bluuebunny/crossref_metadata_2025 huggingface dataset:
Hiérarchies urbaines en Amérique portugaise : São Paulo, Recife, Vila Rica - xvie-xviiie siècle (Les élites)
Authors: de Mello e Souza Laura
Published: December 2023

Les premiers centres urbains de l’Amérique portugaise remontent au xvie siècle, mais l’urbanisation s’est raréfiée tout au long de la période coloniale. Dans un territoire extrêmement varié, il est possible de mettre en évidence trois expériences distinctes, qui ont émergé dans des contextes spécifiques et ont donné naissance à des sociétés très différentes : São Paulo, dont la population s’est tournée vers l’arrière-pays à la recherche de bras indigènes pour ses récoltes (xvie siècle) ; Recife, village marchand créé lors de l’occupation hollandaise du nord-est (xviie siècle) ; Vila Rica, siège de la région de l’or qui a attiré des milliers d’aventuriers (xviiie siècle). Des expériences singulières qui témoignent de la variété assumée par les formes urbaines dans ce sous-continent.
Le cartel taurin en Espagne de la Seconde République au franquisme : entre instrument de propagande et œuvre d’art authentique
Authors: Guitard Justine
Published: December 2023

En Espagne, les cartels taurins qui existent depuis le xviiie siècle subissent une forte politisation durant la Seconde République et les premières années du franquisme notamment, deux périodes aussi emblématiques qu’antagoniques du xxe siècle. En effet, les cartels mettent volontiers en exergue des changements socio-politiques par la présence d’insignes, de drapeaux ou de personnages représentatifs de l’évolution engagée. Envahissant le domaine public, l’affiche, faisant l’objet d’une recherche et d’un travail artistique profond, sert les intérêts des différents gouvernements successifs puisqu’elle véhicule, en un sens, leur idéologie. Elle devient une arme de propagande de façon opportune au même titre qu’une œuvre d’art encensant la corrida.
Naufragios en la costa de Bizkaia (1550-1800)
Authors: Cagigal Ekain
Published: December 2023

Los naufragios representan la faceta menos amable del auge de la navegación y del comercio durante la Edad Moderna. Sin embargo, es un atributo socioeconómico y humano propio de las sociedades marítimas, no abordado en profundidad hasta la fecha para este período histórico en el litoral vizcaíno.Las fuentes documentales de Bizkaia proporcionan información de alto valor histórico que permite caracterizar este fenómeno en términos geográficos, comerciales, socio-económicos y humanos. Para ello, en el presente trabajo se ha generado una base de datos –incluyendo una representación cartográfica– de casi 200 sucesos de naufragios acontecidos en las costas vizcaínas durante el período 1550-1800. A partir de esta información se ha llevado a cabo un análisis de la distribución de las localizaciones, la evolución diacrónica, las causas de los hundimientos, el tipo de embarcaciones afectadas, u otras consideraciones.
Unleashing Business Potential
Authors: Ahmad Munir
Published: December 2023

The economic value of green spaces and their enormous potential can positively impact both community development and business growth. This chapter explored the value of OSM data especially green space data for business development. Strategic investment in parks and other green spaces has positive effects on the environment as well as the economy. Integration of OSM data with other essential datasets can provide businesses with useful tools for utilizing green spaces. OSM improves client segmentation, market analysis, and distribution channels, promoting sustainable business practices. OSM can also help in developing revenue strategies, discovering competitors, and optimizing logistics. When used in business growth, OSM green space data offers a variety of alternatives, from site selection to eco-friendly campuses, eco-tourism, and conservation projects. Additionally, OSM data encourages civic participation, ecological regrowth, and eco-aware consumer marketing.
The Role of Renewable Energy Consumption in Promoting Sustainability and Circular Economy
Authors: Laureti Lucio , Costantiello Alberto , Massaro Alessandro , Leogrande Angelo
Published: December 2023

In this chapter, the authors investigate the role of “renewable energy consumption” in the context of circular economy. They assume that the consumption of renewable energy is a proxy for the development of circular economy. They use data from the environmental, social, and governance (ESG) dataset of the World Bank for 193 countries in the period 2011-2020. They perform several econometric techniques (i.e., panel data with fixed effects, panel data with random effects, pooled ordinary least squares [OLS], weighted least squares [WLS]). The results show that “renewable energy consumption” is positively associated among others to “cooling degree days” and “adjusted savings: net forest depletion” and negatively associated among others to “greenhouse gas (GHG) net emissions/removals by land use change and forestry (LUCF)” and “mean drought index.” Furthermore, they perform a cluster analysis with the application of the k-Means algorithm and find the presence of four clusters. Finally, they compare eight different machine-learning algorithms to predict the value of renewable energy consumption.
Generative AI in Terms of Its Ethical Problems for Both Teachers and Learners
Authors: Le-Nguyen Huong-Tra , Tran Trung Thanh
Published: December 2023

The chapter delves into the intricate ethical challenges posed by the integration of generative AI tools in educational contexts. As the educational landscape undergoes a profound transformation through AI-driven technologies, this chapter navigates the multifaceted ethical concerns that emerge. It explores issues surrounding data privacy, content bias, academic integrity, and the evolving roles of teachers and students in this digital era. Drawing on real-world case studies and ethical frameworks, it provides insights into the complexities of responsible AI integration. Moreover, it offers guidance on fostering ethical awareness in education and emphasizes the critical need for striking a harmonious balance between the capabilities of AI and the enduring value of human educators. This chapter serves as a comprehensive exploration of the ethical tightrope that educators, students, and policymakers must navigate to ensure AI's positive impact on education while safeguarding its ethical underpinnings.
Transformation in the Classroom
Authors: Hurtado María Elena Zepeda , Membrillo Gómez Claudia Angélica , Arias Candanosa Francisco Javier
Published: December 2023

This chapter is the result of the study of the way in which microcontents were incorporated in the hybrid modality in the first semester (January – June 2023) in the different learning units taught in the areas of institutional, humanistic, scientific, and basic technological training at the upper secondary level of the Instituto Politécnico Nacional. The research has a quantitative approach with a descriptive scope based on a comparative approach. The sample population was made up of 150 students from the second, fourth, and sixth semesters to whom the questionnaire is applied as the data collection instrument. The results indicate that teachers incorporate as main materials videos, texts, diagrams, and drawings; on the part of the students, they state that the incorporation of these favored motivation, concentration, access, and creation of content. The chapter addresses pedagogical implications and makes recommendations for the integration of microcontent in the hybrid modality.
Microstructure Based Flow Stress Modelling of Superalloy 718
Authors: Kumar Nilesh , Yadav Surya Deo
Published: December 2023

In order to get the insights about microstructural changes that occurs under the thermo-mechanical processing conditions, the physics based modelling approach is very useful. Therefore, the flow curves of alloy 718 are theoretical simulated using a dislocation density dependent constitutive model for different conditions. Presented model considers the microstructural ingredients that are immobile dislocation density, effective grain size and dislocation cell size as the variables to address the creep. The simulated flow curves show a good agreement with the experimental flow curves. The magnitude of immobile dislocation density and dislocation cell size in between 3.87× 1014 - 3.87× 1014­ m-2 and 8.29-8.45 μm, respectively, at the completion of the simulation. Furthermore, this approach also provides the possibility to quantify and depict the variation in each strengthening contributions.
Effect of Zirconium Conversion Coating on Corrosion Resistance of Small-Defected Auto Steel Sheets
Authors: Fang Bai You
Published: December 2023

For the sake of environmental protection and energy conservation, traditional phosphate pretreatments have been gradually prohibited worldwide during automobile productions. As a promising substitute, the green and environment-friendly zirconate pretreatment technology is developing rapidly. However, because the thickness of zirconium conversion coatings is commonly ranged in nanoscale, its covering capability for small defects is inferior to that of phosphate film, which may have a detrimental impact on the service performance of automotive steel sheets. In this study, comparing the surface characteristics of cold rolled auto steel sheets before and after zirconate treatment, the effects of zirconium conversion coating on the surface defect transmission and the corrosion resistance of the sheet were investigated. The results showed that although the defects were detected and recognized after the treatment, the coating was able to grow normally at the surface of small defects and effectively improve the corrosion resistance of the defects. The surface corrosion resistance for some types of defects was basically equivalent to that of the intact surfaces.
Crystallographic Textures of Al and Al-Mg Alloy Formed by Shot-Peening
Authors: Sato Hisashi , Mihara-Narita Mami , Watanabe Yoshimi , Motozuka Satoshi
Published: December 2023

Shot-peening (SP) is one of the severe surface plastic deformation (SSPD) processing techniques. Due to large plastic strain by the SP, the SP for metallic materials forms crystallographic texture on the peened surface. Since the crystallographic texture formed by the SP depends on the dislocation slip, it can be expected that this texture is affected by stacking fault energy (SFE) of the materials. However, effects of the SFE on the crystallographic texture formed on the peened surface by the SP is not clear. In this study, crystallographic textures of pure Al (higher SFE) and Al-10 mass%Mg alloy (lower SFE) formed by the SP are investigated. When the pure Al is SPed, {001}+{111} double fiber texture with the <001> and <111> directions parallel to the plane normal direction of the peened surface is obtained. On the other hand, in the case of Al-10 mass%Mg alloy with the SFE close to the pure Cu, {110} fiber texture is formed as well as the pure Cu. Therefore, it is found that the crystallographic texture formed by the SP is influenced by the SFE.
Effects of a 4-week Multicomponent Exercise (Vivifrail) on Predicted Maximum Oxygen Consumption and Fatigue Levels in the Elderly with Frailty Syndrome: A Randomized Controlled Trial
Authors: Hartantri Wico , Andriana R. A. Meisy , Andriati  , Satyawati Rwahita , Mikami Yukio , Melaniani Soenarnatalina
Published: December 2023

Introduction:

Frailty syndrome (FS) impairs cardiorespiratory fitness, physical capacity, and disability in the elderly population. Vivifrail, a multicomponent exercise, has shown significant benefits for FS management, but research in the Asian population is still limited. This study aims to see how 4-week Vivifrail program affects predicted maximum oxygen consumption (VO2max) and fatigue levels in the elderly with FS.

Methods:

This randomized controlled trial included 47 participants with FS living in a nursing home in Surabaya, Indonesia. The participants were randomly assigned to either the Vivifrail group (VG) and the control group (CG). The VG followed the 5 days a week Vivifrail program combined with 15 min daily group-based conventional exercise for 4 weeks. The CG was only given the conventional exercise. Six-minute walking test and the Indonesian version of the Fatigue Severity Scale (FSS-I) were measured to assess VO2max dan and fatigue levels before and after the 4-week intervention.

Results:

After 4 weeks of intervention, a significant increase in VO2max and decrease in FSS-I were found in the VG (P = 0.021 and P = 0.002, respectively), whereas no significant changes in VO2max or FSS-I were found in the CG (P = 0.170 and P = 0.052). However, there was no statistically significant difference in VO2max between groups (P = 0.716), but the decline of FSS-I between groups was statistically significant (P = 0.001).

Conclusions:

The addition of Vivifrail exercise for 4 weeks can improve cardiorespiratory fitness and decrease fatigue levels. This supports the routine use of Vivifrail for Indonesian elderly with FS who live in nursing homes.
Outcome of Kidney Trauma Management: Experiences from a Tertiary Referral Hospital in East Indonesia
Authors: Azmi Yufi Aulia , Irsayanto Danang , Soetanto Kevin Muliawan , Renaldo Johan , Wirjopranoto Soetojo
Published: December 2023

Introduction:

Due to the high mortality and morbidity, kidney trauma ranks third among causes of abdominal solid organ injury, accounting for 24% of cases. In terms of trauma patient profiles, including trauma kinds, diagnoses, and management techniques, middle-income nations like Indonesia have distinctive characteristics. In order to improve the kidney trauma database in Indonesia, particularly in Surabaya, this study examines the 7-year treatment results for renal trauma at a tertiary referral hospital.

Methods:

The Department of Urology at Dr. Soetomo General-Academic Hospital handled 116 renal trauma patients over the course of 7 years (2013–2020), and secondary data from these cases were analyzed in this retrospective single-institution analysis. Age, gender, hemodynamic status, injury site, kidney damage score from the American Association for the Surgery of Trauma (AAST), related organ injury, treatment, and treatment outcomes are among the variables.

Results:

Total 116 patients with kidney trauma recorded. 89% of patients in hospitals are male, with male adolescents 20 years of age or under making up about 42% of this group. The majority of cases (94.8%) were caused by motor vehicle accidents (MVAs). Grade I trauma was encountered by nearly half of all patients (43.1%). Abdominal injuries made up the majority of cases (47.9%). Both low- and high-grade AAST injury groups showed stable hemodynamic status (71.3%, P = 0.36), low mortality (71.4%, P = 1.00), and conservative therapy (74.2%, P = 0.40).

Conclusion:

The majority of kidney trauma cases were discovered in men, were MVA-related, and involved severe damage in addition to preexisting injuries. Adult trauma centers should employ nonoperative treatment for low-grade and high-grade renal trauma.
Reconstruction of Defects on Post Electric Burn Injury Scalp with Bone Exposed: Case Series
Authors: Pratama Yanuar Ari , Saputro Iswinarno Doso , Aung Zin Mar
Published: December 2023

Electrical burns typically result in severe tissue damage at a localized area, where the generated heat can lead to necrosis of one or both calvarial tables. This study reports four cases with scalp defects due to electrical burns reconstructed. In all cases, the scalp was the entrance site. A local flap and a skin graft were used to cover scalp defect and secondary defect, respectively. At 5–7 days postoperative, the flap survived with no necrosis or complications; satisfactory cosmesis and preservation of scalp contour were achieved. Successful scalp reconstruction requires meticulous preoperative planning and precise intraoperative execution, thus needing a reconstructive ladder. For scalp reconstruction, local transposition flaps are the best option as the adjacent tissue is of comparable quality to the defect tissue and has good contour preservation, low donor site morbidity, and satisfactory cosmesis.
Effect of Light-Intensity Cycle Ergometer Aerobic Exercise on 2-Min Walking Test Distance and Maximum Oxygen Uptake in Myasthenia Gravis Patients: A Randomized Controlled Trial
Authors: Anggarini Yunita Dwi , Poerwandari Dewi , Narasinta Inggar , Sugianto Paulus , Mazlan Mazlina , Melaniani Soenarnatalina , Kartika Lisa , Bin Satri Muhammad Suhail
Published: December 2023

Introduction:

Fatigue and impaired functional capacity are more likely to be observed with myasthenia gravis (MG). MG prevalence in the Indonesian population is still limited. MG can benefit from participating in aerobic exercise without causing a decline in function, but relatively few exercise training studies have been conducted in this group of patients. This study analyzed how light-intensity cycle ergometer aerobic exercise influences functional and aerobic capacity in MG.

Methods:

An 8-week randomized controlled trial using a light-intensity cycle ergometer for aerobic exercise three times a week was carried out on adult patients with MG Foundation of America Class I-IIa, and adult patients. Eighteen MG patients were randomly assigned to the intervention or control group (standard exercise training). Two-min walking tests (2MWTs) distance and maximum oxygen uptake (VO2Max) were measured before and after the 8-week intervention. VO2Max was calculated from the 2MWT formula. A t-test was used to compare 2MWT distance and VO2Max within and between groups with a significance level of P < 0.05.

Results:

Light intensity cycle ergometer aerobic exercise significantly improved the functional and aerobic capacity in the intervention group at 8 weeks (2MWT distance P = 0.001 and VO2Max
P = 0.001) but not in the control group (P = 0.523 and P = 0.575, respectively). Substantial changes were also found between groups in both 2MWT distances (P = 0.002; effect size = 1.75) and VO2Max (P = 0.001; effect size = 1.81) pre- and post-test.

Conclusion:

Eight weeks of light-intensity cycle ergometer aerobic exercise improves the functional and aerobic capacity of adult MG patients.
Impact of Caregiver’s Burden of Children with Asthma: A Systematic Review
Authors: Mathiazhakan Ushapriya , Abirami Ponnusamy
Published: December 2023

Background: Caregiver stress can have a number of detrimental effects, such as physical health problems, mental health difficulties, and a lower overall quality of life. Stress among caregivers is a public health concern because of its relation to higher costs for the person, family, and the healthcare system. Aim: The aim of this review is to analyze the impact of caregiver burden of parents who have a child with asthma. Methods: The electronic databases PubMed, Cochrane Library, and the Web of Science databases were searched to access related articles. Searching was understood and the articles published between 2011 and 2020 were selected. The search terms used in databases were "Caregiver Burden" [Mesh] OR Caregiver Burdens [tiab] OR Care Burden [tiab] OR "Social Support" [Mesh] OR "Stress, Psychological" [Mesh] OR Psychological Stresses [tiab] OR Psychologic Stress [tiab] OR Psychological Stressor [tiab] OR AND "Quality of Life" [Mesh] OR Health-Related Quality Of Life [tiab] OR Health Related Quality Of Life [tiab] OR HRQOL [tiab] AND “Asthma" [Mesh] OR Bronchial Asthma [tiab] OR childhood asthma [tiab] AND "parents/education" [MeSH Terms]. The quality evaluation of the studies was performed by independent reviewer utilizing Joanna Briggs Institute Critical Appraisal Checklists’. Results: Initially, 46 studies that met the searching strategies stated above were found on databases. Eighteen of them remained following the analysis of their abstracts according to inclusion criteria. All the articles were published in English and out of them 18 studies were of descriptive design. Conclusion: Caring for an asthmatic child obviously has a negative influence on parents as caregivers. One of the study’s most notable findings is that asthma affects both the youngster and his primary caregiver. Second, there is a scarcity of information on interventional strategies for asthmatic children’s caregivers. Appropriate caregiving intervention programmes targeted at promoting caregiver well-being will be necessary in the future. The goals of these programmes should be to help parents improve their disease management abilities, their quality of life, and their daily routines. All of the planned initiatives will surely improve the quality of life for both parents and children.
Dietitians’ and nutritionists’ knowledge of nutritional genomics and perception toward genetic testing for a personalized approach in noncommunicable diseases (NCDs) prevention and management in India: A cross-sectional survey
Authors: Mathew Mary Raju , Medithi Srujana , Muley Arti
Published: December 2023

Objective: Dietitians and nutritionists have been identified as healthcare professionals who are well positioned to interpret and communicate aspects of nutritional genomics into practical and effective dietary recommendations. Therefore, the present study aimed to assess dietitians’ and nutritionists’ knowledge of essential concepts in nutritional genomics; and perceptions toward genetic testing. Methods: Prospective cross-sectional study was conducted among dietitians and nutritionists using an online questionnaire. The data were analyzed using descriptive and analytical statistics. Results: About 142 dietitians and nutritionists were included in the study. The majority of the respondents were female (88%). Around 61.3% had work experience ranging between 1 and 5 years. The knowledge score on nutritional genomics indicated 9% (n = 13) of them scored high, 42% (n = 59) scored medium, and 49% (n = 70) scored low scores. The average knowledge score was 42.3%, indicating a low level of knowledge of genetics and nutritional genomics. The mean perception was 3.85 on a scale from 1 (extremely negative) to 5 (extremely positive), which may be an overall positive perception of applying nutritional genomics into practical and effective dietary recommendations. The findings revealed a statistically significant link between knowledge and perception level, on-job training, and continuing education in nutritional genomics. Perception scores were shown to be positively associated with higher knowledge levels. Conclusions: Dietitians and nutritionists have low knowledge but a high perception level of nutritional genomic. Most of them were informed about nutrigenomics and had a favorable opinion, regardless of whether they had previously studied nutrigenomics as a college-level subject.
Development of regression models to study the effect of osmotic dehydration process in Amla (Emblica officinalis) pieces with spices during processing and stability studies
Authors: Govindarajan Nagamaniammai , Kumarasamy Ramasamy , Arumugam Subarayan , Jeyaprakash Suresh Kumar , Senthilkumar Navin Venketeish Kottur
Published: December 2023

This paper aims to study the effectiveness of variables on process development and stability study under atmospheric condition for freeze-dried (FD) and tray-dried (TD) osmotically dehydrated (OD) amla (Emblica officinalis) with spices. Amla pieces were soaked in brine containing fenugreek powder, cumin seed powder, and fresh ginger extracts for OD process. Then, amla samples were FD at −50 °C for 13 h under 10−3 mbar pressure and TD at 50 °C ± 3 °C for 13 h. Multiple regression models were developed for biochemical and microbial parameters of amla. FD and TD samples were packed in 0.05 mm thickness low-density polyethylene pouches and stored at 35 °C ± 3 °C temperature for 60 days. The moisture content of the sample increases slightly with higher regression coefficient for FD (0.046) sample than TD (0.038) sample. The regression models established positive correlation with acidity of TD and FD samples with coefficient 0.004 and 0.005, respectively. It also indicated that 0.002 increase in pH reduces the shelf life of the products. Ascorbic acid and tannin content of the dried samples followed negative nonlinear trend. The paired t test showed no significant difference (p ≤ 0.05) between TD and FD amla pieces during the study period.
The Influence of Noise Exposure at Different Loudness Levels on EEG Index and Types of Attention
Authors: Mohammadi Zahra , Jafari Mohammad Javad , Khavanin Ali , Jafarpisheh Amir Salar , Ameri Ali , Pouyakian Mostafa
Published: December 2023

Bachground:

Noise is one of the most important harmful factors in the environment. There are limited studies on the effect of noise loudness on brain signals and attention. The main objective of this study was to investigate the relationship between exposure to different loudness levels with brain index, types of attention, and subjective evaluation.

Methods:

Four noises with different loudness levels were generated. Sixty-four male students participated in this study. Each subject performed the integrated visual and auditory continuous performance test (IVA-2) test before and during exposure to noise loudness signals while their electroencephalography was recorded. Finally, the alpha-to-gamma ratio (AGR), five types of attention, and the subjective evaluation results were examined.

Results:

During exposure to loudness levels, the AGR and types of attention decreased while the NASA-Tax Load Index (NASA-TLX) scores increased. The noise exposure at lower loudness levels (65 and 75 phon) leads to greater attention dysfunction than at higher loudness. The AGR was significantly changed during exposure to 65 and 75 phon and audio stimuli. This significant change was observed in exposure at all loudness levels except 85 phon and visual stimuli. The divided and sustained attention changed significantly during exposure to all loudness levels and visual stimuli. The AGR had a significant inverse correlation with the total score of NASA-TLX during noise exposure.

Conclusions:

These results can lead to the design of methods to control the psychological effects of noise at specific frequencies (250 and 4000 Hz) and can prevent non-auditory damage to human cognitive performance in industrial and urban environments.
Epidemiology and changing trends of sexually transmitted diseases over the past 17 years in a tertiary care center
Authors: Mendiratta Vibhu , Meena Amit Kumar , Verma Damini
Published: December 2023

Introduction:

Sexually transmitted diseases (STDs) continue to be a major public health problem with significant burden on the society. Some of this can be attributed to our lack of knowledge about the change of disease spectrum from time to time.

Aims:

The aim of the study was to understand the changing pattern of STDs over the past 17 years (2003–2019).

Materials and Methods:

It was a retrospective study where data of patients who attended our Suraksha Clinic from 2003 to 2019 were collected. All the cases were subjected to detailed history, examination, and investigations done to rule out STDs.

Results:

A total of 2436 patients were included in the study. The majority of the patients were in the age group of 18–30 years. The most frequent diagnosis was vulvovaginal candidiasis, followed by herpes genitalis. 3.3% of patients had human immunodeficiency virus. 4.8% of patients were men sex men (MSM). Overall, viral STDs were most common, followed by fungal and bacterial. To understand the changing trends, data were divided into different phases according to the time period. During Phase 1 (2003–2007), viral STDs were most common, followed by bacterial and fungal. However, this trend changed in Phase 4 (2016–2019) and fungal STDs became most common.

Conclusions:

Despite numerous health initiatives, the number of STD cases is rising day by day. The increasing number of MSM over the study period necessitates dedicated efforts to address the health needs of this population. The National AIDS Control Organization should take necessary measures and steps to address the overall increase in STDs considering recent trends showing a drop in bacterial STDs and an increase in fungal and viral STDs.
Sexually transmitted infections with Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis in pregnant women as detected by molecular testing
Authors: Filho Antônio Chambô , Assis Marcos Cinthia Rafaela Santos , Colnago Jéssica Maria , Miranda Angélica Espinosa Barbosa , Duarte Júlia Nascimento , Peruchi Luiza Spinassé
Published: December 2023

Context:

During pregnancy, sexually transmitted infections can be transmitted vertically to the fetus, leading to an increase in morbidity and mortality for both mother and child.

Aims:

This study aimed to determine the profile of cervical and vaginal infections in pregnant women receiving prenatal care in a single institute.

Settings and Design:

The study was conducted in a tertiary hospital. Molecular testing was used to detect Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis.

Materials and Methods:

Samples of vaginal secretions were collected from pregnant women using the Aptima® Multitest Swab Specimen Collection kit to test for the pathogens. The inclusion criteria consisted of pregnant women of 15–45 years of age receiving prenatal care at the institute, irrespective of gestational age, who agreed to provide vaginal swab. The exclusion criterion was the use of antibiotics in the preceding 3 months.

Statistical Analysis:

Frequencies and percentages were calculated for the pathogens detected in the samples evaluated.

Results:

Overall, 200 samples were tested. Of the pathogens detected, there was a predominance of T. vaginalis (15.5% of the samples) and C. trachomatis (14.5%), followed by M. genitalium (10.0%) and N. gonorrhoeae (0.5%).

Conclusion:

Identifying the microorganisms present in the microbiota of pregnant women is of the utmost importance in assuring the appropriate treatment for each pathogen, thus avoiding complications both for the woman and for her fetus. These results should serve to stimulate the debate on implementing these tests as routine during prenatal care.
Trends in genital ulcer disease
Authors: Patel Zalak R. , Makwana Vaishali S. , Bhadja Sejal G. , Tundiya Hiral J. , Vyas Aniruddha P.
Published: December 2023

Introduction:

Genital ulcer disease (GUD) often creates diagnostic difficulty in developing countries like India, with limited resources available in the health-care system. The changing etiology in GUDs over the years makes it imperative that a correct diagnosis is made to establish appropriate treatment and formulate awareness programs.

Aims:

This study was done to determine the recent trends in the demographic parameters, clinical presentations, etiology of GUDs, and their association with human immunodeficiency virus (HIV).

Materials and Methods:

An observational cross-sectional study was conducted from October 2021 to August 2022 at the Dermatology Outpatient Department in our hospital. All the patients who presented with GUDs were included after written informed consent. The diagnosis of GUD was confirmed by thorough clinical examination and appropriate laboratory test. Data were entered and analyzed using IBM SPSS software.

Results:

Out of 135 cases of GUDs, the majority were males (79%). The most common age group was 21–30 years, with a mean age of 35.23 ± 14.98 years. Most of the patients were heterosexual (90%). Multiple sexual partners were found in 40% of cases. Herpes genitalis was the most common GUD (59%), followed by syphilis (15%). HIV infection was found in 6.6% of cases.

Conclusion:

This study represents the increasing burden of viral GUDs compared to the last three decades. The ulcerative sexually transmitted infection facilitates the transmission of HIV. In this HIV era, there is a need for increased efforts toward acknowledgment, safe sexual practices, periodic screening, and sexual health awareness programs in the high-risk population.
Pediatric human immunodeficiency virus infection presenting as symptomatic hypocalcemia
Authors: Shambhavi  , Nikita  , Shankar Akshay
Published: December 2023

Mother to child transmission still accounts for thousands of children being affected with human immunodeficiency virus (HIV) yearly. These children are often detected late in their disease course, most commonly presenting as protein energy malnutrition. Here we present a unique pediatric case who presented with severe symptomatic hypocalcemia. The case highlights the importance of vitamin D and calcium screening in this subgroup of HIV patients.
Cutaneous cryptococcosis in an adult male of sub-saharan origin
Authors: Thakur Rameshwari , Kalsi Avneet Singh , Kushwaha Pragya
Published: December 2023

Cryptococcosis is caused by the inhalation of the desiccated encapsulated yeast or basidiospores, which are found in the environment. After the infectious particles reach the lungs, get disseminated hematogenously in various organs. Meningoencephalitis is one of the most common manifestations, especially in sub-Saharan Africa. The dermal lesions can be either primary due to the traumatic implantation of infectious propagule or secondary in patients with disseminated infection due to cryptococcus. The typical presentations of the cutaneous lesions are like umbilicated lesions of molluscum contagiosum. The dermal lesions can also be similar to Kaposi sarcoma or talaromycosis (formerly penicilliosis). Here, we present a 34-year-old male HIV-positive and antiretroviral therapy-naive. The patient had a very low CD4 cell count and a high viral load. The patient was referred to the dermatology clinic for multiple eruptions due to umbilicated skin colored lesions 3–5 mm in diameter on the nose. The patient was first treated for the opportunistic infection. The causes of the dermal umbilicated skin lesions are several. We must find out whether the dermal lesion is due to infection with a single organism or more than one. It can be colesional also. Punch biopsy, India ink, and culture on Sabouraud dextrose agar confirmed the diagnosis of Cryptococcus neoformans.
Follmann balanitis – A very rare presentation of primary syphilis
Authors: Arunprasath P. , Someshwaran R. , Mahadevan K. , Babu N. Prasanna , Ashwathi S.
Published: December 2023

Syphilis is a sexually transmitted infection caused by Treponema pallidum. The primary stage of the disease manifests as a chancre. Balanoposthitis as a presenting feature of primary syphilis is a very rare presentation. A 26-year-old male presented with asymptomatic erythematous plaques involving the glans and prepuce after unprotected intercourse with a known female. Routine investigations, serology, and dark field examination were normal. Fontana-Masson stain revealed spirochetes and a diagnosis of syphilitic balanitis of Follmann was entertained. This rare presentation accounts for only 0.3%-0.5% of cases of primary syphilis and hence is highlighted in this case report.
Design and Development of a Low-cost Integrated Dosimeter for External Beam Dosimetry in Radiation Oncology
Authors: Chant Tim , Ramachandran Prabhakar
Published: December 2023

Radiation dosimeters play a crucial role in radiation oncology by accurately measuring radiation dose, ensuring precise and safe radiation therapy. This study presents the design and development of a low-cost printed circuit board (PCB) dosimeter and an integrated electrometer with sensitivity optimized for dose rates intended for use in megavoltage radiation therapy. The PCB dosimeter was designed in KiCad, and it uses a low-cost S5MC-13F general-purpose 1 kV 5A power diode as a radiation detector. The dosimeter is calibrated against a known dose derived from an ionization chamber and tested for dose linearity, dose rate dependence, field size dependence, and detector orientation dependence. The observed average dose differences between the delivered and measured doses for most measurements were found to be < 1.1%; the dose rate linearity between 100 MU/min and 1400 MU/min was found to be within 1.3%. This low-cost architecture could successfully be adapted further for a scalable, cost-effective dosimetry solution through firmware or circuit design.
Overcoming Problems Caused by Offset Distance of Multiple Targets in Single-isocenter Volumetric Modulated Arc Therapy Planning for Stereotactic Radiosurgery
Authors: Ito Takaaki , Kubo Kazuki , Monzen Hajime , Yanagi Yuya , Nakamura Kenji , Sakai Yusuke , Nishimura Yasumasa
Published: December 2023

Purpose:

The purpose of the study is to investigate the impact of large target offset distances on the dose distribution and gamma passing rate (GPR) in single-isocenter multiple-target stereotactic radiosurgery (SIMT SRS) using volumetric modulated arc therapy (VMAT) with a flattening filter-free (FFF) beam from a linear accelerator.

Methods:

Two targets with a diameter of 1 cm were offset by ”±2, ±4, and ±6 cm from the isocenter in a verification phantom for head SRS (20 Gy/fr). The VMAT plans were created using collimator angles that ensured the two targets did not share a leaf pair from the multi-leaf collimator. To evaluate the low-dose spread intermediate dose spill (R50%), GPRs were measured with a criterion of 3%/2 mm using an electronic portal imaging device and evaluated using monitor unit (MU), modulation complexity score for VMAT (MCSv), and leaf travel (LT) parameters.

Results:

For offsets of 2, 4, and 6 cm, the respective parameters were: R50%, 4.75 ± 0.36, 5.13 ± 0.36, and 5.11 ± 0.33; GPR, 95.01%, 93.82%, and 90.67%; MU, 5893 ± 186, 5825 ± 286, and 5810 ± 396; MCSv, 0.24, 0.16, and 0.13; and LT, 189.21 ± 36.04, 327.69 ± 67.01, and 430.39 ± 114.34 mm. There was a spread in the low-dose region from offsets of ≥4 cm and the GPR negatively correlated with LT (r = −0.762). There was minimal correlation between GPR and MU or MCSv.

Conclusions:

In SIMT SRS VMAT plans with an FFF beam from a linear accelerator, target offsets of <4 cm from the isocenter can minimize the volume of the low-dose region receiving 10 Gy or more. During treatment planning, it is important to choose gantry, couch, and collimator angles that minimize LT and thereby improve the GPR.
The role of serum lipid profile, fasting blood sugar, and body mass index on recurrence and metastasis in patients with estrogen receptor-positive breast cancer: A case–control study
Authors: Mohammadbeigy Iman , Khalilian Mohammad Sadegh , Najafizadeh Nadia , Moazam Elham , Hemati Simin , Zeinalian Mehrdad
Published: December 2023

Background:

Breast cancer (BC) is the leading cause of cancer death in women. The current study is designed to evaluate the association of lipid profiles, FBS, and body mass index (BMI) with BC recurrence and metastasis.

Materials and Methods:

This is a case–control study on estrogen receptor-positive BC patients in Isfahan Province, Central Iran, between 2008 and 2020. The control group was patients who had no evidence of recurrence or metastasis at least 1 year after the end of chemotherapy and hormone therapy. The case group was patients with evidence of metastasis or recurrence within 1 year after the end of chemotherapy and hormone therapy. Fasting blood sugar (FBS), total cholesterol (Chol), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured before treatment, after chemotherapy, and after hormone therapy as well as BMI in the case and control groups.

Results:

There were 108 patients in the case and 119 patients in the control group with a mean age of 50.72 ± 13.26 and 51.91 ± 11.79, respectively. There were no meaningful differences between the case and control groups regarding serum FBS, Chol, TG, HDL, LDL, and BMI.

Conclusion:

We found no association between serum FBS, lipid profile, and BMI at initial diagnosis and BC recurrence or metastasis.
Moving from specialist-led to generalist-led hospital care: propensity-matched analyses of clinical outcomes and survey of patient care experiences
Authors: Lim Yee Wei , Neo Sin Hui , Teo Ee Lin Kimberly , Tan Cherylanne , Chong Lin Siew , Bundele Anjali , Sumner Jennifer
Published: December 2023

Introduction:

In this study, we aimed to compare the clinical outcomes of patients who received care under a new generalist-led hospital care model — the Integrated General Hospital (IGH) — with those receiving care under the usual specialist-led hospital model, and to examine patients’ care experiences of the IGH model.

Methods:

A retrospective propensity-matched analysis comparing attendees of IGH (n = 2,127) and usual care attendees at a different hospital (n = 2,127) was conducted between 1 January 2019 and 31 August 2019. Clinical outcomes included length of stay, 30-day readmission, inpatient mortality and mortality within 30 days of discharge. In addition, a patient survey on IGH care experiences (n = 270) was conducted between 7 October 2019 and 12 April 2021. A two-sample t-test or chi-square test was used to compare the matched samples. For time-to-event variables, a Cox proportional hazards model was used to estimate the hazard ratio with 95% confidence intervals.

Results:

After propensity-matching, statistically significant differences were found between the IGH and usual care groups for length of stay (P = 0.003), inpatient mortality (P = 0.007) and mortality within 30 days of discharge (P = 0.014), but not for 30 day readmission (P = 0.456). The hazard ratio for 30-day readmission was 0.94 (P = 0.46) and for mortality within 30 days of discharge was 0.51 (P = 0.01). Survey responses on IGH care found the care experiences were generally positive, particularly in terms of provider–patient communication and perceived staff teamwork.

Conclusion:

Initial analysis of the IGH model was associated with better clinical outcomes in some respects compared with the usual care model. Patient care experiences of IGH were also favourable. An ongoing prospective study will explore the longer-term clinical impact of the IGH care model, including the effect on postdischarge care and care continuity.
Cycles in graphs with geometric property (T)
Authors: Winkel Jeroen
Published: December 2023

We show that a sequence of graphs with uniformly bounded vertex degrees, number of vertices going to infinity, and with geometric property (T) has many small cycles. We also show that when a small part of such a sequence of graphs with geometric property (T) is changed, it still has geometric property (T), provided that it is still an expander. We use this to give an example of a sequence of graphs with geometric property (T) that has large cycle-free balls.
Can Outreach Training and Supportive Supervision Improve Competency in Malaria Service Delivery? An Evaluation in Cameroon, Ghana, Niger, and Zambia
Authors: Ashton Ruth A. , Worges Matt , Zeh Meka Albert , Yikpotey Paul , Domkam Kammogne Irenee , Chanda-Kapata Pascalina , Vanderick Caroline , Streat Elizabeth , Yukich Joshua
Published: December 2023

Outreach Training and Supportive Supervision (OTSS) of malaria services at health facilities has been adopted by numerous malaria-endemic countries. The OTSS model is characterized by a hands-on method to enhance national guidelines and supervision tools, train supervisors, and perform supervision visits. An independent evaluation was conducted to evaluate the effectiveness of OTSS on health worker competence in the clinical management of malaria, parasitological diagnosis, and prevention of malaria in pregnancy. From 2018 to 2021, health facilities in Cameroon, Ghana, Niger, and Zambia received OTSS visits during which health workers were observed directly during patient consultations, and supervisors completed standardized checklists to assess their performance. Mixed-effects logistic regression models were developed to assess the impact of increasing OTSS visit number on a set of eight program-generated outcome indicators, including overall competency and requesting a confirmatory malaria test appropriately. Seven of eight outcome indicators showed evidence of beneficial effects of increased OTSS visits. Odds of health workers reaching competency thresholds for the malaria-in-pregnancy checklist increased by more than four times for each additional OTSS visit (odds ratio [OR], 4.62; 95% CI, 3.62–5.88). Each additional OTSS visit was associated with almost four times the odds of the health worker foregoing antimalarial prescriptions for patients who tested negative for malaria (OR, 3.80; 95% CI, 2.35–6.16). This evaluation provides evidence that successive OTSS visits result in meaningful improvements in indicators linked to quality case management of patients attending facilities for malaria diagnosis and treatment, as well as quality malaria prevention services received by women attending antenatal services.
External Synchronization of Distributed Redundant Flight Control Computers
Authors: Khozin Mokhamad , Holzapfel Florian
Published: December 2023

This work introduces a practical approach to external synchronization for flight control computers (FCCs) deployed in a decentralized fashion. The internal synchronization among the FCCs in distributed flight control systems needs to be extended for specific applications, necessitating an urgent need for an external synchronization mechanism. For instance, when the air data and attitude reference system (ADAHRS) and the flight control computer (FCC) are not synchronized, a dead time or time offset occurs between the time the ADAHRS transmits data and the time the FCC begins executing its control functions, which can impair flight control system performance or even cause system instability, particularly for the system with incremental control approaches, such as incremental nonlinear dynamic inversion (INDI). Therefore, an external synchronization technique that does not rely on establishing a global view of time that is accurately synchronized with an external reference device has been proposed and implemented for distributed flight control systems. The findings of the implemented system demonstrate that the suggested approach can synchronize the distributed FCCs to an external reference device with high synchronization precision and deal with varying clock drift rates.
Some Early Soyinka Letters
Authors: Lindfors Bernth
Published: December 2023

Among the papers of James Simmons held at the Rose Library of Emory University are nine letters he received from Wole Soyinka as well as one from Soyinka’s British partner, Barbara Dixon, both of whom had been his classmates at Leeds University in the mid-1950s. The letters cover Soyinka’s activities from July 29, 1958, a year after he had graduated from Leeds, until January 13, 1960, just after he returned to Nigeria. During this period Soyinka had worked as a broadcaster for the BBC, been a play reader for the Royal Court Theatre, and a teacher in London schools. He also travelled to Paris seeking employment as a singer. Much of this time he and Barbara were under financial pressure, and their relationship eventually broke up a year after their child had been born. These letters and others like them from later years in his life yield vital information for Soyinka’s future biographers.
Literary Byways in Duncan Brown’s Finding My Way: A Review Essay
Authors: Klopper Dirk
Published: December 2023

No Abstract