bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategi Pemasaran Bubuk Kopi Gayo Specialty “Nagayo” di Desa Simpang Peut Kecamatan Kuala Kabupaten Nagan Raya (Studi Kasus UD. Nagan Roasting)
Authors: Fadhiela ND Keumala , Roslita Roslita
Published: May 2023

Gayo Arabica coffee business in Aceh is quite prospective because it is supported by the trend and lifestyle of high coffee drinking behavior of the existence of Micro, Small, and Medium Businesses (MSMEs) active in the Gayo coffee processing industry plays an essential role in boosting the regional economy in Aceh. But marketing strategy problems are often faced by Gayo coffee powder producers, one of which is the lack of product promotion, even though marketing strategy is essential to a company's survival. This research aims to investigate the marketing strategies and challenges for Nagayo specialty coffee powder. This research is a case study at UD. Nagan Roasting is an MSME business for specialty coffee powder (Arabica and Robusta coffee) in Nagan Raya Regency. Data was gathered through observational data, in-depth interviews, and focus groups. The analytical methods used are internal and external factors and SWOT analysis. The results of this study indicate that Nagayo specialty coffee powder in quadrant 1 means that the business of UD. Nagan Roasting is in an advantageous position. Other techniques include focusing on customer happiness by delivering durable items and increasing sales marketing through social media to demonstrate Nagayo's quality. UD. Nagan Roasting has strengths and possibilities, and it can capitalize on them—however, UD. Nagan Roasting needs to increase its promotion to show the quality of the only organic coffee powder business in Nagan Raya Regency, supported by the qualified modern processing equipment.
Strategi Bertahan Pada Masa Pandemi Covid 19 di Ancak Restaurant
Authors: Sanjiwani I Gusti Agung Mirah
Published: May 2023

The Covid-19 pandemic was giving huge impact on tourism business in Bali. These efforts require the proper strategy of the impacts that have been experienced. Ancak Restaurant as one of the restaurants at the Mercure Bali Legian Hotel has been trying to develop a strategy to survive during the pandemic. This study aims to analyze the impact and strategies designed by restaurant management to survive the Covid-19 pandemic. The qualitative approach is carried out by conducting structured interviews and literature studies. Changes has been occurred in operational activities at Ancak Restaurant include operational hours, food portions, employee salaries, laid off of employment and lack of service. The strategy taken by restaurant management to survive during the pandemic is to implement health protocols, regulation in human resources, operational cost savings, and design appropriate promotions. The promotion policy implemented in the restaurant is need to be improved, then in the future it will be more attractive and appropriate to the cost in order to increase number of guest visit to the restaurant.
Learn Welding Techniques to Improve Work Skills in Vocational School Students
Authors: Setiawan Eril , Salam Rendi , Adi Adi
Published: May 2023

Welding training is a learning activity about the science and practice of welding, so that the trainees know the correct welding methods and can practice them. It is hoped that this training activity can become one of the competency provisions for the training participants, in this case the youth of the Pondok Benda sub-district, South Tangerang. In order for this activity to run smoothly, a scientific method was established, namely a theoretical explanation of welding and practice. The participants in this activity were teenagers who were members of the Pondok Benda sub-district, South Tangerang youth organization, which totaled 45 people. The activity was carried out at the community hall RW 014 Pondok Benda, South Tangerang, on Saturday, July 30 2022. This activity went smoothly and the participants were very enthusiastic. It was evident that many questions were asked, the participants' responses were very enthusiastic, and the participants were very enthusiastic about participating in the welding practice. This activity was welcomed positively, because according to one of the training participants, this activity can form welding skills that are useful for the world of work.
Simulasi Perubahan Tata Guna Lahan terhadap Laju Erosi Lahan Menggunakan Metode Universal Soil Loss Equation (USLE) pada Daerah Aliran Sungai (DAS) Ciseel
Authors: Hariati Feril , Muhammad Libasut Taqwa Fadhila , Alimuddin Alimuddin , Salman Nurcholis , Fadhillah Sulaeman Nur Handika
Published: May 2023

One of the causes of the silting of the Sagara Anakan, estuary of Citanduy River is due to sedimentation caused by changes in land use, which causes the erosion rate to become uncontrollable. To predict the rate of surface erosion of the Ciseel watershed, one of Citanduy tributary, the USLE (Universal Soil Loss Equation) method was used, while the Geographic Information System was used to assist in the analysis of spatial data. The results of the analysis of the rate of erosion in the Ciseel watershed show that in 2006 it was 28 tons/ha/yr, in 2012 it was 44.2 tons/ha/yr and in 2016 it was 49.9 tons/ha/yr, so it belongs to the erosion hazard class II/mild. based on the USDA classification. From the results of this study, it can be shown that the rate of surface erosion in the Ciseel watershed has a small contribution to sedimentation in Sagara Anakan. The simulation of land use change as an effort to reduce the rate of erosion from dry agricultural land to rice fields is expected to reduce the rate of erosion up to 24.7% in 2016.
Classification of Immature and Mature Coffee Beans Using Texture Features and Medium K Nearest Neighbor
Authors: Arboleda Edwin
Published: May 2023

In  this  study , texture features  namely entropy,  contrast, energy and   homogeneity were  extracted  from  mature and  immature coffee  beans using  image  processing  and  the  values  were inputted  to MATLAB’s Classification Learner  App for  discrimination. Among  the  23 machine  learning  algorithms  the  best  performance  was  achieved  by  medium  K  nearest  neighbor   which  has 97 %  accuracy  and 0.14574 seconds  in speed.  When compared to previous studies that used RGB and HSV color features to differentiate mature and immature coffee beans, it can be concluded that texture features are far superior in distinguishing the two coffee bean groups.
LA CONDENSACIÓN EN TRES POEMAS DE
LIBERTAD BAJO PALABRA
DE OCTAVIO PAZ
Authors: Sörstad Fredrik
Published: May 2023

La presente investigación tiene como objetivo analizar el recurso estilístico de la condensación en una selección de poemas del libro Libertad bajo palabra (2004) de Octavio Paz. En la introducción, brevemente, se describe el objeto de estudio, se contextualiza la obra de Paz y se indican los estudios previos más relevantes. A continuación, se enfocan varias premisas de dos teorías fundamentales, la estilística de Ricardo Gullón (1970) y la hermenéutica literaria de Paul Ricoeur (2003), que sirven de metodología y de punto de partida para el análisis. Al abordar los poemas, se juzgó conveniente profundizar en la naturaleza de dos procesos paralelos y complementarios, a saber, la concentración y la omisión de determinados elementos integrantes, en relación con los temas de la libertad y la otredad (forma y contenido). Finalmente, se concluye que de los referidos procesos surgen poemas que se caracterizan por su sobriedad y contención, cualidades que se explican, sobre todo, por la recurrencia del empleo de metáforas, sinestesias, antítesis, yuxtaposiciones y desdoblamientos, pero también por la métrica y el ritmo, lo que implica adoptar una perspectiva holística para comprender el proceso de condensación.
LA LITERATURA QUE NO CESA: REFLEXIONES SOBRE
LA GRANDE
, DE SAER
Authors: Havas Teresa Orecchia
Published: May 2023

Si
La grande
(2005), última novela de Juan José Saer, cierra su obra como un capítulo final, lo hace refrendando algunas de sus más significativas temáticas y estrategias narrativas, más que interviniendo en el corpus de manera disruptiva o claramente testamentaria. En cambio, el libro aporta una nota distintiva al advertir que el fluir de la escritura, y de la poesía en particular, no se detienen en él; ni una obra ni un destino individual agotan el tiempo interminable de la literatura. Se examinan aquí los indicadores textuales y paratextuales que así lo muestran, con especial atención a las notas de preparación de la novela, los epígrafes y el título, el uso alusivo de grandes tradiciones literarias y ciertos motivos emblemáticos.
LA SOMBRA DEL FOTÓGRAFO: MODELO VISUAL ANDINO EN DAMIÁN AYMA ZEPITA
Authors: Velasco Javier
Published: May 2023

El fotógrafo indígena Damián Ayma recorrió por cinco décadas los distritos rurales en Bolivia capturando imágenes de fiestas religiosas y cívicas. Este artículo analiza la importancia del archivo fotográfico de Ayma en el desarrollo de un modelo visual alternativo al modelo telúrico “letrado” de principios del siglo XX. Desde la idea de la fotografía como “técnica” condicionando las formas de mirar, el artículo propone que las imágenes de Ayma posesionan al fotógrafo como un espectador más, abren paso a la colectividad como presencia en movimiento, y rompen con el esencialismo autoctonista letrado que imaginó al indígena y el mundo rural andino como la extensión aurática de un paisaje andino petrificado en el tiempo.
The Stellar Mass–Black Hole Mass Relation at z ∼ 2 down to



BH

∼

10

7

M

⊙

Determined by HETDEX
Authors: Zhang Yechi , Ouchi Masami , Gebhardt Karl , Liu Chenxu , Harikane Yuichi , Cooper Erin Mentuch , Davis Dustin , Farrow Daniel J. , Gawiser Eric , Hill Gary J. , Kollatschny Wolfram , Ono Yoshiaki , Schneider Donald P. , Finkelstein Steven L. , Gronwall Caryl , Jogee Shardha , Krumpe Mirko
Published: May 2023

We investigate the stellar mass–black hole mass (



*

–



BH

) relation with type 1 active galactic nuclei (AGNs) down to



BH

=

10

7

M

⊙

, corresponding to a ≃ −21 absolute magnitude in rest-frame ultraviolet, at z = 2–2.5. Exploiting the deep and large-area spectroscopic survey of the Hobby–Eberly Telescope Dark Energy Experiment (HETDEX), we identify 66 type 1 AGNs with



BH

ranging from 107–1010
M
⊙ that are measured with single-epoch virial method using C iv emission lines detected in the HETDEX spectra.



*

of the host galaxies are estimated from optical to near-infrared photometric data taken with Spitzer, the Wide-field Infrared Survey Explorer, and ground-based 4–8 m class telescopes by CIGALE spectral energy distribution (SED) fitting. We further assess the validity of SED fitting in two cases by host-nuclear decomposition performed through surface brightness profile fitting on spatially resolved host galaxies with the James Webb Space Telescope/NIRCam CEERS data. We obtain the



*

–



BH

relation covering the unexplored low-mass ranges of



BH

∼

10

7

–

10

8

M

⊙

, and conduct forward modeling to fully account for the selection biases and observational uncertainties. The intrinsic



*

–



BH

relation at z ∼ 2 has a moderate positive offset of 0.52 ± 0.14 dex from the local relation, suggestive of more efficient black hole growth at higher redshift even in the low-mass regime of



BH

∼

10

7

–

10

8

M

⊙

. Our



*

–



BH

relation is inconsistent with the



BH

suppression at the low-



*

regime predicted by recent hydrodynamic simulations at a 98% confidence level, suggesting that feedback in the low-mass systems may be weaker than those produced in hydrodynamic simulations.
Planetesimal Growth in Evolving Protoplanetary Disks: Constraints from the Pebble Supply
Authors: Fang Tong , Zhang Hui , Liu Shangfei , Liu Beibei , Deng Hongping
Published: May 2023

In the core accretion model, planetesimals grow by mutual collisions and engulfing millimeter-to-centimeter particles, i.e., pebbles. Pebble accretion can significantly increase the accretion efficiency and help explain the presence of planets on wide orbits. However, the pebble supply is typically parameterized as a coherent pebble mass flux, sometimes being constant in space and time. Here we solve the dust advection and diffusion within viciously evolving protoplanetary disks to determine the pebble supply self-consistently. The pebbles are then accreted by planetesimals interacting with the gas disk via gas drag and gravitational torque. The pebble supply is variable with space and decays with time quickly, with a pebble flux below 10 M
⊕ Myr−1 after 1 Myr in our models. As a result, only when massive planetesimals (>0.01 M
⊕) are luckily produced by the streaming instability or the disk has low viscosity (α ∼ 0.0001) can the herd of planetesimals grow over a Mars mass within 2 Myr. By then, planetesimals only capture pebbles about 50 times their mass and as little as 10 times beyond 20 au due to limited pebble supply. Further studies considering multiple dust species in various disk conditions are warranted to fully assess the realistic pebble supply and its influence on planetesimal growth.
Evidence of a Decreased Binary Fraction for Massive Stars within 20 milliparsecs of the Supermassive Black Hole at the Galactic Center
Authors: Chu Devin S. , Do Tuan , Ghez Andrea , Gautam Abhimat K. , Ciurlo Anna , O’neil Kelly Kosmo , Hosek Matthew W. , Hees Aurélien , Naoz Smadar , Sakai Shoko , Lu Jessica R. , Chen 陈 Zhuo 卓 , Bentley Rory O. , Becklin Eric E. , Matthews Keith
Published: May 2023

We present the results of the first systematic search for spectroscopic binaries within the central 2 × 3 arcsec2 around the supermassive black hole at the center of the Milky Way galaxy. This survey is based primarily on over a decade of adaptive optics-fed integral-field spectroscopy (R ∼ 4000), obtained as part of the Galactic Center Orbits Initiative at Keck Observatory, and it has a limiting K’-band magnitude of 15.8, which is at least 4 mag deeper than previous spectroscopic searches for binaries at larger radii within the central nuclear star cluster. From this primary data set, over 600 new radial velocities are extracted and reported, increasing by a factor of 3 the number of such measurements. We find no significant periodic signals in our sample of 28 stars, of which 16 are massive, young (main-sequence B) stars and 12 are low-mass, old (M and K giant) stars. Using Monte Carlo simulations, we derive upper limits on the intrinsic binary star fraction for the young star population at 47% (at 95% confidence) located ∼20 mpc from the black hole. The young star binary fraction is significantly lower than that observed in the field (70%). This result is consistent with a scenario in which the central supermassive black hole drives nearby stellar binaries to merge or be disrupted, and it may have important implications for the production of gravitational waves and hypervelocity stars.
La double peine des femmes par temps de Covid-19 au Brésil : une analyse des dynamiques individuelles sur le marché du travail
Authors: Razafindrakoto Mireille , Roubaud François , Bouvier Mathilde
Published: May 2023

Nous étudions les transitions individuelles sur le marché du travail avant, pendant et après la pandémie. Nous montrons que non seulement les femmes ont davantage souffert au plus fort de la crise, mais elles ont aussi plus de difficultés dans la phase de récupération. Codes JEL: J60, 017.
Smart grid systems infrastructures and distributed solar power generation in urban slums–A case study and energy policy in Rio de Janeiro
Authors: Jean Wesly , Brasil Junior Antonio C. P. , da Silva Eugênia Cornils Monteiro
Published: May 2023

This article discusses the relationship between urban slums and the management of the urban infrastructure network (electrification). An extensive survey of the scientific literature on the subject points out the main challenges and possible solutions for fixing precarious electrical infrastructure in urban slums through the promotion of public policies and the establishment of new arrangements based on distributed generation technologies and smart grid. A dialogue was also developed involving topics such as sustainable development and electrification of slums; relationship between communities and modernization of electrification; and emerging and sustainable technologies in the context of urban slums. Thus, a design was constructed that triggered a discussion of the relationship between this work and several other works found in the literature. This research indicates the need to strengthen local governance and the participation of urban slums for the technological modernization of the local electrical network, mainly with the implementation of smart grid and photovoltaic generation systems.
Regularization scheme for uncertain fuzzy differential equations: Analysis of solutions
Authors: Martynyuk Anatoliy , Stamov Gani , Stamova Ivanka , Martynyuk–Chernienko Yulya
Published: May 2023

In this paper a regularization scheme for a family of uncertain fuzzy systems of differential equations with respect to the uncertain parameters is introduced. Important fundamental properties of the solutions are discussed on the basis of the established technique and new results are proposed. More precisely, existence and uniqueness criteria of solutions of the regularized equations are established. In addition, an estimation is proposed for the distance between two solutions. Our results contribute to the progress in the area of the theory of fuzzy systems of differential equations and extend the existing results to the uncertain case. The proposed results also open the horizon for generalizations including equations with delays and some modifications of the Lyapunov theory. In addition, the opportunities for applications of such results to the design of efficient fuzzy controllers are numerous.
Metagenomic study of the tomato rhizosphere soil microbiome: current state and prospect
Authors: Adedayo Afeez Adesina , Romdhane Samir Ben , Babalola Olubukola Oluranti
Published: May 2023

Plant microbiota has a variety of impacts on the plant. Some are beneficial, while some are pathogenic. This study discusses the general metagenomics procedures in processing plant-related metagenomes and focuses on the tomato plants' rhizosphere species. Metagenomics, associated with eventual DNA, is isolated from environmental samples and thus permits absolute microbial population identification. Meanwhile, the genetic content of the DNA sample obtained allows the functional capability identification and biochemical procedure of many microorganisms. This review reveals the recent utilization and application of the potential of Next-Generation Sequencing (NGS) in agriculture. It involves plant-associated microbiota, the factors driving their diversity, and plant metagenome to tackle current challenges experienced in food security. This review provides the newest methods for rapidly identifying the microbial communities inhabiting the rhizosphere soil of tomato plants.
A limiting model for a low Reynolds number swimmer with $ N $ passive elastic arms
Authors: Alouges François , Lefebvre-Lepot Aline , Levillain Jessie
Published: May 2023

We consider a low Reynolds number artificial swimmer that consists of an active arm followed by $ N $ passive springs separated by spheres. This setup generalizes an approach proposed in Montino and DeSimone, Eur. Phys. J. E, vol. 38, 2015. We further study the limit as the number of springs tends to infinity and the parameters are scaled conveniently, and provide a rigorous proof of the convergence of the discrete model to the continuous one. Several numerical experiments show the performances of the displacement in terms of the frequency or the amplitude of the oscillation of the active arm.
A rare case of basilar artery dissection
Authors: Bhatia Sahibjot , Gahoonia Nimrit , Stenger Jeffrey , Lui Forshing
Published: May 2023

This case describes a 30-year-old Hispanic male who presented with a significant headache that started after a period of weightlifting and squatting. The patient was diagnosed with a basilar artery dissection. His only complaint was a headache that was exacerbated with exertion and sexual activity; there were no neurologic deficits. The diagnosis of basilar artery dissection was established and supported by findings on the CT angiogram of his head and neck. Basilar artery dissections are rarely seen, as they are likely underrecognized due to their varying clinical presentations; however, it is important to consider these phenomena due to the risk of progression and high morbidity rates.
Health and fitness trends in Southern Europe for 2023: A cross-sectional survey
Authors: Batrakoulis Alexios , Veiga Oscar L , Franco Susana , Thomas Ewan , Alexopoulos Antonios , Valcarce-Torrente Manel , Santos-Rocha Rita , Ramalho Fatima , Di Credico Andrea , Vitucci Daniela , Ramos Liliana , Simões Vera , Romero-Caballero Alejandro , Vieira Isabel , Mancini Annamaria , Bianco Antonino
Published: May 2023

The physical activity, exercise and wellness sector is rapidly growing and seems to be an exciting field for business and professional development with great potential globally. The purpose of this observational and cross-sectional study was to determine the most popular health and fitness trends in Southern Europe for the first time, including data from Italy, Spain, Portugal, Greece and Cyprus, and to investigate any potential differences in this area compared to the Pan-European and global fitness trends for 2023. A national online survey was conducted in five Southern European countries, using the methodology of similar regional and worldwide surveys conducted by the American College of Sports Medicine since 2007. In total, a web-based questionnaire was sent to 19,887 professionals who worked in the Southern European physical activity, exercise and wellness sector. A total of 2645 responses were collected from five national surveys with an overall mean response rate of 13.3%. The ten most important fitness trends in Southern Europe for 2023 were personal training, licensure for fitness professionals, exercise is medicine, employing certified fitness professionals, functional fitness training, small group training, high-intensity interval training, fitness programs for older adults, post-rehabilitation classes and body weight training. The present findings are aligned with those reported for the European and worldwide fitness trends.
Modernisation during Franco’s regime: urban planning, traffic, and social discontent in Madrid (1957-1973)
Authors: Prados Martín Marcos
Published: May 2023

This paper focuses on the demolition of boulevards and the construction of flyovers in Madrid. These two engineering works are part of a concept of modernization based on private transport that was promoted during the 1960’s which resulted in a serious urban crisis. The concept of the “urban” is seen as a global phenomenon embedded in wider historical processes that went beyond the Spanish national background: this transformation was a result of the solutions given by traffic engineering and urban planning. These two branches of international knowledge shared a same tendency to prioritize driver’s interests at the expense of pedestrians, who were pushed out of the streets. Moreover, the reliance on private transport failed to organize communications between the center and the outskirts of Madrid, regarded as a metropolitan area. The local authorities used propaganda to legitimize its idea of modernization. However, a wave of discomfort spread across the citizens and was channeled into open criticism of the flyovers. This unease can be linked to a general rejection of the practical applications of post-World War II urban planning.
Vies d’esclaves. Une autre perspective sur l’« esclavage atlantique » ?
Authors: Zuñiga Jean-Paul
Published: May 2023

Cet article a l’ambition de mettre en exergue les apports de l’histoire sociale à une histoire de l’expérience esclave, domaine largement occupé de nos jours par l’histoire culturelle et des concepts. Peut-on aborder les valeurs des temps révolus autrement qu’au travers de regards surplombants ? Les théories scientifiques ou la production de prescriptions juridiques contiennent-elles l’ensemble des normes sociales ? La parole explicite de quelques-uns annule-t-elle les conceptions tacites de la majorité nécessairement silencieuse ? Peut-on écarter sans plus cette immense terra incognita sous prétexte qu’elle n’a jamais été exprimée de manière explicite et directement perceptible ? L’objectif de cet article est de répondre à une partie de ces questions en tentant de saisir l’expérience esclave tout en envisageant les possibles non advenus ou effectivement réalisés qui constituaient son cadre référentiel. Ce procédé doit permettre la mise en perspective de ces expériences et des savoirs vernaculaires qu’elles révèlent avec les appareils et conceptualisations savantes mobilisés par une partie de l’historiographie sur l’esclavage atlantique. Au cœur de cette démarche se trouve par conséquent la question du poids qu’il convient d’accorder à l’exemple individuel ainsi que les conditions de son utilisation comme matériau pour l’histoire.Une première partie s’ouvre par un contrepoint critique entre des interprétations issues de l’historiographie récente sur la race et l’esclavage et ce que l’exemple isolé de la pensée d’un clerc jésuite du xviie siècle peut nous révéler sur ces questions.La deuxième partie pose le problème de l’exemple individuel dès lors que les traces des personnes du passé, en raison de leur statut de subordination, sont minimes. Trois bribes de vie de femmes esclaves sont alors mobilisées afin de les soumettre à un protocole permettant de mettre en travail cet anonymat. Il s’agit de traces écrites retrouvées dans les archives notariales et judiciaires de trois lieux éloignés dans l’espace et dans le temps mais faisant tous partie de la monarchie hispanique : une lettre de vente à Santiago du Chili en 1624 ; une allégation juridique commencée à Tenerife (Canaries) en 1676 et un dossier d’action en justice à la Pointe Coupée (Louisiane espagnole) en 1795.La troisième partie de l’article s’interroge sur les critères permettant d’aboutir à un discours historique à partir d’exemples si épars. Ceux-ci expriment la multiplicité des expériences du social selon les acteurs, les lieux et les périodes : leur confrontation réciproque autorise à porter un regard critique sur la pertinence d’un récit faisant de la race le moteur de la domination esclavagiste coloniale à l’échelle hémisphérique depuis la fin du Moyen Âge, et de la plantation son archétype. Cette explication apparaît dès lors comme un raisonnement téléologique plus que comme une catégorie analytique permettant de comprendre l’agir des acteurs en situation et ses contraintes.
High glucose inhibits neural differentiation by excessive autophagy via peroxisome proliferator-activated receptor gamma
Authors: Pan Yin , Qiu Di , Chen Shu , Han Xiaoxue , Li Ruiman
Published: May 2023

The high prevalence of prediabetes and diabetes globally has led to the widespread occurrence of severe complications, such as diabetic neuropathy, which is a result of chronic hyperglycemia. Studies have demonstrated that maternal diabetes can lead to neural tube defects by suppressing neurogenesis during neuroepithelium development. While aberrant autophagy has been associated with abnormal neuronal differentiation, the mechanism by which high glucose suppresses neural differentiation in stem cells remains unclear. Therefore, we developed a neuronal cell differentiation model of retinoic acid induced P19 cells to investigate the impact of high glucose on neuronal differentiation in vitro. Our findings indicate that high glucose (HG) hinders neuronal differentiation and triggers excessive. Furthermore, HG treatment significantly reduces the expression of markers for neurons (Tuj1) and glia (GFAP), while enhancing autophagic activity mediated by peroxisome proliferator-activated receptor gamma (PPARγ). By manipulating PPARγ activity through pharmacological approaches and genetically knocking it down using shRNA, we discovered that altering PPARγ activity affects the differentiation of neural stem cells exposed to HG. Our study reveals that PPARγ acts as a downstream mediator in high glucose-suppressed neural stem cell differentiation and that refining autophagic activity via PPARγ at an appropriate level could improve neuronal differentiation efficiency. Our data provide novel insights and potential therapeutic targets for the clinical management of gestational diabetes mellitus.
Modelling CD4 reagent usage across a national hierarchal network of laboratories in South Africa
Authors: Cassim Naseem , Coetzee Lindi-Marie , Glencross Deborah K.
Published: May 2023

Background: The National Health Laboratory Service is mandated to deliver cost-effective and efficient diagnostic services across South Africa. Their mandate is achieved by a network of laboratories ranging from centralised national laboratories to distant rural facilities.Objective: This study aimed to establish a model of CD4 reagent utilisation as an independent measure of laboratory efficiency.Methods: The efficiency percentage was defined as finished goods (number of reportable results) over raw materials (number of reagents supplied) for 47 laboratories in nine provinces (both anonymised) for 2019. The efficiency percentage at national and provincial levels was calculated and compared to the optimal efficiency percentage derived using pre-set assumptions. Comparative laboratory analysis was conducted for the provinces with the best and worst efficiency percentages. The possible linear relationship between the efficiency percentage and call-outs, days lost, referrals, and turn-around time was assessed.Results: Data are reported for 2 806 799 CD4 tests, with an overall efficiency percentage of 84.5% (optimal of 84.98%). The efficiency percentage varied between 75.7% and 87.7% between provinces, while within the laboratory it ranged from 66.1% to 111.5%. Four laboratories reported an efficiency percentage ranging from 67.8% to 85.7%. No linear correlation was noted between the efficiency percentage, call-outs, days lost, and turn-around time performance.Conclusion: Reagent efficiency percentage distinguished laboratories into different utilisation levels irrespective of their CD4 service level. This parameter is an additional independent indicator of laboratory performance, with no relationship with any contributing factors tested, that can be implemented across pathology disciplines for monitoring reagent utilisation.What this study adds: This study provides an objective methodology to assess reagent utilisation as an independent measure of laboratory efficiency. This model could be applied to all routine pathology services.
Deuteronomistic theology in Psalms 44, 74, 80 and 89: Examined through the lens of trauma
Authors: Li Xi
Published: May 2023

Biblical scholars are divided regarding the presence of Deuteronomistic theology in Psalms 44, 74, 80 and 89. This article re-examines this issue through the lens of trauma and argues for two points. Firstly, Psalms 44, 74, 80 and 89 do not reject Deuteronomistic theology because the accusations of God in these psalms do not indicate attribution of responsibility but demonstrate trauma victims’ negative cognition and emotion associated with the traumatic event. Secondly, the concept of post-traumatic growth (PTG) helps to clarify two crucial elements of Deuteronomistic theology concerning divine retribution and divine promise. Psalms 44 and 74 assume the first element; Psalms 80 and 89 presuppose the second.Contribution: This article provides a fresh angle from trauma studies to approach biblical texts in the Hebrew Bible, clarifying the connection between Deuteronomistic theology and communal laments.
Facilitators and barriers to voluntary medical male circumcision as an HIV prevention strategy in Kavango East, Namibia
Authors: Ashipala Daniel O. , Nhokwara Trymore B. , Joel Medusalem H.
Published: May 2023

Background: Voluntary medical male circumcision (VMMC) is a strategy used to try to limit new human immunodeficiency virus (HIV) infections, as it has the potential to reduce HIV and/or AIDS transmission from women to men by up to 60%. However, in spite of efforts by the Ministry of Health and Social Services, only a few men in Namibia have been circumcised. The objective of this study was to explore and describe the facilitators of, and barriers to, medical male circumcision for HIV prevention in Kavango East, Namibia.Methods: A qualitative, explorative, descriptive and contextual design was employed. The accessible population in this study comprised 18 health professionals who were selected for the study using a purposive sampling technique.Results: Participants reported numerous barriers to VMMC in Namibia. Barriers to VMMC included ‘myths’ and misconceptions attached to VMMC, age limitations, fear of pain and stigma associated with HIV, small VMMC team and long distances from health facilities. Facilitators to VMMC included family support, having experienced genital sores and genital warts or phimosis and paraphimosis.Conclusion: The study revealed that a number of barriers must be overcome before VMMC before the desired number of men take advantage of VMMC. Multiple factors act as constraints to VMMC, including fear, myths and misconceptions, small VMMC teams and the long distance between clients’ homes and VMMC services.Contribution: The study’s findings can be used to develop targeted interventions and strategies that can be used by VMMC providers to address the identified barriers.
Siphefumula Ngenxeba in our own homes: Gender-based violence during COVID-19 pandemic
Authors: Khosa-Nkatini Hundzukani P. , Mofokeng Jacob T.
Published: May 2023

Gender-based violence (GBV) has become a major problem in South Africa, making headlines on a regular basis. When the president of the Republic of South Africa, Mr. Cyril Ramaphosa, declared the lockdown in reaction to the worldwide pandemic: COVID-19 one of the expectations was that families would spend more time together in harmony. However, the number of recorded domestic violence instances increased as a result of the lockdown. Women have historically been subjected to GBV in their communities, businesses, streets, marketplaces and even churches; recently, their homes have proven to be unsafe as well. There have been a number of marches of women around the country to call for justice for women who are victims of GBV. The lives of women were endangered, what was supposed to be a place of solace became a dungeon to them. They were essentially breathing through the wound in their own homes: Baphefumula ngenxiba. This article, through a literature review, will highlight how the lives of women were endangered during the lockdown in response to the global pandemic in South Africa. This article aims to call missionary churches to practice the theology of missio Dei within this context.Contribution: In the light of the above challenges of GBV, the missionary churches are called to practice the theology of missio Del within the context of gender-based violence that took place in private homes during COVID-19. ‘Siphefumula Ngenxeba’ is a Zulu phrase that means [we are breathing through the wound]. The church is therefore called to play a significant role in response to GBV in South Africa.
Mobilising towards environmental sustainability – challenges and chances for churches in Germany
Authors: Kroeck Thomas
Published: May 2023

The current ecological crisis is considered a major challenge for humanity. Various scholars suggest that Christian congregations may contribute to the changes of mind-set and behaviour necessary to meet this challenge. The article presents the results of an empirical study on how Protestant congregations in Germany deal with this issue. Data were collected in an online survey and group discussions with members of the Evangelical Church of Germany (EKD), the Free Evangelical Church (FeG) and the Gnadau movement. The study showed that the environmental awareness of church members is similar to the population in general. Major pragmatic obstacles to mobilise congregations for environmental sustainability were the (1) views that it may compete with other tasks of the congregation, (2) that church members may feel excluded and (3) the lack of knowledge and competence regarding this topic. However, creation care was seen as a bridge to the community which allows the congregation to engage with people outside the church. The study shows which issues need to be addressed for Christian congregations to play a more active role in creation care.Intradisciplinary and/or interdisciplinary implications: The research is concerned with church management fostering ecologically sustainable practices and is situated in the discipline of practical theology. As church management is based on the understanding of the mission of the church it is linked to ecclesiology. The practice of local congregations may have effects on the general public and can therefore be studied from a sociological perspective as well as in development studies.
The Study of Serum C-reactive Protein/Albumin Ratio as a Prognostic Marker in Patients with Sepsis and Septic Shock in a Tertiary Care Hospital
Authors: Krishnamurthy H A , Kishor U
Published: May 2023

Introduction:

Sepsis is a common and deadly disease. The acute-phase reactants such as high-sensitive C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, procalcitonin, interleukin (IL)-6, tumor necrosis factor-alpha, and IL-1 are elevated in all most all cases of sepsis Their early elevation is associated with high mortality. They are widely used for early diagnosis, management, and risk stratification of patients with septic shock. However, in resource-poor setup and financial constraints, getting above investigations is not always possible. This study would like to examine, is there any role of ratio between serum CRP and albumin level as a potential prognostic marker of outcome in sepsis and septic shock in a resource-poor and constrained setup.

Materials and Methods:

This was a prospective cross-sectional study conducted on 100 subjects, who were admitted in intensive care unit, emergency ward, and various other wards with sepsis and septic shock. The purpose of the study was explained to subjects and their attenders; informed consent was taken from the study subjects. The following biochemical parameters were done on day 1 and day 3 of admission. They were complete blood count, liver function test, renal function test, serum electrolytes, random blood sugar, electrocardiogram, arterial blood gas, lactate level, CRP, LDH, serum ferritin, erythrocyte sedimentation rate, blood culture, urine culture, sputum culture, and sensitivity. The quick Sequential Organ Failure Assessment (qSOFA) score was used to assess the severity of sepsis and septic shock. All the parameters were correlated with inhospital outcome of subjects. Data obtained from the subjects were systematically recorded and analyzed using SPSS (Statistical Package for the Social Sciences) software version 23.

Results:

The male cases constituted about 63%. One-fourth of the patients belonged to the age group of 61–70 years. The mortality in the present study was 27%. The serum CRP/albumin ratio was 73.58 mg/dl: 3.14 g/dl on day 1 and 65.66 mg/dl: 3.03 g/dl on day 3 of admission (P < 0.001). The serum CRP/albumin ratio, serum LDH level, and serum ferritin level on day 1 (P = 0.019) and day 3 (P < 0.001) of admission were positively correlated with the outcome of sepsis and septic shock.

Conclusion:

The serum CRP/albumin ratio is a highly sensitive marker, which is noninferior to the other high-cost biomarkers (serum ferritin and LDH) in assessing the daily prognosis in patients with sepsis in a resource-poor and constrained setup. Hence, this study endorses and reiterates that serum CRP/albumin ratio is a cost-effective, novel, easily feasible, and one of the most relevant investigations available in assessing the severity and mortality of sepsis and septic shock in a rural resource-limited and financially poor health-care setting.
Neurological Manifestations of Scrub Typhus in Children: Clinical Profile and Outcome
Authors: Gupta Medha , Tapaswini A. P. , Panda Subhasmita , Sarangi Rachita
Published: May 2023

Background:

Re-emerging scrub typhus is gaining recognition as an important cause of focal or disseminated vasculitis or perivasculitis which is responsible for its various clinical manifestations and complications. Neurological manifestations with varied presentations have been reported in rickettsial diseases with variable prevalence (28%–80%).

Methods:

A cross-sectional study among admitted children was conducted for 1½ years in a tertiary care hospital with the objective to study the clinical profile and outcome of the patients with neurological manifestations of scrub typhus.

Results:

Out of 105 scrub typhus cases (immunoglobulin M enzyme-linked immunosorbent assay positive), 32 patients (30.4%) had neurological manifestations with a male: female ratio of 19:13. These children presented with fever (100%), headache (71.8%), vomiting (62.5%), convulsion (53.1%), and altered sensorium (43.7%). Neurological manifestations included meningeal signs (75%), ataxia (6.2%), lateral rectus palsy (9.3%), papilledema (18.7%), stroke (6.2%), and retinal hemorrhage (3.1%). Lumbar puncture was done in 31 cases and the mean cerebrospinal fluid (CSF) white blood cell count, lymphocyte, and neutrophil proportion was 66 cells/cu.mm, 60%, and 27%, respectively, with the mean CSF protein and glucose is 67 mg/dl and 55 mg/dl. Neuroimaging was done in 24 patients and the abnormalities found were cerebral edema (n = 5), basal ganglia infarct (n = 2), and features of cerebellitis (n = 2).

Conclusion:

Rickettsial disease should be considered an etiological agent in all febrile illnesses with neurological manifestations, especially in endemic areas. Early recognition and treatment of rickettsial infections with neurological manifestations are important to prevent morbidity and mortality of the disease.
The Study of Lactate/Albumin Ratio as a Predictor of In-Hospital Mortality in Patients with Sepsis and Septic Shock in a Tertiary Care Hospital
Authors: Krishnamurthy H. A. , Kishor U.
Published: May 2023

Background:

Sepsis is a common and deadly disease that is characterized by elevated levels of acute phase reactants such as high-sensitivity C-reactive protein, lactate dehydrogenase, ferritin, procalcitonin, interleukin (IL-6), tumor necrosis factor, and IL-1. These markers are often used for early diagnosis, management, and risk stratification in patients with septic shock, but they may not be accessible in resource-poor settings with financial constraints. This study aimed to investigate the potential use of the ratio between serum lactate and negative acute phase reactant serum albumin level as a prognostic marker for the outcome of sepsis in resource-poor and -constrained settings.

Materials and Methods:

The study was a prospective observational study that included 122 patients admitted to the intensive care unit and emergency ward with sepsis or septic shock. Ethical clearance was obtained from the Ethics Committee of Mysore Medical College and Research Institute, and informed consent was obtained from the patients and their attendants. Blood samples for analysis of arterial blood gases, albumin, and other biochemical parameters were collected on the 1st and 3rd days of admission. The outcome of the disease was compared to these parameters using statistical methods such as ANOVA and Chi-square tests with multivariate analysis.

Results:

The study population consisted of 54.09% males, with one-third of the patients belonging to the age group of 61–70 years. The mortality rate was 27%. The mean serum lactate level on day 1 was 1.7 ± 0.15 mmol/L and on day 3 was 2.65 ± 0.32 mmol/L. The mean serum albumin level on day 1 was 3.14 ± 0.14 g/dL and on day 3 was 3.03 ± 0.13 g/dL. The lactate/albumin ratio on day 1 was 0.49 ± 0.12 and on day 3 was 0.89 ± 0.1 and was positively correlated with the severity of sepsis and septic shock (P < 0.001) and showed a greater significance than lactate or albumin alone.

Conclusion:

The serum lactate/albumin ratio is a highly sensitive marker that is noninferior to other high-cost biomarkers in assessing the daily prognosis of patients with sepsis in resource-poor and -constrained settings. This study suggests that the lactate/albumin ratio may be a cost-effective, novel, easily feasible, and relevant investigation for assessing the severity and mortality of sepsis and septic shock in rural resource-limited and financially poor hospital settings.
Competency-Based Medical Education for Indian Undergraduates: Where do we Stand?
Authors: Gehlawat Mamta , Thumati Goutham , Samala Priyanka , Alekhya Chaganti Lalitha , Shailaja Are , Sharma Anamika
Published: May 2023

The traditional system of medical education was a structure and process-based system with limited assessment of application of knowledge, skills, and attitudes. Decades after the World Health Organization gave preliminary guidelines on Competency-based medical education (CBME) in 1978, countries around the world are still taking to the newer medical education systems. In India, CBME replaced traditional system of medical education in 2019 while the National Medical Council replaced Medical Council of India in 2020. The annual intake of medical undergraduates has reached an all-time high of one lakh students per year in India and our medical education system is taking baby steps toward CBME. The implementation of CBME poses different hurdles for medical educators as well as medical students. Medical educators are yet to develop confidence in the newer teaching learning methods (e.g., Small Group Teaching, Role-play, Peer group learning etc.), along with the array of newer assessment methods. There in lies an immense and urgent need of training medical educators with continued hand holding along with adapting newer teaching learning methods to the students of generation Z who are tech-savvy but anxious and indulged yet stressed. This review has tried to articulate the current situation of CBME in the world and in India, acceptance of CBME by faculty and students and the way forward for India’s medical education system.
IgA Vasculitis Following ChAdOx1 nCoV-19 Vaccination
Authors: Basu Manabendra , Prathibha P. M. , Mohan B. V. Murali
Published: May 2023

IgA vasculitis (IgAV), a small-vessel vasculitis, is more frequently seen in children than in adults. IgAV is triggered by various bacterial and viral infective agents. Here, we are describing a case of IgAV following ChAdOx1 nCoV-19 vaccination. A 39-year-old male presented with skin rash, joint pain, and pain abdomen. Symptoms started within 3 days of ChAdOx1 nCoV-19 vaccination. His clinical examination and investigations lead to a diagnosis of IgAV. After ruling out other possible etiologies, we concluded it as vaccine-induced IgAV. A few cases of IgAV have been reported worldwide post SARS-CoV-2 vaccination. Although rare and often self-limited, it is important to recognize the possibility of IgAV post-SARS-CoV-2 vaccination because early recognition, initiation of treatment, and timely follow-up can improve the disease outcome.
Brucellosis: A Neglected Endemic Zoonosis
Authors: Kamath Vasantha , Sheeba R , Markanday Kushal
Published: May 2023

Brucellosis is a major public health concern worldwide with a prevalence of 10/1 lakh population. Although brucellosis is endemic in several countries it goes under-diagnosed and under-reported. The diverse presentations of brucellosis have led clinicians a challenge in its diagnosis and management. Musculoskeletal manifestation and lesions of spine are the common focal manifestation of brucellosis. Differentiating Brucella spondylitis from tubercular spondylitis is a clinical challenge. We herewith highlight the prevalence of brucellosis, the need, and method for early diagnosis and management to prevent disability and mortality.