bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Value of Urinary Neutrophil Gelatinase-Associated Lipocalin in Detection of Severe Acute Kidney Injury in Critically Ill Children
Authors: Roy Aniket , Sarkar Mihir , Nandi Mousumi , Raut Sumantra
Published: June 2023

Aims and Objectives:

The primary objective was to determine the positive and negative predictive values, sensitivity, and specificity of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for diagnosis of severe acute kidney injury (AKI). The secondary objectives were to find the association between uNGAL with day-3 cumulative fluid balance (CFB), requirement of kidney replacement therapy (KRT), and length of pediatric intensive care unit (PICU) stay.

Materials and Methods:

In this prospective cohort, uNGAL was done by chromatography on patients admitted at PICU in a tertiary care hospital with Pediatric Risk of Mortality III (PRISM III) score of >10. AKI was defined by KDIGO 2012 criteria. Urinary NGAL was done on all patients (>3 months to ≤12 years) with PRISM III score >10 on day 1 and day 3 of PICU admission who had no AKI on admission.

Results:

Out of 288 patients admitted with PRISM III score >10 and normal kidney function on admission, 58.3% developed AKI and 29.9% developed severe AKI. Day-3 uNGAL was found to be superior to day-1 uNGAL in detecting AKI with 96.4% sensitivity, 84.4% specificity, 85.04% PPV, and 96.26% NPV. The percentage increase in day-3 CFB and risk of requiring KRT was significantly (P < 0.001) higher in the groups with raised day-1 uNGAL and day-3 uNGAL. The length of PICU stay was significantly correlated to the group with raised day-3 uNGAL (P < 0.001).

Conclusion:

Urinary NGAL had a good predictive value in detecting severe AKI in critically ill children. It is also associated with requirement of KRT and day-3 CFB. Duration of PICU stay was significantly associated with day-3 uNGAL (P < 0.001).
Prevalence of Bladder Bowel Dysfunction in Children with Autism Spectrum Disorder and Response to Urotherapy
Authors: Kalra Suprita , Bamal Manu , Sharma Aditi , Gupta Aparajita , Goswami Jyotindra Narayan
Published: June 2023

Background:

Children with autism spectrum disorder (ASD) have a high prevalence of bladder bowel dysfunction (BBD), with symptoms including urinary incontinence, dribbling, voiding postponement, constipation, and encopresis. BBD is, however, underdiagnosed and has been studied prospectively in few studies.

Methodology:

All children, aged 2–14 years, diagnosed with ASD using the Childhood Autism Rating Score (CARS), were reviewed in the outpatient department and objectively evaluated for lower urinary tract symptoms using the dysfunctional voiding and incontinence symptoms score, and presence of constipation using the Rome IV criteria. The presence of voiding dysfunction and/or constipation was correlated with the severity of ASD. All children with BBD were advised standard urotherapy and followed up for improvement over the next 3 months. Adherence to the prescribed urotherapy was assessed using the Brief Adherence Rating Scale (BARS) adapted for children with ASD.

Results:

Of 54 children included, 40 (70.1%) were boys. The mean ± standard deviation of age was 7.5 ± 2.5 years. ASD was mild to moderate in 24 children and severe in 30 children. Nineteen (35.2%) patients had constipation, including four with mild-to-moderate ASD and 15 with severe ASD. Seventeen (31.5%) patients had voiding dysfunction, including nine who could not be toilet trained, and 12 of these patients had moderate-to-severe ASD. Ten (18.5%) patients had both constipation and voiding dysfunction. The presence of voiding dysfunction and/or constipation correlated with the severity of ASD (correlation coefficient 0.55). Adherence to urotherapy correlated inversely with CARS. Children with BARS score >70 showed improvement in constipation and/or voiding dysfunction.

Conclusions:

Children with ASD have a high prevalence of BBD, and the presence of BBD correlates strongly with the severity of ASD. Children with ASD should be evaluated for BBD and managed appropriately to prevent associated morbidity.
Quality of Life assessment among post-COVID-19 undergraduates of a tertiary institution in India
Authors: Ibirogba Damilola , Dinesh Avani , Jose Ankitha , Bisheko Muganyizi J
Published: June 2023

Background:

The coronavirus disease (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 virus has been devastating, with over a billion confirmed cases and seven million deaths globally. Studies suggest that the virus can be transmitted through fecal-oral routes, in addition to respiratory transmission. Survivors of COVID-19 often experience long-term symptoms known as post-COVID-19 syndrome, which can have a significant impact on their Quality of Life (QOL) for years after infection. This study aims to evaluate the QOL of undergraduate students who have experienced post-COVID-19 syndrome and identify any associated risk factors.

Materials and Methods:

The EQ-5D-5L questionnaire was distributed to undergraduate students via online platforms using convenience sampling. The survey received 213 responses (76.5% of whom were women and 22.5% were men). The questionnaire included the health dimensions and levels, as well as the Euro quality of life visual analogue scale. Socio-demographic and clinical data were also included. All statistical analyses were carried out using the Statistical package for the social sciences statistical software.

Results:

With a mean and standard deviation age of 19 ± 1.3, we discovered that 131 (61.5%) of our respondents have a poor QOL, whereas 82 (38.5%) have a good QOL. Furthermore, 5.1% of respondents stated that they have no post-COVID symptoms. The most common symptoms among those who presented symptoms were fatigue (99.6%) and hair loss (92.4%). Among participants, EQ-5D-5L utility scores were distributed as follows: pain/discomfort 58 (27.2%), anxiety/depression 94 (44.1%), usual activities 58 (27.2%), mobility 57 (26.8%), and self-care 32 (15.1%). With a P-value of 0.001, we discovered that students with comorbidities such as asthma, coronary artery disease, and others are further affected post-COVID.

Conclusion:

COVID-19, like every other pandemic, has been shown to have deleterious effects on patients even months after recovery. To this end, it is imperative to monitor closely, the QOL of these patients to understand the long-term impact of the disease on them and also to offer timely interventions.
Pathways of intersection between climate extremes and health risk
Authors: Abhilash S
Published: June 2023

Climate change can lead to a multitude of deleterious effects. These include increase in frequency and severity of heat waves, decline in cold-related mortality, increase in floods and droughts, malnutrition, and changes in the distribution of vector-borne infectious diseases. Climate change adaptation, its mitigation, and human health are intricately linked. Current human activities like urbanization, deforestation, and energy usage will put enormous strain on natural ecosystems, accelerating climate change and having consequences for human health. Yet another harmful environmental element is the loss of biodiversity. The functioning of ecosystems and services that are vital to our health, such as food systems and nontoxic places to live in, is supported by biodiversity. This acknowledges the interdependence and tight relationship among the health of people, domestic and wild animals, plants, and the larger (planetary) environment. Hence, the well-being of the former depends on the well-being of the latter. It is necessary to stop the degradation of flora and fauna that make up the living systems of Earth. All of humanity will be impacted by the effects of climate change. However, as with other social parameters, inequity will result in inequality. Depending on their capacity to adjust to the stressors, different people, societies, and countries will suffer the negative health effects of climate change to varying degrees. A comprehensive plan must prioritize human health, via adaptation to and mitigation of climate change. We must take action, especially to address the issues at their source, particularly at the ecosystem levels. In the context of climate change and health, it is time to activate that old proverb: “Prevention is better than cure.”
Climate change and marine ecosystems: Implications for human health
Authors: Abdulla Mohamed Hatha
Published: June 2023

Despite serious progress in the development of nonconventional energy resources, fossil fuel continues to remain the most convenient source of energy across the globe. Ever-increasing usage of fossil fuels has resulted in a significant increase in the concentration of carbon dioxide in the air, which has resulted in global warming and climate change. While the degree of warming varies across various geographical locations, there is a consensus that the net effect of increasing CO2 emissions is that of warming. Another effect is the increased dissolution of CO2 in sea water resulting in ocean acidification. This has dire consequences for marine life, especially to the calcareous shell-forming organisms such as molluskans. There is also clear-cut evidence that the harmful algal blooms (HABs) are increasing in frequency and intensity, leading to massive fish kills and entry of potential toxins to the food chain, endangering even human life. Warming trends in the subtropics and near-polar regions also favor mesophilic pathogens to extend their range to these regions. The characteristic feature of climate change is the frequent occurrence of extreme weather events. It is a sobering thought that the countries affected, both developed and developing, do not have the wherewithal to fight against the powers of nature and are in danger of incurring losses, both economic and lives.
A Case of Myasthenia Gravis Successfully Treated with Individualized Homoeopathic Treatment - A Case Report
Authors: Srigiri Chakravarthy G. S. , Mundanattu Neelima
Published: June 2023

Myasthenia gravis (MG), an autoimmune disorder affecting receptors on the postsynaptic end-plate, leads to functional disability of end organs. The treatment of MG in conventional system remains still unsatisfactory on account of its after effects on the immune system. Due to lack of advocacy on the effectiveness of homeopathic medicines, a very few cases of neurological diseases like MG opt for treatment. In this case report of refractory MG, after administration of homeopathic potentized Natrum Muriaticum, shown a marked improvement in a brief period without any adverse reaction. The MONARCH score of + 8/11 shows a positive causal relationship between Natrum Muriaticum and treatment outcome. This case report shows the efficacy of classical homeopathy in neuromuscular junction disorders like MG.
Nutritional Status of Underprivileged Indian Children and Youth with Type-1 Diabetes - A Multicentre Study
Authors: Khadilkar Anuradha V. , Oza Chirantap , Mondkar Shruti A. , Khadilkar Vaman , Kanungo Alok , Sethi Bipin K. , Kumar KM Prasanna , Tandon Nikhil , Rao P V , Kumar Surendra , Bandgar Tushar R. , Raghupathy Palany
Published: June 2023

Background:

India has the highest number of prevalent type-1 diabetes (T1D) cases in the under-20-year age population. Data on the anthropometry of underprivileged Indian children with T1D are scarce. In economically disadvantaged countries like India, poor growth in patients with T1D is a major concern due to limited accessibility and affordability. Besides, due to the double burden of malnutrition, the prevalence of obesity is increasing mirroring the global trends, which may lead to the development of insulin resistance.

Objectives:

This study aims to assess the prevalence of malnutrition in Indian children and youth with T1D and to identify the determinants of short stature.

Methods:

A registry-based cross-sectional analysis of data collected from various centres across India enrolled in the Changing Diabetes in Children (CDiC) programme.

Results:

We observed that 6.4% were undernourished (3.4% severe undernutrition) and 17.7% (overweight 13.2%) had combined overweight/obesity. 21.2% of participants had short stature (adjusted for mid-parental height) with 7.4% cases of familial short stature. Longer duration of illness and insulin requirement were significant positive predictors of short stature while glycaemic control, insulin regimen and mid-parental height did not have a significant relationship with short stature. Participants on basal-bolus regimen had significantly higher insulin requirements and better glycaemic control than the ones on mixed-split regimen.

Conclusion:

We report that around one-fifth of children and youth with T1D were overweight/obese and around a fourth were stunted, especially those with longer duration of diabetes and higher insulin requirements. Close monitoring of anthropometric parameters is necessary for all children with T1D to optimize growth and nutrition.
A study on the prevalence of RLS in OSA and the consequences of co-occurrence
Authors: Gothi Dipti , Kumar Rahul , Anand Shweta , Patro Mahismita , Malhotra Nipun , Vaidya Sameer
Published: June 2023

Background:

Restless leg syndrome (RLS) is common among patients with obstructive sleep apnoea (OSA) but the prognostic importance of this is not studied. We have called OSA and RLS coexistence as ComOSAR.

Materials and Methods:

A prospective observational study was done on patients referred for polysomnography (PSG) with the aims to evaluate 1) the prevalence of RLS in OSA and comparing it with RLS in non-OSA, 2) the prevalence of insomnia, psychiatric, metabolic and cognitive disorders in ComOSAR versus OSA alone, 3) chronic obstructive airway disease (COAD) in ComOSAR versus OSA alone. OSA, RLS and insomnia were diagnosed as per respective guidelines. They were evaluated for psychiatric disorders, metabolic disorders, cognitive disorders and COAD.

Results:

Of 326 patients enrolled, 249 were OSA and 77 were non-OSA. 61/249 OSA patients, i.e. 24.4% had comorbid RLS, i.e. ComOSAR. RLS in non-OSA patients was similar (22/77, i.e. 28.5%); P = 0.41. ComOSAR had a significantly higher prevalence of insomnia (26% versus 10.1%; P = 0.016), psychiatric disorders (73.7% versus 48.4%; P = 0.00026) and cognitive deficits (72.1% versus 54.7%, P = 0.016) compared to OSA alone. Metabolic disorders like metabolic syndrome, diabetes mellitus, hypertension and coronary artery disease were also observed in a significantly higher number of patients with ComOSAR versus OSA alone (57% versus 34%; P = 0.0015). COAD was also seen in a significantly higher number of patients with ComOSAR compared to OSA alone (49% versus 19% respectively; P = 0.00001).

Conclusion:

It is essential to look for RLS in patients with OSA as it leads to a significantly higher prevalence of insomnia, and cognitive, metabolic and psychiatric disorders. COAD is also more common in ComOSAR compared to OSA alone.
Role of sleep questionnaires in predicting obstructive sleep apnea amongst interstitial lung diseases patients
Authors: Kamgo Tome , Spalgais Sonam , Ravishankar N , Kumar Raj
Published: June 2023

Introduction:

The co-existence of obstructive sleep apnea (OSA) and interstitial lung diseases (ILD) results in significant morbidity and mortality. So screening for OSA is important for its early diagnosis among ILD patients. The commonly used questionnaires for screening of OSA are Epworth sleep score (ESS) and STOP-BANG. However, the validity of these questionnaires among ILD patients is not well studied. The aim of this study was to assess the utility of these sleep questionnaires in detection of OSA among ILD patients.

Methods:

It was a prospective observational study of one year in a tertiary chest centre in India. We enrolled 41 stable cases of ILD who were subjected to self-reported questionnaires (ESS, STOP-BANG, and Berlin questionnaire). The diagnosis of OSA was done by Level 1 polysomnography. The correlation analysis was done between the sleep questionnaires and AHI. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for all the questionnaires. The cutoff values of STOPBANG and ESS questionnaire were calculated from the ROC analyses. P value of <0.05 was considered to be significant.

Results:

OSA was diagnosed in 32 (78%) patients with mean AHI of 21.8 ± 17.6.The mean age was 54.8 ± 8.9 years with majority being female (78%) and mean body mass index (BMI) was 29.7 ± 6.4 kg/m2. The mean ESS and STOPBANG score were 9.2 ± 5.4 and 4.3 ± 1.8, respectively, and 41% patients showed high risk for OSA with Berlin questionnaire. The sensitivity for detection of OSA was highest (96.1%) with ESS and lowest with Berlin questionnaire (40.6%). The receiver operating characteristics (ROC) area under curve for ESS was 0.929 with optimum cutoff point of 4, sensitivity of 96.9%, and specificity of 55.6%, while ROC area under curve for STOPBANG was 0.918 with optimum cutoff point of 3, sensitivity of 81.2% and specificity of 88.9%.The combination of two questionnaires showed sensitivity of >90%. The sensitivity also increased with the increasing severity of OSA. AHI showed positive correlation with ESS (r = 0.618, P < 0.001) and STOPBANG (r = 0.770, P < 0.001).

Conclusion:

The ESS and STOPBANG showed high sensitivity with positive correlation for prediction of OSA in ILD patients. These questionnaires can be used to prioritize the patients for polysomnography (PSG) among ILD patients with suspicion of OSA.
Childhood Routine Immunization Data in Enugu: Findings from a Quality Assessment Survey
Authors: Ugwu George O. , Bisi-Onyemaechi Adaobi I. , Uche Ezema G , Odii Aloysius , Nympha Enebe O , Joy Ugwu I , Charity Onyishi , Chinyere Okeke C , Uzochukwu BSC , Obinna E Onwujekwe
Published: June 2023

ABSTRACT

Background:

Immunization data are critical for the effective delivery of immunization programs, health planning, and-decision-making. It can also help to identify gaps in vaccine coverage and service delivery. Immunization data quality is dependent on the quality of the collection process at individual health facilities and its transmission to an integrated system.

Aim:

This study set out to appraise the quality of childhood routine immunization data across the different levels of transmission in selected health facilities in Enugu, Nigeria.

Materials and Methods:

This was a cross-sectional, analytical study of the immunization data of two vaccine antigens in 103 health facilities across 10 local council areas offering routine immunization services in Enugu state. Accuracy, discrepancy consistency, completeness, and timeliness of the data for the year 2020, the study period, were determined using WHO data quality assessment tools.

Results:

This study noted that childhood routine immunization data from health facilities to the state are inconsistent, incomplete, and untimely in the transmission. Accuracy ratios were 110 and 108, discrepancy -10 and -8 for BCG and Penta III, respectively, at the health facility level. These signify the underreporting of the two vaccine antigens. This pattern was observed to be reversed as the data were transmitted from the local councils to DHIS 2. Timeliness of reporting did not go beyond 65% for the entire year 2020, while the completeness of reporting was below 80% for the same period.

Conclusion:

There were significant changes in childhood routine immunization data as it were transmitted across the different levels of the data management processes in the state. Routine immunization data from health facilities in the state are inconsistent, incomplete, and untimely in their transmission. This calls for interventions to improve data quality and make use of it in decision-making.
Assessment of the Burden and Factors Associated with Missed Opportunities for Vaccination in a South-Western State of Nigeria: Toward Immunization Agenda 2030
Authors: Eze UT. , Tanimowo SO. , Ajadi AE. , Okeke C , Ohazurike C , Uzochukwu BS.C.
Published: June 2023

ABSTRACT

Background:

Immunization Agenda 2030 prioritized the tackling of certain factors stalling immunization progress globally, among which are missed opportunities for vaccination (MOV), when eligible children have contact with health facilities without being vaccinated.

Aim:

This paper presents the baseline of an implementation research aimed at assessing the burden and identifying the factors leading to MOV in a South-Western Nigerian state.

Materials and Methods:

The 10-step World Health Organization MOV strategy was used to select local government areas and health facilities in Lagos State purposively. Children 0–23 months and healthcare workers were sampled through exit interviews with caregivers and knowledge, attitude, and practice surveys with health workers. MOV was estimated using documented (child health card or health facility register) vaccination histories included in the National Immunization Programme (NIP).

Result:

Among the caregivers, 475 (79.2%) had complete documentation of vaccination histories among which 292 (61.5%) children were eligible for vaccination. About 15% of the eligible children had one or more MOVs at the survey dates. Among curative service visits, 80% of the children had MOVs compared to 6.7% for vaccination visits. Among the healthcare workers, about two-thirds have poor knowledge of NIP and are not aware that the immunization status of children should be screened at each visit.

Conclusion:

The findings showed that MOV occurs especially in non-vaccination visits, where healthcare workers care less about immunization statuschecks. Active immunization status checks and providing linkages for immunization services may help in reducing MOV and improving immunization coverage rates in Lagos State towards fulfiling immunization Agenda 2030.
Low Immunization Completion among Under-Five Children: Are Underserved Nomadic and Farming Communities in a North Central State of Nigeria doing Better?
Authors: Nwachukwu BC , Alatishe-Muhammad BW , Ibizugbe S , Alake ID , Bolarinwa OA
Published: June 2023

ABSTRACT

Background:

The recent drop in immunization coverage in Nigeria has left more than 3.25 million children unimmunized and has risen concerns over immunization completion among the under-five children. More so among underserved communities of pastoralist nomads and farmers that were isolated from immunization services because of operational and sociocultural factors.

Materials and Methods:

A cross-sectional analytical (comparative analysis) study was carried out among 550 eligible caregivers of under-five children in nomadic and farming communities in Niger State, Nigeria. The mothers and caregivers paired with under-five children were recruited into the study using a multi-stage sampling technique. Data were collected using a validated interviewer-administered questionnaire. Data were analyzed with SPSS (version 23).

Results:

More than half of the under-five children studied were males in both the nomadic (57.5%) and farming (52.0%) communities. The aggregated score of immunization knowledge was significantly (p < 0.001) better (Good 44.4%; Fair 49.8%) among farmers compared to their nomad counterparts (Good 21.1%; Fair 43.6%). Conversely, almost all the respondents (98.2%) in the nomadic community significantly had a good overall perception of childhood immunization compared to 77.1% in the farming community. More farmers’ children (99.6%) had received immunization compared to 92.4% of the nomads’ children. About 87.3% of farmers compared to 76% of the nomads’ (76.0%) children reported immunization completion. About 50.5% of the farmers’ and 41.4% of the nomads’ children have achieved immunization on card inspection.

Conclusion:

This study revealed that average immunization completion reported among under-five children in both farming and nomadic communities is higher than the national average. It is recommended that more strategies are needed to intensify immunization campaigns targeted at populations in Nigeria.
Assessing the Acceptability of Data Dashboards and Charts for Monitoring Routine Immunisation in Local Governments and Primary Health Centres in Adamawa State, Nigeria
Authors: Hassan AM , Bashir SS , Mbachu C , Umar AA , Ezumah N , Onwujekwe OE
Published: June 2023

ABSTRACT

Background:

The need to strengthen the quality of routine immunisation data (RI) has been underscored. Thus; affecting effective decision-making and efficient resource allocation.

Aim:

This study was undertaken to determine the level of acceptability and perceived effectiveness of data dashboard and monitoring chart among RI data managers in Local Governments Areas (LGA) and Primary Health Centers (PHC) in Adamawa State, Nigeria.

Method:

A cross-sectional survey of 28 data managers from LGAs and 262 from PHCs was carried out in seven underperforming LGAs in the state. The data managers were trained and monitored for implementation of data management using dashboards and monitoring charts. Structured questionnaire was used for the survey. Acceptability was measured across seven domains of Theoretical Framework for Accountability on a five-point Likert scale using a 37-item composite scale for the LGA survey and 36-item composite scale for the PHC survey.

Results:

Median acceptability scores were generated for each domain and these were used to determine the rates and levels of acceptability. The composite score for acceptability was 4.59 (IQR: 4 - 4.82) and 4.24 (IQR: 4 -4.69) for LGA and PHC data managers, respectively. The median scores for perceived effectiveness and affective attitude were higher than the composite acceptability scores. While the median scores for experienced burden, ethicality and opportunity cost were lower than the composite acceptability scores. The overall rate of acceptability was 75% among LGA data managers and 69.23% among PHC data managers. The levels of acceptability were high at 100% among LGA data managers and 96.92% among the PHC workers. A unit increase in age decreased acceptability by 3.3%, while being male decreased acceptability by 47.1%.

Conclusion:

The use of data dashboards and charts to monitor RI data quality and performance is acceptable in Adamawa state, and should be scaled up in the State.
The Impact of Household and Community Indoor Residual Spray Coverage with Fludora Fusion in a High Malaria Transmission Setting in Northern Zambia
Authors: Ferriss Ellen , Chaponda Mike , Muleba Mbanga , Kabuya Jean-Bertin , Lupiya James Sichivula , Riley Christina , Winters Anna , Moulton Lawrence H. , Mulenga Modest , Norris Douglas E. , Moss William J. , _ _
Published: June 2023

Zambia’s National Malaria Elimination Program transitioned to Fludora Fusion in 2019 for annual indoor residual spraying (IRS) in Nchelenge District, an area with holoendemic malaria transmission. Previously, IRS was associated with reductions in parasite prevalence during the rainy season only, presumably because of insufficient residual insecticide longevity. This study assessed the impact of transitioning from Actellic 300CS to long-acting Fludora Fusion using active surveillance data from 2014 through 2021. A difference-in-differences analysis estimated changes in rainy season parasite prevalence associated with living in a sprayed house, comparing insecticides. The change in the 2020 to 2021 dry season parasite prevalence associated with living in a house sprayed with Fludora Fusion was also estimated. Indoor residual spraying with Fludora Fusion was not associated with decreased rainy season parasite prevalence compared with IRS with Actellic 300CS (ratio of prevalence ratios [PRs], 1.09; 95% CI, 0.89–1.33). Moreover, living in a house sprayed with either insecticide was not associated with decreased malaria risk (Actellic 300CS: PR, 0.97; 95% CI, 0.86–1.10; Fludora Fusion: rainy season PR, 1.06; 95% CI, 0.89–1.25; dry season PR, 1.21; 95% CI, 0.99–1.48). In contrast, each 10% increase in community IRS coverage was associated with a 4% to 5% reduction in parasite prevalence (rainy season: PR, 0.95; 95% CI, 0.92–0.97; dry season: PR, 0.96; 95% CI, 0.94–0.99), suggesting a community-level protective effect, and corroborating the importance of high-intervention coverage.
Experimental and Numerical Investigation of Spark Plug and Passive Pre-Chamber Ignition on a Single-Cylinder Engine with Hydrogen Port Fuel Injection for Lean Operations
Authors: Bucherer Sebastian , Rothe Paul , Sobek Florian , Gottwald Theo , Kraljevic Ivica , Vacca Antonino , Gal Thomas , Chiodi Marco , Kulzer Andre
Published: June 2023

The race towards zero carbon emissions is ongoing with the need to reduce the consumption of fossil energy resources. This demands immediate and reliable developments regarding technical environmentally friendly solutions for the power and transportation sectors. An alternative way to achieve a carbon-free powertrain is the use of green hydrogen for internal combustion engines. In this work the self-designed Fraunhofer single-cylinder engine with a displacement volume of 430 mm3 developed for extreme lean combustion and passive pre-chamber ignition was adapted for hydrogen engine operation. With hydrogen combustion, the customized cooling system resulting in low metal temperatures is simulated and optimized to avoid hot spots in the combustion chamber. The investigated single-cylinder engine is characterized by a compression ratio of 12.2, port fuel injection and a conventional spark plug. Based on the results, the engine is operated with a passive pre-chamber to investigate its influence on the ignition of hydrogen mixture. The advantages of pre-chamber combustion for short burning duration and high knock resistance have been demonstrated, especially at full load. This work points out the possibility to reach 23 bar indicated mean effective pressure with optimization of the port fuel injection strategies, operating the engine at lambda 2 and achieving an indicated efficiency above 43 %. The further increase in performance is restricted by the mechanical load limit of 180 bar peak cylinder pressure. Since the engine was still not knock-limited, virtual optimisation showed the possibility to increase the indicated mean effective pressure up to 28 bar at lambda 1.5, with 4 bar boost pressure.
A Fast and Reliable CFD Approach to Design Hydrogen SI Engines for Industrial Applications
Authors: Ramognino Federico , Sforza Lorenzo , Cerri Tarcisio , Lucchini Tommaso , Onorati Angelo , Novella Ricardo
Published: June 2023

SI engines fueled with hydrogen represent a promising powertrain solution to meet the ambitious target of carbon-free emissions at the tailpipe. Therefore, fast and reliable numerical tools can significantly support the automotive industry in the optimization of such technology. In this work, a 1D-3D methodology is presented to simulate in detail the combustion process with minimal computational effort. First, a 1D analysis of the complete engine cycle is carried out on the user-defined powertrain configuration. The purpose is to achieve reliable boundary conditions for the combustion chamber, based on realistic engine parameters. Then, a 3D simulation of the power-cycle is performed to mimic the combustion process. The flow velocity and turbulence distributions are initialized without the need of simulating the gas exchange process, according to a validated technique. However, coupled 1D-3D simulations of the engine scavenging can be carried out as well to increase the accuracy of the predicted intake valve closing (IVC) flow fields. The proposed methodology was validated against experimental measurements from a pent-roof single-cylinder spark-ignition (SI) engine, in which different values of hydrogen-air dilution were investigated. The achieved results were able to capture the measured pressure and heat release trends, demonstrating the industrial applicability of the presented methodology.
Charismatic leadership accountability under international criminal law
Authors: Márquez Velásquez María Manuela
Published: June 2023

Existing modes of liability in international law have been derived from the experiences of the Holocaust and the Nuremberg Trials. Since then, international criminal responsibility has developed in how it addresses and responds to international crimes, albeit primarily in the context of warfare characterised by well-organised hierarchical structures where leaders possess a defined scope of influence and ‘effective control’ over their subordinates. Charismatic leadership breaks down this strict understanding of organisations and ‘effective control’ and demonstrates the need for a broader understanding of international criminal liability. It introduces scenarios where despite the absence of a formal, hierarchical organisation or superior–subordinate relationship, the leader plays a determining role in crime commission and directly and effectively shapes their subordinates’ behaviours. This article examines whether such situations are captured by the existing framework for leaders’ liability under international criminal law, using Colombian ex-president Álvaro Uribe Vélez and the crimes committed during and after his presidency as a case study. In doing so, the article underlines the tensions and shortcomings of the current modes of liability when seeking accountability of charismatic leaders while stressing the need to reconceptualise and revisit classic modes of liability to answer to less formalised leadership styles.
Extraterritorial sanctions in response to global security challenges: countermeasures as gap-fillers in the United Nations collective security system
Authors: Franchini Daniel
Published: June 2023

This article challenges the common understanding according to which unilateral and extraterritorial sanctions are a threat to the international legal order. It shows that sanctions of this kind may have a role to play as responses to challenges to global security, particularly when the centralised action by the United Nations (UN) encounters limitations. The article considers two examples of extraterritorial sanctions that may be lawful in this sense: those expanding on the territorial scope of restrictive measures decided by the UN Security Council, and those mapping on certain measures recommended by the UN General Assembly. In these circumstances, countermeasures may provide the legal basis to support otherwise unlawful unilateral and even extraterritorial measures, provided that certain conditions are met. The article shows that such measures act as gap-fillers to ensure the widest possible compliance with communitarian norms and may ultimately strengthen the international rule of law.
The Influence of Organisational Conflict Management on Interpersonal Relations and Performance.
Authors:   , Flowers Melanie
Published: June 2023

Studies of organisational conflicts have predominantly conceptualised conflict and conflict management as static and one-dimensional, and attributed benefits for decision-making, creativity and/or learning to certain conflict types (e.g., Jehn, 1995, 1997; Rahim, 2002; Simons & Peterson, 2000). This research, by contrast, ascertains that counterproductive conflict behaviour has adverse consequences for involved individuals and organisations and explores what challenges organisations face in manifest conflict scenarios (in line with, e.g., De Dreu & Beersma, 2005; De Dreu & Weingart, 2003; Dijkstra et al., 2011; Giebels & Janssen, 2005; Knippen & Green, 1999; Lewis et al., 2006; Spector & Jex, 1998). This research further shows how conflicts are dealt with in organisations and investigates how the selection of respective conflict management methods influences the outcome of the conflict at affected organisational levels. Rather than relying on single static properties of conflict to explain the outcome of conflict, this research demonstrates how the interplay of conflict management approaches and multiple conflict properties determines the conflict outcome (considering research from, e.g., Cronin & Bezrukova, 2019; Galtung, 1996; Glasl, 2013; Humphrey et al., 2017; Korsgaard et al., 2008; Rahim, 2011; Rubin et al., 1994; Shah et al., 2020; Thomas, 1992a; Van de Vliert, 1997; Wall Jr. & Callister, 1995). Thereby, this research provides insight into conflict-related challenges, and adds a dynamic, processual understanding to existing conceptualisations of conflict and conflict management. In comparison to most organisational conflict studies, this research follows a qualitative research approach: Using the critical incident technique and caricatures during semi-structured interviews assists to gather an in-depth understanding of organisational conflicts and their management through the perception of interviewees. Twelve interviewees from different German private sector organisations participated in this study, relating conflict experiences of diverse escalation levels, utilised conflict management approaches and conflict outcomes. The findings reveal that beside conflict, conflict management consists of several phases, with conflict parties tending towards cooperative or individual-centred behaviours and involves third parties to different extents. Whereas a cooperative conflict management in the last stage of conflict management facilitates improved interpersonal relations and performance, individual-centred conflict management fosters and sustains strained interpersonal relations and affected performance post-conflict. With the dynamics exemplified in a model framework for handling conflicts, the findings suggest tackling incompatible conflict issues as they arise and seeking a cooperative solution to conflicts.
A EMERGÊNCIA DO PARADIGMA DA COMPLEXIDADE NO SÉCULO XX
Authors: Meggiolaro Tiago Henrique
Published: June 2023

Este artigo tematiza os fundamentos e princípios do paradigma da complexidade proposto por Edgar Morin. A partir desta referência apresenta o conceito e as raízes filosóficas da complexidade bem como seus princípios organizadores. O paradigma da complexidade assimila e supera o paradigma da simplificação adotando novos princípios organizadores do conhecimento como: o dialógico, o hologramático e o anel recursivo. O artigo aponta para a necessidade de novas práticas a partir da superação da fragmentação dos saberes e da simplificação do conhecimento.
Finding Harmful Comments on Social Networking Sites Using NLP and Machine Learning Methods
Authors: Bansal Esha , Bansal Nisha
Published: June 2023

The usage of violent language has significantly increased due to social media and networking. A key component in this is the younger generation. More than half of young people who use social media are affected by cyberbullying. Harmful interactions occur as a result of insults expressed on social net-working websites. These comments foster an unprofessional tone on the internet, which is usually un-derstood and mitigated through passive mechanisms and techniques. Additionally, the recall rates of current systems that combine insult detection with machine learning and natural language processing are incredibly poor. To establish a viable classification scheme for such concepts, the research ana-lyzes how to identify bullying in writing by examining and testing various approaches. We propose an effective method to assess bullying, identify aggressive comments, and analyze their veracity. NLP and machine learning are employed to examine social perception and identify the aggressive impact on in-dividuals or groups. The ideal prototyping system for identifying cyber dangers in social media relies heavily on an efficient classifier. The goal of the paper is to emphasize the critical role that learning strategies play in enhancing natural language processing efficiency.
Competitions and Community of Philosophical Inquiry: Compatible or not?
Authors: García Moriyón Félix , Lafuente-Aliaga Irene
Published: June 2023

Philosophy contests proliferate today. The Philosophy Olympiads are the most common. In the International Council of Philosophical Inquiry with Children (ICPIC) community there is some concern about a possible contradiction between the cooperative and community-centred approach to the practice of philosophy in education and the intrinsic rivalry of competitions. The arguments against these contests focus on their main risks. It is thought that they potentially reinforce the particularly harmful meritocratic educational system while simultaneously increasing inequality and reinforcing private education. Furthermore, the belief is that they promote destructive controversy where the goal is winning the debate. In Community of Philosophical Inquiry (CoPI), however, notions exist that could potentially be favoured in these competitions. CoPI focuses on demanding and cooperative argumentative dialogue and encourage parresia, the assertive and reasoned defence of one’s ideas in adversarial contexts. Likewise, the Olympic principles promote fair play; the search for excellence and the ideals of isonomy, isegory and isokratia, fostering participant skills and values which are desirable from an educational, philosophical and democratic perspective.We consider that, from an educational perspective as well as from the Philosophy for Children educational approach, participation in competition is possible and even desirable if the negative aspects it might have are addressed.
Impact of Industrial Technology 4.0 In Improving Service Quality and Customer Experience on E-Commerce Platforms: Literature Review
Authors: Martasari Gacelia Weny
Published: June 2023

With the rise of Industry 4.0 technology, e-commerce platforms have the opportunity to enhance their operations and improve customer experience. Industry 4.0 technology, which includes the Internet of Things (IoT), artificial intelligence (AI), and blockchain, has the possibility to revolutionize e-commerce by enabling personalized, secure, and convenient shopping experiences. The aim of this research is to evaluate the affect of Industry 4.0 technology in improving service quality and customer experience on e-commerce platforms. This article is focused on impact industrial technology 4.0 on e-commerce for data collection. Finding relevant and reputable papers is the first step in creating this article. Then, the search results are sorted by title and abstract. If it is suitable, it is necessary to conduct a literature review and then make a comparison. It was found that industrial technology 4.0 has a significant affect on improving service quality and customer experience on e-commerce platforms. Moreover, the use of industrial technology 4.0 has also improved the personalization of services on e-commerce platforms. With the rapid advancements in technology, e-commerce companies have been able to leverage various tools and solutions to improve their customer service and operational efficiency. By adopting these technologies, e-commerce companies have been able to offer a seamless and personalized shopping experience to their customers, which has, in turn, resulted in higher customer satisfaction rates and increased sales.
Industrial Revolution 4.0: The Role of Technology In Existence Mastery Business and Implementation
Authors: Putri Nada Kustia Perdana
Published: June 2023

This research aims to analyze the extent of the role of technology in implementation business to development era Which the more demand modern acceleration of regeneration. The evolutionary rotation cycle that will continue to be treaded by public throughout circles can create innovations new Which influence on business development. Research methods conducted in This study uses descriptive qualitative methods from various reference sources. Population Which function strengthen argument in study This is a number of districts/cities in Indonesia that can be taken with a simple sample size random sampling. From results study simple random sampling the, revealed that the emergence of this revolution causes many things to change such as machine technology that replaces operational systems. And also the results of research from all explanations state (1) Various site in application technology digital give convenience For coordinating every input and output of business actors. (2) Existing businesses can be revived with technology in various fields. (3) All aspects related to technology will enter the realm of the speed economy.
The Effects Of Customer Orientation, Competitor Orientation, And Promotion On The Marketing Performance Of Logistics Companies In Surakarta City
Authors: Utami Eva Yuniarti , Nuvriasari Audita
Published: June 2023

This study aims to explore the effects of customer orientation, competitor orientation, and promotion on marketing performance of logistics companies in Surakarta City. The research design employed a quantitative approach, utilizing a sample population of micro, small and medium-sized enterprises (MSMEs) in the expeditions or courier services sector. Data collection involved questionnaires and secondary data obtained from the Departement of Cooperatives, MSMEs, and Industry in Surakarta City. Descriptive statistics and regression analysis were used to analyze the data. The result of hypothesis testing revealed that customer orientatiom, competitor orientation, and promotion did not have a significant effect on the marketing performance of expedition services companies in Surakarta City. These findings contribute to the existing body knowledge and provide practical implications for logistics companie in Surakarta City to enhance their marketing strategies and overall performance. In conclusion, customer orientation, competitor oerientation, and promotion were found to be insignificant factors influencing the market performanceof logistics companies in Surakarta City. This reserach highlights the need for tailored strategies and futher investigations in the logistics industry. The implications of these findings provide insights for policy and practical in enhancing marketing strategies and suggest avenues for future studies in this context.
Kebijakan Pengaturan Pajak Hotel dan Restoran Sebagai Sumber Pendapatan Daerah DKI Jakarta Di Tengah Pandemi Covid-19
Authors: Inasito David Osvaldo
Published: June 2023

Covid-19 has implications for social, economic growth, decreased state and regional revenues and economic growth that has slowed so that state and regional incomes do not reach the desired target. The government not only measures health efforts and handling this outbreak but also makes economic efforts that still have to run in pandemic conditions through policies and major steps taken. The Central Government issued Government Regulation In lieu of Law No. 1 of 2020 on State Financial Policy and Financial System Stability for The Handling of coronavirus pandemic 2019 and each region issued several policies related to the fulfillment of local original income, especially for the City of DKI Jakarta which is also affected related to local tax arrangements, namely hotel taxes and restaurant taxes that contribute greatly.  against PAD Kota DKI Jakarta. The purpose of this study is to see what the implications are for the existing condition of reducing hotel and restaurant tax rates in DKI Jakarta in the current pandemic conditions. This research uses a type of normative juridical research and with a type of research approach to the statutory approach, the case approach, the conceptual approach. The results of research on the implications of conditions in the city of DKI Jakarta and the efforts of the DKI Jakarta Provincial Government to overcome the decline of PAD through the policies provided one of them provides relief to hotel and restaurant taxpayers in pandemic conditions and provides freedom in the payment of tax penalties for hotels and restaurants that are certainly adjusted to certain conditions and requirements so that PAD Kota DKI Jakarta from the local tax sector continues to run.  and able to meet the targets that have been determined as they should