bluuebunny/crossref_metadata_2025 huggingface dataset:
Les objets dans l’activité interindividuelle en classe : l’exemple de leçons d’Education Physique et Sportive et de géographie
Authors: Adé David , Veyrunes Philippe , Poizat Germain
Published: April 2021

Cette étude porte sur le rôle des objets dans l’activité interindividuelle lors de situations d’enseignement variées (à l’école primaire en géographie, et au collège en Education Physique et Sportive). A partir de l’analyse de l’activité d’enseignants et d’élèves, les résultats pointent (a) les objets comme sources de divergences au sein de l’activité interindividuelle (les objets dans ce cas ouvrent des possibles qui entravent l’activité interindividuelle) et, (b) les objets comme sources de ritualisation et de conservation de l’activité interindividuelle (les objets dans ce cas ouvrent des possibles qui facilitent l’activité interindividuelle). Il ressort que les objets constituent un « potentiel sémiotique » qui s’actualise au gré de l’activité des acteurs et de leur engagement dans la situation. Nous proposons de prendre en compte les objets dans la formation professionnelle des enseignants.
Preventive oral kefir supplementation protects mice from ovariectomy-induced exacerbated allergic airway inflammation
Authors: Mendes E. , Casaro M.B. , Fukumori C. , Ribeiro W.R. , dos Santos A.L. , Sartorelli P. , Lazarini M. , Bogsan C.S.B. , Oliveira M.A. , Ferreira C.M.
Published: April 2021

Asthma is an inflammatory lung disease that affects more women than men in adulthood. Clinical evidence shows that hormonal fluctuation during the menstrual cycle and menopause are related to increased asthma severity in women. Considering that life expectancy has increased and that most women now undergo menopause, strategies to prevent the worsening of asthma symptoms are particularly important. A recent study from our group showed that re-exposure of ovariectomised allergic mice to antigen (ovalbumin) leads to an exacerbation of lung inflammation that is similar to clinical conditions. However, little is known about the role of probiotics in the prevention of asthma exacerbations during the menstrual cycle or menopause. Thus, our objective was to evaluate the effects of supplementation with kefir, a popular fermented dairy beverage, as a preventive strategy for modulating allergic disease. The results show that the preventive kefir administration decreases the influx of inflammatory cells in the airways and exacerbates the production of mucus and the interleukin 13 cytokine. Additionally, kefir changes macrophage polarisation by decreasing the number of M2 macrophages, as shown by RT-PCR assay. Thus, kefir is a functional food that potentially prevents allergic airway inflammation exacerbations in ovariectomised mice.
Gut microbiota, body weight and histopathological examinations in experimental infection by methicillin-resistant Staphylococcus aureus: antibiotic versus bacteriocin
Authors: Bendjeddou K. , Hamma-Faradji S. , Meddour A. Ait , Belguesmia Y. , Cudennec B. , Bendali F. , Daube G. , Taminiau B. , Drider D.
Published: April 2021

Bacteriocins have been steadily reported as potential agents that may contribute, in different ways, to overcome antimicrobial drug resistance. Here, holoxenic NMRI-F mice microbiota, their body weight recovery and histopathological alterations of organs like colon, spleen and liver were examined in mice intraperitoneally infected with 108 cfu of a clinical methicillin-resistant Staphylococcus aureus (MRSA-1), and treated with enterocin DD14 alone (165 mg/kg), erythromycin alone (100 mg/kg) or their combination. Animals that received both antimicrobials presented a better body weight recovery than other groups. Less pronounced histopathological alterations were observed in mice MRSA-infected and treated with bacteriocin than in those MRSA-infected but untreated or MRSA-infected and treated with erythromycin. Noteworthy, these alterations were absent when mice were treated with MRSA-infected and treated with both antibacterial agents. Furthermore, the genus richness was significantly lower in mice infected and treated with erythromycin, compared to mice infected and treated with both antimicrobials. The beta-diversity analysis showed that non-infected mice and those infected and treated with both antimicrobials, stand apart from the other groups as supported in a NMDS model. This in vivo study shows the relevance of bacteriocin, or bacteriocin-antibiotic formulation in protecting colonic, liver and spleen soft tissues and controlling the mouse gut microbiota, following MRSA infection.
Limosilactobacillus reuteri ATCC PTA 5289 and DSM 17938 as adjuvants to improve evolution of pharyngitis/tonsillitis in children: randomised controlled trial
Authors: Maya-Barrios A. , Lira-Hernandez K. , Jiménez-Escobar I. , Hernández L. , Ortiz-Hernandez A. , Jiménez-Gutiérrez C. , López-Velázquez G. , Gutiérrez-Castrellón P.
Published: April 2021

Pharyngitis and tonsillitis are the most common acute respiratory infections (ARIs) in children aged ≤5 years. The analysis of published data showed that some probiotics could decrease the frequency and number of days with ARIs. This study evaluated the safety and efficacy of Limosilactobacillus reuteri ATCC PTA 5289 and DSM 17938 to reduce the duration and severity of ARI symptoms. This randomised controlled trial included children aged from 6 months to 5 years, with pharyngitis or tonsillitis, who were randomised to receive a probiotic product containing L. reuteri ATCC PTA 5289 and L. reuteri DSM 17938 or placebo, as drops, ingested orally for 10 days as adjuvants to the use of non-steroidal anti-inflammatory drugs. The main outcomes were the duration and severity of ARI symptoms. The secondary outcomes were changes in salivary immunoglobulin A and inflammatory biomarkers. There was no fever on day 2 and subsequent days in the L. reuteri group (37.3 ±0.5 °C vs 38.6±0.3 °C, P<0.05). Beginning on day 3, the severity of sore throat (5±0.9 vs 8±1.2, P<0.05) was lower in the L. reuteri group. Significant differences in the days with runny nose, nasal congestion, days of non-programmed visits to the medical office or emergency department, levels in tumoral necrosis factor-alpha (TNF-alpha) and related costs of treatment were observed in the L. reuteri group. The frequency of adverse events was similar between the groups. Therefore, L. reuteri ATCC PTA 5289 combined with L. reuteri DSM 17938 is a safe and effective adjunct to reduce the symptoms of pharyngitis or tonsillitis in children.
A narrative review of the risk factors and psychological consequences of injury in horseracing stable staff
Authors: Davies E. , McConn-Palfreyman W. , Williams J.M. , Lovell G.P.
Published: April 2021

Horseracing stable staff have a multifaceted role, acting as care givers, skilled athletes and equine experts, resulting in inherent high emotional, physical and mental demands. Despite these demands, and reports of significant injury risk to those working in racing at ground level, there has been no research investigating the psychological risk factors for injury in UK racing stable staff and how psychological responses to injury may affect long term mental health and wellbeing. With mental health at the forefront of industry consideration, this narrative review aimed to reflect on the current literature to propose occupational, life and social stressors that may be increasing the risk of injury in racing staff. In addition, this review aims to apply current injury theory to propose whether stable staff are at heightened risk of injury mismanagement. A literature search was undertaken to investigate the psychological aspects of injury, using five search engines and the following key words: injury, psychological responses, occupational, sport and/or athlete, equestrian, horseracing, jockey, risk of injury, rehabilitation, and injury minimisalisation. Articles were selected based on relevance to review aims, and research findings were synthesised under two primary areas: predictors of injury (working hours, job security, job control, life stressors, mental health and drug misuse) and responses to injury (positive and negative responses to injury, the role of social support, rehabilitation adherence, and injury minimalisation). Whilst there are limitations to narrative reviews, this study provides a novel interpretation of injury risk and responses specific to staff working in horseracing, where injury-related challenges are currently a key focus for sector employees, managerial staff and racing organisations. Recommendations for further research have been made to direct the advancement of knowledge in the field.
CYP1A2, 2A13, and 3A4 network and interaction with aflatoxin B1
Authors: Khan M. Tahir , Irfan M. , Ahsan H. , Ali S. , Malik A. , Pech-Cervantes A.A. , Cui Z. , Zhang Y.J. , Wei D.Q.
Published: April 2021

Aspergillusfungi are known to produce aflatoxins, among which aflatoxin B1(AFB1) is the most potent carcinogen that is metabolised by cytochrome P450 (CYP450). In the liver, AFB1is metabolised into exo-8,9-epoxide by the CYP1A2 enzymes. The resulting epoxide can react with guanine to cause DNA damage. Natural inhibitors are being identified. However, the modes of action are poorly understood. In the current study, we have investigated the mode of action of AFB1with CYP1A2, CYP3A4 and CYP2A13 using molecular dynamic simulation (MD simulation) approaches. The interaction network and paths among CYP1A2, CYP3A4, and CYP2A13 have been investigated using the STRING database and PathLinker plugin of Cytoscape. CYP3A4 is the most active protein involved in interactions with AFB1during its metabolism. Residues 362ARG, 445SER, 450LEU and 451PHE of CYP1A2 are important, interacting with AFB1and converting it to toxic exo-AFB1-8,9-epoxide (AFBEX). The pathway shows that microsomal epoxide hydrolase (EPHX1) may acts as initiator in the signalling pathway where CYP1A2, CYP3A4 and CYP2A13 interact in a sequential order. The interaction network shows there to be a strong association in expression among CYP1A2, CYP3A4 and CYP2A13 along with other metabolising enzymes. The complex of AFB1and CYP1A2 was found to be stable during the MD simulation. This study provides a better understanding of the mode of action between AFB1and CYP1A2, CYP3A4 and CYP2A13 which relates to the effective management of AFB1toxicity. EPHX1 in the protein network may be an ideal target when designing inhibitors to prevent the toxin’s activation. Peptide inhibitors may be designed to block the substrate site residues of CYP1A2 in order to prevent the conversion from AFB1into AFBEX. This would either neutralise or reduce its toxicity.
Effectiveness of a novel fungicide pydiflumetofen againstFusarium head blight and mycotoxin accumulation in winter wheat
Authors: Xia R. , Schaafsma A.W. , Limay-Rios V. , Hooker D.C.
Published: April 2021

Fusarium head blight (FHB) causes yield loss, quality reduction, and grain mycotoxin accumulations. A novel pydiflumetofen-containing fungicide, Miravis Ace, was recently registered in North America. The main objective of this study was to assess the efficacies of Miravis Ace and the timing of application alongside industry standard triazole fungicides (Prosaro, Caramba, Proline and Folicur) on suppressing FHB, reducing mycotoxins and improving wheat agronomic performance. The assessment was conducted across six natural environments on commercial farm fields and in two artificially inoculated-misted environments. All environments included 5 fungicides (Miravis Ace and the four triazole fungicides) and 3 application timings (Zadoks GS 59, 65, 69-71). Additionally, for the ZGS 65 timing, the experiment in the natural environment included a quinone outside inhibitor (QoI) fungicide pyraclostrobin (Headline). In general, Miravis Ace tended to be more effective on FHB suppression than the triazole fungicides across all environments. However, any biological differences tended to be statistically non-significant, likely because of a lack of statistical power. Miravis Ace reduced total deoxynivalenol (DON) concentration by 52-73% compared to the non-treated control. If applied at ZGS 59-65, Miravis Ace was more effective in increasing yield and test weight than the triazoles tested. Across fungicides, applications made at ZGS 65 were most effective in FHB suppression compared to earlier or later application timings. There was no evidence that pyraclostrobin increased mycotoxin concentrations. Overall, compared to the triazole fungicides, the novel pydiflumetofen-containing fungicide tended to have lower FHB suppression and mycotoxins, higher grain yield and test weight, and higher harvest moisture, but differences were not always statistically significant. Because the main active ingredient in Miravis Ace has a different mode of action than the triazoles, we speculate that this fungicide will be competitive with industry standards, and benefit strategies for fungicide resistance management.
Des relations entre jouer et créer des jeux vidéo
Authors: Delbouille Julie , Hurel Pierre-Yves
Published: April 2021

Jouer et créer sont deux activités qui semblent liées : il y a une part de créativité dans l’acte de jeu et une part de jeu dans l’acte créatif. Il n’est cependant pas aisé de caractériser, au-delà de cette intuition, ce qui unit ces deux activités. Nous proposons d’éclairer ce lien par la notion d’improvisation, que nous allons construire depuis deux perspectives pragmatiques : d’abord en identifiant le caractère improvisé de l’acte de jouer aux jeux vidéo et ensuite en cherchant à comprendre ce qu’il y a d’improvisé dans la création de jeux vidéo amateurs.
The Stanley Parable : le joueur contre le narrateur
Authors: Hoare Douglas
Published: April 2021

L’expérience interactive du jeu vidéo permet à tout joueur de concourir à la narration de sa partie. D’un jeu vidéo à l’autre, le dispositif lui laisse une certaine latitude dans la mise en scène des événements et dans leur déroulement. En tant que « co-créateur de son expérience ludique », le joueur entre dans The Stanley Parable (Galactic Cafe, 2013) en conflit ouvert avec un personnage singulier : le narrateur. Figure allégorique s’il en est, ce personnage de narrateur – simple voix hors champ dictant le cours de l’action – est le symbole d’une contrainte structurelle qui s’exerce habituellement de manière impersonnelle. Alors que la plupart des jeux vidéo ont tendance à faire passer le fil d’un scénario pré-écrit pour une suite de décisions appartenant au joueur seul, la contradiction est ici tendue à l’extrême : la contrainte de la narration est personnalisée et l’on peut lui désobéir. Lorsque Stanley, avatar du joueur, arrive devant deux portes, la voix lui intime de prendre celle de gauche. Libre à lui de prendre celle de droite. Une lutte s’instaure alors entre le joueur et le narrateur pour le contrôle de l’histoire.Cette lutte entre narrateur et avatar, au cœur de la mécanique ludique de The Stanley Parable, nous semble questionner la place du joueur dans le dispositif du jeu vidéo. À l’instar des films de la Nouvelle Vague, le jeu de Galactic Cafe parodie les codes et les canons de l’industrie et va jusqu’à les déconstruire pour proposer une expérience singulière de jeu. Cette lutte entre le joueur et le narrateur, explicitée par la mise en scène, n’est-elle pas à l’image de l’ambivalence entre poïèse et esthèse qui structure toute expérience vidéoludique ? N’est-elle pas l’expression imagée d’une lutte intérieure que connaît tout joueur ?
Ouvrir l’espace poétique potentiel des jeux vidéo
Authors: Xiong Guofan , Chen Chu-Yin
Published: April 2021

Comment pouvons-nous recréer des jeux originaux inspirés des formes poétiques littéraires, étroitement liées à leur contexte culturel, et offrant aux joueurs des expériences ludiques et poétiques ? Dans cet article, nous analyserons les liens profonds entre le jeu de table traditionnel mah-jong et la forme poétique chinoise juéjù, afin de déterminer comment ces formes poétiques sont représentées par les règles du jeu et d’autres éléments ludiques. En les comparant avec des exemples de jeux vidéo traitant d’un sujet similaire, nous verrons quelles inspirations peuvent contribuer à créer un gameplay support d’expérience poétique, qui présente à la fois les formes et le sens de la poésie. Par l’exploration de ces formes dans des projets de game art, nous allons découvrir l’espace poétique potentiel de médium du jeu vidéo.
After the Storm
Authors: Sprull Nakiesha Melvin , Starling Cristy B.
Published: April 2021

This chapter describes the experiences of two Black women that have earned doctoral degrees from predominately white institutions, through their narratives. The authors described their experiences using the metaphorical backdrop of a storm. The beginning of their doctoral program represents the calm before the storm. Their experiences within their doctoral program symbolize the authors' movement through the eye of the storm. Finally, the description of the aftermath of the storm symbolizes their post-doctoral journey. They use Tinto's student integrations model as the lens to view their narratives. They describe their institutional experiences by elaborating on their goal and institutional commitments, and their academic and social systems. One of the social aspects of the institutional experience that helped them successfully navigate their doctoral program was inclusion in the Brown Gurlz. The Brown Gurlz is a group of Black women who need a space and place to collaborate and share experiences to benefit all that are in the group.
Three Challenges of Early-Career Faculty and the Importance of Self-Care
Authors: Zimmerman Aaron Samuel
Published: April 2021

This chapter presents three challenges associated with being an early-career faculty member: learning to teach in the context of higher education, learning to advise in the context of higher education, and learning to cope with organizational change. After describing the nature of these challenges in detail, the framework of self-care is introduced. Seven strategies are presented: insisting that your students take responsibility for their actions, learning to say no, learning to identify burnout in your colleagues, establishing a network of family and friends, scheduling breaks throughout the day and doing things you enjoy, taking care of yourself physically, and not trying to be perfect. The aim of this chapter is for readers to understand more comprehensively (some of) the challenges associated with becoming an early-career faculty member and to acquire some strategies that can help one to cope with these challenges before, during, and after experiencing these challenges.
Voices From the Field
Authors: Kubasko Wendy , Brunner Rhonda A. , Vandrew Alan
Published: April 2021

The chapter will center on exploring the perspectives of higher education faculty around the challenges and opportunities that develop while navigating a successful career transition from PK12 to higher education. The authors will survey and conduct focus groups with colleagues from universities across the United States to capture their voices and authentic experiences. Emphasis will be placed on unpacking the personal, professional journeys of faculty in the areas of teaching, service, and scholarship. Potential lenses and themes that may emerge from the data collected include teaching (andragogy, managing the workload and time, academic freedom, course schedule, accountability, accreditation, evaluation), service (leadership responsibilities, defining service [campus and community, committees, partnerships, professional organizations]), scholarship (publishing, presenting, time for your own research, grant writing, guiding student research).
Reverse Logistics in the Age of Digital Transformation for Circular Economy and Halal Logistics Through the Leadership of Asia
Authors: Musari Khairunnisa , Zaroni Zaroni
Published: April 2021

Asia is changing rapidly. Realizing the nature of change, Asia can influence the value of change to the world. At the same time, digital technology is transforming the economic and business world. In the logistics industry, not only digitalization, but the circular economy is also disrupting. However, there is great potential for the logistics business to develop efficiency opportunities through reverse logistics. Asia has a chance to spread the value of reverse logistics as one form of a circular economy. Asia has opportunities also to bring the value of reverse logistics into halal industry. This chapter will show empirical studies from several leading companies based in Asia that implementing reverse logistics and halal logistics. All of them reinforces the opportunity of Asia's leadership to influence the reverse logistics values to the world. Through blockchain, Asia may lead the reverse logistics in the age of digital transformation for circular economy and halal logistics.
Development of Financial Technology With Reference to Peer-to-Peer (P2P) Lending in Indonesia
Authors: Tambunan Tulus T. H.
Published: April 2021

This study aims to explore the growth of financial technology (fintech) and its impact on the ability of small businesses to access funding in Indonesia with reference to peer-to-peer (P2P) lending. It adopted a case study methodology using a semistructured interview and a series of focus group discussions (FGDs) with 10 owners of small businesses and 30 owners or managers of peer-to-peer (P2P) lending companies. Two important findings were (1) the sampled small businesses benefited from P2P lending and (2) banks are the most important investor in P2P lending companies. However, this study has its limitations. First, the sample was too small to generalize to a broader population. Second, there is no national data on credit to small businesses from P2P lending to support the findings of the case. To the authors' knowledge, this is the first study on this topic, specifically in Indonesia. It takes stock of the empirical evidence in the literature through the lens of small business owners.
Digital Technology in Retail
Authors: Pei Tan Jing , Dastane Omkar
Published: April 2021

Industrial Revolution 4.0 has initiated digital transformation in Asia and resulted in Retail 4.0 forcing shopping malls to upgrade themselves digitally to remain competitive. The purpose of this research is to investigate the impact of upgrading shopping malls with digital retail technology (digital up-gradation) on shoppers' satisfaction mediated by operational performance. This study adopted explanatory, quantitative research by collecting empirical data from 212 shoppers at a famous shopping mall in the city of Kuala Lumpur using convenience sampling. The normality and reliability assessment was carried out followed by confirmatory factory analysis, validity assessment, and structural equation modelling. Findings reveal that digital up-gradation has a direct impact on shopper satisfaction, and operational performance has full mediation effect between them. The chapter then discusses implications, limitations, and future research avenues in this context.
Development of Family Business Innovation
Authors: Nasution Muhammad Dharma Tuah Putra , Rafiki Ahmad , Pahlufi Cut Kesuma
Published: April 2021

This current literature looks closely into the aspects of family firm and innovation to enhance the general understanding on Indonesia's family business innovation. More specifically, the attention will rest on the challenges and opportunities of the family business. Indonesia promises a huge potential of economics' prospects, one of which comes from its wealth of natural resources. There is also a series of dynamic social and cultural characteristics in Indonesia that uniquely support its bustling economic development. The family-owned businesses' innovation processes highlighted in this chapter shall explore and resolve issues connected to innovation's implementation.
Assessment of an Educational Tool for Pediatric Cardiac Nurses on Individualized Family-Centered Developmental Care
Authors: Dean Spencer , Long Meghan , Ryan Edie , Tarnoviski Kelly , Mondal Antara , Lisanti Amy Jo
Published: April 2021

Background

Prevention of neurodevelopmental sequelae is a high priority in the care of infants with congenital heart defects. Individualized family-centered developmental care has been identified as a promising approach to promote infant neurodevelopment during hospitalization.

Objective

To educate nurses on the concept of individualized family-centered developmental care and its application to nursing practice and to reduce perceived barriers to its implementation.

Methods

Two evidence-based visual educational tools called “developmental care flowers” were created and implemented in the inpatient and procedural units of a cardiac center. Each flower petal represented a core component of individualized family-centered developmental care: cue-based care, patient positioning, supportive environment, and parent engagement. Surveys were administered before and after the educational intervention to assess changes in nurses’ knowledge and perceptions of individualized family-centered developmental care.

Results

Nurses reported that the developmental care flowers improved their understanding of individualized family-centered developmental care. The educational tools reduced some perceived barriers to implementation of this care model and increased nurse-reported inclusion of parents in care. Qualitative feedback from staff members regarding the tools was positive and acknowledged that individualized family-centered developmental care should be an ongoing priority.

Conclusions

The inpatient and procedural developmental care flowers are useful tools for educating nurses about individualized family-centered developmental care. They could be revised into more interactive tools that might be used to educate parents and further support the integration of this care concept into nursing practice.
Critical Thinking Tools for Quality Improvement Projects
Authors: Whiteman Kimberly , Yaglowski Jason , Stephens Kimberly
Published: April 2021

Topic

This article explores the use of 4 quality improvement tools and 2 evidence-based practice tools that, when used within the nursing process, encourage critical thinking about quality issues.

Clinical Relevance

Patients and families expect to receive patient-centered, high-quality, and cost-effective care. Caring for critically ill patients is challenging and requires nurses to engage in quality improvement efforts to ensure that they provide evidence-based care.

Purpose of Paper

To explore the use of critical thinking tools and evidence-based practice tools in assessing and diagnosing quality issues in the clinical setting.

Content Covered

The nursing process serves as the framework for problem solving. Some commonly used critical thinking tools for assessing and diagnosing quality issues are described, including the Spaghetti Diagram, the 5 Whys, the Cause and Effect Diagram, and the Pareto chart.
Comparison of CGRP distributions in the maxillary sinus and trigeminal ganglion between elderly dentulous and edentulous humans
Authors: Matsuda Hiroyuki , Sato Iwao , Asaumi Rieko , Omotehara Takuya , Kawata Shinichi , Nagahori Kenta , Li Zhong-Lian , Itoh Masahiro
Published: April 2021

Thickening of the Schneiderian membrane (SM, mucosa of the maxillary sinus) appears in the paranasal sinus. Information on SM thickening is available for patients receiving sinus lift treatments, which is a risk factor for SM excretory dysfunction. However, more information is needed on the structure of the SM and the relationship between the maxilla sinus and palatine with the alveolar bone and the SM for dental implant treatment in the human maxilla. One hundred twenty-six sides of the maxilla from 71 cadavers were subjected to cone-beam CT (CBCT) analysis and macroscopic and immunohistochemical observations in this study. A thickened SM was mainly observed in the middle region of the basal layer of the maxillary sinus (MS). Strong calcitonin gene-related peptide (CGRP)-positive reactions were observed in the alveolar bone, oral mucosa, mucosa of the maxillary sinus, and trigeminal ganglion (TG) cells in dentulous samples compared with edentulous samples. TG cells play important roles in delivering CGRP through axons to the mucosal gland and in regulating the maxilla-related thickening of the SM. These data could help determine CGRP functions in the mucosal gland and bone formation between dentulous and edentulous samples and indicate that CGRP may pass from the TG to the maxillary sinus glands.
Sustained complete response on crizotinib in primary lung inflammatory myofibroblastic tumor - Case report and literature review
Authors: Mittal Abhenil , Gupta Aarushi , Dhamija Ekta , Barwad Adarsh , Rastogi Sameer
Published: April 2021

Inflammatory myofibroblastic tumors (IMT) are rare soft tissue tumors of intermediate malignant potential occurring usually in children and adolescents. Treatment options for advanced diseases are limited. A 35-year-old lady presented to us with fever, cough and decreased appetite. On evaluation, she was diagnosed with left lung IMT. She underwent surgery and developed recurrence with pleural nodules after two years. Immunohistochemistry showed positivity for ALK (diffuse). Since recent evidence suggested that crizotinib is effective in advanced IMT with 50% response rates, she was treated with crizotinib 250mg BD with which she had a complete radiological response at three months. She has completed one year of treatment thus far and continues to be in complete remission. Treatment with ALK inhibitors like crizotinib has brought about a paradigm shift in the management of advanced ALK-positive IMT’s with excellent clinical responses which are durable in a majority of cases.
Geological hazards off Cape Lazo, eastern Vancouver Island
Authors: Barrie J V , Douglas K , Molloy B
Published: April 2021

Just offshore Cape Lazo, near Comox, British Columbia, a significant seabed geological hazard occurs that has been tentatively termed the Cape Lazo Fault. Nearshore the seabed has been ripped open to form a 25 m deep, 2 km long pit, as part of the possible active
faulting process. A limited sub-surface survey undertaken by the Canadian Hydrographic Service in September 2020 reveals the nature of the scarp in the ocean floor and provides new insights into the possible hazard for the Department of National Defense Comox site just inshore of the
Cape.
Preliminary assessment of active faulting in the Victoria/Esquimalt region of British Columbia
Authors: Barrie J V , Molloy B , Douglas K
Published: April 2021

Based on recently collected seismic-reflection survey data, the western extent of the active Devils Mountain Fault where it meets the Leech River Fault has been mapped for the first time, just offshore of the cities of Victoria and Esquimalt, British Columbia.
This combined approximately 180 km long fault has now been mapped from the interior of Washington State, USA onto southern Vancouver Island, BC, Canada. The occurrence of such an active fault zone poses a high possibility of a significant crustal earthquake occurring near the cities of Victoria and
Esquimalt.
Table of Contents Vol 24, No 1 (2020)
Authors: Office Editorial
Published: April 2021

No abstract available.
Evidence of Superiority of Sacubitril/Valsartan versus Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers in the Heart Failure with Reduced Ejection Fraction Patient's Journey
Authors: Gori Mauro , D'Elia Emilia , Senni Michele
Published: April 2021

Abstract

Sacubitril/valsartan (S/V) is a new drug which has been recently recommended by the international guidelines for the treatment of patients with chronic heart failure (HF) with reduced ejection fraction (HFrEF). Compared to angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs), S/V is associated with a better cardiovascular outcome, and to a greater beneficial effect on myocardial reverse remodeling. Recent evidence has shown that S/V is not only recommended in chronic patients but it is also approved in the acute setting; moreover, its safety and tolerability have been demonstrated also in the pediatric population. This review summarizes data on the effectiveness and tolerability of S/V in HFrEF patients and offers practical insights to manage this drug in every setting, providing an overview from randomized clinical trials' data to real-world evidence.
Potential Adverse Effects of Coronavirus Disease 2019 on the Cardiovascular System
Authors: Wang Bing-Yin , You Bin-Quan , Liu Feng
Published: April 2021

Abstract

Coronavirus disease 2019 (COVID-19) has spread, at an unprecedented speed and scale, into a global pandemic, infecting more than 29 million cases worldwide across 215 countries and territories and killing more than 930,000 individuals. There is evidence that preexisting cardiac disease can render individuals vulnerable. A large number of patients with COVID-19 present with preexisting cardiovascular disease or develop new-onset cardiac dysfunction during the course of the illness. Therefore, particular attention should be given to cardiovascular protection during COVID-19 treatment. This review highlights recent advances in our understanding of the interaction between COVID-19 and the cardiovascular system, with special attention to the virological, pathological, and immunological characteristics of COVID-19, acute myocardial injury, myocarditis, arrhythmias, coronary artery disease, heart function, and the possible mechanisms.
Antidepressant-Induced Sexual Dysfunction
Authors: Donthu Raj Kiran , Manohar Shivanand J , Thunga Ravish
Published: April 2021

Background:

Antidepressant drugs are frequently associated with sexual dysfunction. Sexual side effects affect the patients' quality of life and in the long term and can lead to noncompliance and relapse. However, studies covering many antidepressants with different mechanisms of action are scarce.

Aims:

The aim of this study is to compare the rates of sexual dysfunction among patients taking escitalopram, desvenlafaxine, and mirtazapine.

Settings and Design:

Cross-sectional study.

Materials and Methods:

Arizona Sexual Experience Scale (ASEX), Hamilton Rating Scale for Depression (21 items), and State and Trait Anxiety Inventory.

Statistical Analysis Used:

Fisher's exact t-test, Chi-square test, and analysis of variance depending on the type of variable.

Results:

Eighty-four participants (42 males and 42 females) completed all instruments. Of these, 28 were taking escitalopram (13.93 ± 5.15), 28 were taking desvenlafaxine (76.79 ± 25.39), and 28 were taking mirtazapine (16.88 ± 3.88). A substantial number of patients (40.5%, n = 34) had sexual dysfunction. The prevalence of sexual dysfunction varied across the drugs; escitalopram (60.7%), desvenlafaxine (35.7%), and mirtazapine (25%). Regression analysis revealed that the significant factor for sexual dysfunction was the type of antidepressant used. The mirtazapine group's total ASEX score was significantly lower than the scores for escitalopram and desvenlafaxine (χ2 = 7.807, P = 0.020).

Conclusion:

The incidence of sexual dysfunction is substantially high during antidepressant treatment. The rates of sexual dysfunction differed among antidepressants having different mechanisms of action. Mirtazapine-induced lesser sexual dysfunction compared to desvenlafaxine and escitalopram.
Caregiver Burden and Psychiatric Morbidity Among Caregivers of Children with Thalassemia Major
Authors: Prajapati Nisha Kanaiyalal , Samani Mukesh Jyantilal , Jani Arpit Madhusudanbhai
Published: April 2021

Background:

Caregivers of children with thalassemia major experience higher caregiver burden and psychiatric morbidity.

Aims:

The aims of this study were as follows: (1) to assess the caregiver burden and psychiatric morbidity among caregivers of children with thalassemia major and (2) correlation between caregiver burden and psychiatric morbidity.

Settings and Design:

This was an observational, cross-sectional study carried out at the tertiary care hospital setup among 245 caregivers of children with thalassemia major.

Subjects and Methods:

Sociodemographic details of children and their caregivers and clinical variables of children were obtained. The Caregiver Burden Scale and General Health Questionnaire (GHQ)-12 were applied. Psychiatric diagnosis was made after clinical interview as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Statistical Analysis Used:

Chi-square test, t-test, analysis of variance, and Pearson coefficient correlation were used for statistical analysis.

Results:

33.06% were having severe burden, 30.61% moderate-to-severe burden, 27.34% mild-to-moderate burden, and 8.97% were having little or no burden. 13.46% of caregivers had psychiatric illness, out of which 8.57% had major depressive disorder, 4.08% generalized anxiety disorder, and 0.8% alcohol use disorder. “Weakly positive correlation” (P = 0.0284) was found between GHQ score and burden score.

Conclusions:

Higher caregiver burden and presence of psychiatric morbidity among caregivers of thalassemia children suggest that caregivers should be screened at regular intervals for early detection and management of psychiatric morbidity. Social and professional networks for psychosocial support and self-help groups should be planned for caregiver burden.
Live-Related Renal Transplant with Bench Repair of Saccular Aneurysm of Graft Renal Artery - A Case Report
Authors: Hosamani Amit , Bhaskara K. G. , John Roy P. , Iqubal Mohamed
Published: April 2021

Renal artery aneurysm is a rare entity with an incidence of about 1%. The preoperative evaluation of a voluntary kidney donor incidentally revealed a saccular aneurysm of the right renal artery on a computed tomography angiogram. Laparoscopic right donor nephrectomy was performed with Bench repair of the aneurysm and transplantation of this kidney to the recipient in the right iliac fossa. Transplant kidney had good perfusion on revascularization with normal postoperative graft function. Transplanting kidneys with renal artery aneurysm can be safely performed with a win-win situation for both donor and recipient.
Renal Transplantation in a Patient With Polyarteritis Nodosa - A Case Report
Authors: Kumar K. Vinod , Unni V. Narayanan , Kachare Nanda , Kumar R. Anil , Prasannan Bipi , Urs Vishnu Dev
Published: April 2021

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis, predominantly affecting medium-sized arteries, and usually involving the kidneys, heart, gastrointestinal tract, and nervous system. The common clinical presentation is renovascular hypertension due to renal artery stenosis. We report a 38-year-old man, who presented with secondary hypertension and progressive renal failure leading on to end-stage renal disease (ESRD). He had renal artery stenosis on evaluation which caused ischemic damage to the kidneys resulting in ESRD. He also had multivessel coronary artery disease requiring percutaneous transluminal angioplasty. Coronary angiogram and renal angiogram showed areas of ectatic segments and aneurysms along with stenotic segments, which was consistent with medium-vessel vasculitis. We had challenges in considering him for kidney transplantation due to significant coronary artery disease, and he required coronary angioplasty on two occasions 6 months apart. He underwent bilateral nephrectomy prior to the transplantation as he had refractory hypertension requiring five antihypertensive medications. Histology of the nephrectomy specimen confirmed the diagnosis of PAN. Our patient did not show evidence of hepatitis B infection which is commonly associated with PAN. Renal failure and progression to ESRD are rare in PAN and are due to ischemic damage to the kidneys. He underwent kidney transplantation and had a smooth perioperative period and normal graft functions 6 months after the transplant surgery. To the best of our knowledge, this is the second reported case of PAN, who underwent successful kidney transplantation. Significant coronary artery disease is a rare manifestation in PAN.
Immunomodulation in Sepsis - A Case Report
Authors: Madarasu Rajasekara Chakravarthi , Kumthekar Girish V
Published: April 2021

Sepsis and septic shock affect anywhere between 100 and 1000/100,000 person-years and 19 per 100,000 person-years depending on the cohort studied, with mortality rates ranging between 20% and 50%. The recently updated Sepsis 3.0 consensus definitions state that sepsis is an infection accompanied by life-threatening organ dysfunction caused by a dysregulated host response. Given the pivotal role of cytokine production in sepsis and post major surgery, it follows that removal of these substances may attenuate the response particularly in the early phase of sepsis.
Acute Pancreatitis in a Kidney Transplant Recipient and Proposal of a Step-Wise Diagnostic Algorithm - A Case Report
Authors: Etta Praveen Kumar , Madhavi Thatipamula , Parikh Namrata
Published: April 2021

Acute pancreatitis (AP) is a rarely encountered complication in patients following kidney transplantation and is associated with significant morbidity and mortality. The diagnosis is often difficult due to the lack of classic symptoms and laboratory findings. Herein, we report the case of azathioprine-induced AP leading to acute kidney injury in a kidney transplant recipient, in whom we have encountered diagnostic difficulty. Patient spontaneously recovered after drug withdrawal. We propose a step-wise diagnostic algorithm for the evaluation of AP in kidney transplant recipients.
Graft and Survival Outcome in Renal Transplant Patients Receiving Cyclosporine and Azathioprine Versus Tacrolimus and Mycophenolate Mofetil
Authors: Sathish Renuka , Marisiddappa Limesh , Kedlaya Prashant , Nagaraj Vinod , Kruthika D. M.
Published: April 2021

There is paucity of data on long-term outcome of renal transplantation across different immunosuppression groups.

Rationale and Objective:

The study looks at long-term outcomes in renal transplant patients receiving azathioprine, cyclosporine combination (Group 1) with mycophenolate mofetil and tacrolimus (Group 2) with terms of patients and graft survival. We also analyzed the spectrum of infections across the two groups.

Study Design:

A retrospective observational study was conducted from 1995 to 2014 at St. John's Medical College and Hospital, Bengaluru. Patients received treatment as per standard protocol.

Setting and Participants:

Renal transplant recipients who regularly visited outpatient department.

Analytical Approach:

Statistical analysis was done by using SPSS 19 software. Continuous variables were analyzed using Student's t-test. Pearson's correlation test used for correlating variables. Kaplan–Mere curve used for calculating survival.

Primary Outcomes:

Rejection rates were similar across both the groups. The patient survival was 65% and 70% in Group 1 and 2 at 5 years, respectively. Graft survival was 65% and 75% in Group 1 and 2 at 5 years.

Secondary Outcome:

Bacterial and fungal infections were more common in Group 1, whereas viral infections were more in Group 2. In addition, infections tend to occur early in Group 2.

Limitations:

Single center, retrospective study.

Conclusion:

Patient and graft survival were similar across both the groups.
Perceptions and Attitude Toward Cadaveric Organ Donation Among Health-Care Professionals at a Tertiary Health-Care Setting
Authors: Da Silva Kenneth Xavier , Dsouza Delia Basil , Mascarenhas Von Richard , Kankonkar Prajoth Narayan , Vaz Frederick Satiro , Kulkarni Manojkumar S.
Published: April 2021

Introduction:

Organ donation provides a life-saving opportunity for those individuals with organ failure who have no other options. The knowledge, attitude, and practices of medical professionals play a vital role in promoting the positive impact of organ donation. Therefore, it is necessary to understand and assess the knowledge and attitude about cadaveric organ donation among the medical health professionals.

Objectives:

To assess the knowledge, attitude, and practices of health-care professionals toward cadaveric organ donation and to know their awareness regarding legislations pertaining to cadaveric organ donation.

Materials and Methods:

A self-administered questionnaire was filled out by consenting consultants, resident doctors, and nurses working at a tertiary health-care setting, to evaluate their knowledge, attitude, and practices regarding cadaveric organ donation. Data were analyzed and summarized as frequencies and proportions.

Results:

Majority (74%) of the participants were females and most (67.8%) of them below 40 years of age. Hindus comprised 55.2% and Christians 41% of the study population. All consultants, 99.1% of resident doctors and 83.1% of nurses were familiar with the concept of cadaveric organ donation. Although willingness to donate organs was expressed by a majority of the health-care professionals, only a few have actually taken the initiative and pledged to donate their organs.

Conclusion:

The knowledge of the health-care professionals pertaining to cadaveric organ donation was found to be relatively good, whereas their attitude was found to be favorable. As far as practices were concerned, they were found to be unsatisfactory. Awareness level regarding legislations pertaining to organ donation was relatively high.
Use of Panel Reactive Antibodies for Immunological Risk Stratification and Its Correlation with Antecedent Events in Live Donor Kidney Transplant
Authors: Gadde Ashwini B. , Mahapatra Amit , Tiwari Assem , Sethi Sidharth Kumar , Jha Pranaw Kumar , Jain Manish , Yadav Dinesh , Bansal Dinesh , Bansal Shyam B
Published: April 2021

Background:

Panel reactive antibody (PRA) is a screening test to identify the immunological sensitization of the transplant recipients. The current study focuses on the role of PRA in immunological risk stratification in live donor kidney transplant and its correlation with antecedent events and posttransplant outcomes.

Methods:

This was a prospective, single-center, observational study. All patients with end-stage renal disease between January 1, 2016, and October 1, 2016, were included. The patient's sensitization history and other immunological workup were recorded. Patients were followed up for 6 months.

Results:

PRA positivity was seen in 29/185 (15.7%) patients. Female sex (P = 0.004), longer duration renal replacement therapy (P = 0.037), and hepatitis C virus infection positivity (P = 0.047) were significantly associated with PRA positivity. Only 3/87 (3.4%) patients who had no history of sensitizing events had high PRA. Less number of patients in PRA-positive group received transplant as compared to PRA-negative group (12/29; [41.4%] vs. 143/156 [91.7%, P < 0.0001]). In transplanted patients, there was no significant difference between PRA-positive and PRA-negative group in terms of serum creatinine (1.22 ± 0.26 mg/dl vs. 1.30 ± 0.38 mg/dl, P = 0.63) and number of acute rejection (1 vs. 6, P = 0.507).

Conclusions:

PRA positivity is not uncommon in live donor kidney-transplant patients. Previous transplants, pregnancies, and multiple blood transfusions are important sensitizing events. PRA testing was useful in identifying high-risk patients and evaluating them further. There was no difference in short term outcomes between PRA-positive and PRA-negative groups after exclusion of high-risk patients from transplantation.