bluuebunny/crossref_metadata_2025 huggingface dataset:
Away-from-Home Meat Consumption in China
Authors: Liu Hongbo , Parton Kevin ,   Charles Sturt University, Australia, Cox Rod ,   Charles Sturt University, Australia, Zhou Zhangyue ,   James Cook University
Published: February 2023

This paper investigates significant forces that affect away-from-home (AFH) meat consumption in China. Multivariate Tobit models were used to analyze a set of survey data from 340 households in Jiangsu, Shandong, Inner Mongolia, Liaoning, and Sichuan Provinces in 2005. AFH meat consumption accounts for an increasing share of food consumption expenditure in China. Aside from income level and urban location, family characteristics (e.g., the employment status of the wife and the opportunity to participate in collective consumption) also influence AFH meat consumption. Beef and mutton consumption is higher in Inner Mongolia and Liaoning. This paper makes the case that studies of food consumption in China should focus on expenditure on food away from home. In addition, future studies should integrate food consumption at home with food consumption away from home. As the Chinese economy continues to grow and the country becomes more urbanized, the wealth generated will result in further rapid growth in AFH beef consumption. Sourcing an adequate supply to meet the increasing demand will pose a significant challenge for the Chinese beef industry and the Chinese government.
Hypothesizing ICT4D in Philippine Agriculture: Deriving from Trends, Setting Directions
Authors:   Development Communication Division, Philippine Rice Research Institute, Manalo IV Jaime , van de Fliert Elske ,   School of Journalism and Communication University of Queensland, Australia
Published: February 2023

The yield gap in rice production can be narrowed by improving farmersâ€™ access to information. In recent years, the Philippines has witnessed a profusion of information and communication technology (ICT) interventions expected to increase Filipino famersâ€™ access to rice farming information, led by the PhilRice Farmersâ€™ Text Center. Despite these initiatives, the digital divide further excludes the marginalized. Drawing from literature on ICT for development (ICT4D) and recent trends in Philippine ICT, this paper proposes policy directions that can be pursued by the agriculture sector for more relevant ICT interventions (i.e., making technology generation participatory, marrying of disciplines, exploring technological hybrids, focusing on critical evaluation of ICTs, and tapping farmersâ€™ children as infomediaries). It is essential to engage farmers in various stages (i.e., from design to evaluation) of ICT initiatives to maximize the impact of ICTs on their lives and to avoid the misdirection of ICT interventions.
Data mining to map the nutrition value of industrial cheese produced in France
Authors: Dinh T  Nguyen  , Swati  Singh  , Saurav  Goel
Published: February 2023

Cheese is a dairy product with a long history in the human diet. In countries such as France, cheese is one of the strongest attractions for visitors from around the globe. The cheese was thought of as only a source of energy alone; however, with advances in nutritional science, cheese has become a rich source of essential nutrients such as proteins, bioactive peptides, amino acids, vitamins and minerals. This perspective offers new insights into the nutrition analysis of various types of cheese sold in France, using advanced data visualization and analysis techniques. This article aims to raise awareness about making an informed selection of the type of cheese people should consume as a long-term measure of taking a health-conscious diet. Overall, the study provides a testbed for turophiles (cheese lovers) in selecting the right kind of cheese to relish themselves while taking care of their health condition depending on their physical condition, particularly lactose intolerance.
INFLUENTIAL FACTORS OF FLIGHT ATTENDANTS’ FATIGUE- CASE OF AIRLINE COMPANIES IN TAIWAN
Authors: CHIANG CHAO-HUNG
Published: February 2023

Fatigue poses an important safety risk to aviation, while it has been suggested as a key human factor which influences crew's working ability and flight safety. Flight attendants are in the first line to serve customers and also play an important role in flight safety. Thus, the modified Delphi method and grey correlation analysis are used to find the influential factors of the fatigue. Furthermore, the weight analysis and ranking of the fatigue factors of the flight attendants are discussed in the study context of the analytic hierarchy process. The results show that the company’s planning and scheduling have the highest weight of fatigue. Furthermore, a load factor of 80% appears tiring for the crew, despite the fact that the number of flight attendants meets the legal requirements. In fact, this has the highest weight of fatigue in short-haul flights, unlike long-haul flights where the weight differs. Research findings may have managerial implications to airlines and relevant government agencies towards fatigue’s reduction and improvement of flight attendants’ working life.
Product Preparation of Instant Noodles from Wheat Flour Supplementing with Sweet Potato Flour
Authors: Nawaz Sana , Khaskheli Shahzor Gul , Soomro Aijaz Hussain , Panhwar Aasia Akbar , Khaskheli Ashfaque Ahmed , Soomro Shaista , Lohano Dileep Kumara
Published: February 2023

Sweet potato (Ipomoea batatas) available throughout the country and is very important. Sweet potato flour is good source of carbohydrates less expensive and highly beneficial. The current study was carried out to evaluate the noodles prepared from the supplemented flour of sweet-potato flour with various proportions. Four different treatments were used for this study including T1 100 % wheat flour, T2 90 % wheat flour and 10 % sweet potato flour, T3 80% wheat flour and 20 % sweet potato flour, and T4 70 % wheat flour and 30 % sweet potato flour. The noodles prepared with T1 = (WF 100 % Control) showed 8.42% moisture, 2.36 ash, 11.11% protein, 6.72% fat content, 59.53% starch, 67.41% carbohydrate, 0.68% crude fiber, 0.11% acidity of water, as compared to noodles prepared with (T3 = WF 80+ SPF 20%) results showed that 8.23% moisture, 5.80% ash, 11.99% protein, 7.23% fat content, 61.50% starch, 68.50% carbohydrate and 0.88% crude fiber,  It was concluded that noodles prepared with T1 WF 90% + 10% showed better results in physico-chemical properties of instant noodles. Overall acceptability was given in terms of sensorial parameters due to the good flavor of instant noodles. It was concluded from the study that addition of sweet potato flour improved the visual appearance of noodles from white to creamy, and the texture was found to be softer, as indicated by sensory analysis of the resulting noodle.
Formation of an Intermediate Filament Driven by Small-scale Magnetic Reconnection
Authors: Sun Xia , Yan Xiaoli , Liang Hongfei , Xue Zhike , Wang Jincheng , Yang Liheng , Xu Zhe , Yang Liping , Peng Yang , Li Qiaoling , li Zihan , Zhang Xinsheng
Published: February 2023

We present the formation process of a filament in NOAA active region 12765 from 2020 June 5 to 8, using observations from the New Vacuum Solar Telescope, the Solar Dynamics Observatory, and the Global Oscillation Network Group. We found that intermittent small-scale magnetic reconnection occurs at the northern part of the filament, and the small-scale magnetic reconnection shows the characteristics of the oscillatory reconnections. During the magnetic reconnection process, a large amount of material is continuously injected into the filament channel. Furthermore, there are bidirectional inflow and outflow, current sheets, and bright cusp-shaped structures. The velocities of the material injections range from 17 to 183 km s−1 with an average velocity of about 57 km s−1. A total of 53 material injections were found from 03:10 UT on 2020 June 5 to 00:10 UT on June 8. The total mass carried by the injection events is about 7.39 × 1014 g, and the total kinetic energy released through magnetic reconnection is approximately 3.09 × 1021 J. The projection area of the filament increased from less than 1 × 102 Mm2 to around 7 × 102 Mm2. We conclude that the filament is formed by direct material injection into the filament channel due to the small-scale magnetic reconnections.
Astronomical Detection of the Interstellar Anion C10H− toward TMC-1 from the GOTHAM Large Program on the Green Bank Telescope
Authors: Remijan Anthony , Scolati Haley N. , Burkhardt Andrew M. , Changala P. Bryan , Charnley Steven B. , Cooke Ilsa R. , Cordiner Martin A. , Gupta Harshal , Herbst Eric , Kelvin Lee Kin Long , Loomis Ryan A. , Shingledecker Christopher N. , Siebert Mark A. , Xue Ci , McCarthy Michael C. , McGuire Brett A.
Published: February 2023

Using data from the Green Bank Telescope (GBT) Observations of TMC-1: Hunting for Aromatic Molecules (GOTHAM) survey, we report the first astronomical detection of the C10H− anion. The astronomical observations also provided the necessary data to refine the spectroscopic parameters of C10H−. From the velocity stacked data and the matched filter response, C10H− is detected at >9σ confidence level at a column density of

4.04

−
2.23

+
10.67

×

10

11

cm−2. A dedicated search for the C10H radical was also conducted toward TMC-1. In this case, the stacked molecular emission of C10H was detected at a ∼3.2σ confidence interval at a column density of

2.02

−
0.82

+
2.68

×

10

11

cm−2. However, as the determined confidence level is currently <5σ, we consider the identification of C10H as tentative. The full GOTHAM data set was also used to better characterize the physical parameters including column density, excitation temperature, line width, and source size for the C4H, C6H, and C8H radicals and their respective anions, and the measured column densities were compared to the predictions from a gas/grain chemical formation model and from a machine learning analysis. Given the measured values, the C10H−/C10H column density ratio is ∼

2.0

−
1.6

+
5.9

—the highest value measured between an anion and neutral species to date. Such a high ratio is at odds with current theories for interstellar anion chemistry. For the radical species, both models can reproduce the measured abundances found from the survey; however, the machine learning analysis matches the detected anion abundances much better than the gas/grain chemical model, suggesting that the current understanding of the formation chemistry of molecular anions is still highly uncertain.
Radiation Transport Two-temperature GRMHD Simulations of Warped Accretion Disks
Authors: Liska M. T. P. , Kaaz N. , Musoke G. , Tchekhovskoy A. , Porth O.
Published: February 2023

In many black hole (BH) systems, the accretion disk is expected to be misaligned with respect to the BH spin axis. If the scale height of the disk is much smaller than the misalignment angle, the spin of the BH can tear the disk into multiple, independently precessing “sub-disks.” This is most likely to happen during outbursts in black hole X-Ray binaries (BHXRBs) and in active galactic nuclei (AGNs) accreting above a few percent of the Eddington limit, because the disk becomes razor-thin. Disk tearing has the potential to explain variability phenomena including quasi-periodic oscillations in BHXRBs and changing-look phenomena in AGNs. Here, we present the first radiative two-temperature general relativistic magnetohydrodynamic (GRMHD) simulation of a strongly tilted (65°) accretion disk around an M
BH = 10 M
⊙ BH, which tears and precesses. This leads to luminosity swings between a few percent and 50% of the Eddington limit on sub-viscous timescales. Surprisingly, even where the disk is radiation-pressure-dominated, the accretion disk is thermally stable over t ≳ 14,000 r

g
/c. This suggests warps play an important role in stabilizing the disk against thermal collapse. The disk forms two nozzle shocks perpendicular to the line of nodes where the scale height of the disk decreases tenfold and the electron temperature reaches T

e
∼ 108–109 K. In addition, optically thin gas crossing the tear between the inner and outer disk gets heated to T

e
∼ 108 K. This suggests that warped disks may emit a Comptonized spectrum that deviates substantially from idealized models.
XMM-Newton Detection of X-Ray Emission from the Metal-polluted White Dwarf G 29-38
Authors: Estrada-Dorado S. , Guerrero M. A. , Toalá 杜 J. A. 宇君 , Chu 朱 Y.-H. 有花 , Lora V. , Rodríguez-López C.
Published: February 2023

A recent analysis of Chandra X-ray data of the metal-polluted white dwarf G 29-38 has revealed X-ray emission that can be attributed to the accretion of debris from a planetary body. In the light of this detection we revisit here archival XMM-Newton observations of G 29-38 from which only an upper limit was derived in the past due to the presence of a relatively bright nearby X-ray source. An analysis of these data in multiple energy bands allows disentangling of the X-ray emission at the location of G 29-38 from that of the nearby source. The similar spectral properties of the source in the XMM-Newton and Chandra observations and their spatial shift, consistent with the proper motion of G 29-38 between these observations, strengthen the origin of the X-ray emission from G 29-38. The X-ray luminosities from both observations are consistent within the 1σ uncertainties, so too are the best-fit plasma temperatures. Although the count number is small, there is tantalizing evidence for line emission in the 0.7–0.8 keV energy band from an optically thin hot plasma. The most likely candidate for this line emission would be the Fe complex at 16 Å.
Comprehensive molecular and morphological analysis of Brachystemma calycinum and Stellaria ovatifolia in the tribe Alsineae (Caryophyllaceae)
Authors: Wang Wen-Qiao , Su Zhi-Wei , Ma Zhong-Hui
Published: February 2023

Over the course of the recent decade, the composition of Alsineae has been drastically changed by means of molecular phylogeny. However, the genus Brachystemma has not been sampled in any of the previous studies, and its phylogenetic position is still pending. In addition, the related species Stellaria ovatifolia, which has at times been placed in Brachystemma, Schizotechium, or Stellaria, has also not been sampled. Here, nuclear ribosomal internal transcribed spacer (ITS) and four plastid regions (trnL-F, matK, rbcL, rps16) were used to conduct phylogenetic analyses within Caryophyllaceae and the tribe Alsineae. Ancestral characters (petal margin and number of seeds) were reconstructed in the tribe Alsineae based on the phylogenetic results. Our results indicate that Brachystemma is nested in the tribe Alsineae and forms a monophylum with S. ovatifolia, and apically lobed petals and numerous seeds may be the ancestral characters in the tribe Alsineae. Based on our study, Stellaria ovatifolia should be considered within Brachystemma, and Brachystemma is clearly a separate genus and now includes two species.
Revision of the genus Charitoprepes Warren (Lepidoptera, Crambidae), with the description of a new species from China
Authors: Huang Shi-Qi , Du Xi-Cui
Published: February 2023

The genus Charitoprepes is revised based on morphological characteristics, and Charitoprepes aciculatasp. nov. is described as new from China. Additionally, the female genitalia of C. lubricosa are described for the first time based on new material. The differences among species of this genus are diagnosed, along with images of adults and their genitalia.
Une proposition touristique à contre-courant du marché mondialisé : des pratiques en tension genrées. Les Guides de Pays en Provence
Authors: Moïse Claudine
Published: February 2023

Dans le département rural des Alpes-de-Haute-Provence, le développement du tourisme comme ressource économique, essentiellement autour du patrimoine naturel ou sportif, s’est effectué récemment à travers des produits du terroir (la lavande notamment) et des lieux valorisés. À la marge de toutes les propositions visant le tourisme culturel, l’article se penche sur l’activité d’une association Les Guides de Pays qui s’inscrit dans une démarche de proximité et qui se voudrait à distance de logiques libérales mondialisées. À partir d’une enquête ethnographique, cet article cherche à analyser comment ce tourisme, qui revendique une valorisation d’une identité locale et de proximité et qui refuse une dimension libérale ou commodifiée de ses pratiques, ne peut échapper aux tensions qui le traversent, notamment autour de « l’authenticité ». On se rend compte, alors que cette tentative d’échapper à la dimension marchande et mondialisée du tourisme est caractéristique de pratiques genrées.
Exploiter le plurilinguisme pour vendre une expérience « monolingue ». Le cas du tourisme linguistique à Malte
Authors: Schedel Larissa Semiramis
Published: February 2023

La recherche sociolinguistique sur le tourisme linguistique a longtemps porté son attention en premier lieu sur les pratiques langagières des apprenant·e·s et a largement ignoré les différent·e·s acteur·trice·s travaillant dans cette industrie. De plus, la gestion institutionnelle du plurilinguisme dans des écoles de langues avec une clientèle internationale est peu étudiée. En s’appuyant sur une étude ethnographique menée dans une école d’anglais sur l’archipel bilingue de Malte, cette contribution examine comment le personnel du service d’accompagnement des élèves négocie les tensions entre l’exigence de l’accommodation linguistique envers des élèves avec un faible niveau d’anglais et la mise en scène d’une communauté globale anglophone qui réponde à la quête d’immersion des élèves. L’article montre qu’afin de faciliter la marchandisation de l’anglais, l’école exploite le plurilinguisme de ce personnel, tout en le dissimulant pour fabriquer une expérience imaginée comme monolingue, et reproduit ainsi un régime linguistique néocolonial.
Le consensus de Washington existe-t-il encore ?
Authors: Treillet Stéphanie , Montalieu Thierry
Published: February 2023

La question du rôle des institutions internationales dans la réforme des politiques de développement et en particulier ce qu’il a été convenu d’appeler le Consensus de Washington, a connu des débats intenses depuis 40 ans. Ces débats théoriques et institutionnels ont produit une évolution dans le contenu et la mise en œuvre des politiques dites d’ajustement structurel. Partant d’un bilan critique de ces changements d’approche, l’article vise à en repérer les étapes essentielles tout en soulignant les invariants. L’ouverture vers le traitement de la pauvreté, la notion de croissance inclusive, la question de la qualité des institutions ou celle du genre et plus récemment encore l’introduction du concept de vulnérabilité (sanitaire ou climatique) offrent des perspectives fructueuses si le stade du discours est dépassé. Classification JEL : F02, F42, O19
Après 60 ans de coopération internationale pour le développement, celle-ci serait-elle devenue anachronique ?
Authors: Gabas Jean-Jacques , Vernières Michel
Published: February 2023

La coopération pour le développement est née, au lendemain de la colonisation, de la volonté des États de conserver des liens forgés au temps des colonies, en suivant un modèle de développement. Au cours des 50 dernières années, ces relations de coopération ont, de période en période, évolué de façons très diverses et ont fait l’objet de nombreux débats auxquels la revue Mondes en développement a participé. Le monde de 2022 a radicalement changé et les vieux outils et politiques de coopération pour le développement apparaissent désormais anachroniques. Mais face à l’ampleur des défis situés à l’échelle mondiale, la réinvention de cette dernière est plus nécessaire que jamais. Classification JEL : F2, F35, F42, H81, H84, H87, O01, O019, O02
La victime au centre. Perspectives philosophiques
Authors: Causse Guilhem
Published: February 2023

L’un des enseignements majeurs du travail de la CIASE est que les victimes de crimes et d’abus sexuels dans l’Église doivent être mises au centre. Elles seules peuvent dire ce qu’elles ont subi et ce qu’elles vivent encore, et nous indiquer les transformations, y compris structurelles, à mettre en œuvre. Ce geste salutaire de mettre les victimes au centre représente pourtant une révolution, non seulement pour l’Église, mais pour la société entière. Un retour sur la manière dont les places respectives du « coupable » et de la victime ont évolué depuis les années 1950 le montrera. Cette évolution est notamment liée au renouveau de la question du pardon et trouve une forme pratique dans la justice restaurative, qui pourra inspirer l’Église pour l’accueil et l’accompagnement des victimes.
Du « contre nature » aux valeurs interpersonnelles : une évolution inachevée de la théologie de la sexualité
Authors: Saintôt Bruno
Published: February 2023

L’article cherche à répondre à certaines demandes formulées par les recommandations 10 et 11 du rapport de la CIASE, notamment celle de ne pas privilégier la matière de l’acte à l’évaluation de la responsabilité personnelle, et celle de favoriser la réflexion doctrinale pour ne pas séparer doctrine sur la sexualité et doctrine sociale. L’article soutient que l’évolution de la théologie de la sexualité amorcée par le « tournant personnaliste » de la théologie morale dès avant Vatican II reste inachevée. Il pointe ainsi la permanence des héritages stoïciens et aristotéliciens du « contre nature » assimilé à la sacralité d’un « ordre naturel », et invite à son dépassement. Il insiste enfin sur l’écoute de l’expérience des chrétiens et sur l’élaboration d’une nouvelle pédagogie de la sexualité.
Que devient l’enseignement de la morale sexuelle si on introduit la notion de justice ?
Authors: Fino Catherine
Published: February 2023

Pour remettre en valeur la notion de justice en morale sexuelle, on peut s’appuyer sur le pape François qui réintègre l’éthique sexuelle dans la perspective de la doctrine sociale de l’Église. L’éthique sexuelle ne doit plus se limiter au jugement à poser sur des pratiques sexuelles et à la promotion du mariage, mais aussi dénoncer les injustices faites aux personnes, et protéger ceux qui sont rendus vulnérables par leur différence en matière de sexualité. Sans renoncer pour autant à une anthropologie et une éthique personnaliste, ni à solliciter les ressources spécifiques de la foi, il faut proposer un cadre éthique sous-jacent qui assure la protection des corps. Les principes de la doctrine sociale de l’Église sont des exigences préalables au développement de toute relation amoureuse et conjugale.
On the symmetries in the dynamics of wide two-layer neural networks
Authors: Hajjar Karl , Chizat Lénaïc
Published: February 2023

We consider the idealized setting of gradient flow on the population risk for infinitely wide two-layer ReLU neural networks (without bias), and study the effect of symmetries on the learned parameters and predictors. We first describe a general class of symmetries which, when satisfied by the target function $ f^* $ and the input distribution, are preserved by the dynamics. We then study more specific cases. When $ f^* $ is odd, we show that the dynamics of the predictor reduces to that of a (non-linearly parameterized) linear predictor, and its exponential convergence can be guaranteed. When $ f^* $ has a low-dimensional structure, we prove that the gradient flow PDE reduces to a lower-dimensional PDE. Furthermore, we present informal and numerical arguments that suggest that the input neurons align with the lower-dimensional structure of the problem.
A discrete mixed distribution: Statistical and reliability properties with applications to model COVID-19 data in various countries
Authors: Eliwa Mohamed S. , Alhumaidan Buthaynah T. , Alqefari Raghad N.
Published: February 2023

The aim of this paper is to introduce a discrete mixture model from the point of view of reliability and ordered statistics theoretically and practically for modeling extreme and outliers' observations. The base distribution can be expressed as a mixture of gamma and Lindley models. A wide range of the reported model structural properties are investigated. This includes the shape of the probability mass function, hazard rate function, reversed hazard rate function, min-max models, mean residual life, mean past life, moments, order statistics and L-moment statistics. These properties can be formulated as closed forms. It is found that the proposed model can be used effectively to evaluate over- and under-dispersed phenomena. Moreover, it can be applied to analyze asymmetric data under extreme and outliers' notes. To get the competent estimators for modeling observations, the maximum likelihood approach is utilized under conditions of the Newton-Raphson numerical technique. A simulation study is carried out to examine the bias and mean squared error of the estimators. Finally, the flexibility of the discrete mixture model is explained by discussing three COVID-19 data sets.
Management of the patient with urostomy: Caregiver needs during the three months after discharge. A qualitative study
Authors: Bolgeo Tatiana , Ruta Federico , Gatti Denise , Gambalunga Francesca , Iacorossi Laura , Di Matteo Roberta , Cotroneo Salvatore , Boccafoschi Carmelo , Maconi Antonio
Published: February 2023

Objective: To examine caregivers' experiences and training needs after radical cystectomy with urinary diversion for the ﬁrst three months following the patient's discharge.
Methods: This study applied a phenomenological design approach through open-ended interviews and descriptive analysis. Phenomenology applied to empirical research requires researchers to explore the empirical facts narrated by partici-pants. This study followed the Consolidated Criteria for Reporting Qualitative Research guidelines, a 32 – item checklist for inter-views and focus groups. The study population included caregivers of bladder cancer patients, admitted to three Italian hospitals. Data were collected between March 2020 and March 2022.
Results: Fifty-two caregivers of patients who underwent cystecto-my with urinary diversion from three Italian hospitals (41 males and 11 females) participated to the study. The data analysis con-verged in the identiﬁcation of three themes – with sub-themes –that included various aspects of the caregiver’s lived experiences: 1) living with the burden of being indispensable, for the family member, 2) feeling abandoned by institutions, 3) tiredness and less willingness to look after the relative due to work burden.
Conclusions: Our study demonstrates that the caregiver of a patient with bladder cancer and urostomy in the ﬁrst three months of hospital discharge is very worried and stressed. Despite the training program received in hospital, the caregiver does not recognize the newly acquired skills and has difﬁculty applying them. Further study would be required.
Safety proﬁle of treatment with greenlight versus Thulium Laser for benign prostatic hyperplasia
Authors: Campobasso Davide , Barbieri Antonio , Bocchialini Tommaso , Pozzoli Gian Luigi , Dinale Francesco , Facchini Francesco , Grande Marco Serafino , Kwe Jean Emmanuel , Larosa Michelangelo , Guarino Giulio , Mezzogori Davide , Simonetti Elisa , Ziglioli Francesco , Frattini Antonio , Maestroni Umberto Vittorio
Published: February 2023

Objective: The major strengths of surgical treatment of benign prostatic hyperplasia with laser are reduced morbidity compared to endoscopic resec-tion. No studies analysed the different risk of intra/peri-opera-tive events between patients undergoing Thulium and GreenLight procedures.Materials and methods: We retrospectively reviewed 100 con-secutive cases undergoing GreenLight vaporization and Thulium procedures performed during the learning curve of two expert endoscopic surgeons. Pre-operative data, intra and post-opera-tive events at 90 days were analysed. Results: Patients on antiplatelet/anticoagulant therapy were pre-dominant in the Green group (p < 0.0001). Rates of blood trans-fusion (p < 0.0038), use of resectoscope (p < 0.0086), and tran-sient stress urinary incontinence were statistically higher in the Thulium group. On the contrary conversions to TURP(p < 0.023) were more frequent in GreenLight patients. Readmissions were more frequently necessary in GreenLight group (24%) vs. Thulium group (26.6%). The overall complica-tion rate in GreenLight and Thulium groups were 31% and 53%respectively; Clavien 3b complications were 13% in Thulium patients versus 1% in GreenLight patients.Conclusions: GreenLight and Thulium treatments show similar safety proﬁles. Randomized controlled trial are needed to better clarify the rate of major complications in Thulium group, and the incidence of post-operative storage symptoms in these patients’ populations.
Alternative surgical management of penile siliconoma using partial degloving and resurfacing
Authors: Chico Goerne Manuel Belmonte , Khogeer Abdulghani , Davison Peter , Carrier Serge , Aubé-Peterkin Melanie
Published: February 2023

Introduction: Siliconoma represents an inﬂammatory tissue response to extravasated silicone. Penile enhancing silicone injections have been described for over 50 years. Most of the publications report complications including negative effects on penile appearance and function which require corrective procedures. Penile circumferential skin and siliconoma excision with skin grafting has been described in multiple case reports and series as an effective and feasible option to remove the silicone and achieve good esthetic results. Methods: We describe a simple and feasible single stage proce-dure removing the siliconoma with adjacent non-viable skin while preserving 50% of healthy penile skin and resurfacing the defect with a split-thickness skin graft to treat a long-term com-plication of penile silicone injection associated with recurrent infections and a chronic skin ulceration. Conclusion: Partial excision of the affected penile skin and sili-conoma with defect resurfacing with a split-thickness skin graft is a feasible with good functional and cosmetic outcomes.
GERD surgery in non-neurologic patients: Modified Laparoscopic Hill-Snow Repair is a valid alternative to Nissen fundoplication. Results of a 20 years of follow-up
Authors: Chiarenza Salvatore Fabio , Costa Lorenzo , Conighi Maria Luisa , Zolpi Elisa , Fasoli Lorella , Brooks Giulia , La Pergola Enrico , Bleve Cosimo
Published: February 2023

Nowadays laparoscopic Nissen fundoplication represents the gold standard in surgical treatment of complicated Gastro-Esophageal-Reflux Disease (GERD), above all in cerebral palsy patients. In non-neurological patients without gastrostomy Nissen fundoplication can create some problems (gas bloat syndrome, dysphagia). Laparoscopic Hill-Snow repair is an established surgical alternative, but it is reported only in adult population. We describe our modification of Hill-Snow technique and our experience in a large series of non-neurological children in order to report its effectiveness and applicability in pediatric patients affected by complicated GERD. Between 2000 and 2022, 319 children underwent surgical correction of gastro-esophageal reflux at our Department. All were affected by complicated gastro-esophageal reflux unresponsive to PPI (Proton Pump Inhibitors). 251 underwent laparoscopic Nissen fundoplication; 68 non-neurological patients underwent laparoscopic Hill-Snow repair. Of these 68 children 48 were males (71%) and 20 females (29%); median age was 5years (3 months-11 years). Weight range was 4-37kg.
52 patients (76.5%) presented the following symptoms: retrosternal pain, dysphagia, regurgitation, coughing, failure to thrive, persisting reflux esophagitis. 16 (23.5%) had chronic respiratory problems (aspiration, apneic-spells, dysphagia, coughing, choking, gagging). For 8 (11.8%) symptoms were expression of chronic recurrent gastric volvulus. All underwent modified-laparoscopic-Hill-Snow repair. Contrast study showed sliding hiatal hernia in 55 patients (81%), while endoscopy demonstrated 16 cases of histologically severe esophagitis (23.5%) and 52 of mild esophagitis (76.5%). No intraoperative/postoperative complications were recorded. 60patients had a complete follow-up (range 1-20 years). 60/68 patients were evaluated with barium-swallow-study at 6-12 months; 40/68 patients with upper-gastrointestinal-endoscopy at 12months. No relapse was reported. 50 patients (73.7%) were symptom-free. 18 (26.3%) referred occasional epigastric pain, associated with vomit in 2 cases. 64 (94.1%) referred ability to vomit; 4 temporary difficulty to swallow (average 30 days). All patients reported being able to burp. 3(4.5%) presented episodes of gas-air-bloat during the first 2 months with spontaneous resolution. No case of dumping syndrome was recorded. This technique’s modification yields excellent results in term of relapse and side effects at long-term follow-up. We reported the first and largest pediatric series in non-neurological children with encouraging results.
The relationship between knowledge and disaster preparedness of undergraduates responding to forest fires
Authors: Wulandari Fajar , Budijanto Budijanto , Bachri Syamsul , Utomo Dwiyono H.
Published: February 2023

Forest and land fires are disasters that regularly occur on the island of Kalimantan, Indonesia. Higher education students on the island of Kalimantan are considered vulnerable to these disasters, hence the need for mandatory disaster knowledge and preparedness for every individual in the area. This research aimed to: (1) determine disaster knowledge and student preparedness in dealing with forest and land fire disasters, (2) determine the relationship between knowledge and student preparedness. This study used a quantitative correlation method with a questionnaire. The data were processed using the Statistical Package for the Social Sciences 21. The research sample used purposive sampling because it followed the needs of the study, which involved 300 students affected by forest fires, representing three universities located in a forest fire–prone area in West Kalimantan province, Indonesia. Each campus has 100 students, a total of 300 students. The results showed as many as 284 students had experienced forest and land fire disasters. In addition, 202 out of 284 students were known to have low disaster knowledge. Four main parameters of disaster preparedness were used to measure student preparedness, namely (1) knowledge and attitudes, (2) emergency response plans, (3) disaster warning system and (4) resource mobilisation. The number of students with high preparedness was 141, while 143 had low preparedness. Thus, student preparedness measures need to be increased to avoid disaster impact.Contribution: Based on the data analysis, students’ knowledge and preparedness to face forest fires are positively related. It was shown that the higher the learning of students, the higher their readiness and vice versa. It is suggested that there is a need for increasing knowledge and preparedness actions for students in dealing with forest fire disasters through regular disaster lectures, simulations and training so that they can make the right decisions in coping with disasters.
Effects of brisk walking on fasting blood glucose and blood pressure in diabetic patients
Authors: Opoku Bridgette , De Beer-Brandon Caroline R. , Quartey Jonathan , Mshunqane Nombeko
Published: February 2023

Background: Aerobic exercises have been administered as an adjunct treatment for health conditions; however, the effects of brisk walking on Type 2 diabetes mellitus (T2DM) patients living with hypertension in Ghana are yet to be explored.Aim: To determine the effects of brisk walking on fasting blood glucose and blood pressure of patients with T2DM living with hypertension in Ghana.Setting: The National Diabetes Management and Research centre at Korle-Bu Teaching Hospital.Methods: Males and females above 18 years with T2DM and hypertension were included. Fasting blood glucose, anthropometric measurements and distance walked were measured at baseline and after 8 weeks of intervention. The intervention consisted of brisk walking three times a week for 8 weeks.Results: Sixty participants completed the intervention. There was a statistically significant reduction of fasting blood glucose (baseline: 8.79 mmol/L (3.55), after intervention: 7.62 mmol/L (2.73) with p = 0.02) and blood pressure levels: (systolic blood pressure baseline: 141.12 mmHg (2.91) after intervention 120.75 mmHg (1.21) with p = 0.00); diastolic blood pressure (baseline: 80.78 mmHg (1.66), after intervention mmHg 69.38 (1.05) with p = 0.00) between baseline and post-intervention.Conclusion: Eight weeks of brisk walking reduced the levels of fasting blood glucose and blood pressure in patients with T2DM and hypertension.Contribution: This study will enlighten healthcare workers about the integration of brisk walking as a possible adjunct to control blood glucose and blood pressure levels in patients with T2DM and hypertension.
The family physician’s guide to the private sector galaxy
Authors: Mathew Sheena , Murphy Shane D.
Published: February 2023

No abstract available.
Weighing up the pros and cons of dysphagia triage in South Africa
Authors: Kater Kelly-Ann , Seedat Jaishika
Published: February 2023

Background: Early identification of dysphagia followed by intervention reduces, length of hospitalisation, degree of morbidity, hospital costs and risk of aspiration pneumonia. The emergency department offers an opportune space for triage. Triaging offers risk-based evaluation and early identification of dysphagia risk. A dysphagia triage protocol is not available in South Africa (SA). The current study aimed to address this gap.Objectives: To establish the reliability and validity of a researcher-developed dysphagia triage checklist.Method: A quantitative design was used. Sixteen doctors were recruited from a medical emergency unit at a public sector hospital in SA using non-probability sampling. Non-parametric statistics and correlation coefficients were used to determine the reliability, sensitivity and specificity of the checklist.Results: Poor reliability, high sensitivity and poor specificity of the developed dysphagia triage checklist was found. Importantly, the checklist was adequate in identifying patients as not being at risk for dysphagia. Completion time for dysphagia triage was 3 minutes.Conclusion: The checklist was highly sensitive but not reliable or valid for use in identifying patients at risk for dysphagia.Contribution: The study provides a platform for further research and modification of the newly developed triage checklist, which is not recommended for use in its current form. The merits of dysphagia triage cannot be ignored. Once a valid and reliable tool is confirmed, the feasibility of implementation of dysphagia triage must be considered. Evidence to confirm that dysphagia triage can be conducted, when considering the contextual, economic, technical and logistic aspects of the context, is necessary.
Kuyper’s sphere sovereignty and institutional religious freedom in Indonesia
Authors: Kristanto David , Salurante Tony
Published: February 2023

Although the Indonesian Constitution guarantees religious freedom in Indonesia, the implementation of that freedom is not without ambiguity. As the state defines what constitutes religion and categorises official and nonofficial religions, religious communities such as indigenous religious groups are struggling to obtain equal access to the public administration and to express their faith to the broader society. The ambiguity of religious freedom in Indonesia is obvious in the matter of institutional freedom of religion. Minority religious groups, especially those of nonofficial religions, would find their institutional freedom much restricted. Kuyper’s sphere sovereignty has proved to be successful in establishing institutional religious freedom in the Netherlands. This article seeks to show the relevance of Kuyper’s sphere sovereignty to the matter of institutional religious freedom in Indonesia.Intradisciplinary and/or interdisciplinary implications: Kuyper’s sphere sovereignty does not only show the importance of religious freedom but also the equal access for every religious community to institutionalise themselves. In the Indonesian context, sphere sovereignty could contribute to the issue of institutional religious freedom, especially for the adherents of nonofficial religions.
The Effect of Normal Saline and Plasmalyte on Acid–Base Status in Patients Undergoing Head-and-Neck Surgery with Free Flap Reconstruction
Authors: Trivedi Saurabh , Sharma Anand , Baghel Kaushal Singh , Karna Sunaina Tejpal , Thaware Pooja , Trivedi Gaurav , Tejpal Manvinder
Published: February 2023

Background:

Intraoperative fluid strategy may affect the graft viability in head-and-neck surgeries with free flap reconstruction (HNS-FFR). Studies to guide regarding association of intraoperative fluid with metabolic parameters during such surgeries are infrequent.

Aim:

This study aimed to compare plasmalyte (PL) and normal saline (NS) (0.9%) in terms of acid–base balance and electrolytes in the peri-operative period along with graft viability during above-mentioned surgeries.

Settings and Design:

Prospective, observational cohort study was conducted in patients, 18–65 years, undergoing HNS-FFR at a tertiary care center.

Materials and Methods:

The cohort was categorized into two groups based on the intraoperative fluid used, i.e., PL (Group A) and NS (Group B) group. The primary objective was to compare arterial blood gas parameters at seven time points till the 3rd postoperative day. We studied the effect on graft viability and length of hospital stay.

Statistical Analysis Used:

The independent t-tests, Chi-square, or Fisher's exact test were used to evaluate the categorical variables with a repeated measures analysis of variance for inter-group comparison with P < 0.05 as significant.

Results:

Seventy-one (36 in Group A and 35 in Group B) patients were included in the study with comparable baseline characteristics. Group A had a better acid–base status, especially after the conclusion of vascular anastomosis (pH 7.37 ± 0.06 vs. 7.33 ± 0.04, P = 0.014) and in the postoperative period (pH 7.35 ± 0.07 vs. 7.31 ± 0.05, P = 0.013). No statistically significant difference was observed in outcome parameters between the groups.

Conclusions:

PL may be preferred over NS due to better metabolic milieu during HNS-FFR surgery.
Postoperative Chylothorax and Left Internal Jugular Vein Thrombus after Complex Cyanotic Heart Disease Surgery
Authors: Bagri Dhan Raj , Meena Kailash , Meena Jeetam Singh , Gurjar Umesh , Jeengar Balveer
Published: February 2023

Chylothorax is the accumulation of lymphatic fluid in pleural space following traumatic injury to lymphatic vessels, systemic venous obstruction, dysfunction of the right ventricle, thrombosis of the duct, superior vena cava or subclavian vein, or postoperatively. A 2 ½-year-old male child operated for transposition of great arteries (TGA), tricuspid atresia (TA), and hypoplastic right ventricle 15 days ago developed chylothorax and left internal jugular vein thrombus. The child was initially managed conservatively with nutritional management, anticoagulation, and octreotide followed by interventional radiological management with lipoidol injection. Early suspicion and diagnosis are crucial. The management was difficult owing to a lack of proper guidelines. Further research is warranted.
Cyanotic Congenital Heart Disease_Effects of Iron Supplementation on Hematological Indices in Iron-Sufficient and Iron-Deficient Children
Authors: Sharma Rambabu , Meena Devendra , Bagri Dhan Raj
Published: February 2023

Background:

Cyanotic congenital heart disease (CCHD) children often have malnutrition and iron-deficiency anemia along with poor weight gain. Low arterial oxygen saturation due to CCHD affects hematological indices.

Objective:

The objective of the study is to find iron status and hematological indices in children having CCHD and to study the impact of iron therapy in the sample population under study.

Materials and Methods:

This hospital-based, prospective, cross-sectional, observational type of study evaluated 50 CCHD children aged more than 1 year with informed written consent from the parents. Sample size is calculated at 95% confidence level and alpha error 4.005 assuming 52.2% iron deficiency in patient with CCHD with hematocrit value <60%.

Results:

Tetralogy of Fallot was the most common CCHD followed by transposition of great arteries and tricuspid atresia. Most common age of presentation is <50 months with cyanosis (50%) and congestive cardiac failure (16%) with male preponderance (M:F = 3:1). 60% CCHD patients were iron deficient. Iron-deficient group shows significant improvement in all hematological parameters after iron supplementation compared with iron-sufficient group.

Results and Discussions:

Serum iron levels, serum ferritin levels, mean hemoglobin levels, total red blood cell count, hematocrit, and red cell distribution width along with red cell indices (mean corpuscular volume, mean corpuscular hemoglobin, and MCHC) should be used as diagnostic tool for the evaluation of iron status in patients as well as for monitoring improvement. This emphasizes that iron therapy iron must be supplemented with special focus on iron status of children.
Finding Association Between Lipid Profile and Demographic and Disease Status of Patients Undergoing Coronary Angiography
Authors: Prashanth R. M.
Published: February 2023

Background:

Coronary artery disease has higher prevalence in India than the West. Studies suggest that vascular age of Asian Indians is older to their chronological age, making them more susceptible for the disease. Association between various factors involved in patients having coronary artery disease and their lipid profiles in rural India is not clear.

Objectives:

The study focuses on the prevalence and comparative analysis of dyslipidemia in the patient group with respect to demographic data and comorbid conditions.

Patients and Methods:

This was a retrospective study which analysed 957 patients' hospital record in whom angiography was done for their coronary artery disease in a rural south India.

Results:

Statistically significant data (P < 0.005) were found in case of total cholesterol levels, with a mean being elevated in age below 45 years (178 ± 46 mg/dl) as compared to age above 45 years (167 ± 48 mg/dl). The mean total cholesterol levels were greater (177 ± 49 mg/dl) in women as compared to men (166 ± 48 mg/dl) with P < 0.005. Hypertensive patients showed elevated levels of total cholesterol and triglycerides. Patients with diabetes had elevated triglyceride levels in general.

Conclusion:

Triglyceride levels might be playing an important role than total cholesterol in the pathophysiology of CAD and for atherogenesis, it is the presence of hypertension with a deranged lipid profile, more so with total cholesterol and triglycerides.