bluuebunny/crossref_metadata_2025 huggingface dataset:
Epistemic Injustice and Legitimacy in U.S. Doctoral Education: A Systematic Review of Literature
Authors: Gonzales Leslie D. , Pasque Penny A. , Farris Kyle D. , Hansen Jordan M.
Published: August 2023

Epistemic injustice is a condition where knowers and knowledge claims are unduly dismissed. Philosophers suggest that epistemic injustice manifests in three forms: testimonial, hermeneutical, and contributory. Although distinct, all forms of epistemic injustice stem from relations of power, privilege, and positionality — where some have the opportunity and authority to legitimize the knowledge contributions of others. The purpose of this study was to explore the presence of epistemic injustice in U.S. doctoral education through a systematic review of literature. We methodically searched hundreds of peer-reviewed journals for studies focused on teaching, advising, peer interaction, doctoral socialization, and other experiences concerning doctoral education across the humanities, social science, and science disciplines. We retained, reviewed, and analyzed 107 manuscripts. Our analysis revealed epistemic injustice in doctoral education as well as rules that foster the conditions for epistemic injustice. Implications for doctoral education and future research are offered.
The Role of Project Health Check Reports in Identifying Indicative Factors of a Troubled Project
Authors: Breesam Hatem Khaleefah , Rajab Hanan Abdul Munem
Published: August 2023

Government-sponsored projects in Iraq significantly improve the economic situation and provide services but face high rates of troubling blocks. This work aims to identify indicative factors of the Troubled Project using periodic health check reports based on a literature review and interviews with Iraqi experts. As a result, a questionnaire was prepared that included four sections. The first is personal information; the second section is information about knowing the level of institutions’ implementation of project management through prepared documents. The third section is about indicative factors for the project's trouble, including 25 workers; the fourth section is about the questions in the periodic reports to check the project's health. Findings show that the following factors affect the troubled projects: inaccurate initial budget and schedule estimates; poor project scope description; poor team communication; poor planning and definition of the project; lack of a risk management plan and disregarding risk indicators; high rate of rework, and ineffective documentation of project plans with a high relative importance index that ranges from 0.91 to 0.81. Thus, the institutions' activation of the project examination reports with the proposed questions with a relative importance index ranging from 0.88 to 0.77 helps identify the main factors for the troubled projects.
Angiogenesis in Aortic Aneurysm and Dissection: A Literature Review
Authors: Jia Yu , Li Dongze , Yu Jing , Jiang Wenli , Liu Yi , Li Fanghui , Zeng Rui , Wan Zhi , Liao Xiaoyang
Published: August 2023

Aortic aneurysm and aortic dissection (AA/AD) are critical aortic diseases with a hidden onset and sudden rupture, usually resulting in an inevitable death. Several pro- and anti-angiogenic factors that induce new capillary formation in the existing blood vessels regulate angiogenesis. In addition, aortic disease mainly manifests as the proliferation and migration of endothelial cells of the adventitia vasa vasorum. An increasing number of studies have shown that angiogenesis is a characteristic change that may promote AA/AD occurrence, progression, and rupture. Furthermore, neocapillaries are leaky and highly susceptible to injury by cytotoxic agents, which promote extracellular matrix remodeling, facilitate inflammatory cell infiltration, and release coagulation factors and proteases within the wall. Mechanistically, inflammation, hypoxia, and angiogenic factor signaling play important roles in angiogenesis in AA/AD under the complex interaction of multiple cell types, such as smooth muscle cells, fibroblasts, macrophages, mast cells, and neutrophils. Therefore, based on current evidence, this review aims to discuss the manifestation, pathological role, and underlying mechanisms of angiogenesis involved in AA/AD, providing insights into the prevention and treatment of AA/AD.
The effectiveness of social stories in an intervention program in late adolescence with high functioning autism spectrum disorders: A case study report
Authors: Papadopoulos Angelo , Tsapara Angeliki , Plotas Panagiotis , Tzortzakis Ioannis , Tafiadis Dionysios , Siafaka Vassiliki
Published: July 2023

People with high-functioning autism (HFA) demonstrated significant social skill deficits compared to those typically developing. Relatively limited data is still known about the challenges faced (friendship, social networks) by adolescents with HFA and so far with a delayed diagnosis. The case study aimed to investigate social stories’ effectiveness by using an intensive intervention approach on a late-adolescent female with autism. A 17-year-old girl with a recent diagnosis of HFA was selected as a case study from a private Speech and Language Therapy Center to involve in an immediate intervention program. A single-case research design was used to monitor changes after an intervention. Specifically, observation and training lasted four weeks, plus two weeks of maintenance. The intervention was done exclusively with social stories personalised to her needs. The targeted behaviours were to enhance social interaction skills, especially her ability to make friends and improve communication. There was a positive response from the young female in the intensive intervention program. Moreover, she displayed more positive peer interaction throughout the intervention program (6 weeks). She managed to participate and ask peers to companies in High school, to start a conversation, and to call them into her house in a positive way 44 times in 6 weeks. In addition, after every intervention week, we recorded an increase in her positive interactions with peers. The results demonstrate that social story use enhances HFA adolescents' social engagement. This study provides insights into the relationship between intensive social story intervention, social communication and social interaction behaviours between adolescents with a recent diagnosis of HFA and peers. Moreover, the findings support the effectiveness of social stories in encouraging social interaction of a late adolescent with HFA.
Economic Value and Utilization of social media in Fertilizer Sales in Taruna Mandiri Ngemplak Sleman, Yogyakarta
Authors: Kusumastuti Tri Anggraeni , Widiati Rini , Syahlani Suci Paramitasari , Muzayannah Mujtahidah Anggriani Ummul , Wankar Tian Jihadan , Triatmojo Agung
Published: July 2023

Taruna Mandiri is farmers group that sells cattle and organic fertilizer. Since the Foot and Mouth Disease outbreak, they have relied more on selling organic fertilizers. This research aims to analyze the economic value of selling organic fertilizers and understand the use of social media in selling fertilizers. Selection of the location in the Taruna Mandiri farmers group, Ngemplak District, Sleman Regency. Purposive sampling of 15 out of 40 members who are administrators and manage the manufacture and processing of fertilizers for sale. The research was conducted in a quantitative descriptive method. Primary data retrieval through direct interviews using a questionnaire tool. The primary data taken include respondents' characteristics, livestock ownership, and understanding of the use of social media. The results showed that with 55 cattle ownership, the economic value of selling fertilizer was IDR. 535,000/period or IDR. 2,140,000/month. Farmers group are interested in selling by online because it is useful for expanding the market, adding information, and at the same time promoting products. The social media platforms that farmers want are WhatsApp business, Instagram and Facebook but due to limited knowledge, farmers use the personal WhatsApp platform. The existence of a touch of technology, both in labeling and using the right social media platforms, is very necessary for the group to improve product quality and expand the consumer market.
Fermentation Characteristics, Digestibility, and Estimation of Ruminant Methane from Saponin: A Quantitative Study
Authors: Syamsiyah Dzorifatus , Suharti Sri , Jayanegara A.
Published: July 2023

The effect of using saponins on ruminants' performance differed from several published research data based on the level of saponins added to the feed. This research was conducted to analyze the effect of saponins on fermentation characteristics, digestibility, and estimation of methane in ruminants with a mixed model approach from published journal articles—a total of 127 studies from 32 journals national and international. The variable measured included the level of saponins (%), dry matter intake, Average Daily Gain (ADG), Dry Matter Digestibility (DMD), Organic Matter Digestibility (OMD), Crude protein (CP), Neutral Detergent Fiber (NDF), Acid Detergent Fiber (ADF), protozoa population, bacterial population, Volatile Fatty Acid (VFA), acetate/C2, propionate/C3, butyrate/C4, valerate/C5, acetate/propionate (C2/C3), NH3, pH, and methane gas production. The results showed that using saponins in ruminants increased ADG, CP, ADF, NDF degradation, Total VFA, and proportion of propionate. The addition of saponins level reduced the protozoa population, acetate proportion, and the ratio of acetate: to propionate (C2/C3). In contrast, feed intake and digestibility decreased with the administration of saponin. The bacterial population were similar among treatments, and methane production increased by increasing saponins. In conclusion, the administration of saponin level recommended is 0.3-3.1% of the total ration to improve performance and increase feed efficiency.
The Determination of Nutrient Intake on Productivity and Potential Methane Emission of Fat-Tailed Sheep Fed Odot Grass as a Source of Crude Fibre
Authors: Luthfi N. , Solkhan M. , Suryani Hasna Fajar , Hindratiningrum N.
Published: July 2023

The purposes of this study were to examine the determination of crude protein (CP), Crude Fibre (Cfi) and total digestible nutrients (TDN) on the productivity and potential methane emission of fat-tailed sheep (FTS) fed Odot grass (Pennisetum purpureum cv. Mott) as a source of crude fibre. The materials used were 15 male FTS with an initial body weight (BW) of 19.5 kg ± 0.61 (CV = 0.59). The feed consisted of 28.57% Odot grass, 14.29% coffee peel, 4.28% rice bran, 7.86% pollard, 21.43% cassava, 21.43% corn cobs and 2% molasses. Sheep were reared intensively in pens for 30 days. Feed and water were provided ad libitum. The parameters in this study were dry matter intake (DMI), CP intake, Cfi intake, TDN, FTS productivity, and the determination of nutrient intake on FTS productivity and methane output. The data were analysed using correlation regression analysis. The results showed that the DMI was 956.67 g/day, CP intake was 119.31 g/day, Cfi intake was 256,22 g/day, TDN intake was 634.54 g/day, ADG 102,03 g/day and FCR of 10.1 g feed/g ADG. The potential methane emission of FTS-fed Odot grass as a source of fibre was 59.49 litres/day. DMI, CP and TDN positively correlate with methane emission (r=0.77). Cfi intake consumption is very closely related to methane output (r=1). Based on the results of the study, to increase FTS ADGs of 100 g required DM 4.76% BW, CP requirement was 120.8 g/100 gADG and TDN requirement was 642.4 g/100gADG, Cfi requirement was 259.40g/100gADG with methane emission of 60.26 litres.
The Consumers' Choice of Purchasing Location and the Preferences for Beef in Yogyakarta
Authors: Wankar Tian Jihadhan , Morales E. , Griffith G. , Agus A. , Guntoro B.
Published: July 2023

This study aims to analyze the consumer preferences about choosing a place to buy beef and beef attribute product influence in buying decision of consumers in Yogyakarta. There were 300 beef consumers selected near traditional markets, butcher or meat shops, supermarkets, restaurants and food stalls for the survey using the questionnaire. The data were analyzed descriptively and used the chi-square test to evaluate the relationship between demographic characteristics and the consumers' choice of place when buying beef in Yogyakarta. The study reveals that most respondents buy beef at butcher or meat shops, followed by traditional markets and supermarkets. Consumers consider price, top quality of beef, the freshness of the product, shopping convenience and friends with sellers as the top five reasons when they choose a place to buy beef. Further, there is no correlation between demographic aspects with consumer preferences in choosing a place to buy beef. Finally, the beef attributes consumers consider when buying beef are the halal slaughtering method, bright red colour, quality assured and beef cuts.
TECHNICAL EFFICIENCY OF POST-DISASTER HEALTH SERVICES INTERVENTIONS: THE 2023 KAHRAMANMARAŞ EARTHQUAKE IN TURKEY
Authors: Birinci Şuayıp
Published: July 2023

Purpose – In order to meet the most urgent needs of the regions affected by the biggest earthquake of the century, government, national and international actors have made enormous efforts. However, some international studies evaluating the effectiveness of previous disaster relief efforts have expressed that inefficient use of resources in the disaster relief process should be a matter of concern. The main purpose of this study is to obtain evidence to support post-earthquake healthcare interventions and to establish a reference on earthquake relief.
Design/methodology/approach – The data of the study covers the period from 6 February to 16 February 2023 and was obtained from the official daily reports of the Health Disaster and Coordination Centre Unit (SAKOM) of the Ministry of Health. The data consisted of allocations of rescue units, human resources, workload and other information recorded in official daily reports. In addition, Data Envelopment Analysis (DEA) method was used to evaluate the technical efficiency of health services provided in 10 provinces affected by the earthquake in the first emergency period of the Kahramanmaraş-centered earthquake
Findings – The technical efficiency scores of the health services provided in the earthquake-affected provinces are analysed, it is seen that while the average technical efficiency was 52% (SD: 0.30) on the 5th day of the earthquake, it increased significantly to 80% (SD: 0.21) on the 10th day. This result shows that health services in earthquake zones have started to be provided more efficiently over time. The rapid normalisation of health services in earthquake zones is an important indicator for the performance of disaster management and crisis response teams.
Originality/value – Despite the extensive research on earthquake response and health services individually, there's a noticeable gap in literature explicitly exploring the relationship between the two. This lacuna in research is particularly evident when it comes to examining the efficiency of health services during seismic disasters.
Number Theory and Cryptography: Unraveling the Foundations of Data Security
Authors: Said Amelia
Published: August 2023

Number theory and cryptography form the bedrock of modern data security, providing robustmechanisms for protecting sensitive information and ensuring secure communication. This studydelves into the fundamental principles of number theory and its applications in cryptographicprotocols. By exploring the mathematical concepts underpinning data security, the research shedslight on how number theory enables the development of secure encryption schemes, digitalsignatures, and secure communication channels. The study showcases the critical role of numbertheory in safeguarding digital information, enhancing cybersecurity, and enabling securetransactions in the digital age.
Fear of Falling: Prevalence Trends in European Countries, 2004-2019
Authors: Kolpashnikova Kamila
Published: August 2023

In European countries, the prevalence of fear of falling (FoF) among older adults has increased over the period from 2004 to 2019. Approximately 17% of older adults aged 65 and above reported experiencing FoF. On average, FoF prevalence increased by half a percent every year during this period.
Kinerja Karyawan Dilihat dari Motivasi dan Kepuasan Kerja Dengan Lama Kerja Sebagai Variabel Moderating
Authors: Martha Kurnia Ningsih
Published: July 2023

The purpose of this study was to determine the effect of work motivation and job satisfaction on employee performance with length of working as a moderating variable on CV.Jamko Karya Karya city work, where motivation and work satisfaction variables are moderated by length of working. The method used by MRA (Moderated Regression Analysis) analysis techniques. The population and sample in this study were 50 people. The results of the study note that motivation and job satisfaction have a positive effect on employee performance, where motivation is partially a positive effect on employrr performance, job satisfaction partially has a positive effect on employee performance, the relationship of motivation with employee perfoemance is not moderated by the length of work and the relationship of job satisfaction with employee performance is not moderated by length of work. Manager should stick to the principle of always trying to motivate employees and find the best ideas for achieving maximum job satisfaction by sticking to the principle of togetherness without reducing the values of work ethics in the company.
The Role of Identity Theories in British and American Gothic War Fiction
Authors: ethan Amelia
Published: August 2023

This research delves into the role of identity theories in British and American Gothic war fiction,exploring how authors from both literary traditions employ Gothic elements to portray characters'identities amidst the backdrop of conflict. By analyzing selected works of war fiction, this studysheds light on the psychological, sociological, and philosophical dimensions of identity in timesof war. The integration of Gothic elements, such as eerie settings, haunting narratives, andpsychological complexities, allows for a profound examination of characters' inner struggles andtransformations. Through an interdisciplinary approach, this research uncovers the enduring powerof literature in reflecting the complexities of human nature and the quest for identity amidst thehaunting realities of war.
A Toolbox to Evaluate the Trustworthiness of Published Findings
Authors: Adler Susanne Jana , Röseler Lukas , Schöniger Martina Katharina
Published: July 2023

During the past few years, researchers have criticized their professions for providing an entry point for false-positive results arising from publication bias and questionable research practices such as p-hacking (i.e., selectively reporting analyses that yield a p-value below 5 %). Researchers are advocating replication studies and the implementation of open-science practices, like preregistration, in order to identify trustworthy effects. Nevertheless, because such consumer research developments are still emerging, most prior research findings have not been replicated, leaving researchers in the dark as to whether a line of research or a particular effect is trustworthy. We tackle this problem by providing a toolbox containing multiple heuristics to identify data patterns that might, from the information provided in published articles, indicate publication bias and p-hacking. Our toolbox is an easy-to-use instrument with which to initially assess a given set of findings.
Ethical use of administrative data in inequality research
Authors: Lee Diana Da In , Velez Yamil Ricardo
Published: July 2023

The growth of machine learning techniques and massive administrative data sets has dovetailed with increasing interest in racial inequality in political science. While this has invigorated research on race and politics, scholarly investments in Big Data have proceeded without sufficient attention to ethical considerations governing the use of publicly available, but sensitive, information. This paper closes this gap by providing empirical evidence on perceptions of ethics regarding data use by participants themselves. In two large-sample survey experiments, we examine how members of the public perceive research ethics in studies of racial and ethnic politics that leverage public and administrative records, and provide practical recommendations for scholars using these data sets in their research. By highlighting this growing gap, we hope to spark conversation regarding ethics as the academic community confronts these dramatic advances in data collection and statistical analysis.
China's Brain Drain Reversal: Unraveling the Mysteries of the Surging Outflow Migration
Authors: Jin Ruining
Published: July 2023

Since China lifted its zero-COVID policy in 2022, it has been reported that more than 300,000 people have left China—an astonishing figure that doubled the annual outflow migration from 2010 to 2017 [1]. Such a new wave of brain drain reversed the previous Chinese brain gain and posed a new challenge for the current administration.
S M Nazmuz Sakib’s Climate Conflict Theory (CCT): A New Approach to Understand the Link between Climate Change and Armed Conflict in Africa
Authors: Sakib S M Nazmuz
Published: July 2023

This paper presents S M Nazmuz Sakib’s Climate Conflict Theory and tests its hypotheses using a quantitative analysis of 36 African countries from 1990-2020. The theory argues that climate change affects armed conflict risk through its impacts on state capacity, ethnic diversity, and regional spillovers. The results of logistic regression analysis provide empirical support for the theory. Lower state capacity, higher ethnic diversity, and greater regional spillovers are found to increase the likelihood of conflict. The effect of ethnic diversity on conflict is also shown to be moderated by exposure to climate change. The findings highlight the importance of strengthening state capacity, promoting ethnic inclusion, and enhancing regional cooperation for preventing climate-induced conflicts in Africa.
Our essence? Conscious, Eternal, Infinite, Nonjudgmental, Unconditional Love
Authors: Tressoldi Patrizio
Published: July 2023

Which is our fundamental essence? Are we biological machines or spiritual eternal beings? In this essay, I attempt to demonstrate that our essence is nothing else than conscious eternal, infinite, nonjudgmental, unconditional love. This eternal, infinite, non-judgmental unconditional love expresses itself as a never-ending creative force that gives rise to infinite expressions with different potentialities to achieve self-consciousness, from photons to molecules, from stones to trees, from bacteria to invertebrates, and from vertebrates to humans.Conscious eternal, infinite, nonjudgmental, unconditional love is not a powerful emotion, but the creative energy of all that exist.
ASD and Sexual and Gender Minority Identity in College Students (Original Submission)
Authors: Soto Elia , Orantes Destiny , Russo Natalie , Antshel Kevin
Published: July 2023

Objective: The current study builds on existing literatures on autism spectrum disorder (ASD) and sexual and gender minority (SGM) identities and is the first to examine prevalence rates, associated functional impairments, and treatment engagement levels for SGM and non-SGM populations with and without ASD cross-sectionally via a large nationwide college-student sample across 3 years. Methods: Using data from the American College Health Association-National College Health Assessment (ACHA-NCHA) III, we analyzed data from 82,030 college students (ages of 18-25 years old) randomly selected from 75 US colleges and universities across three years. Included ACHA-NCHA-III measures consisted of self-reported demographics, SGM identity, ASD diagnosis, stress, academic impairment, mental health symptoms, and treatment engagement. Results: We found a 2.7% prevalence of ASD in the SGM group, compared to a 0.9% prevalence among the non-SGM sample. Autistic college students with SGM identities had the highest levels of stress and averse academic and mental health outcomes across groups. Conclusions: These findings emphasize the need for mental healthcare providers to consider SGM identity in autistic college students to inform treatment. Implications for autistic college students with an intersecting SGM identity include the need for tailored supports and resources at multiple levels (e.g., academic, mental health).
Bilingual Infants Readily Orient to Novel Visual Stimuli
Authors: Singh Leher
Published: July 2023

Bilingualism has been shown to modify infants’ responses in a range of domains. In particular, early bilingual experience is associated with greater flexibility and openness in infant perception and learning. In this study, we investigated whether bilingual infants demonstrate more fundamental differences in how they explore their environment in ways that could contribute to greater openness. Specifically, we investigated whether bilingual infants orient more rapidly to new information. Capitalizing on a classic paradigm by Fantz (1964), monolingual and bilingual infants (5 to 6 months and 8 to 9 months) were simultaneously presented with familiar and novel stimuli. As they received increased exposure to the familiar and novel stimuli, monolingual infants demonstrated a null preference, followed by a novelty preference, as previously evidenced in Fantz’ study. In contrast, an orientation towards novelty emerged more readily in bilingual infants. Characteristics of a bilingual environment that may modulate the allocation of attention towards novelty are discussed.
Polysemy does not exist, at least not in the relevant sense
Authors: Brody Gabor , Feiman Roman
Published: July 2023

Based on the existence of polysemy (e.g. lunch can refer to both food and events), it is argued that central tenets of externalist semantics and Fodorian concept atomism, an externalist theory on which words lack semantic structure, are unsound. We evaluate the premise that these arguments rely on—that polysemous words have separate, finer-grained senses. We survey the evidence across psychology and linguistics and argue that it shows that polysemy does not exist, at least not in this “sense”. The upshot is that if polysemy does not exist, it cannot pose a problem for atomism or externalism.
Abordagem da Saúde Ocupacional perante surtos de Escabiose
Authors: Couto Carla , Rodrigues Andrea , Roque Alexandra , Eiras João , Carvalhas Jacinta
Published: July 2023

INTRODUCTION The occurrence of outbreaks of scabies in hospitals has been serving as an alert to the importance of early diagnosis and correct approach by Occupational Health services. OBJECTIVES Review the literature on the diagnosis and treatment of scabies, as well as describe the approach taken by Occupational Health services in the face of scabies outbreaks. METHODOLOGY Review of the topic in the scientific database (PubMed), using the search terms “scabies”, “diagnosis”, “treatment” and “outbreak” anywhere in the text. Only reviews published in the last five years and available for full reading were included. RESULTS Scabies (commonly known as human scabies) is a parasitic skin infection caused by a mite that only infects humans, called Sarcoptes scabei, variety hominis. Transmission occurs by direct skin-to-skin contact or through contaminated fomites (as bedding, towels, among others). There are two clinical variants, the classic and the crusted (or Norwegian). First-line treatments are topical permethrin and oral ivermectin. Occupational Health plays a key role in addressing and controlling outbreaks in health institutions. DISCUSSION AND CONCLUSION Early detection of infected individuals, with due isolation in the case of crusted scabies; adequate and frequent cleaning of clothes; simultaneous treatment of all patients, professionals and family members who may have been exposed and continuous surveillance of affected professionals until cure are key aspects for controlling outbreaks. KEYWORDS: Scabies, Outbreaks, Diagnosis, Treatment, Occupational Health, Occupational Nursing and Occupational Medicine.
Is cervicodynia associated with head load carrying in construction site workers in Lucknow
Authors: Dev Prakash  , Vipin Kumar  , Shalabh Varshney  , Ahmad Ayaz  , Srijan Kapoor  , Girish Kumar Singh
Published: August 2023

Background: Cervicodynia is one of the most common musculoskeletal symptoms reported by construction workers, particularly those involved in head-load carrying jobs. One of the reasons for this could be accelerated degenerative changes in the cervical spine as a result of continuous stress on it owing to head-load carrying. Apart from carrying a heavy load on the head, frequently have to work in an awkward posture involving “repeated movement of the back and limbs and work above the shoulder during loading on the head and unloading as well as stacking bricks.” In response to the continuous stresses on the neck muscles, Cervicodynia is a commonly occurring phenomenon among construction workers, particularly head-load carrying workers.
Aims and Objectives: This cross-sectional study aims to determine the association between cervicodynia and head-load carrying in construction site workers in Lucknow.
Materials and Methods: A total 68 workers were enrolled in the study and their details were recorded in the questionnaire Pro forma and they were asked to provide their job details. Those workers responding affirmatively to cervicodynia, the intensity, and its distribution along the brachial plexus and vertigo was recorded. Data were recorded on a separate case recording sheet, and statistical analysis was done using SPSS Version 21.0 statistical Analysis Software. The values were represented in number (%) and Mean±SD. The Chi-square test and Student’s “t” test was used. The level of significance was P<0.05.
Results: Out of 68 workers, 57.4% were male, whereas 42.6% were female with a mean age of 32.15 years. The overall complaints of neck pain were 55.9%. Workers with complaints of neck pain carry significantly higher weight per round, carry weight for significantly longer duration, and cover significantly longer distance with weight.
Conclusion: It can be concluded that cervicodynia is a common occurrence among construction workers, particularly, head-load carriers. Although univariate analysis highlighted the role of occupational factors in the occurrence of neck pain, on multivariate assessment, only age emerged as an independent predictor.
Assessment of clinic-biochemical parameters in severe acute malnutrition children admitted in a tertiary care hospital of Western Uttar Pradesh, India
Authors: Akshay Shukla  , Gaurav Arya  , Alok Kumar Gupta  , Kumar Navin , Santosh Kumar Barman
Published: August 2023

Background: Severe acute malnutrition (SAM) is one of the major causes of mortality and morbidity among children in developing countries and is an important contributing factor to deaths occurring from preventable causes in children <5 years of age. Decreasing child mortality and improving maternal health depends heavily on reducing malnutrition.
Aims and Objectives: To study the prevalence, risk factors, medical complications, and outcome (morbidity and mortality) of children admitted with SAM along with biochemical changes.
Materials and Methods: This was an observational cross-sectional study conducted in the Department of Pediatrics, Uttar Pradesh University of Medical Sciences, Saifai, Uttar Pradesh, India. Indoor Patient admitted in the department of pediatrics with SAM between ages 6 and 59 months. A total of 100 children were included in the present study. This study was done from January 2019 to June 2020.
Results: Approximately 59% of admitted SAM patients were under 1 year of age and 24% were between 1 and 2 years. Most of the patients have rural residences nearly 93%, as most of the vicinity of our institute belonged to rural areas. According to Modified Kuppuswamy’s socio-economic status (SES) 46% that is maximally belonged to the Lower middle class and 45% belonged to the Lower class of SES. Out of 100 children, 20% were having magnesium deficiency and 56% children were having phosphate deficiency.
Conclusion: Survival of children was significantly associated with random blood sugar, mg, and PO4 level. Therefore, timely identification and intervention of biochemical derangement in SAM patients are necessary to improve the survival of SAM patients.
Thiamine-responsive acute pulmonary hypertension – A case series and review from a pediatric ICU
Authors: Prudhvi Raju Pericherla V  , Raghava Badabagni  , Sripal Reddy Cheguru  , Madhu Kiran Reddy Devireddy  , Mabbul Shaik  , Prasanth Kumar Battula  , Sohail Zeeshan Shaik
Published: August 2023

Pulmonary hypertension is seen in approximately 10% of infants with respiratory distress admitting to pediatric ICUs. Causes can be idiopathic or secondary to lung parenchymal or vascular diseases. Among various causes of pulmonary arterial hypertension, thiamine deficiency (TD) is one of the reversible causes. TD is still prevalent in selected parts of India. This review outlines five typical patients admitted to KIMS, Amalapuram, with thiamine-responsive acute pulmonary hypertension who responded dramatically to thiamine supplementation. It can cause life-threatening pulmonary hypertension in exclusively breastfeeding infants of mothers who are on a restricted diet predominantly consisting of polished and washed rice which can contribute to infant mortality. Thiamine administration based on clinical suspicion and echo findings leads to remarkable recovery. To tackle this fatal disease, a very high degree of awareness and thiamine supplementation in relevant geographical areas is required.
Microbiological analysis of urinary calculi: A study from a tertiary care hospital of Eastern India
Authors: Kumar Ashutosh , Kunal  , Manish Kumar  , Kumar Aamresh  , Hassan Ashif Ali , Anupma Anjoo
Published: August 2023

Background: Among various renal pathology, urolithiasis among patients of urinary tract infections (UTIs) forms a major group. The pathophysiology of such patients varies from the group of urolithiasis patients without infection.
Aims and Objectives: The current study was planned and conducted to find out the bacteriological profile of urinary calculi among patients of UTI.
Materials and Methods: A descriptive study was conducted by the Department of Microbiology and Surgery of JLNMC, Bhagalpur, Bihar. A total of 100 patients were enrolled in the study, having urinary calculi who either visited the outpatient department or who were admitted at the hospital for planned procedure for removal of stone between January 2021 and December 2021.
Results: Male predominance was noted with a mean age of presentation at 44.3 years. 67% of the patients had some or the other symptoms of UTI, most common symptom being excruciating groin pain. Recurrent episodes of UTI were noted among female patients. Bacterial growth on culture was obtained from the urine samples of 46 patients. Escherichia coli were the most common isolated organism. Most common type of stone was a mixed type of stone formed by calcium oxalate and calcium phosphate followed by struvite stones and uric acid stones.
Conclusion: Various factors of clinical significance among patients of urolithiasis and UTI are gender, age, and clinical symptoms. Gram-negative bacilli are the most common bacteria found in UTIs in patients with urolithiasis.
A prospective observational study on role of laparoscopy in patients presenting with abdominal trauma in a tertiary care government medical college in Uttar Pradesh
Authors: Akash Gupta  , Chitrangana Gupta
Published: August 2023

Background: Laparoscopic surgery, also called minimal access surgery or key hole surgery, is a modern surgical technique, in which operations are performed far from their location through small incisions (usually 0.5–1.5 cm).
Aims and Objectives: The aim of the study was to study the role of diagnostic laparoscopy (DL) in reassessing solid organ injury, diagnosing occult injuries, and selecting patients for conservative or operative line of management in cases of abdominal trauma with equivocal findings on CT scan And to study the role of therapeutic laparoscopy in a select group of cases where it can follow the initial DL and avoid laparotomy.
Materials and Methods: The prospective study source of data will be from patients a presenting with abdominal trauma in the emergency at M.L.B. Medical College Jhansi (Trauma Centre). The duration of study will be from May 2021 till December 2022. We concluded that total study size of 152 patients for the assessment of diagnostic and therapeutic laparoscopy.
Results: Among this, 130 (85.53%) were male patients. Females were 22 (14.47%). Most of the abdominal trauma caused by road traffic accidents 116 (76.32%). Other mode of injuries are assault, fall from height, gunshot injuries, and working machine-related injuries. Most commonly involved age groups are young adults between 21 and 30-year age group (42.76%). Most commonly injured organ is the spleen, i.e., 45 cases (30%) followed by liver, i.e., 23 cases (18.63%).
Conclusion: In our study, we concluded that laparoscopic surgery can be considered an alternative option over conventional laparotomy.
A comparative study of the efficacy and safety of thiocolchicoside and chlorzoxazone in patients with acute musculoskeletal pain
Authors: Rajeev Kumar Togiti  , Raj Kumar Goud K  , Kiran D  , Ramakrishna K  , Suresh Babu Sayana
Published: August 2023

Background: Thiocolchicoside and chlorzoxazone are commonly used muscle relaxants for the management of acute musculoskeletal pain. However, there is limited evidence comparing their efficacy and safety.
Aims and Objectives: The aim of the study was to compare the efficacy and safety of thiocolchicoside and chlorzoxazone in patients with acute musculoskeletal pain.
Materials and Methods: This was a randomized, open-label, parallel-group study conducted in a tertiary care hospital. A total of 50 patients with acute musculoskeletal pain were randomized to receive either thiocolchicoside (8 mg) or chlorzoxazone (500 mg) thrice daily for 7 days. The primary outcome measure was the change in pain intensity from baseline to Day 7, assessed using a visual analog scale (VAS). The secondary outcome measures were the percentage reduction in pain intensity and the incidence of adverse events.
Results: The baseline characteristics of the patients were similar in both groups. The mean baseline pain intensity was 7.2±1.3 in the thiocolchicoside group and 7.1±1.2 in the chlorzoxazone group. After 7 days of treatment, both drugs significantly reduced pain intensity from baseline. The mean pain intensity at Day 7 was 2.9±1.1 in the thiocolchicoside group and 3.1±1.2 in the chlorzoxazone group. The percentage reduction in pain intensity was 59.7%±12.3% in the thiocolchicoside group and 56.3%±11.5% in the chlorzoxazone group. However, there was no statistically significant difference between the groups in terms of pain intensity reduction (P=0.453).
Conclusion: The results of this study suggest that thiocolchicoside and chlorzoxazone are equally effective and safe in the management of acute musculoskeletal pain. The choice of drug may depend on the patient’s individual characteristics and risk factors.
Pathological response of different molecular subtypes of locally advanced breast carcinoma to neoadjuvant chemotherapy
Authors: Nidhi Aley Alex  , Sankar S  , Saji Mary Varghese  , Suresh Kumar K
Published: August 2023

Background: This study was done on modified radical mastectomy (MRM) specimens of patients with locally advanced breast carcinoma (LABC) who were categorized into molecular subgroups based on Immunohistochemistry and underwent neoadjuvant chemotherapy (NACT). The purpose of the study was to look for the pathological response of the tumor to the NACT. The molecular subtypes include Luminal A, Luminal B, Human epidermal growth factor receptor 2 (HER2) enriched, and triple negative. For HER2 enriched subtype, trastuzumab was also given along with the chemotherapy regimen.
Aims and Objectives: The primary objective of this study is to find out the pathological complete response (pCR) in various molecular subgroups of breast carcinoma following NACT. The secondary objective is to describe the cellular changes in tumor tissue following NACT.
Materials and Methods: This is a descriptive study done on MRM specimens of patients with LABC received in histopathology lab of Government Medical College, Kottayam to look for the pCR of the tumor following NACT. Gross examination and histopathology study of the specimen including axillary lymph nodes were done. The trucut biopsies of these cases with immunohistochemistry study were reviewed for confirming the grade and molecular subtype. pCR was assessed based on Chevallier system.
Results: Of the 131 MRM specimens studied, overall pathologic complete response rate was 24.4% and the pathologic complete response rate in Luminal A subtype, Luminal B subtype, HER2 enriched tumors, triple negative tumors were 23.6%, 24%, 33%, and 20%, respectively.
Conclusion: 33% of HER2 enriched subtype showed a pCR, i.e., no residual foci of neoplasm seen in the MRM specimens following NACT. Following NACT, change in tumor cellularity, changes in the morphology of neoplastic cells, changes in the surrounding breast tissue, and a change in grade of tumor were also noticed.
To compare the safety and efficacy of intrastromal voriconazole alone and in combination with intracameral voriconazole in intractable cases of fungal keratitis
Authors: Dahiya Monika , Dua Mohit , Rathi Manisha , Sachdeva Sumit , Dabas Ruchi , Phogat Jitender
Published: August 2023

Background: Mycotic keratitis is a potential sight-threatening infection and a leading cause of ocular morbidity worldwide. It is inherently difficult to treat due to the delayed diagnosis and fungistatic nature of available topical medications.
Aims and Objectives: The aim is to compare the safety and efficacy of intrastromal voriconazole alone and in combination with intracameral voriconazole in recalcitrant fungal keratitis cases.
Materials and Methods: A prospective, hospital-based, interventional study was conducted in 40 cases of fungal keratitis involving >50% stromal thickness and not showing a good response to conventional antifungal treatment even after 4 weeks. Cases were randomly divided into two groups: group A and group B of 20 each; group A patients received intrastromal voriconazole, while group B patients were given intrastromal+intracameral voriconazole combination in 50 mg/0.1 mL dose. Cases were examined daily for 1 week and then every week for 4 weeks to monitor progression.
Results: Out of 20 cases in group A, 14 (70%) patients got improved, while 18 (90%) patients in group B showed significant improvement after 4 weeks, and the difference was statistically significant (P=0.02). In group A, the average number of injections given to the patients was 3.65±1.56 for 15.2±8.79 days, while in group B, the average number of injections given to the patients was 2.65±1.44 for 13.2±7.768 days, with a statistically significant difference (P=0.033).
Conclusion: Intrastromal and intracameral voriconazole combination is a cost-effective and highly efficacious modality in managing recalcitrant cases of fungal keratitis. It should be recommended in cases with thick hypopyon and Aspergillus as the causative fungi that do not respond to conventional treatment.
Pregnancy with heart disease: Fetomaternal outcome: A retrospective analysis from a tertiary care teaching hospital in Northern India
Authors: Verma Menka , Ashwani Kumar  , Smiti Nanda  , Meenakshi Chauhan  , Pushpa Dahiya  , Savita Rani Singhal
Published: August 2023

Background: Heart diseases are the most significant non-obstetrical causes of maternal deaths, accounting for up to 15% of all cases. The present retrospective analysis is an attempt to assess the spectrum and impact of cardiac diseases on pregnancy.
Aims and Objectives: The aims of this study were to analyze the maternal and perinatal outcomes and spectrum of heart disease in pregnancy.
Materials and Methods: The study was carried out in the Department of Obstetrics and Gynecology at PGIMS, Rohtak, where retrospective record of inpatient obstetrics registry of pregnant women with cardiac diseases was analyzed. Clinical information obtained from the patient’s medical records including clinical presentation, laboratory investigations, 2-D echocardiography, maternal, and neonatal outcomes were noted. All pregnant women as well as postpartum patient with cardiac disease were included in the study.
Results: A total of 62 pregnant women with heart diseases were hospitalized during the study period. Spectrum of heart disease among these women analyzed and we found that the 22 had rheumatic heart disease (RHD), 14 had congenital heart disease (CHD), and 14 had cardiomyopathies (CMP). LSCS was done for 24 and out of these, nine were elective LSCS while 15 were emergency LSCS. Vaginal deliveries were performed in 31 women. Twenty-eight women got shifted to intensive care units during course of treatment. Three intrauterine deaths were noted in our study.
Conclusion: We have concluded from the present study and after reviewing the literature about spectrum of heart diseases in pregnancy, that the most common cardiac lesions complicating the pregnancy are RHD followed by CHD and CMP. Successful management of heart disease with pregnancy can be achieved by timely diagnosis and safe transfer of patient to the cardiomaternal tertiary care, where multidisciplinary teams are available.
Intraoperative plethysmography variability index directed fluid management versus standard care during intraabdominal surgery in cancer patients
Authors: Pardeep Kumar  , Asthana Unnati , Shweta Bhardwaj  , Jai Prakash Rohilla
Published: August 2023

Background: During the past 20 years, numerous publications have described the usefulness of systolic pressure variation, pulse pressure variation, stroke volume variation, etc., to guide intraoperative fluid administration. However, we still lack robust noninvasive physiological variables to successfully predict the response to fluid loading.
Aims and Objectives: The present study was designed to evaluate the utility of plethysmography variability index (PVI) to optimize fluid management during intra-abdominal surgery in cancer patients.
Materials and Methods: After the Institutional Ethics Committee approval and consent, 60 patients scheduled for elective lower abdominal cancer surgeries were randomized to receive fluid by either PVI-directed management (2 mL/kg/h) or using central venous pressure (8 mL/kg/h) after standardized technique of general and lumbar epidural anesthesia. The PVI was calculated by measuring changes in the PI during the respiratory cycle (PVI = [(PImax - PImin)/PImax] × 100). Arterial blood samples were taken at the time of incision and after 6 h postoperatively. Instances of intraoperative hypotension and oliguria were recorded.
Results: Among the 60 patients enrolled in the study, demographic data, ASA status, duration of surgery, and hemodynamics were found to be comparable. The amount of crystalloid given was significantly lesser in Group P (984.70±51.16) as compared to Group C (2395.27±209.68) (P<0.001). Four patients in Group P and three patients in Group C required vasopressors.
Conclusion: The use of PVI-guided fluid management was associated with lower lactate levels and crystalloid requirement. Reduced lactate levels in PVI-guided patients suggest that PVI-guided fluid management may be tailored to everyone’s needs.