bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphemes
Authors: Ashcraft Nikki
Published: April 2022

This chapter introduces basic concepts in the field of morphology. In the first section, a morpheme is defined as the smallest unit of meaning in a language. In the second section, morphemes are divided into free and bound types, with bound morphemes further classified as either affixes (prefixes, infixes, suffixes, or circumfixes) or bound roots. This section additionally distinguishes between the role of function words and content words in a sentence. The third section outlines the nine word classes in English: nouns, pronouns, adjectives, determiners, verbs, adverbs, prepositions, conjunctions, and interjections. The final section of the chapter explains the implications of this information for teaching vocabulary, grammar, and language skills. The chapter concludes with questions for discussion and some practice exercises.
Ideology as Social Imagination
Authors: Torricelli Patrizia
Published: April 2022

Ideology is a social imagination of world's truth that can be shaped and eventually corrected before it becomes historically dangerous. The methodology of linguistic analysis offers the essential approach to a positive resolution of this problem because it suggests how to prevent risky ideologies, or how to change them once they are established. The suggested linguistic strategies refer, particularly, to the textual analysis of meaning as the key to discover the imaginative value of words in a culture from which the people's mentality derives. Cultural interventions in this field of social life are, obviously, very important to foster mutual understanding, welfare, and world peace.
Navajo Speech and Language Evaluation
Authors: Vining Christine B. , Henderson Davis E.
Published: April 2022

The case study highlights the importance of culturally and linguistically appropriate assessment of young Navajo/American Indian children and the importance of alternative assessment procedures to support appropriate diagnoses and recommendations. The case also illustrates systemic issues that result in lack of coordinated care, appropriate diagnosis, and lack of American Indian speech-language pathologists who understand linguistic and cultural differences. The case is based on a typical experience when clinicians who are not familiar with the Navajo language perform speech-language evaluations in Navajo-speaking communities.
English as a Lingua Franca
Authors: Rahal Aicha
Published: April 2022

English has occupied a unique place in today's interconnected world. The emergence of ELF opens questions revolving around the change of the teaching and learning habitus. Researchers point to the disparity between theory and practice in this new paradigm and the need for bridging gap between them. The suggested study tries to explore this problem. Its purpose is to reflect on new approaches, which go hand in hand with how English is currently being used, and how it can also be integrated in classrooms. It first presents the development of ELF. The monolingual view of language and language use and the plurilingual view are also highlighted. Then, the discussion will be turned to the central topic of the study. It focuses on approaches to bridge the gap between theory and practice.
Linguodidactic Analysis of Professionally-Oriented Language Education and CLIL Special Features
Authors: Khalyapina Liudmila , Almazova Nadezhda , Baranova Tatiana
Published: April 2022

The chapter provides a consistent analysis of two approaches to teaching foreign languages in the system of professional education: the concept of professionally oriented education in Russia and the concept of ESP in the European science. The chapter presents a comparative analysis of CLIL theoretical fundamentals, which were developed by a group of European researchers and professionally-oriented language learning popular, which is still widely spread in the system of higher education in Russia. Nowadays CLIL is becoming popular in Russia too, and in some educational establishments, it is broadly applied. But at the same time, educators are still confused in differentiating these two approaches. The chapter considers common differences between the two approaches in terms of comparing methodological principles, regulatory requirements in organizing education, teaching techniques; it analyzes and systematizes methodological errors committed by teachers when shifting to curriculum integration learning.
Learning Law Using Augmented Reality and Neuro-Linguistic Programming
Authors: Amirnuddin Puteri Sofia , Turner Jason J.
Published: April 2022

In the era of the Fourth Industrial Revolution (4 IR), there are various legal tasks that are becoming increasingly automated, and hence, it is no longer sufficient for law students to only know the law. Today's law graduates have to be equipped with skills that can future-proof their careers from automation; hence, the onus is on education providers to embed those skills in the curriculum. In an attempt to address the identified skills gap and better enable graduate work readiness, augmented reality (AR) and neuro-linguistic programming (NLP) have been introduced into a law module at Taylor's University to encourage first-year law students to learn law using AR and utilise NLP techniques to deliver a human element through digital learning. Through the interpretation of students' feedback from a module survey, this chapter aims to understand student learning experience on the role of AR and NLP in facilitating and enhancing their legal studies and preparing the graduate more effectively for the workplace.
Sociolinguistic Factors Influencing English Language Learning
Authors: Bakos Jon
Published: April 2022

This chapter examines processes of language variation and change that take place in all languages, with a focus on English. Sociolinguists have observed that demographic and social variables such as where someone is born, their age, gender, and socio-economic status can be relevant to how they speak. However, contemporary work indicates that there is more to how someone speaks than a few checkboxes on a survey. Who does a speaker feel empathy with and want to emulate? How does a multi-faceted sense of personal identity affect how a person speaks? How might a second language (L2) learner's sense of belonging affect their own realization of English? These are some of the questions that this chapter seeks to address.
Modern Linguodidactics as a Scientific Foundation for FLT in Russia
Authors: Galskova Natalia Dmitrievna
Published: April 2022

The development of linguodidactics as a science, its object, subject, research tasks, and axiological senses are justified by synthesizing the reflexive analytical and empirical components of methodological knowledge in foreign language teaching. As this science accumulates multiple knowledge, it is proved to study both the interaction of phenomena such as language, consciousness, culture, society, and processes of teaching a foreign language, mastering this language as part of educational process, using the language as a means of communication, (self)-knowledge, and (self)-development. Emphasis is placed on both describing linguodidactics research areas through addressing its notion “professional language personality” and interpreting content-specific and innovative features of the contemporary sociocultural model of students' linguistics education and its essential structural elements, including the value of this education, its purpose, content, and methods, as well as students' communication activities, their involvement in the system of social relations, and educational outcomes.
Measuring Phonological and Orthographic Similarity
Authors: Ögeyik Muhlise Coşgun
Published: April 2022

Marked and unmarked language forms can be distinguished with the level of simplicity or complexity denotations of the forms. Unmarked target language forms may create little or no difficulty, even if they do not exist in the native language of the learner, while marked forms can be relatively difficult for language learners. In addition to the notions of markedness/unmarkedness, there has also been an emphasis on similarity and dissimilarity between the items of first (L1) and second languages (L2). Along with similarity or dissimilarity of L1 and L2 forms, the level of difficulty may vary enormously in different language-specific procedures. In this chapter, therefore, it is intended to build an understanding of the recognized pronunciation and orthographic problems of similar loanwords in both Turkish (L1 of the participants) and English (L2).
The Teaching of Corpus Languages in Higher Education
Authors: García González Vega María
Published: April 2022

Late Eastern Aramaic (Syriac) is one of the main languages of the Aramaic linguistic group. During the Middle Ages, it became the liturgical language of the Christian communities that arose in the Near and Middle East. Its scholars wrote a large amount of literature and implemented a movement for the translation of Greek theological and scientific works. The extent of Arabic after the Muslim conquest led to the gradual disuse of Late Eastern Aramaic. However, today it still remains a communication and liturgical language in several churches. The aim of this chapter is to offer an overview of Late Eastern Aramaic (Syriac) language teaching at the University of Salamanca, including a summary of the learning goals and a description of the approach and method followed. It is preceded by a brief introduction to the tradition of the studies about this language.
The Rhetoric of Mass Communication and Media in the Contrastive Sociolinguistics
Authors: Pham Duc Huu
Published: April 2022

In the field of mass communication and media, the use of language has become so versatile that it can help to improve relationship between peoples, but it can somehow have a negative effect on the mutual understanding. Rhetoric makes it clear and persuasive to communicate to make language work for their purposes. Sociolinguistics in the contrastive analysis deals with speech communities and the language use in particular contexts such as dialects or bilingualism in society and language variation and change over time, especially in the post-COVID-19 era. This chapter presents Kenneth Burke's rhetorical theory and William Labov's sociolinguistic method, analyzing genres and registers in the systemic functional linguistics perspective to derive a conceptual framework for the study of news report. The resulting framework provides for the identification of news writing style in mass media and other social networks and its performance in language use regarding the power of words to avoid the ambiguity in situational contexts and to better interpersonal and intercultural communication.
A Photo-Narrative of the Sociolinguistic and Sociocultural Identities of a Refugee Adolescent
Authors: Davies Alex P.
Published: April 2022

One's linguistic discourse is directly linked to his or her identity construction. The author conducted a qualitative study that investigated the sociolinguistic and sociocultural identities, both current and imagined, of a newly arrived adolescent of refugee status, named Yerodin, through a photo-narrative approach. Yerodin was unique in that he was 11 years old when he arrived to the United States but did not have any prior formalized schooling. Therefore, he was illiterate in both his first language of Swahili and second language of English. This study took place during a summer school program that sought to develop Yerodin and his siblings' literacy skills before the upcoming school year. Findings illustrated Yerodin's current identity as one who appreciated his experiences in the refugee camp prior to resettlement and as an English learner. Furthermore, Yerodin realized that English, his second language, and academics were key to accessing his desired communities of identity, including aspects of American culture and friendships with “American peers.”
Catalan Sociolinguistics
Authors: Mollà Orts Toni
Published: April 2022

Humans learned to talk a thousand years ago, but our written abilities are more modern. Technological progress—from writing to digitalization—have crucially changed the way we communicate with each other. Yet, research about linguistic uses, which happens under the area of sociolinguistics, is only a modern phenomenon. In fact, the concept sociolinguistics was only coined in 1949. In the Catalan culture, the first sociolinguistic studies took the form of anti-Franco essays. It was only during the late 1960s that these essays took a sociological dimension thanks to Lluís-Vicent Aracil and Rafael-Lluís Ninyoles. Nowadays, in a context of increasing multidisciplinary approaches, Catalan sociolinguistic studies have become a hybrid field. For the discipline, the main challenge that lies ahead is how find its own perspective and how to incorporate theoretical and methodological tools without eroding the goal of sustaining a collective identity, which is the ultimate purpose that led to its foundation.
Language Shift and Maintenance in Uttarakhand, a Hilly State of India
Authors: Rastogi Kavita , Kakoti Madri
Published: April 2022

Several lesser known and tribal languages of India are rapidly choosing to shift to local and official languages in educational, social, and even personal domains. This preference of the ‘other' language is aided by social, political, and economic factors that often devise the ‘other' as dominant. This chapter looks at the extent of language shift with respect to two communities living in the state of Uttarakhand in India and speaking respectively named endangered languages, Jad and Raji, in the light of these factors. The authors examine how language contact that is causal in language shift is changing their linguistic make up. In the Jad community, Hindi and Garhwali are the major dominating languages, and their presence can be seen in all the domains (100% in education, 35% in religious activities, and even 25% at home). In the Raji community, the usurping languages are Kumaoni and Hindi, and their presence in education is 100%, in religious activities is 45%, and 35% at the home front.
Are We Living in a Globalized World?
Authors: Wang Ai-Ling
Published: April 2022

The author first points to some prejudiced or inappropriate language use in an era of globalization, for example, distinctions between language and dialect, Global South and Global North, developed countries and developing countries, majority and minority, intercultural education, and multicultural education. Then the author extends the discussion to the inequality in different fields, such as the educational and economic fields. Finally, the author calls for elimination of the biased language use and unequal practice in an era of globalization. This chapter concludes that a real globalization will not be attained without an equal globe and suggests unbiased language use and equal practices in language use in various domains.
Modified Road Traffic Signs in the South African Linguistic Landscape
Authors: Mokwena Lorato
Published: April 2022

Drawing on the linguistic landscape material of modified road traffic signs in different areas of South Africa, the article illustrates how modified traffic road signs continue to have situated contextual meanings regardless of altered physical placement or content. Drawing on semiotic repurposing this article argues for an extended definition of situated semiotics that takes into account repurposed signs. A fluid interpretation of ‘situatedness' will broaden the scope of what is perceived as situated semiotics and discourage the use of delinquent categories such as ‘transgressive' semiotics for ‘out of place' semiotics.
Digital Identity and Reputation in a Virtual Practice Network - Insights Using Linguistic Features
Authors: Abdallah Salam
Published: April 2022

Many studies have focused on the motivation of knowledge contributions in virtual communities. However, one of the most fundamental ways in which people present their knowledge contributions is through the use of language, and its effect on social identification and impression management has not been thoroughly examined. The goal of this study is to better understand language use in regards to reputation management in virtual practice networks. The study recognizes why participants on virtual communities, in the pursuit of higher status reputations, will generate better content, more specific to the collective and display better commitment. The research will also address how to evoke these social engagement and commitment behaviors, so that the network community is sustained. This research is valuable for academics and practitioners who seek to understand why people participate and commit to providing knowledge contributions in virtual practice networks.
The Causes of Learner Pronunciation Problems in English
Authors: Rothgerber John
Published: April 2022

This chapter will provide the language teacher with an introduction to the theory behind the challenges and problems that learners from a variety of language backgrounds face as they learn to pronounce the sounds of English. The primary focus will be on the influence of the first language in second language phonological acquisition. This will include an overview of the role of perception of non-native sounds, as well as a consideration of phonological representation in the mental lexicon and articulatory constraints, all of which can have an effect on difficulties that learners encounter as they learn to pronounce English sounds. Attention will be given to the various components that make up the phonological system, including segmentals, suprasegmentals, phonotactics, and phonological processes. This theoretical understanding will then be applied to pronunciation instruction within the classroom by addressing what teachers can do to maximize the effectiveness of instruction.
Discourse Analysis
Authors: Lwin Soe Marlar
Published: April 2022

This chapter introduces discourse analysis as a sub-discipline of linguistics. Relevant concepts from pragmatics, another closely-related sub-discipline, are also discussed within the context of discourse analysis. The chapter begins by explaining the relationship between pragmatics and discourse analysis, and key terms such as “text” and “discourse.” It then examines the distinctions between linguistic and non-linguistic contexts, and situational and sociocultural contexts. To help readers understand the importance of culture in using language to make meanings, the introduced concepts are illustrated with sample authentic texts as well as examples from English and a few other languages. Placing discourse at the core of language teaching and learning, the chapter recommends a discourse-based approach to help ELLs develop not only communicative competence but also intercultural communicative competence. The chapter provides ESOL teachers with knowledge of discourse analysis and the implications of this knowledge for teaching culturally and linguistically diverse learners of English.
An Exploration of the Manipulative Use of Language and Visuals in Advertisements
Authors: Jongore Magret , Phaahla Pinky , Masubelele Rose
Published: April 2022

The article presents an analysis of TV advertisements targeted at African audiences. It further foregrounds the use of language and visuals to associate a product to an appropriate solution to social conflicts rooted in oppositional African and Western worldviews. The author applies the critical discourse analysis (CDA) method to the analysis to highlight the use of manipulative language and visuals. The author argues that CDA is an effective tool for analysing both visual and linguistic elements of advertising discourse compared to other discourse analysis methods that focus on either texts or visuals. This article is relevant to the literature on semiotic construction of social discourse as applied in advertising.
Australian Aboriginal Languages
Authors: Tsunoda Tasaku
Published: April 2022

The present chapter describes the decline and revitalisation of Australian Aboriginal languages — also called Australian languages. As preliminaries, it looks at the following: (i) a brief history of Aboriginal Australians, (ii) degrees of language viability, (iii) current situation of Australian languages, (iv) value of linguistic heritage, and (v) methods of language revitalisation. It then describes five selected language revitalisation activities, concerning Warrongo, Kaurna, Bandjalang, Thalanyji and Wiradjuri languages. In particular, it provides a detailed account of the Warrongo language revitalisation activity (in which the author has been participating). It finally examines a problem that is frequently encountered in language revitalisation activities: confusion over writing systems. The entire chapter pays careful attention to the changing political climate that surrounds Australian languages and activities for them.
Note corologiche su quattro specie di Alticini interessanti per la fauna italiana
Authors: Farina Laura
Published: April 2022

In questo lavoro vengono presentati nuovi dati corologici e tassonomici riguardanti alcune specie di Alticini. In particolare, vengono fornite informazioni su Chaetocnema wollastoni Baly, 1877, che risulta nuova per l’Italia (e per l’Europa); su Longitarsus bertii Leonardi, 1973 e Longitarsus stragulatus (Foudras, 1860): in base a nuove segnalazioni vengono migliorate e, ampliate, le conoscenze sulla loro distribuzione in Italia; su Psylliodes ausoniae Leonardi, 2013: grazie ad una nuova segnalazione, viene confermata la sua presenza in Turchia. Il lavoro è completato da fotografie di C. wollastoni.
TREATMENT OF INDOLENT AND ADVANCED SYSTEMIC MASTOCYTOSIS
Authors: Buonomo Alessandro , Nucera Eleonora , Criscuolo Marianna
Published: April 2022

Management of Indolent and Smoldering SM is focused on preventing anaphylactic reactions, identifying and avoiding symptom triggers. Skin and gastrointestinal symptoms are managed with H1- and H2-antihistamines. When skin symptoms are not adequately controlled, leukotriene antagonists and oral psoralen combined with ultraviolet therapy may be added. Proton pump inhibitors, sodium cromolyn and oral corticosteroids may be added for gastrointestinal symptoms. Patients should be prescribed with self-injectable epinephrine and trained to treat recurrent cardiovascular symptoms or anaphylaxis. Depression and cognitive impairment require a psychiatric evaluation for tailored treatment. Bone involvement is managed with bisphosphonates, and eventually interferon. Omalizumab is effective on all vasomotor symptoms, including anaphylaxis, but not on respiratory, musculoskeletal, and neuropsychiatric symptoms. A cytoreductive treatment is not recommended unless anti-mediator therapy has failed. Venom immunotherapy is mandatory for patients with hymenottera venom allergy.
There is not a curative option for patients with Advanced SM. The available therapeutic options include tirosin-kinase inhibitors and cladribine, with variable duration and extent of response. Imatinib mesylate was the first drug approved for SM lacking the cKIT D816V mutation; dasatinib and nilotinib are not effective. Midostaurin is active on both wild type and mutant cKIT D816V while Avapritinib is a selective cKIT D816V inhibitor: they are approved for treatment of Advanced SM. Cladribine is a purine analogue with significant activity against monocytes that were thought to have a common progenitor with mast cells. Allogeneic stem cell transplantation is usually performed in younger selected patients.
 
MASTOCYTOSIS; THERAPY; SKIN INVOLVEMENT, SYSTEMIC MASTOCYTOSIS; TYROSINKINASEINHIBITORS; MIDOSTAURIN.
Prostaglandin F2 Receptor Inhibitor Overexpression Predicts Advanced Who Grades and Adverse Prognosis in Human Glioma Tissue
Authors: Chen Ho-Wen , Lin Meng-Chi , Wu Pei-Ru , Chang Yu-Chan , Weng Sung-Shun , Tsai Wen-Chiuan
Published: April 2022

Prostaglandin F2 receptor inhibitor (PTGFRN) promotes neoplastic cell migration and metastasis in some human cancers. However, the role of PTGFRN in human gliomas is still undetermined. First of all, PTGFRN messenger ribonucleic acid (mRNA) overexpression correlated with some poor prognostic factors of glioma after analyzing The Cancer Genome Atlas and Chinese Glioma Genome Atlas database. In order to detect the effect of PTGFRN expression on tumor characteristics of gliomas, U87MG, LN229, and glioblastoma 8401 glioma cell lines were cultured and prepared for western blot analysis and real-time polymerase chain reaction, respectively. The results revealed the overexpression of PTGFRN in all glioma cell lines as compared to normal brain cells. In addition, PTGFRN immunohistochemical (IHC) staining was performed on two sets of glioma tissue microarrays. Consistent with the results of in vitro studies, cytoplasmic PTGFRN immunostaining scores positively correlated with tumor grades and poor prognosis of gliomas. Therefore, PTGFRN IHC staining may be useful for the evaluation of tumor grades and overall survival time to facilitate the tailoring of appropriate treatment strategy. PTGFRN may serve as a potential pharmacologic target for the suppression of gliomagenesis.
Analysis of Academic Performance, Study Behaviour and Factors Influencing Study Behaviour among Nursing Students
Authors: Thomas Shany , Mahida Ankur
Published: April 2022

Every student is distinctive and uniquely learns things. There are numerous factors, which may encourage or hamper the students' learning style and intellectual performance. These factors must be addressed with due significance to ease learning. The study is designed to look at the academic performance, study behaviour and factors influencing study behaviour among nursing students. A cross-sectional survey was carried out among 223 basic BSc nursing students. Instruments used for data collection were demographic pro forma, checklist on factors influencing study behaviour, study behaviour inventory by Bliss and University result sheet. Academic performance revealed that 52.9% of students scored between 70% and 79.9% regarded as first class. Majority (70.9%) of the participants demonstrated a moderate level of study behaviour (mean-107.3, standard deviation-13.3). Learning environment, personal factors, interest, attention, learning behaviour, language, home-related factors and time management were the extracted components influencing study behaviour. Among the factors, 'absenteeism', 'getting disturbed by siblings/friends during study hours', 'feeling to take time off from college frequently' and 'doing assignments regularly' were significantly associated with study behaviour. Ability to make lecture notes (χ2-12.39, Sig.− 0.05, P < 0.05), utilisation of learning facilities (χ2-9.35, Significance − 0.025, P < 0.05) and satisfaction with learning facilities provided (χ2-13.62, Significance − 0.034, P < 0.05) were significantly associated with academic performance. The findings of the study exposed some of the factors, as perceived by the students, influencing the study behaviour and academic performance. Understanding these factors will help the faculty to come up with a strategy to enhance the students' overall performance.
Perception of Indian Nursing Students about E-learning During COVID-19 Pandemic
Authors: Dhawan Shelly , Kumar Mahendra , Joshi Binal , Singh Ankita
Published: April 2022

COVID-19 pandemic led to abrupt disruption in the routine functioning of nursing education, which resulted in a sudden transition from on-campus face-to-face learning to e-learning approaches. The fast advancement of science and technology insists educational institutions think about different ways of teaching and learning in both formal and informal environments. The purpose of this study was to investigate the nursing student's perceptions regarding e-learning. This cross-sectional study was conducted by using non-probability sampling technique. Data from 835 graduate and post-graduate nursing students across the nation were collected through 20 items web-based questionnaire to sort information regarding their perception towards benefits and limitations of e-learning, challenges encountered and required modifications in teaching–learning techniques through online platform. Findings of this study suggested that nursing students find e-learning beneficial in terms of saving time to travel and their ability to communicate. Students perceived this technique limited as far as problem-solving techniques, clinical skills, teamwork etc., are concerned. In this study, 42.4% and 38.9% of students agreed and strongly agreed respectively that utilisation of excessive data and connectivity is one of the encountered challenges while learning through e-platforms. 64.6% of students stated their preference to learn some part of the syllabus through online mode even after pandemic. A well-planned e-learning method can deliver numerous benefits but student retention in virtual/e-learning can be a barrier to the growth of technology depended teaching–learning. The future of nursing education should include a combination of technology-based and traditional learning.
The Need of the Hour
Authors: Singh Hemant Kumar , Balakrishna Pavithra , Chaitanya Ganne , Panneerselvam Naresh Kumar , Aravindakshan Rajeev , Ganne Pratyusha
Published: April 2022

Background:

Understanding the public awareness, attitudes, and practices is needed to successfully control the COVID-19 pandemic. With the second wave of the pandemic spreading and reinstatement of lockdown in many countries, there is an urgent need to understand the knowledge, attitudes, and practices (KAP) of the people (especially the high-risk groups) to control mortality and morbidity.

Aims:

To explore the KAP of the general population of India and in particular, the at-risk groups, i.e., aged >55 years and those with comorbidities (diabetes, hypertension, chronic kidney disease, ischemic heart disease, and chronic obstructive pulmonary disease) who are at a high risk for developing severe COVID-19 infection and death.

Patients and Methods:

In this cross-sectional study, the questionnaires were administered through online survey links. The questionnaire had four sections, one for demographics and three each for KAP. The KAP scores were compared for a priori defined questions using Chi-square test, t-test, or ANOVA appropriately. Bonferroni corrected P < 0.05 was considered statistically significant.

Results:

Of the1259 responses, 83 (6.6%) were above 55 years and 193 (15.3%) had comorbidities. Higher education and income groups were more informed about COVID-19 disease (F > 18.5, P < 0.002). Participants in the at-risk groups had the same level of KAP scores as the general public. While a seemingly higher proportion of the at-risk group followed use-of-mask (n = 206, 94%) and 20 seconds of handwashing (n = 142, 65%), it was not significantly higher compared to the general population (P's > 0.4). Of the 1259 participants, 7%–10% of them did not practice social distancing at all times and 5%–7% were not wearing a mask at all times. Only 538 (42.7%) participants believed that this COVID-19 pandemic will be successfully controlled.

Conclusions:

This study highlights that at-risk groups are not better prepared compared to the general public, which is the need of the hour to prevent over-crowding of health systems and possibly mitigating COVID-19-related mortality.
Referral Process in Tuberculosis − Human Immunodeficiency Virus Collaborative Activities – Need for a Relook Into Policy Implementation in Uttarakhand
Authors: Kumari Ranjeeta , Nath Bhola , Saxena Vartika , Semwal Priyanka
Published: April 2022

Background:

Provider-initiated testing and counselling (PITC), an essential component of tuberculosis (TB) human immunodeficiency virus (HIV) collaborative activities, is intended to translate into the increased rates of HIV testing in TB patients.

Aim:

The study intends to assess compliance with the referral process and other attributes of HIV testing in TB patients.

Methods:

The study was conducted at various designated microscopy centres (DMCs) in four randomly selected districts in the Garhwal region of Uttarakhand and included 346 patients.

Results:

Only 46.8% of patients went for HIV testing. The most common reason cited for not going was the absence of specific advice by the health staff at DMC. In addition, the long waiting time at Integrated Counselling and Testing Centres favoured the spread of infection to susceptibles in the waiting area. Binary logistic regression analysis also found that patient's importance towards HIV testing, advice by the health worker and higher education and age were significant predictors of HIV testing.

Conclusions:

The referral process at DMC requires closer monitoring and supervision for improvement in qualitative parameters. Training and supportive supervision of health staff at DMC for 'counselling' of patients during referral for testing are also necessary to preserve the essence of PITC.
Role of Systemic Antibiotic Prophylaxis and Burn Dressings in Preventing Invasive Burn Infections – A Systematic Review
Authors: Vathulya Madhubari , Kapoor Akshay , Chattopadhyay Debarati , Rao Neeraj
Published: April 2022

Background:

Burn dressings and systemic antibiotics are used to combat invasive burn wound infections. With emergence of antibiotic resistance and a emergence of a large variety of dressings, it becomes important to work out a strategy to use systemic antibiotics and burn dressings effectively.

Materials and Methods:

A systematic database search to include PubMed/Medline, EMBASE, COCHRANE, SCOPUS was performed from January 2000 to January 2021 and reviewed to define invasive burn infection, and the topical antimicrobial therapy for clinical use. For the section on antimicrobials, MESH terms used were 'Antimicrobial Prophylaxis' AND 'burn Infection' and randomised controlled trial studies were alone selected. For the section on Burn dressings, another search was carried out with search words 'Dressings' AND 'Burn Infections'. Since the Search revealed several systematic reviews, the analysis was restricted to only those studies.

Results:

Systemic antibiotic prophylaxis does not seem to offer advantage in preventing burn wound infection, septic episodes or mortality. Although there is some benefit in decreasing mortality in patients of inhalation burn injury who would require mechanical ventilation. It can be given pre-operatively before skin grafting as there is improved graft survival in patients getting prophylaxis. Honey and hydrogel were found to promote wound healing while honey and skin substitutes prevented infection better than conventional dressings including silver sulphadiazine. For wound cover, though the permanent method of choice is still autologous skin grafts, with the advent of cell culture technologies, cultured autografts may hold a promising future.

Conclusion:

Systemic antibiotic prophylaxis can be given to patients of inhalational burn injury and as a pre-operative prophylaxis but not for preventing invasive burn wound infections. The ideals strategy for preventing invasive burn infection is isolation of the patient, wound cover (surgical/artificial) and frequent wound tissue sampling.
Delta beta thalassemia, a rare hemoglobin variant
Authors: Jain Promil , Marwah Nisha , Dalal Niti , Pawar Richa , Gill Meenu , Kumar Sanjay
Published: April 2022

CONTEXT:

Fetal hemoglobin (HbF) reduces to <1% few months after birth. However, it can persist beyond infancy into adult life in rare conditions such as delta-beta (δβ) thalassemia and hereditary persistence of HbF. δβ thalassemia is a relatively rare type of thalassemia due to decrease in both beta and delta globin chain production.

AIMS:

This study aims to assess the hematological and high-performance liquid chromatography (HPLC) findings in δβ thalassemia.

SETTINGS AND DESIGN:

Cross-sectional observational study.

SUBJECTS AND METHODS:

The study was conducted in department of Clinical Pathology, PGIMS, Rohtak. On screening of 1197 patients over a period of around 1 year, a total of 13 cases of δβ thalassemia were detected by HPLC.

STATISTICAL ANALYSIS USED:

Not done.

RESULTS:

The age of presentation ranged from 1 to 42 years with a mean age of 22.8 years. Eleven cases were diagnosed as heterozygous δβ thalassemia and two as homozygous δβ thalassemia.

CONCLUSIONS:

δβ thalassemia is an uncommon cause of elevated HbF. Clinical and hematological parameters should be carefully analyzed for accurate diagnosis.
Atypical Morphology and Aberrant Immunophenotypic Expression
Authors: Verma Shipra , Singhal Paresh , Singh Sharanjit , Das Satyaranjan
Published: April 2022

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia, which is highly aggressive, yet the most curable. It is a medical emergency that requires a very high index of suspicion, as delay in the treatment could lead to fatality. The initial diagnosis is made on the basis of its typical clinical presentation, morphological and immunophenotypic features. However, definitive diagnosis rests on the cytogenetic study. We present one such interesting case of APL where the morphology as well as immunophenotypic features was quite deceiving, leading to a diagnostic dilemma.
Evaluation of Pediatric Anemia in Rural Population of Maharashtra, India
Authors: Chatterjee Debopriya , More Swapnil A. , Joshi Sneha R.
Published: April 2022

INTRODUCTION:

World Health Organization showed that the prevalence of anemia among children of 6–59 months was 42.6% globally in 2011 and 59% in India. Fourth National Family Health Survey, 2016, shows 58.6% of Indian children are anemic, of which 53.8% are in Maharashtra, especially among rural children.

AIMS:

The aim of the study was to study the morphologic and cytometric evaluation of anemia in pediatric population.

MATERIAL AND METHODS:

The study was conducted after obtaining approval from the ethics committee. All patients that came to outpatient department and inpatient department between 2016 and 2018, satisfying the inclusion criteria were included. Routine investigations performed were hemoglobin estimation, blood indices, and peripheral blood smear examination.

RESULTS:

The total number of pediatric patients that were found to be anemic was 400 (54.9%). Toddlers, aged 6 months to 6 years, were most anemic (48.0%). Moderate severity of anemia was seen most frequently (50.5%). Microcytic hypochromic anemia (67.0%), iron deficiency anemia was the most common cause seen (65.2%).

CONCLUSION:

The occurrence of anemia in children is essential to be constantly monitored to identify causes, formation of intervention strategies, and ensure already formed national programs are effective.
Weak Transcranial Direct Current Effect on I Waves
Authors: Gurses Asli Akyol , Boran Hurrem Evren , Vuralli Doga , Cengiz Bulent
Published: April 2022

Background:

A single transcranial magnetic pulse over the motor cortex is known to generate repetitive descending activity along the corticospinal tract. With respect to the origin; the earliest volley is named direct wave and the subsequent activity forms indirect (I) waves. I waves are assumed to originate from corticocortical afferents; they can be modulated by several methods and are practical parameters for evaluating motor cortex excitability. Weak transcranial direct current stimulation (tDCS), which has been widely used in human studies since the early 2000s, is a noninvasive and painless modulatory method for studying cortical excitability. We aimed to investigate the modulatory effects of anodal and cathodal tDCS on I waves of healthy controls, as a component of the motor evoked potential response generator.

Materials and Methods:

Twelve healthy volunteers were enrolled in the study. One mA tDCS was applied for 10 min and; single motor unit (SMU) recording technique was used for the identification of I waves. Two conditions were analyzed for each SMU in both anodal and cathodal current polarities; before tDCS and after tDCS. Separate peristimulus time histograms were constituted for each condition. Total peak duration, early peak latency, early peak duration, and early peak discharge rate were calculated.

Results:

Total peak duration, early peak latency, and early peak duration did not differ between pre- and post-tDCS conditions in either polarity. However, I1 peak discharge rate was found to be significantly decreased after cathodal tDCS (P: 0.017) and increased after anodal tDCS (P: 0.003).

Conclusion:

Our results confirm polarity-specific effects of tDCS of the primary motor cortex on I waves. According to our knowledge, this is the first study evaluating modulatory effects of tDCS on I waves using SMU recording technique.
Spontaneous Intracerebral Hemorrhage among Hypertensive Patients in Saudi Arabia
Authors: Albakr Aishah Ibrahim
Published: April 2022

Background:

Spontaneous intracerebral hemorrhage (ICH) is the second most common cause of stroke, yet there is paucity of evidence regarding the same from Saudi Arabia.

Objectives:

To describe the clinical characteristics of spontaneous ICH as well as determine the role of gender in ICH and the usefulness of the ICH scoring system for assessing the 30-day mortality risk.

Patients and Methods:

This retrospective study included all patients diagnosed with spontaneous ICH at King Fahd Hospital of the University, Al Khobar, Saudi Arabia, between April 01, 2014, and April 30, 2019. Data regarding clinical characteristics, risk factors, and radiological features of ICH were extracted. Further, gender-related differences were determined. The 30-day mortality rates were assessed using the ICH score.

Results:

A total of 148 patients were diagnosed with spontaneous ICH during the study period. Of these, 100 (67.5%) were male and the overall mean age was 60 ± 15 years. About 48% of the male patients were aged ≤50 years compared to 27% of the female patients (P = 0.016). Impaired renal function (35.8%) and diabetes (33.7%) were the most frequent risk factors; hemiparesis (51%) and language impairment (42%) were the most common presenting symptoms; and basal ganglia (40.5%) was the most common location. The 30-day mortality rate was 30%. The mean ICH score at presentation was significantly high in those who died within 30 days of presentation (2.2 ± 1.6; P < 0.0001). Each increase in the ICH score was associated with an increase in mortality rate (P < 0.001 for trend).

Conclusion:

Patients with spontaneous ICH were found to have a high prevalence of vascular risk factors and mortality rate. The ICH scoring system was shown to be a useful clinical tool for evaluating the 30-day mortality risk.
Thymectomy in Myasthenia Gravis
Authors: Aljaafari Danah , Ishaque Noman
Published: April 2022

Myasthenia gravis (MG) is a rare condition caused by autoantibodies against acetylcholine receptors on postsynaptic membrane that leads to weakness of skeletal muscles. About 7 of 10 patients with MG have thymic hyperplasia and about 1 of 10 patients have thymoma. Thymectomy has increasingly been used as a treatment modality for MG. Several observational studies have shown that thymectomy results in improvement in MG and a randomized trial has established that thymectomy leads to a better outcome in non-thymomatous generalized MG. However, thymectomy is yet controversial in some disease subtypes and there are potential concerns regarding the selection of the ideal surgical approach to achieve complete removal of the thymic tissue to achieve stable remission rates. This review highlights the role of thymectomy in non-thymomatous and thymomatous MG, the effectiveness of various thymectomy methods, postoperative myasthenic crisis, and remission after thymectomy.
Is a Lateral Internal Sphincterotomy Necessary after Fistulotomy in a Fissure–Fistula Complex?
Authors: Diaz Sarah E. , Morgan Brittney L. , McClure Amanda M. , Hain Jon M.
Published: April 2022

Background:

Fissure–fistula complex is a poorly described condition involving patients with chronic anal fissure and associated fistula-in-ano. Currently, there are no published guidelines on the surgical management of this problem.

Objective:

The aim of this study was to help establish guidelines for the surgical management of patients with fissure–fistula complex.

Design:

The study was designed as a retrospective cohort study.

Setting:

Data were obtained from the operative reports and medical records of patients from two colorectal surgery practices in southeast Michigan from 2000 to 2019.

Patients and Methods:

Forty-nine patients (47% female, 53% male) with fissure–fistula complexes were included for data analysis. The average age was 45 years. A total of 45 patients (92%) had no previous anorectal surgery, 45 (92%) had a posterior fissure complex, 26 (53%) had an intersphincteric fistula, and 23 (47%) had a low transsphincteric fistula. Although this was a retrospective study, data were described for outcomes of patients who received only a simple fistulotomy as a treatment for fissure–fistula complex.

Main Outcome Measures:

The primary outcome was the necessity of a lateral internal sphincterotomy after fistulotomy for resolution of the fissure.

Sample Size:

Forty-nine patients.

Results:

Three patients (6%) required repeat fistulotomy or abscess drainage during the follow-up period, and only one patient (2%) required a lateral sphincterotomy to resolve the chronic fissure. Forty-five patients (98%) healed their fissures after fistulotomy without sphincterotomy (95% confidence interval [89.1, 99.9]).

Conclusions:

Our study demonstrated that there is no likely need for a lateral internal sphincterotomy in addition to a fistulotomy in patients with a fissure–fistula complex for resolution of the chronic fissure. Clinical guidelines for the management of this condition should highlight primary fistulotomy as the standard treatment of fissure–fistula complex.

Limitations:

This study was limited by its retrospective nature and small sample size.

Conflict of Interest:

None.
The effect of time management education on critical care nurses’ prioritization: a randomized clinical trial
Authors: Vizeshfar Fatemeh , Rakhshan Mahnaz , Shirazi Fatemeh , Dokoohaki Roya
Published: April 2022

necessiBackground:Nurses are at the forefront of patient care, and time management skills can increase their ability to make decisions faster. This study aimed to assess the effect of a time management workshop on prioritization and time management skills among nurses of emergency and intensive care units.Methods: This randomized clinical trial was performed with 215 nurses. The educational intervention about time management was held in the form of a workshop for the intervention group. The time management questionnaire was completed by both groups before, immediately after, and 3 months after the intervention.Results: Most participants were female (n=191, 88%), with a mean age of 31.82 years (range, 22–63 years). Additionally, the participants’ work experience ranged from 1 to 30 years (mean±standard deviation, 8.00±7.15 years). After the intervention, the mean score of time management increased significantly in the intervention group, but no significant difference was observed in this regard in the control group. The results also revealed a significant difference between the intervention and control groups regarding the mean score of time management 3 months after the intervention (P<0.001).Conclusions: Time management training helped nurses adjust the time required to perform and prioritize various tasks.