate concepts by coding the data and synthesising the data critically. The systematic literature search and review considered 90 papers (35 were studied).FindingsThe findings identify three strategies: hybrid activity patterns, new layout for hybrid and changing behaviour and culture. Each strategy demonstrates the connection between the hybrid living-working interior spaces in the post-pandemic period and security-pandemic variables. The results on security design factors focused on interior control, detection and deterrence; connection to nature creates a safer environment to prevent further variables; and hybrid activity requires more elements to govern users' behaviour and culture.Research limitations/implicationsLimitations of this study are as follows: excluded papers that are not written in English/Bahasa or do not have gold/green open access; some aspects were not discussed (such as social distancing); the articles included in this review are up to April 2023 (and there is the possibility of recent papers). Future studies can be developed to update building certification for post-pandemic interiors or research with psychological, social equity or family vitality issues.Originality/valueThe study offers strategies and the holistic relationship between the post-pandemic concept and security-pandemic design variables within the built environment, especially in the users' culture and behaviour context.

Eichholtz P., Kok N., Sun X.

Abstract The recent COVID-19 pandemic has made people acutely aware of the importance of indoor air quality (IAQ) and building ventilation systems, particularly in densely occupied places like offices and schools. As a result, governments and other public entities are increasingly investing in the installation, maintenance, and upgrades of ventilation systems in public buildings. However, little is known about the effect of building ventilation systems on actual IAQ and its impact on occupant behavior. This paper exploits exogenous closing and opening events of schools during the COVID-19 pandemic, combined with policy measures focusing on maximizing ventilation rates inside classrooms, to assess the effectiveness of building ventilation systems in primary schools. We use a unique sensor network implemented before the COVID-19 pandemic, consisting of measurement devices installed in 252 classrooms across 27 Dutch primary schools, continuously monitoring IAQ indicators such as CO2 levels and fine particle concentrations. Using high-frequency data from the 2018 to 2022 school years, we compare the IAQ differences between natural and mechanical ventilation through a fixed-effect identification strategy. Our results show that mechanically ventilated classrooms perform better with respect to CO2 and fine particle levels. However, the post-COVID-19 ventilation measures implemented after school reopening had stronger effects on naturally ventilated classrooms, suggesting behavioral changes at the classroom level. We also investigate the longer-term effects of these new ventilation measures and show some evidence of decay in effectiveness, as well as a strong seasonal effect, particularly in naturally ventilated classrooms, which seems the result of a trade-off between ventilation and thermal comfort.

Naim R., Ziadé N., Haouichat C., Baron F., Al-Mayouf S.M., Abdulateef N., Masri B., El Rakawi M., El Kibbi L., Al Mashaleh M., Abutiban F., Hmamouchi I.

Burnout is frequent among physicians and seems to be underestimated among rheumatologists. To estimate the frequency of burnout in a sample of rheumatologists practising in the Arab countries and determine its associated factors. This was a descriptive cross-sectional study conducted by the Arab League of Associations for Rheumatology (ArLAR research group) using an anonymous electronic questionnaire set up on the Google Forms platform. All Arab rheumatologists and rheumatology fellows were invited to participate in the spring of 2022 via ArLAR social media accounts, societies' WhatsApp groups, and mass emails. Burnout was defined by at least one positive domain of the Maslach Burnout Inventory (MBI) (Emotional exhaustion, Depersonalization, and Personal accomplishment). The final score was correlated to socio-demographic factors using a multivariable binary logistic regression. The study included 445 rheumatologists and rheumatology fellows with an average age of 45.2 years (SD 11.5); 61.8% were men. The frequency of burnout among rheumatologists was 61.3% and was driven by low personal accomplishment scores (58.1%). Younger age (OR 1.92 (95%CI 1.20–3.08)), dissatisfaction with the specialty (OR 2.036 (95% CI 1.20–3.46)), and low income (OR 2.26 (95% CI 1.01–5.10)) were associated with burnout. The frequency of burnout in a sample of rheumatologists in Arab countries is very high, driven by low personal accomplishment scores and associated with a low income, dissatisfaction with the specialty and younger age. Some associated factors might be modifiable, thus reducing the burden of burnout on rheumatologists and on the healthcare system.

Akkemik O., Acikgoz A.

Zhang S., Zhao Z., Zhang H., Zhu Y., Xi Z., Xiang K.

Workplace violence (WPV) is a prevalent phenomenon, especially in the healthcare setting. WPV against healthcare workers (HCWs) has increased during the COVID-19 epidemic. This meta-analysis determined the prevalence and risk factors of WPV. A database search was conducted across six databases in May 2022, which was updated in October 2022. WPV prevalence among HCWs was the main outcome. Data were stratified by WPV/HCW type, pandemic period (early, mid, late), and medical specialty. WPV risk factors were the secondary outcome. All analyses were conducted through STATA. Newcastle Ottawa Scale evaluated the quality. Sensitivity analysis identified effect estimate changes. A total of 38 studies (63,672 HCWs) were analyzed. The prevalence of WPV of any kind (43%), physical (9%), verbal (48%), and emotional (26%) was high. From mid-pandemic to late-pandemic, WPV (40–47%), physical violence (12–23%), and verbal violence (45–58%) increased. Nurses had more than double the rate of physical violence (13% vs. 5%) than physicians, while WPV and verbal violence were equal. Gender, profession, and COVID-19 timing did not affect WPV, physical, or verbal violence risk. COVID-19 HCWs were more likely to be physically assaulted (logOR = 0.54; 95% CI: 0.10: 0.97). Most healthcare employees suffer verbal violence, followed by emotional, bullying, sexual harassment, and physical assault. Pandemic-related workplace violence increased. Nurses were twice as violent as doctors. COVID-19 healthcare employees had a higher risk of physical and workplace violence.

Mao H., Yu H., Tang Y., Zhang K., Luo M., Zhuang L.

Quarantine is one of the effective approaches to control the spread of COVID-19. However, prolonged isolation may harm the health of residents, especially students, who are quarantined in dormitories. This study surveyed students’ behaviors, living environment, and psychological state through an online questionnaire. The results showed that during the isolation period, the participants’ discomfort mainly came from high temperatures, high humidity, loud sounds, and dark lighting. Moreover, about half of the students experienced severe anxiety or depression, with poor sleep and an unclear mind being the most common problems. Additionally, this study focused on exploring the correlations between environmental perceptions and the psychological state of isolated students, that were identified to be significant. Furthermore, as isolation time was prolonged, the psychological state of isolated students worsened, and the most significant factor changed from thermal sensations to acoustic sensations. Interestingly, the psychological state of males was worse than females, and they were more easily affected by their thermal and acoustic environments. Therefore, keeping the environment comfortable has a positive influence on maintaining the good psychological condition of people in isolation. This study can provide suggestions for the improvement of indoor environments and for the mental health of people in isolation and in other similar situations.

Guzmán J., Abarca J., Navarro P., Garay I., Arnabat-Domínguez J., Betancourt P.

The inferior alveolar nerve (IAN), contained within the mandibular canal (MC), is a structure prone to damage in clinical and surgical procedures on the mandible. This study aimed to analyze the MC morphology and its anatomical variants in a Chilean subpopulation using cone beam computed tomography (CBCT). In total, 342 images from patients with the following parameters were observed: 120 kV, 9 mA, field of view 12 × 9 MC, and voxel size 0.12 mm. The average length of the MC recorded a mean value of 70.493 ± 4.987 mm on the right side and 70.805 ± 5.177 mm on the left side. The location of the mental foramen (MF) was most frequently found between the mandibular first and second premolar. The greatest bone thickness was found at the level of the basilar border of the 2MPM. The root closest to the MC was distal from the mandibular second molar. The lowest thickness was in the lingual area at 1MM. The prevalence of the anterior loop (AL) (61.5%) and the retromolar canal (RC) (17.5%) showed no significant differences between men and women. The results obtained showed that the morphology of the MC in the Chilean subpopulation can vary.

de Castro R.W., Marlière D.A., Haiter Neto F., Groppo F.C., Asprino L.

To evaluate the positions of the mandibular foramen (MF) and mandibular canal (MC) between different skeletal classes to highlight the implications for bilateral sagittal split osteotomy (BSSO). A cross-sectional study was performed using cone-beam computed tomography on 90 patients classified into classes I, II and III. Linear measurements were performed on multiplanar reconstructions as follows: from the MF to the edge of the mandibular ramus (1), to the mandibular notch (2), to the ramus width (3) and to the occlusal plane (4); and from the MC to the alveolar crest (A), to the lower border of the mandible (B) and to the mandibular buccal cortical bone (C). Mandibular thickness (D), width (E) and height (F) of the MC were measured. Intra-class correlation coefficient (ICC) checked the reliability. Two-way ANOVA and Tukey’s test were used to compare measurements and classes. Linear measurements 2 presented a statistically significant difference between classes I and II. There was no statistically significant difference between the classes and measurements B, C, D, E and F. Linear measurements A were shorter in class III than in class II. Although most measurements suggest that the BSSO technique does not need to be modified for each skeletal class, measurements from the MF to the mandibular notch in class II and from the MC to the alveolar crest on distal of the second molars in class III could help surgeons to recognize critical regions.

Darawsheh H., Alsaegh A., Kanukoeva E., Saleev R., Saleeva G., Volel B., Kireeva N., Rebrova E., Vasil’ev Y.L.

Inferior alveolar nerve block (IANB) is one of the most common procedures in operative dentistry, and a deep understanding of the normal anatomical variation of the pterygomandibular space (PM) is essential for its safe and successful administration. This cadaveric anatomical study aimed to use A-silicone injections to evaluate the volume of the PM. This study was conducted using 46 human cadaver heads (25 males and 21 females). A craniometric analysis was performed using the cadavers’ ages, the number of silicone cartridges (carpules) used to fill the pterygomandibular space, Izard’s Facial Index (FI), and the Cranial Index (CI). A Halstead mandibular block was performed by injecting 1.7 mL A-silicone cartridges (as an equivalent to standard local aesthetic carpules volume) into the PM. The cured silicone was extracted from the dissected mandibles. The volume (length, width, and thickness) of the extracted silicone and the number of silicone cartridges used to fill the space were evaluated. The results showed that there are statistically significant positive correlations between the CI and the width of the right PM, as well as the width and length of the left PM. A statistically significant correlation was found between the width of the left PM and the age of the cadaveric heads; the higher the age, the thicker the space on both sides. The volume of the PM corresponded to 1.5 cartridges on average.

Darawsheh H.M., Makarova N.I., Dydykina I.S., Lezhnev D.A., Dobrokhotova M.O., Saleeva G.T., Saleev N.R., Saleev R.A., Dydykin S.S., Vasil’ev Y.L.

A thorough knowledge of the anatomy and variability of the pterygomandibular space (PMS) is essential to the success of local anesthesia. This study is aimed at determining the volume of the PMS depending on the shape of the skull, face and mandible using the computed tomography (CT). anonymized computed tomograms of 48 adult patients were analyzed, the indicators of the cranial index (CI), facial index (FI) according to Yzard, the high lengthy index of the mandible (HLI), the latitudinal-altitude index of the mandible (LAI), the longitudinal latitude index of the mandible (LLI) were calculated. Differences in the volume of the PMS were found depending on the shape of the skull, face and mandible. When determining the CI, the largest volume of space on the right was observed with brachycrania (2.05 ml), on the left - with mesocrania and brachycrania (2.0 ml each). With regard to the FI, the largest volume of space was obtained with medium face on the right side (2.03 ml) and broad and medium types of faces (2.0 ml each) on the left. When calculating the indicators for the shapes of mandible, the largest volume of space was found in the brachygenic (2.05 ml), leptogenic (1.98 ml) and platigenic (1.97 ml) shapes on the right and leptogenic and platigenic shapes on the left (2.0 ml each). There were statistically significant differences in the volume of the right side of the PMS between different shapes according to the cranial index (F = 5.075; p = 0.0095). The most pronounced difference was present between samples with brachycrania and dolichocrania: 0.35 mm³ (95% CI 0.05-0.65); p = 0.0188. There was a statistically significant correlation with sex for parameters on both the right and left sides. The values of indicators in men exceeded those of measurements obtained from women. The data obtained determine the differences in the volume of the PMS in individuals with different shapes of the skull, face and mandible, as well as sex differences. Thus, indicating the need to take into account these features when choosing the required amount of anesthetic in clinical practice. The average volume of the PMS space, according to our data, is 1.8-2.0 ml, which is consistent with the clinical data described in the literature.

Krishna S., Selvarasu K., Kumar S.P., Krishnan M.

Noguchi T., Odaka K., Fukuda K.

The inferior alveolar nerve block (IANB) is an established technique with a success rate of 60–80%; however, large errors have been reported among operators. Some dentists do not prefer to use IANB because of the risk of complications. Nevertheless, it is a useful technique for pain control, and a secure IANB offers significant benefits to operators and patients. This case series study aimed to investigate the efficacy of the “IANB Device,” a nerve block guide for IANB, and the adverse events associated with its use in clinical practice. IANB was performed using the device on five patients who had undergone detailed computed tomography examination for chronic orofacial pain in the third division of the trigeminal nerve. Lidocaine 1% (1 mL, no adrenaline added) was used as the local anesthetic. IANB was performed by three dentists with 2, 5, and 11 years of experience in orofacial pain treatment. Thus, the data were collected in triplicate for each patient. The primary endpoints were whether adjustment of the IANB device was required, changes in the sensation threshold of the lower lip, the time to disappearance of pain, the presence or absence of tongue sensation (“Do you have numbness in your tongue?”: “Yes/No”), and discomfort (visual analog scale). The incidence of any other adverse events was recorded. The procedure was judged to be successful if the pain disappeared and an elevation in the sensation threshold of the lower lip was observed. Adjustment of the IANB device was not required in any patient. A significant elevation in the sensation threshold of the lower lip and the disappearance of pain were observed in all patients. Three of the five patients reported experiencing tongue numbness. Discomfort with the use of the IANB device was less than 30 mm on the visual analog scale. No notable complications were observed. The appropriate type, concentration, and dosage of the local anesthetic must be considered during general dental treatment and oral surgical procedures. Our findings suggest that the IANB device is useful for eliminating errors between operators, enhancing safety, and improving the success rate.

Roi C.I., Roi A., Nicoară A., Motofelea A.C., Riviș M.

Anesthetic techniques play an important role in the outcome of the therapeutic procedures in dentistry. Although inferior alveolar nerve block (IANB) anesthesia is currently the most often used, there are situations that imply the need of an alternative anesthesia technique to overcome the potential risks and complications. The aim of the study was to evaluate the efficacy of the retromolar triangle anesthesia technique in achieving the desired nerve block, while evaluating the duration of the anesthesia for the included cases. Methods: The present prospective study included 50 subjects that had indication of inferior molar extraction. The performed anesthesia technique for these cases was the retromolar triangle approach, and the analyzed parameters for evaluating the efficacy of this anesthesia technique were the positive nerve block of the branches involved in the area (inferior alveolar, buccal, and lingual nerves) and the duration of the anesthesia. Results: The efficiency of the retromolar triangle anesthesia technique was positive in 64% of the cases for the inferior alveolar nerve, 46% of the cases for the lingual nerve, and 22% of the cases for the buccal nerve. The duration of the anesthesia revealed a mean value of 72.4 min, suggesting that the duration is an essential factor in its effectiveness. Conclusions: Retromolar triangle anesthesia can be a viable option for clinicians, offering a simple and easy approach for the management of clinical cases.

Orafi M., Abd Elmunem H., Krishnaraaj S.

The study aims to compare the effectiveness and quality of intraligamentary anesthesia (ILA) and inferior alveolar nerve block (IANB) for primary mandibular molar extraction. This prospective, randomized clinical study included patients aged 5 to 13 years scheduled for primary mandibular molar extraction. A total of 208 participants were randomly allocated into two groups (n = 104 each group), IANB and ILA, who were administered 2% lignocaine with epinephrine 1:100,000. Patients rated their pain during injection and extraction (VAS pain score). Frankl’s behavior rating score, quality of anesthesia as perceived by clinician, and duration of procedure were recorded. Demographic and other variables were analysed using Pearson x2 test, Pearson correlation coefficient, Fisher exact test, or an analysis of variance, as appropriate. In patients who received IANB, the clinician reported a slightly better quality of anesthesia (p = 0.19) than those who received ILA (VAS score 1.3 ± 0.7 Vs 1.6 ± 0.4). Mean (±SD) score for pain during extraction were found be 1.7 (±0.6) for the IANB group and 1.8 (±0.5) for the ILA group. The clinician observed 46.2% of patients in the IANB group and 39.4% of patients in the ILA group had no discomfort during extraction. Frankl’s behavior score was negatively correlated with the quality of anesthesia and the time taken to complete the extraction (p = 0.017 and p = 0.053, respectively). The efficacy of conventional ILA was similar to IANB, and thus ILA might be a good alternative to the IANB while extracting primary mandibular molars.

Absalan F., Eftekhari Moghadam A.R., Rezaian J.

This study aimed to evaluate the cephalometric landmarks, cranial measurements, and cephalic index based on geographical and ethnic characteristics to make a database for the southwest Iranian population. In this analytical cross-sectional study, different anatomic criteria were collected from head MRI images. The anthropometric measures taken included the maximum cranial length, maximum cranial height, maximum cranial breadth, cranial base length, foramen magnum length, upper facial height, lower facial height, foramen magnum breadth, bizygomatic breadth, orbital breadth, nasion-opisthion. The categorization of the head shape was based on the cephalic index. The cranial index was calculated using the equation ([maximum cranial breadth/maximum cranial length] × 100). These assessments were compared to define sexual dimorphism and inter-population variation in size and shape. Sexual dimorphism existed in all cephalometric data except the cephalic index. The measurements comparisonin ethnicities showed that only (eu–eu) differs significantly between the two groups, which is 2,253 mm less in the Arab population compared to the Lur population (P value = 0.022). The cephalic index in males and females was found to be 73.66 and 75.08, respectively. Accordingly, 53.99% were dolichocephalic, 30.06% were mesocephalic, 14.11% were brachycephalic, and 1.84% were hyperbrachycephalic. The shape of the head had no relation to ethnicity but was related to sex (P value = 0.045). Conclusion: It is shown that cephalometric data can be used as diagnostic criteria to determine sex and ethnicity in the southwest Iranian population. It should be further verified on a greater sample size that evaluates more study age distribution.

Darawsheh H.M., Safronova A.A., Vasil’ev Y.L., Makarova N.I., Diachkova E.Y., Saleeva G.T., Saleev N.R., Saleev R.A.

One of the most popular methods of local anesthesia in dentistry, inferior alveolar nerve block (IANB) involves the blockade of the inferior alveolar nerve (IAN) and lingual nerve (LN) in the pterygomandibular space. Despite the large number of works describing the contents of this space, the spatial displacements of the anatomical structures of this area at different positions of the mandible have not been sufficiently studied. The aim of our study was to study the spatial movements of the IAN and inferior alveolar artery (IAA) at various positions of the mandible using computer simulation and finite element analysis to find the safest way to conduct IANB.Reverse engineering was used to create a model of the cranial base and the mandible based on computed tomography (CT) data obtained from patient N (male, 24 years old), the arteries of the head and neck were designed from the data of multiphase angiography of patient M (female, 61 years old). Masticatory muscles, sphenomandibular ligament, temporomandibular joint and mandibular nerve were modeled in the SolidWorks software package based on an open database of anatomical structures. The finite element grid was generated in the Solidworks software. In the first series of experiments, the displacement of the mandible was modeled along the vertical axis down by 48 mm (maximum opening of the mouth), in the second series, the jaw was displaced vertically by 48 mm with a simultaneous transversal movement of 10 mm, in the third series, the jaw was displaced along the vertical axis down by 34 mm and transversally by 22 mm.The largest distance between IAN and IAA was noted in the third series of experiments. The distance between the nerve and the vessel was minimal in the first series, with an open mouth without lateral displacements.The generated computer model opens new possibilities for studying the dynamic anatomy of the pterygomandibular space. The results of this study can be used for further experimental and clinical trials to find the safest approach to the implementation of IANB, as well as applied in the practice of the educational process.

Nzenwa I.C., Iqbal H.A., Bazira P.J.

Chen C., Lee H., Chen Y., Hsu K.

This study aimed to review the literature on adult mandibular lingula (ML) locations and related distances determined using cone-beam computed tomography (CBCT). A search was conducted for studies on CBCT using the following databases: PubMed, Web of Science, and Embase. The search results were limited to studies published between 1970 and 2021. The inclusion criteria were the investigation of ML location, CBCT, and participants aged ≥18 years. Eligible studies were examined for the distances from the lingual tip to the anterior ramus border, posterior ramus border, sigmoid notch, inferior ramus border, and occlusal plane. Eight studies on CBCT qualified for inclusion in the study. The mean distances from the ML to the anterior ramus border were 15.57 to 20 mm. In most of these, the ML was located above the occlusal plane. No significant differences were observed in the location and related distances for the ML among patients of different sexes, ethnicities, or skeletal patterns.

Rabinovich S.A., Grin M.A., Omerelli E.R., Velichko E.V., Dashkova O.P., Kheygetyan A.V., Karammayeva M.R., Semo S.

ОБОСНОВАНИЕ Нижняя челюсть имеет плохо проницаемый и плотный наружный кортикальный слой, поэтому обычно требуется использование проводникового обезболивания в месте, удаленном от зубов, подлежащих лечению. Представляет интерес хлористоводородная кислота (E507), которая в составе раствора местного анестетика в качестве вспомогательного вещества играет крайне важную роль. Кислая среда способствует тому, что артикаин и эпинефрин, содержащие аминогруппы в своем составе, существуют в форме аммонийных солей. Это существенно повышает растворимость вышеназванных фармацевтических субстанций в водной среде. ЦЕЛЬ ИССЛЕДОВАНИЯ Оценка клинического опыта использования анатомо-ориентированной мандибулярной анестезии по методу П.М. Егорова при лечении зубов на нижней челюсти. МАТЕРИАЛ И МЕТОДЫ Для оценки эффективности индивидуального подхода к проводниковому обезболиванию проведена сравнительная оценка показателей электроодонтодиагностики (ЭОД) 1 моляра на нижней челюсти при лечении пациентов в возрасте 30—55 лет (40 человек) по поводу обострения хронического периодонтита (К046 периапекальный абсцесс с полостью). Усредненные показатели нормы приняты к электровозбудимости пульпы от 2 до 6 мкА. В качестве препаратов использовали 4% артикаинсодержащий местный анестетик с эпинефрином 1:200 000 препарат №1 (Ультракаин Д-С) без и препарат №2 (Артикаин ИНИБСА) с хлористоводородной кислотой в качестве консерванта. РЕЗУЛЬТАТЫ Несмотря на наличие апикального воспалительного процесса в случае применения препарата №2 отмечалось более эффективное изменение показателей ЭОД, свидетельствующих о наступлении клинически значимого обезболивания. В связи с тем что оптимальным значением пульпарной анестезии условно считается 90 мкА, очевидно преимущество препарата №2. Сохраняющийся высокий показатель к 40-й минуте исследования указывает на клиническую значимость консерванта E507. ЗАКЛЮЧЕНИЕ Анатомическое обоснование проводникового обезболивания в стоматологии позволяет индивидуально подходить к пациентам с различной морфометрией черепа; определена клиническая эффективность использования местного анестетика с консервантом E507 при лечении зубов по поводу воспалительных заболеваний в сочетании с персонализированным методом проводникового обезболивания.

Darawsheh H.M., Vasil'ev U.L., Panin A.M., Kuznetsov A.I., Heigetyan A.V., Karammaeva M.R.

Wezgowiec J., Paradowska-Stolarz A., Malysa A., Orzeszek S., Seweryn P., Wieckiewicz M.

There is an ongoing search for novel disinfection techniques that are not only effective, cheap, and convenient, but that also do not have adverse effects on the properties of dental impressions. We compared the effects of various methods (UVC, gaseous ozone, commercial solution, and spray) on the dimensional change, tensile strength, and hardness of silicone impressions. Moreover, as a secondary aim, we performed a statistical comparison of the properties of nondisinfected addition (Panasil Putty Soft, Panasil monophase Medium, Panasil initial contact Light) and condensation silicones (Zetaplus Putty and Oranwash L), as well as a comparison of materials of various viscosities (putty, medium-bodied, and light-bodied). Our results revealed that addition silicones had higher dimensional stability, tensile strength, and Shore A hardness compared to condensation silicones. Both traditional (immersion and spraying) and alternative methods of disinfection (UVC and ozone) had no significant impact on the tensile properties and dimensional stability of the studied silicones; however, they significantly affected the hardness, particularly of Oranwash L. Our study demonstrated that, similarly to standard liquid disinfectants, both UVC and ozone do not strongly affect the material properties of most silicones. However, before recommendation, their usefulness for each individual material should be thoroughly evaluated.