bluuebunny/crossref_metadata_2025 huggingface dataset:
Teachers as Agents of Change
Authors: Loder Buechel Laura
Published: August 2021

Public school teachers in Switzerland often feel bound by decisions made by ministries of education as to materials used in the classroom. In teacher training, teachers are often taught superficially about reflective practices, equity, and equality, but in their training to teach English as a Foreign Language (EFL), the focus is too often on the mechanical aspects of foreign language teaching and the examples provided are often not provocative enough to allow for an anti-bias stance to education. Yet this stance is a tenet of most national curricula and is to precede subject-specific curricular aims. Therefore, neither teachers nor materials should shy away from or banalize topics around civil rights and social change. This chapter provides examples of how the dispositions for culturally responsive pedagogy scale and teaching tolerance social justice scales can be used in teacher training for analyzing and planning out lessons. Examples from lessons on the Black Lives Matter movement and general suggestions act as springboards for rethinking and unpacking EFL teaching.
Critical Praxis and Teacher Language Awareness
Authors: McNeill Arthur
Published: August 2021

Within the field of TESOL, opinions often differ about the role of learners' first language (L1) in second language learning. When teachers are aware of their students' L1, this awareness can increase their understanding of second language acquisition processes and issues. It can also provide teachers with insights into learners' backgrounds and cultures that may influence their approach to studying English and attitudes towards multilingualism. Specifically, the chapter proposes that the notion of teacher language awareness (TLA) should be expanded to include awareness of students' language backgrounds. TLA is regarded as an important component of the knowledge base of a language teacher. Two questionnaires are provided to assist teachers with the elicitation of information about students' L1: (1) a language-focused set of questions to allow comparison between a learner's L1 and English and (2) a sociolinguistic-oriented questionnaire that explores issues related to status and use.
Critical Consciousness Checklist
Authors: Liliedahl Shane Donovan
Published: August 2021

This chapter aims at providing pre-service and in-service teachers with a tool to analyze the criticality of their lessons. Teacher training programs are focused heavily on reflection of the effectiveness of an educator's classroom. This reflection generally concerns itself with ensuring that students meet learning targets and master the content. This chapter examines reflection through the lens of critical praxis, including positions of power, funds of knowledge, and meaning making. It provides a recommended checklist of questions aimed at facilitating an analysis of the extent to which lessons and activities successfully allow students to inhabit positions of power, access their funds of knowledge, and make meaning. Implications of critical reflective inquiry will enable teachers to more equitably guide students through their education.
Fostering Active Learning via Critical Pedagogies
Authors: Durmaz Nevin
Published: August 2021

This chapter aims to provide a guideline for pre-service and in-service teachers to apply reflective research in language classrooms to gain a multidimensional overview of language teaching strategies in increasing active learning via critical pedagogies. A previously conducted reflective research will be used throughout the chapter to reach the stated aim. Analyzing language teaching techniques and strategies in an English for Academic Purposes classroom where all the students are originally from East Asia, the sample reflective research illustrates the needs and expectations of East Asian students in language learning through the research students, and also it aims to provide clues for TESOL educators to implement a similar study in classrooms employing critical pedagogies to develop language instruction.
Taking an (Inter)cultural View of Students with Disabilities to Promote Inclusive Practices Within the TESOL Field
Authors: Young Davey
Published: August 2021

Considering the TESOL field's global presence, much more can be done to prepare TESOL practitioners to teach inclusively, particularly with regard for students with disabilities, and in line with international policy. This chapter begins by conceptualizing disability and inclusive education before providing an overview of concerns related to TESOL teacher training for inclusive practices. Complicating cognitive and affective factors commonly experienced by students with specific learning difficulties (SpLDs) are briefly outlined. The author then advocates for adopting a social justice definition of culture to be adopted within the field and provides three sets of discussion/reflection questions to help TESOL practitioners connect their understanding of existing models of cultural competence and language acquisition with an understanding of how students with disabilities may experience language learning. The chapter concludes by contemplating some impending challenges and potential solutions for securing inclusive education as a human right within and across the field.
Historical Insight, Classification, and Common Features of Coronavirus Family
Authors: El Hidan Moulay Abdelmonaim , El Baz Soraia , Merzouki Mohamed , Kahime Kholoud , Ait Baamrane Moulay Abdeljalil , Rhazi Mohammed , Draoui Ahmed , Agnaou Mustapha , Ait Hamza Mohamed , El Finti Aissam , Zahidi Abdelaziz , El Mousadik Abdelhamid
Published: August 2021

Coronaviruses are a large family of viruses that usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. They were named according to the shape of glycoprotein spikes present on the viral surface and resembling to the solar corona. The first coronaviruses identified in human were HCoV 229E and the HCoV OC43, known also as β-coronavirus. This virus family has become increasingly important and received more attention within scientific community in the past two decades because of three new viruses that can cause serious, even fatal, disease. These are SARS coronavirus (SARS-CoV), which emerged in November 2002 and caused severe acute respiratory syndrome (SARS); Middle East respiratory syndrome (MERS) caused by the MERS coronavirus (MERS-CoV), identified in September 2012 and continues to cause sporadic and localized outbreaks. The third novel coronavirus to emerge in this century is called SARS-CoV-2. This chapter will describe the history of the coronavirus family discovery, emergence, and classification of the main coronaviruses.
COVID-19
Authors: Kahime Kholoud , El-Mansoury Bilal , Aimrane Abdelmohcine , Bougadir Blaid , El Hidan Moulay Abdelmonaim , Elkalay Khalid
Published: August 2021

In December 2019, the world saw the appearance of a severe acute respiratory syndrome, SARS-CoV-2, in Wuhan. The virus originated in bats and was transmitted to humans. The number of cases started increasing exponentially. According to the World Health Organization, the massive migration of Chinese during the Chinese New Year fuelled the epidemic. Cases in other provinces of China, other countries (Thailand, Japan, and South Korea in quick succession) were reported in people who were returning from Wuhan. After two months, the World Health Organization reclassified this virus as a pandemic. This virus caused a great danger in the world; most countries declared a state of emergency and implemented quarantine in order to stop the spreading of the virus. We don't yet have an effective medicine against this virus. More than 155 million people are now infected with COVID-19 and more than three million people have died. This chapter will discuss the history and spread of the COVID-19 pandemic.
The Impact of the COVID-19 Pandemic on Stock Exchanges
Authors: Kartobi Salah Eddine , Aba Oubida Abdeljamil
Published: August 2021

The current world health crisis is characterized by the speed of its spread and its scale, and causing a direct global destructive economic impact that is present in every area of the globe. In this context of high uncertainty, the financial markets, especially the stock exchanges, have witnessed a decline in double figures in a very short period of time. In this chapter, the authors analyze how the COVID-19 pandemic impacts all variables of significant interest to financial economists, market regulators, and investors. This impact will be examined taking into account measures taken by governments, such as cities lockdown, border closures, canceling public events, and stopping public transport in order to slow down and stop the pandemic.
Mindful Eating
Authors: M. A. Fathima , Anto Milu Maria
Published: August 2021

The chapter is an attempt by authors to highlight the scope of mindful eating as an adjunct therapeutic tool. There is a close link between emotional states and eating, specifically intense emotional states and unhealthy eating practices. Mediating factors such as an individual's perception of food-related cues, changes in cognitive control, and eating as an emotional coping strategy influence the relationship between emotion and eating behavior. Mindful eating can be utilized as an adjunct in therapy by helping clients to practice cognitive control and by breaking the cycle of unhealthy coping strategies like emotional eating. Similar to other mindfulness techniques, mindful eating involves paying attention to the food intentionally, in the moment and without judgment. The chapter covers various approaches to mindfulness eating. Authors have compiled guidelines for therapists on how to introduce mindful eating as an adjunct in therapy settings for clients who have unhealthy eating patterns along with anxiety and depressive symptoms as well as for those suffering from eating disorders.
Mindfulness and the Elderly
Authors: Venkatesan Srinivasan
Published: August 2021

With growing life expectancy, age-related mental health issues are rising in the elderly. Whether normal aging or pathological senility, mindfulness practices are useful, economic, and accessible. The elderly experience many forms of anxiety with varying severity. There can be stress, anxiety, depression, and negative emotions. Quality of life and sleep, cognitive impairments, chronic pain, decreased social contacts are common concerns of the elderly. There is growing evidence that mindfulness practices mitigate their suffering. This chapter covers details on mindfulness-based tools for the elderly, their practices, exercises, and techniques. The recommended techniques are group-based, participatory, age-appropriate, and reflective. Given the vulnerability of the elderly, the chapter cautions about latent medico-legal and ethical issues in using mindfulness for the elderly. They must be blended with cultural, religious, moral, and spiritual elements to derive optimum benefits for the individual or small groups of such persons. A future road map is given.
Mindfulness-Based Interventions in Attention Deficit Hyperactivity Disorder
Authors: Gupta Tanu , Singhai Kartik
Published: August 2021

Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder in children and adolescents. It is marked with deficits in behavioral symptoms of hyperactivity/impulsivity along with cognitive deficits in the domain of attention, self-regulation, and executive function. Mindfulness-Based Interventions (MBI) have come up as an intervention of choice for various psychological disorders such as anxiety disorder, depression, substance abuse, and eating disorder. Mindfulness at its core is paying non-judgmental attention to the present moment. Despite the robust evidence for both of the treatment modalities available, the cognitive symptoms of ADHD still progress towards adulthood affect the individual's achievement and overall psychosocial adjustment. A number of recent studies have found preliminary evidence about the effectiveness of MBI as an adjunct treatment in ADHD. The chapter will discuss the evidence-based interventions that incorporate mindfulness.
Mindfulness-Based Interventions in Psychosis
Authors: Gupta Preeti , Sahu Anamika , Prasad Surjit , Prasad Mata
Published: August 2021

Individuals suffering with psychotic disorders face lifelong emotional dysregulation and may have impairments in their thought processes and perceptual experiences despite the availability to pharmacological treatment and good compliance. They feel extreme distress with their psychotic experiences that may result in avoidance of these experiences which may further warrant for residual symptoms and frequent hospitalizations. For a few decades literature has focused on exploring the possibilities of acceptance-based interventions in psychosis. Mindfulness interventions employ the strategies of direct use of meditation practice or combined use of meditation with acceptance-based or compassion-based practices. This chapter tends to summarize the various mindfulness interventions used for psychosis and review their feasibility in terms of evidence base and therapeutic specificity. Furthermore, it recommends the guidelines for protocol to be used with psychotic individuals and advocates the need for more methodologically rigorous evidence.
Mindfulness-Based Well-Being Interventions in Organizations and the COVID-19 Pandemic
Authors: Şahin Safiye
Published: August 2021

Dramatic changes in social, economic, and working life have occurred with the COVID-19 pandemic. These changes cause stress for employees. Therefore, it is important to implement cost-effective and purposive interventions targeting employee well-being during the COVID-19 pandemic. One of these interventions is Mindfulness-Based Interventions (MBIs). MBIs are generally implemented as a face to face with 8-session program. However, in the COVID-19 pandemic, remote work has been adopted widely by organizations, causing an urgent need for digital well-being interventions. This study aims to investigate effectiveness of digital mindfulness-based interventions on employees' well-being during the COVID-19 pandemic. To do this, the effect of the COVID-19 pandemic on employee well-being will be explained in the first part. In the second part, mindfulness and mindfulness-based interventions will be discussed. In the last part, digital mindfulness interventions and their effects on employee well-being during the COVID-19 pandemic will be clarified.
The No-Self of Zen/Gen
Authors: Kamperis Aya
Published: August 2021

The Buddhist practice of mindfulness has enjoyed a tremendous surge in popularity in the last few decades, both in the popular press and in the psychotherapy literature. However, the philosophy and practice of mindfulness has often been erroneously equated with quietism or a withdrawal from the world of action, misconceived as a practice of sterile, self-absorbed contemplation. On the contrary, the core Buddhist conception of existential freedom lies in the belief of doing over thinking, and intersubjectivity over introspection. Moreover, the cultural differences in how one conceives oneself, particularly in relation to others around, prove to be a critical factor in determining the efficacy of various clinical techniques including mindfulness practice. The chapter explores the interpersonal dimensions of mindfulness philosophy and practice, and the implications of such paradigms to question whether the current methods of intervention and training based on internality are sufficient for the clinical application.
Yoga for Attaining the State of Mindfulness
Authors: Roy Gitanjali
Published: August 2021

Mental peace, inner peace, and spiritual enlightenment are often emphasized in ancient scriptures for the holistic development of man. Every culture and religion of the world teaches, preaches, and practices these virtues for a vertical development of love and restating the brotherhood in society. Yoga and Mindfulness are two prominent and popular practices to achieve the good values and virtues. These two practices are dissected by philosophers, researchers, and physicians to the threshold only to conclude that the effects are inevitably gainful. This chapter brings together yoga and mindfulness on same page to show their complementary relationship. Here are mentioned few challenges and issues that both the practices have to face often.
Mindfulness in Education
Authors: Devi Sunita
Published: August 2021

Complexity of the modern era has led to increased difficulties of people, especially the youth. Living in the current stressful, uncertain, and highly stimulating technological era is not very easy for the young ones. Hence, there is an urgency to teach skills of stress management and resilience among children through mindfulness-based practices. This change in the present scenario has attracted the attention and interest of psychologists and educationists to the practice of mindfulness-based interventions with children and adolescents for enhancing their overall well-being. The last few years have observed a growing number of research and applications of mindfulness in educational settings because of its effectiveness and the urgent need of prevention and interventions of the youths' problems. In this chapter, the author has discussed research supporting the idea of mindfulness in education for both students and teachers and its usage to increase the academic performance, enhance overall wellbeing, and reduce the stress level of youth.
A Framework for Evaluating Children's Books About Poverty
Authors: Hartsfield Danielle E.
Published: August 2021

Enacting a class-sensitive pedagogy means disrupting negative discourses about social class and affirming the lives and experiences of children and families from poverty and the working class. One step that educators can take toward embracing a class-sensitive pedagogy is the inclusion of books with poor and working-class perspectives in the curriculum. This chapter describes a framework that educators can use to analyze and evaluate depictions of poor and working-class characters in books for children. This framework can support educators with selecting books that are respectful of and affirming to children from low-income families. In addition, the chapter offers book recommendations and approaches for integrating children's literature in elementary and middle grades classrooms.
Literacy Development, Higher Education, and the Achievement Gap
Authors: Garling Brittany Ann , DeWitt Lucas
Published: August 2021

This chapter will explore the challenges of students entering college who have gaps in their literacy development. Historical events within education that have led to some of these skills set gaps will be reviewed. Additionally, causes and current remedies to help students as they try to navigate higher education while needing additional support with their literacy skills will be discussed. Finally, the issue of how colleges are forced to react to students who do not have the skills to compete with the expected academic rigor and steps needed to help both high school educators and professors remedy these instructional challenges will be reviewed.
Challenging the Poverty Narrative Through Children's Literature
Authors: Peters Kimberly M.
Published: August 2021

Poverty and homelessness are often portrayed in children's literature as an individual problem rather than a larger systemic issue involving societal inequities. Children's literature can be used as a means of self-affirmation and as an opportunity for dialogue around social justice issues in the classroom. Through thoughtful planning, identity work, and the use of critical frameworks, educators can evaluate the quality of children's literature, monitor their students' textual experiences, and plan for dialogue to promote change. This intentional planning will help students build a strong sense of self-agency and a broader understanding of how to think critically around improving the overall human condition.
Supporting Students Impacted by Poverty Through Literacy Methods, Resources, and Strategies
Authors: Tussey Jill T. , Haas Leslie
Published: August 2021

This chapter is based on supporting students impacted by poverty through literacy education. Specifically, it looks at literacy methods, resources, and strategies that offer students engaging opportunities to learn in safe and supported environments. Student-centered instructional examples provide both voice and choice through quality pedagogical practices. As the wealth gap continues to widen, it is more important than ever to be diligent in ensuring equitable access to educational resources available to all students regardless of income status. Within this chapter, the authors have offered ways in which educators can access some of these resources.
Optimization of Modern Manufacturing Processes Using Three Multi-Objective Evolutionary Algorithms
Authors: Majumder Arindam
Published: August 2021

The optimization in manufacturing processes refers to the investigation of multiple responses simultaneously. Therefore, it becomes very necessary to introduce a technique that can solve the multiple response optimization problem efficiently. In this study, an attempt has been taken to find the application of three newly introduced multi-objective evolutionary algorithms, namely multi-objective dragonfly algorithm (MODA), multi-objective particle swarm optimization algorithm (MOPSO), and multi-objective teaching-learning-based optimization (MOTLBO), in the modern manufacturing processes. For this purpose, these algorithms are used to solve five instances of modern manufacturing process—CNC process, continuous drive friction welding process, EDM process, injection molding process, and friction stir welding process—during this study. The performance of these algorithms is measured using three parameters, namely coverage to two sets, spacing, and CPU time. The obtained experimental results initially reveal that MODA, MOPSO, and MOTLBO provide better solutions as compared to widely used nondominated sorting genetic algorithm II (NSGA-II). Moreover, this study also shows the superiority of MODA over MOPSO and MOTLBO while considering coverage to two sets and CPU time. Further, in terms of spacing a marginally inferior performance is observed in MODA as compared to MOPSO and MOTLBO.
A Novel Approach for Semantic Web Application in Online Education Based on Steganography
Authors: Gurunath R.  , Samanta Debabrata
Published: August 2021

Semantic Web technology is not new as most of us contemplate; it has evolved over the years. Linked Data web terminology is the name set recently to the Semantic Web. Semantic Web is a continuation of Web 2.0 and it is to replace existing technologies. It is built on Natural Language processing and provides solutions to most of the prevailing issues. Web 3.0 is the version of Semantic Web caters to the information needs of half of the population on earth. This paper links two important current concerns, the security of information and enforced online education due to COVID-19 with Semantic Web. The Steganography requirement for the Semantic web is discussed elaborately, even though encryption is applied which is inadequate in providing protection. Web 2.0 issues concerning online education and semantic Web solutions have been discussed. An extensive literature survey has been conducted related to the architecture of Web 3.0, detailed history of online education, and Security architecture. Finally, Semantic Web is here to stay and data hiding along with encryption makes it robust.
An Extensive Review of Web-Based Multi-Granularity Service Composition
Authors: Sah Anushree , Rawat Saurabh , Choudhury Tanupriya , Dewangan Bhupesh Kumar
Published: August 2021

The paper reviews the efforts to compose SOAP, non-SOAP and non-web services. Traditionally efforts were made for composite SOAP services, however, these efforts did not include the RESTful and non-web services. A SOAP service uses structured exchange methodology for dealing with web services while a non-SOAP follows different approach. The research paper reviews the invoking and composing a combination of SOAP, non-SOAP, and non-web services into a composite process to execute complex tasks on various devices. It also shows the systematic integration of the SOAP, non-SOAP and non-web services describing the composition of heterogeneous services than the ones conventionally used from the perspective of resource consumption. The paper further compares and reviews different layout model for the discovery of services, selection of services and composition of services in Cloud computing. Recent research trends in service composition are identified and then research about microservices are evaluated and shown in the form of table and graphs.
Business startup motives and growth expectations of micro and small-scale entrepreneurs in Southern Province of Sri Lanka: the mediating role of entrepreneurial orientation
Authors: Sriyani G. T. W. , Fairoz F. Mafasiya , Silva M. W. S. Sanjeewa , Jayampathi E. K.
Published: August 2021

New venture creations are vital for the economic growth of any country because of its contribution to employment generation, employment generation, GDP, innovations and value additions. Though a large number of new venture creations occur every year in Sri Lanka, research findings highlighted that a smaller percentage was able to survive. Hence, the number of business establishments cannot be considered as a meaningful indicator of economic growth of the country and the high failure rate is a crucial issue.  Past studies revealed that business startup motives effect on the business growth and Entrepreneurial Orientation (EO) plays a crucial role in directing the business towards success.  Studies are lacking about the impact of business startup motives on the success and survival of newly established ventures and the mediating role of the EO on the relationship between start-up motives and new venture success.  Therefore, the present study focused to reveal whether significant relationship exists between business startup motives and growth expectations; growth expectations between the necessity driven (NDEs) and opportunity driven entrepreneurs (ODEs); and whether EO plays a mediating role on the relationship between business startup motives and growth expectations. Independent Sample T test and Structural Equation Modeling were applied to test the hypotheses. Findings revealed that significant difference exists between the NDEs and ODEs in terms of proactiveness, competitive aggressiveness, and autonomy and no significant difference exists in growth expectations between the NDEs and ODEs.  Entrepreneurial Orientation partially mediates the relationship between business startup motives and growth expectations.
Culture in translation: a comprehensive study
Authors: Nagodawithana K. A.
Published: August 2021

The process of translation involves rendering a text written in one language with the use of the symbols of another language. This act of translation is governed by a myriad of textual and extra-textual elements. Amongst them, culture has a profound impact on the process of translation. The succulent dishes catering to an individual’s taste palate to clothes donned; culture showcase a unique combination of attributes that construct a formidable deterrent for the translator. Hence, the present study seeks to clarify the position of the culture within the translation process, the magnitude of impact on translators and readership, and the strategies adopted by translators to overcome the obstacles posed by cultural distinctions to reap a productive translation. A highly qualitative approach consisting of in-depth, semi-structured interviews was conducted with six individuals actively involved in translation. The garnered data were evaluated and reviewed under the Thematic Analysis method to reach conclusions. The analyzed data revealed that during translation, the contact between two different cultural systems inevitably leads to a confrontation amid two heterogeneous value systems deeply embedded within the respective communities. As a result, culture portrays a dominant figurine, inadvertently endorsing the translators to act as cultural –mediators during translation. In the course, translators adopt a plethora of techniques manipulating culture-specific dimensions up to a certain extent to achieve a translation where the message received by the receptor is substantially the same as the message received via the Source Text.
Effects of Piper nigrum fruit and Cinnamum zeylanicum bark alcoholic extracts, alone and in combination, on scopolamine-induced memory impairment in mice
Authors: Teymuori Mohammad , Yegdaneh Afsaneh , Rabbani Mohammad
Published: August 2021

Background and purpose:

Alzheimer’s disease is a progressive brain disorder that is thought to be triggered via disruption of cholinergic neurons and enhanced oxidative stress. Therefore, antioxidant phytochemicals with the ability to fortify cholinergic function should help in preventing the progress of the disease. This study aimed at evaluating the combinational effects of two popular herbs one with anticholinesterase activity namely Piper nigrum and the other with antioxidant capacity, Cinnamomum zeylanicum.

Experimental approach:

In this study, P. nigrum extract (PN) (50, 100 mg/kg, ip) and C. zeylanicum extract (CZ) (100, 200, 400 mg/kg, ip) and their combinations were administered for 8 days before the injection of scopolamine (1 mg/kg, ip). Mice were then tested for their memory using two behavioral models, namely the object recognition test and the passive avoidance task.

Findings/Results:

Administration of scopolamine significantly impaired memory performance in both memory paradigms. In the passive avoidance test (PAT) model, PN at doses up to 100 mg/kg and CZ at doses up to 400 mg/kg did not significantly alter the memory impairment induced by scopolamine. The combination of these two plant extracts did not change the PAT parameters. In the object recognition test (ORT) model, however, administration of 100 mg/kg CZ alone and a combination of PN (50 mg/kg) with CZ (400 mg/kg), significantly increased the recognition index (P < 0.05).

Conclusion and implications:

Two plant extracts when administered alone or in combinations affected the memory performance differently in two memory paradigms. In the PAT model, the extracts did not show any memory improvement, in ORT, however, some improvements were observed after plant extracts.
Effect of ethanolic extract of Stachys pilifera Benth on subacute experimental models of inflammation and some underlying mechanisms
Authors: Zarezade Vahid , Sadeghi Heibatollah , Panahi Kokhdan Esmaeel , Nikbakht Jafar , Molavi Mehdi , Mostafazadeh Mostafa , Abedi Sayed Aghil , Sadeghi Hossein
Published: August 2021

Background and purpose:

This study was designed to evaluate the anti-inflammatory activities of S. pilifera (HESP) in two sub-acute models of inflammation and clarified some possible mechanisms.

Experimental approach:

Colorimetric methods were used to determine total phenol and flavonoid contents. Carrageenan or formalin-induced rat paw edema (seven days) and multiple application TPA-induced ear edema in mice (9 days) were used. The concentration of IL-1 and TNF-α were measured in the inflamed paw, as well as MDA levels in the serum and liver. Histopathological studies and in vitro anti-inflammatory effects of the extract were also studied using heat-or hypotonicity-induced hemolysis in RBC humans.

Findings/Results:

Total phenol and flavonoid contents of HESP were 101.35 ± 2.96 mg GAE/g extract and 660.79 ± 10.06 mg RE g extract, respectively. Oral (100 and 200 mg/kg) and topical application (5 mg/ear) of HESP significantly inhibited formalin-induced paw edema and multiple TPA-induced ear edema. The extract also significantly decreased the serum and liver levels of MDA in the carrageenan and formalin tests. The elevated levels of TNF-α and IL-1β in the carrageenan-injected paw were not affected by HESP. The extract (50-800 μg/mL) inhibited heat-or hypotonicity-induced hemolysis. Histopathological examination of the inflamed tissues revealed that HESP inhibited congestion and leukocyte infiltration.

Conclusion and implications:

The findings confirmed the potent anti-inflammatory effects of S. pilifera in two sub-acute inflammation models and suggested that these properties were not related to IL-1 and TNF-α, but could be attributed to inhibition of lipid peroxidation, membrane stabilization, and inhibition of leukocyte penetration.
Anti-inflammatory effects of saxagliptin and vildagliptin against doxorubicin-induced nephrotoxicity in rats
Authors: Mostafa Rasha Ezzat , Morsi Azza Hassan , Asaad Gihan Farag
Published: August 2021

Background and purpose:

The clinical use of the chemotherapeutic drug, doxorubicin (DXR), is significantly limited by its extensive multi-organ toxicity. Dipeptidyl peptidase-4 (DPP4) is over-expressed in oxidative stress, inflammation and apoptosis. DPP4 inhibitors have proven pleiotropic effects. The study investigates the protective effects of some DDP4 inhibitors; namely, saxagliptin (SAX) and vildagliptin (VIL) against DXR-induced nephrotoxicity in rats.

Experimental approach:

Forty rats were divided into 4 groups. Group I served as normal control. Nephrotoxicity was induced in the remaining 3 groups by single-DXR injection (15 mg/kg, i.p.). Groups III and IV administered oral SAX (10 mg/kg) and VIL (10 mg/kg) for 2 weeks.

Findings/Results:

DXR-control rats showed deteriorated renal functions, elevated renal inflammatory parameters (tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), and inducible nitric oxide synthase (iNOS)), up-regulated nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3) inflammasome and significant tubulointerstitial injury manifested by elevated neutrophil gelatinase-associated lipocalin concentration and distorted renal histopathological pictures. Immunohistochemical studies showed increased iNOS and Bax positivity in renal tissues of DXR-control rats. Treatment with SAX and VIL significantly attenuated DXR-induced nephrotoxicity via alleviation of all the above-mentioned parameters when compared to DXR-control rats.

Conclusion and implications:

The study elucidated the possible mechanisms beyond DXR-induced nephrotoxicity to be through inflammation plus tubulointerstitial injury. DXR nephrotoxicity has been linked to TNF-α, IL-1β, and NLRP3 inflammasome up-regulation and iNOS expression. The protective role of SAX and VIL in mitigating the tubular injury and inflammatory effects of DXR on renal tissues has been tested and proved.
Attitude of Prescribers about the Rational Use of Antibiotics for Common Infections in a Clinical Setting as Part of Antibiotic Stewardship Program
Authors: Palanisamy Priyadharsini Raman , Natrajan Nagalingam , Balaji Vignesh Kanna
Published: August 2021

Background:

The resistance of the bacteria toward the antibiotics is growing day by day, and it is a serious threat globally. The reasons are self-medication, unjustified prescription of antibiotics, high use of antibiotics in livestock, and nonadherence to antibiotic treatment guidelines by prescribers. The aim of the present study is to assess the knowledge and attitude of the prescribers toward the prescription of antibiotics and antibiotic resistance.

Methodology:

A descriptive cross-sectional study was conducted using a questionnaire which contains questions to assess the knowledge and attitude of the prescribers. The questionnaire had three parts: the first part was used to obtain the basic demographic characteristics from participants, the second part had questions regarding the antibiotic indication in common infections, and the third part assessed the knowledge questions about antibiotic resistance. The questionnaire was attempted by eighty prescribers.

Results:

More than 50% of the medical practitioners agreed that antibiotics had to be used for some common infections such as acute gastroenteritis, asymptomatic bacteriuria in nonpregnant patients, and burn wounds with no evidence of infection. The knowledge of the prescribers regarding antibiotic resistance is variable.

Conclusion:

A higher percentage of the prescribers responded in favor of the use of antibiotics for common infections. It requires an awareness program to sensitize the prescribers regarding the prescription of antibiotics for appropriate indications and the seriousness of antibiotic resistance.
Risk and Predictors of Patients Receiving Neoadjuvant Chemotherapy Followed by Radical Cystectomy or Transurethral Resection Alone for Muscle-Invasive Bladder Cancer
Authors: Chiang Pei-Jhang , Ko Kai-Hsiung , Meng En , Cha Tai-Lung , Sun Guang-Haun , Yu Dah-Shyong , Kao Chien-Chang
Published: August 2021

Background:

Upper urinary tract urothelial carcinoma and muscle-invasive bladder cancer (MIBC) incidence rates are high in Taiwan. Our patients with MIBC are commonly managed with a radical cystectomy (RC); however, recurrence rates remain high.

Aim:

We aimed to establish a protocol regarding neoadjuvant chemotherapy (NAC) followed by RC or transurethral resection (TUR) alone from 2008 to 2013. We outline the efficacy and prognosis of NAC followed by RC.

Methods:

This was a retrospective study. The clinical data of 38 patients who underwent NAC from 2008 to 2013 at a single institution were retrospectively reviewed. Patients were divided into Group 1 (NAC with RC) and Group 2 (NAC with TUR alone). Age, sex, tumor size, prechemotherapy characteristics, and oncological outcomes were analyzed.

Results:

Group 1 had worse chemotherapy responses than Group 2 (48% vs. 71%, P = 0.0002). There were no significant differences in the 3-year progression-free survival and overall survival (OS) between the groups. High-risk patients were defined as having a tumor size >5 cm, concurrent hydronephrosis, and adverse pathological features. High-risk Group 1 patients had a better 3-year OS than high-risk Group 2 patients (13/17, 76%; and 3/5, 63%; respectively).

Conclusion:

In high-risk patients or patients with poor chemotherapy responses, NAC followed by RC with pelvic lymph node dissection resulted in a significantly increased 3-year OS. NAC with TUR alone was suitable only for low-risk patients with good chemotherapy responses.
Malignant Extragastrointestinal Stromal Tumor
Authors: Deshmukh Abhay Vilas , Hagone Swati Dhanraj , Shivkumar Vitaladevuni Balasubramanyam , Gangane Nitin M.
Published: August 2021

Gastrointestinal stromal tumors are the most common mesenchymal tumors of gastrointestinal tract which comprise <1% of all primary gastrointestinal malignancies. These tumors show mutations in the KIT gene or platelet-derived growth factor receptor-A gene and usually stains positively for CD117. Very few cases of extragastrointestinal GIST (EGIST) have been reported in literature which originate from omentum and mesentery as per our knowledge. Here, we report a case of EGIST arising from omentum with no connection to gastrointestinal tract organs in a 60-year-old woman who presented with abdominal pain for 2–3 months. Intraoperative findings showed the presence of multiple globular masses and nodules in the peritoneal cavity. Microscopically, the spindled tumor cells were arranged in interlacing fashion. Immunohistochemistry showed positivity for CD117 and negativity for smooth muscle actin (SMA). Thus, EGIST should always be considered as a differential diagnosis for nodular mesenteric masses.
Risk Factors for Early and Late Recurrence in Hepatocellular Carcinoma after Liver Transplantation
Authors: Hsiu-Lung Fan , Chung-Bao Hsieh , Shih-Ming Kuo , Teng-Wei Chen
Published: August 2021

Background:

Risk factors of early and late recurrence in hepatocellular carcinoma (HCC) after liver transplantation (LT) remain unclear.

Aim:

To identify factors that affect, both early and late recurrence in this setting.

Methods:

We retrospectively analyzed outcomes of 220 patients with HCC who received LT. Two patients who underwent re-transplantation were excluded. Early, late, and very late recurrence were defined as recurrence in the 1st year, 1–5 years, and >5 years after LT, respectively. Kaplan–Meier survival curves were generated, and log-rank tests were performed to compare survival between these groups. Univariate and multivariate Cox proportional-hazard models for risks of early and late recurrence were established.

Results:

Twenty and 19 patients experienced HCC recurrence in the 1st year and between 1 and 5 years, respectively, after undergoing LT. The groups differed significantly in cumulative postrecurrence survival rate. The hazard ratio of early recurrence for tumor size >3 cm was 1.766 (P = 0.046) and that for tumor number >3 was 1.929 (P = 0.027). Alpha-fetoprotein >20 ng/mL was a predictor of early recurrence in multivariate analysis (P = 0.077). The hazard ratio of late recurrence for HCC with microvascular invasion was 1.891 (P = 0.047).

Conclusion:

The recurrence rate of HCC was high in the 1st year after LT. Patients with early recurrence had a poorer survival rate than those with late recurrence. Tumor size >3 cm and tumor number >3 were risk factors of early recurrence. Microvascular invasion was a risk factor for late recurrence. Close individual surveillance is needed in patients with these risk factors.
Clinical Analysis for Osmotic Demyelination Syndrome in Patients with Chronic Hyponatremia
Authors: Chen Hsi-Chih , Sung Chih-Chien , Lin Yi-Chang , Chan Lin-Chien , Lin Shih-Hua
Published: August 2021

Background:

Although osmotic demyelination syndrome (ODS) has been well known to be associated with a rapid correction of sodium (Na+) in patients with chronic hyponatremia, its risk factors and clinical outcomes have not been examined in Taiwan.

Aim:

The aim of the study was to analyze the underlying causes and overlooked risk factors in patients with ODS.

Methods:

We retrospectively collected chronic hyponatremic patients developing ODS and analyzed their clinical characteristics.

Results:

Fourteen patients (7 males and 7 females) with a mean age of 62.7 ± 17.9 years old were enrolled. Their underlying causes included gastrointestinal illness with poor intake (n = 7), chronic use of diuretics (n = 2), syndrome of inappropriate antidiuretic hormone (n = 2), pneumonia (n = 2), and hypopituitarism (n = 1). Their serum Na+ was 107.2 ± 1.2 mmol/L with mild hypokalemia (potassium 3.1 ± 7 mmol/L), hypoalbuminemia (albumin, 3.4 ± 0.6 g/dL), and hypophosphatemia (phosphorus, 2.3 ± 1.0 mg/dL). Their mean Na+ correction rate was 8.4 ± 9 mmol/L/day and most patients (60%) developed ODS in first 3 days. Their manifestations included delirium, seizures, unstable gait, aphasia, and drowsy consciousness. Brain magnetic resonance imaging demonstrated that 42.8% had isolated central pontine myelinolysis. Totally, 43% of ODS patients had unfavorable outcome with death and disability. In addition, patients with rapid Na+ correction rate (>12 mmol/L/day, n = 4) usually exhibited significant hypokalemia (2.5 ± 0.4 vs. 3.5 ± 0.7 mmol/L, P < 0.05) as compared with those without.

Conclusion:

Nutritional status and concurrent electrolyte deficiencies such as hypokalemia are major risk factors in patients with ODS. Clinicians should timely recognize these potential risks of ODS and reduce Na+ correction rate to avoid catastrophic outcomes.
A Cross-Sectional Study to Compare Anesthesia Techniques Employed for the Conduct of Upper Gastrointestinal Endoscopic Procedures in a Gastroenterology Suite of a Tertiary Care Hospital
Authors: Sud Saurabh , Dwivedi Deepak , Dudeja Puja , Hooda Bhavna , Singh Shalendra , Aggarwal Manish
Published: August 2021

Background:

Endoscopic procedures in gastroenterology (GE) imaging suite are conducted primarily under moderate sedation (MS) and general anesthesia (GA). Various factors determine the choice of the technique such as the physical status of the patient, an anticipated difficult procedure, or an unanticipated complication.

Aims:

The aim was to study various factors affecting the selection of anesthesia techniques in patients undergoing endoscopy. This was a cross-sectional descriptive study in a tertiary care hospital.

Methods:

All patients who underwent upper gastrointestinal endoscopic procedures (n = 373) from January 2017 to December 2018 were included in the study. Patients were divided into groups on the basis of the anesthesia technique employed as MS – Group I (n = 343) and GA – Group II (n = 30). Data were collected for patient related and procedure related factors such as age, sex, physical status of the patient, complexity of the endoscopic procedures, anesthesia duration, drugs used, complications and recovery profile, which were analyzed for the two groups as per the entries made in the GE suite and central anesthesia registry. Statistical analysis was done using SPSS software Version 22.0 (IBM Corp., Armonk, NY, USA). Categorical variables were tested using Chi-square test and means were compared using t-test.

Conclusions:

MS was preferred in patients with lesser grades of physical status and in less complex GE procedures as compared to GA.
Unusual Cause of Abdominal Pain in a Young Adult
Authors: Wang Ren-Tzer , Chen Jheng-Yan , Yu Jyh-Cherng , Chen Teng-Wei , Hsieh Chung-Bao , Chan De-Chuan , Hsu Kuo-Feng
Published: August 2021

Gallbladder (GB) cancer is a rare cause of abdominal pain in young adults. It is difficult to confirm an immediate and correct diagnosis based on the presentation of an acute episode of abdominal pain. We report a 36-year-old man who was referred to our hospital because of right upper abdominal pain that had persisted for 1 month. The tentative diagnosis was gallstone-induced acute on chronic cholecystitis according to the clinical symptoms/signs and imaging studies. Laparoscopic cholecystectomy (LC) was performed after admission. Histological examination revealed adenocarcinoma of the GB that was moderately differentiated and invading the perimuscular connective tissue. Magnetic resonance imaging was performed after the surgery, showing negativity for the invasion to other organs. Laparoscopic bisegmentectomy of the liver (seg. 4b + 5) and lymph node dissection was performed following LC. Adjuvant chemotherapy was administered, and the patient is currently alive without recurrence for 6 months. The uncommon etiology of cholecystitis in young adults is discussed.
Management of Grade IV Diabetic Foot Ulcer by Vrana Ropana Chikitsa
Authors: Jose Ann Mariya , Adiga Shripathi , Ciraj A. M. , Shettigar Kavitha S. , Velladath Saleena Ummer , Ramachandra Lingadakai
Published: August 2021

In this study, we present a case of Grade IV diabetic foot ulcer (DFU) and its management with Vrana ropana chikitsa along with Ayurvedic precision medicines. A 72-year-old male patient having grade IV DFU was given the Vrana ropana chikitsa with precision medicines. The bacterial profile and antibiotic resistance, and wound characteristics were monitored before and after the treatment. After the treatment, significant progressions were found in the patient. There was a decrease in the growth of Staphylococcus aureus in the wound after the treatment. Doxycycline and erythromycin-resistant isolates were switched to antibiotic sensitive strains with Vrana ropana chikitsa. Progression of Grade IV ulcer to healing wound was found in the patient. A case of Grade IV DFU with drug-resistant S. aureus was managed with the alternative treatment of Vrana ropana chikitsa and showed improved wound healing.