bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome of tonsillectomy in children without the use of postoperative antibiotics at two tertiary care hospitals of Peshawar
Authors: Dawar Saqib Aziz , Rehman Saba , Dawar Humera Khan , Salahuddin Abid , Dawar Aziz Khan
Published: April 2021

Introduction: Overuse of antibiotics can lead to antimicrobial resistance and unnecessary costs. Although early studies reported improved outcomes following use of perioperative antibiotics for tonsillectomy, more recent studies have not been able to demonstrate a significant benefit on post tonsillectomy morbidity.

Objective: To determine the need for postoperative antibiotics in children undergoing tonsillectomy under aseptic conditions at two tertiary care hospitals of Peshawar.

Materials & Methods: Children aged 5-14 years admitted to the departments of Otorhinolaryngology-A unit of Hayatabad Medical Complex and Rehman Medical Institute, Peshawar from March 01, 2018 to September 30, 2018 for recurrent sore throat and recurrent quinsy were included in this quasi-experimental study based on prospective data collection and convenience sampling. Children with blood dyscrasias, upper and lower respiratory tract infections, and cardiopulmonary diseases were excluded. Routine preoperative investigations were done, and all were given postoperative analgesics. The patients were divided into two consecutive groups of 60 each; Group-A was given Co-amoxiclav 20mg/5mg/kg/day for 10 days and Group-B was not given any antibiotic. During their stay in the hospital and on follow up they were asked about pain via Visual Analogue Scale, and presence of fever and/or bleeding were documented.

Results: Of 120 children, 50 (41.6%) were males and 70 (58.4%) were females, of ages 05-14 years; 01(1.6%) from Group-A and 01(1.6%) from Group-B presented with reactionary hemorrhage. However, 01(1.6%) from Group-A and 25(40%) from Group-B presented with secondary hemorrhage for which they were readmitted and put on injectable antibiotics. Similarly, 05(8.3%) from Group-A and 14(23.3%) from Group-B presented with pain for which pain killers were prescribed.

Conclusion: Post tonsillectomy antibiotics may have a role in reducing the morbidities associated with the procedure in our setup.

Keywords: Tonsillectomy; Postoperative Infections; Antibiotic Resistance; Hemorrhage.
L’emocromo: così convenzionale, così richiesto, ma così sconosciuto
Authors: Calia Margherita , Lattuada Martina , De Luca Ester , Chiaraluce Sofia , Varotto Elena , Corti Paola , Ferrari Giulia Maria , Montini Orsola
Published: April 2021

Complete blood count (CBC) is one of the mostly performed diagnostic exam. It can give a variety of informations about a child’s health status. The article has the aim of guiding the pediatrician into reading the the different values of the CBC, in order to properly recognize and interpret the alterations and underlying the red flags which must be identified in order to proceed into further investigations or to request a specialist consultation (pediatric hematologist).
Considerazioni medico-legali sulla mozione del Comitato Nazionale per la Bioetica sull’accanimento clinico nei confronti di bambini con limitate aspettative di vita
Authors: Aprile Anna , Bolcato Matteo , Russo Marianna , Rodriguez Daniele
Published: April 2021

The motion approved by the Italian National Bioethics Committee January 30th,2020, entitled “Aggressive treatments or unreasonable obstinacy in medical care of children with short life expectancy”, sets out 12 recommendations for physicians who take care of these children and have the duty to communicate with their parents. The intent of this motion is to give the family the necessary information and support during the decision-making process. Each recommendation is analytically commented. Recommendation 1 advocates the adoption of shared decision-making by the entire healthcare team; promotes the relief of pain and suffering; inhibits disproportionate and ineffective medical treatments; opposes a defensive medicine. Recommendation 2 asks for the promulgation of a national law that establishes clinical ethics committees in Children’s Hospitals. Recommendation 3 implies that parents or legal guardians should be involved in the decision-making process of physicians and clinical ethics committees. Recommendation 4 states that a second opinion may be requested by both the parents and the physicians. Recommendation 5 admits an appeal to the judge in the event of an irreconcilable conflict between the health care team and the family. Recommendation 6 endorses the medical accompaniment of the dying patient, also by means of continuous deep sedation and analgesia. Recommendation 7 enunciates the principle that patients shall have the right to access to palliative care. Recommendation 8 confirms the necessity to strengthen research focused on pediatric pain and suffering. Recommendation 9 excludes that excessive medical treatment may be justified by the need to carry out experiments or research projects. Recommendation 10 concerns the training of physician, other healthcare workers and psychologists in order to support children’s parents both emotionally and practically. Recommendation 11 exhorts to encourage the interaction between parents and seriously ill children. Recommendation 12 assigns a prominent role to parents’ associations for ill children.
Scialorrea e tappi di muco: consigli pratici di gestione nei pazienti eleggibili alle cure palliative pediatriche
Authors: Avagnina Irene , Paolin Chiara , Santini Micaela , Benini Franca
Published: April 2021

Pediatric palliative care is a multidisciplinary area of pediatrics that aims to ensure a quality of life for children suffering from incurable diseases with high care complexity and also respond to their needs and those of their families. At the clinical level, there are many disturbing symptoms with a wide impact on the quality of life, which must be managed and treated. In particular some of them represent a major challenge for caregivers and health professionals looking after children eligible for PPC. This work aims to present, with a practical and immediately useful cut for the pediatrician, the management strategies of frequent symptoms, starting with drooling and mucus plugs; the latter are very frequent in children with non-oncological disease, followed by PPC. If not treated, they limit the child’s quality of life and have a significant impact on the concerns and management of family members / caregivers.
Entre o impresso e o digital na obra Camilão, o comilão, de Ana Maria Machado
Authors: Almeida Odilene Silva do Nascimento , Assis Emanoel Cesar Pires de
Published: April 2021

O universo literário tem sido cenário de intensas discussões acerca das produções contemporâneas, notadamente, no que se refere ao contexto das ferramentas tecnológicas. Nesse sentido, o presente artigo pretende discutir sobre a forma com a qual o avanço da tecnologia tem influenciado profundamente as obras classificadas como infanto-juvenis, sobretudo, no que se refere a Camilão, o comilão, de Ana Maria Machado. Considera-se, assim, a necessidade de propiciar a compreensão de abordagens que encontram-se no cerne da perspectiva da literatura fomentada no meio digital, bem como as transmutações conferidas ao estabelecimento de um novo suporte. Desse modo, a premissa que sustenta a presente discussão parte da migração da obra em texto impresso para a esfera digital. Como contribuições teóricas, temos os textos de Chartier (1998), Lévy (2008), Hayles (2009), Santaella (2013), Rocha (2014), dentre outros.
Adiamento e suspensão de sentido em Grande sertão: veredas - do pacto demoníaco
Authors: Soares Claudia Campos
Published: April 2021

Riobaldo, o narrador-protagonista de Grande sertão: veredas, demonstra, ao longo de toda a sua narrativa, grande preocupação com a questão do mal e com a figura do demônio; e afirma, mais de uma vez, que pode falar do assunto com particular propriedade. Durante boa parte do livro, entretanto, ele não explicita o principal motivo de o assunto interessa-lo tanto, nem o que lhe permite afirmar que é particularmente apto a falar sobre ele. Riobaldo propõe mistérios e, ao modo das narrativas de suspense, adia o seu esclarecimento. Diferentemente dessas narrativas, entretanto, quando ele enfim narra o episódio que teria motivado suas preocupações (o duvidoso pacto demoníaco), o “esclarecimento” que se dá não é suficiente para responder às questões que o inquietam. E coloca outras. Assim, o caminho da elucidação acaba levando à incerteza e à indeterminação.
Research on Entity Label Value Assignment Method in Knowledge Graph
Authors: Yang Linqing , Liu Bo , Huang Youpei , Li Xiaozhuo
Published: April 2021

The lack of entity label values is one of the problems faced by the application of Knowledge Graph. The method of automatically assigning entity label values still has shortcomings, such as costing more resources during training, leading to inaccurate label value assignment because of lacking entity semantics. In this paper, oriented to domain-specific Knowledge Graph, based on the situation that the initial entity label values of all triples are completely unknown, an Entity Label Value Assignment Method (ELVAM) based on external resources and entropy is proposed. ELVAM first constructs a Relationship Triples Cluster according to the relationship type, and randomly extracts the triples data from each cluster to form a Relationship Triples Subset; then collects the extended semantic text of the entities in the subset from the external resources to obtain nouns. Information Entropy and Conditional Entropy of the nouns are calculated through Ontology Category Hierarchy Graph, so as to obtain the entity label value with moderate granularity. Finally, the Label Triples Pattern of each Relationship Triples Cluster is summarized, and the corresponding entity is assigned the label value according to the pattern. The experimental results verify the effectiveness of ELVAM in assigning entity label values in Knowledge Graph.
A Nonuniform Reference Voltage Optimization Based on Relative-Precision-Loss Ratios in MLC NAND Flash Memory
Authors: Lv Caifeng , Huang Xiujie , Zhao Shancheng
Published: April 2021

In Multi-Level-Cell (MLC) NAND flash memory, cell-to-cell interference (CCI) and retention time have become the main noise that degrades the data storage reliability. To mitigate such noise, a relative precision loss (RPL) nonuniform reference voltage sensing strategy is proposed in this paper. First, based on the NAND flash channel model with CCI and retention noise, we simulate the data storage process of MLC NAND flash by Monte Carlo method, and find that the threshold-voltage of each disturbed storage state shows approximately to be Gaussian distributed. Then, by Gaussian approximation, the distribution of threshold voltage can be estimated easily in mathematics with a little loss. Second, we introduce a concept of log-likelihood ratio (LLR)-based RPL ratio to determine the dominating overlap regions, and then propose a new nonuniform reference voltage sensing strategy. This strategy does not only reduce the memory sensing precision (i.e., the number of reference voltages), but also maintains the reliability of the soft information of NAND flash memory channel output for soft decoding. Third, we implement extensive simulations to verify the performance of the new nonuniform sensing strategy. The BER performances of LDPC codes for different sensing strategies are provided to show that the proposed LLR-based RPL-nonuniform sensing strategy can make a good compromise between memory sensing latency and error-correction performance.
Boekbespreking Hydropolitiek. Samenwerking en conflict op zeven zeeën
Authors: van Tatenhove Jan
Published: April 2021

Boekensignalement

In this feature authors review recently published books on subjects of interest to readers of Beleid en Maatschappij.
Boeken 3 en 5 BW. Vermogensrecht in het algemeen en zakelijke rechten
Authors: Klik P.
Published: April 2021

Boeken 3 en 5 BW. Vermogensrecht in het algemeen en zakelijke rechten

In deze bijdrage wordt een overzicht gegeven van de ontwikkelingen ten aanzien van de onderwerpen in Boeken 3 en 5 BW. In de kroniek komt vooral de jurisprudentie aan bod. Onderwerpen uit Boek 3 die aan de orde komen zijn begripsbepalingen, rechtshandelingen (algemeen) en volmacht, verkrijging door verjaring en bezit en houderschap, de gemeenschap, en de regeling van de langdurig onverdeeld gebleven boedels, zoals ingevoerd als onderdeel van de regeling van de gemeenschap (art. 3:200a-3:200h BW). De bespreking van de onderwerpen uit Boek 5 is meer beperkt.
Het recht van de intellectuele eigendom 2000-2020
Authors: Jänsch C.A.D. , de Baar J.A.
Published: April 2021

Het recht van de intellectuele eigendom 2000-2020

De rol van het intellectuele eigendomsrecht is de laatste jaren aanzienlijk toegenomen, niet in de laatste plaats door de toename van het gebruik van internet, sociale media en smartphones. Dit artikel is een bewerking van de laatste kroniek, gepubliceerd in TAR-Justicia 2000 nr. 4. De auteurs gaan in op relevante ontwikkelingen in de wetgeving en de rechtspraak, onder meer op het gebied van het auteursrecht, het merkenrecht en het octrooirecht sinds het begin van deze eeuw. Daarbij komen ook de verschillen in de vier jurisdicties binnen het Caribische deel van het Koninkrijk aan de orde. Tot besluit worden mogelijke ontwikkelingen in het komende decennium besproken.
Kroniek burgerlijk procesrecht 2010-2020
Authors: Veling Th.
Published: April 2021

Kroniek burgerlijk procesrecht 2010-2020

Overzicht van ontwikkelingen in het burgerlijk procesrecht in het Caribische deel van het Koninkrijk der Nederlanden. Onder andere over griffierecht, waarheidsplicht, procestalen, suggestiebevoegdheid, procedure in hoger beroep, digitalisering en beslag.
Nederlands Caribisch financieel recht
Authors: Frielink K.
Published: April 2021

Nederlands Caribisch financieel recht

In deze bijdrage over het Caribisch financieel recht wordt een overzicht gegeven van de ontwikkelingen op het terrein van wetgeving, rechtspraak en literatuur in de afgelopen 10 jaar.
Ontwikkelingen in het notariaat 2010-2020
Authors: Parisius M.E.
Published: April 2021

Ontwikkelingen in het notariaat 2010-2020

Deze bijdrage schetst een aantal relevante ontwikkelingen in het afgelopen decennium die voor het notariaat in het Caribisch deel van het Koninkrijk der Nederlanden relevant zijn.

Hierbij worden onder meer de volgende onderwerpen aangestipt:

notariële standplaatsen en werkgebied;

notariële dienstverlening in de openbare lichamen Sint Eustatius en Saba;

notarisbenoeming en defungeren;

Kamer van Toezicht op het Notariaat;

rechercheplicht;

notaris als poortwachter;

verdwenen akten;

wijzigingen burgerlijk recht.
Doubly Warped Product Submanifolds of a Riemannian Manifold of Nearly Quasi-constant Curvature
Authors: Lone Mehraj Ahmad , Lone Mohamd Saleem , Shahid Mohammad Hasan
Published: April 2021

In the present paper, we form a sharp inequality for a doubly warped product submanifold of a Riemannian manifold of nearly quasi-constant curvature.
ESTIMATION OF TRIBOLOGICAL PROPERTIES OF SELECTED
PLASTICS MATERIALS MANUFACTURED BY EXTRUSION AND 3D
PRINTING
Authors: Bąkowski Henryk , Krzysiak Zbigniew
Published: April 2021

The following work presents the results of research about the assessment of tribological properties of plastics
used as components in modes of transport. For this purpose, the wear resistance of materials used in 3D
printing (PA6CF and ABS), and extrusion moulding
(PA) were tested. The tribological research was carried out with the use of the T-05 tester in the roller-block
system. The samples in the form of cuboids with a concave rounding of one wall were made on a 3D printer
using the FDM method. The counter-sample was a ring made of aluminium alloy subjected to anodizing.
The research was carried out under a variable loads, in reciprocating motion, under dry friction conditions.
After that the tribological characteristics were assessed. The research and analysis of the results confirmed the
possibility of using selected plastics in modes of transport.
EFFECT OF ABRASIVE PARTICLE SHAPE ON TWO-BODY ABRASIVE WEAR OF STEEL
Authors: Ligier Krzysztof , Lemecha Magdalena
Published: April 2021

This paper presents the results of Hardox Extreme steel wear rate testing using an abrasive mass of varying
grain shapes. The tests were conducted by the ASTM G65 method using crushed and natural sand with a
grain-size distribution of 0.05–2 mm, obtained from a gravel pit. The abrasive materials used in the tests
differed in grain shape, while the particle-size distribution was similar. The test results show that the wear rate
in crushed sand is four times higher than that in natural sand, which is attributable to the shape of grains and
the geometry of their edges.
THE EFFECT OF THE BIOCARBON TYPE
ON THE TRIBOLOGICAL CHARACTERISTICS OF GREASES
MANUFACTURED WITH VEGETABLE AND SYNTHETIC BASE
OILS
Authors: Pawelec Zbigniew , Molenda Jarosław , Kaźmierczak Bernadetta
Published: April 2021

The article presents the tribological characteristics of plastic greases in which the dispersing phase was
vegetable (rapeseed) oil or synthetic ester oil (Priolube). The lithium stearate was used as a thickener in
an amount sufficient to obtain a composition in the second consistency class, and the functional additives
were biocarbon produced in the process of pyrolysis of the following plant waste: flax straw, wheat straw,
corn leaves and stalks, and cherry stones. The compositions containing 5% m/m of biocarbon were prepared
and the influence of the type of biocarbon on the tribological properties of the obtained plastic greases was
assessed. The tribological characteristics of the grease compositions were determined using the T-02 tester
in accordance with the requirements of the relevant standards. The influence of the applied biocarbon on the
anti-wear (Goz) and anti-seize (Pt, poz) properties of plastic greases made with vegetable and synthetic basis
was determined. It was found that some of the biocarbon, especially those derived from the pyrolysis of
corn waste, significantly improve the tribological properties of plastic greases, both those based on plant and
synthetic sources.
INFLUENCE OF 3D PRINTING technology OF AUTOMOTIVE
PARTS MADE OF PLASTICS ON THEIR TRIBOLOGICAL
PROPERTIES
Authors: Posmyk Andrzej , Marzec Przemysław
Published: April 2021

This paper presents results of tribological examinations of chosen automotive subassemblies made of plastics
by using of 3D-printing. The influence of chosen technological parameters, i.e. plastic temperature, the
velocity of printing head, and the height of deposited simple layer on wear of samples produced of PA 12
polymer rubbing against hard anodised sliding guide of car sunroof is defined. It was found that samples
printed at minimal temperature (t = 240°C), a minimal height of deposited simple layer (h = 0,1 mm), and
a minimal (40 mm/s) and maximal (v = 60 mm/s) deposition velocity show the minimal wear. Examining
under similar conditions (p = 0.4 MPa, v = 2.5 m/s, reciprocating movement) of samples made by using press
moulding cut out from car sub-assemblies for a comparison were carried out. As a result of experiments, it
was concluded that the wear intensity of roller stretching drive belt made from composite (PA15GF) and the
wear intensity of the belt itself during sliding, caused by seizure of bearing, is so high that menaces engine
with damage.
TRIBOLOGICAL CHARACTERISTICS OF POLYURETHANES USED
FOR THE SOLES OF FOOTWEAR
Authors: Przepiórka Jacek , Szczerek Marian , Sułek Marian W.
Published: April 2021

The inability to take into account the type of base material (floor, pavement, soil), as well as the inability to
take into account the variable friction conditions – load, intermediary medium (water, loose abrasive, sand or
other soil particles), sliding velocity, and ambient temperature – is a significant limitation the use of friction
methods and devices used so far in the footwear industry to precisely anticipate the behavior of the bottom
materials in the actual operating conditions of the footwear.
These limitations prompted the authors to adapt a tribological tester for this purpose, used in the area of
construction and operation of machines and material engineering. A research methodology was developed
and, in order to verify it, measurements of the coefficient of friction and wear of polyurethane used for shoe
soles in combination with a raw and varnished wooden substrate were carried out.
The obtained test results are characterized by diversity, which proves the high research resolution of the
developed method. It allows determining the coefficient of friction of associations influencing the slip of the
footwear and the wear and tear that determines the length of use of the footwear.
New Identity in Local Community-owned Woven Fabrics in Tuban, East Java, Indonesia
Authors: Ciptandi Fajar
Published: April 2021

The tradition of weaving fabrics by the local community in Tuban, East Java, Indonesia began in the 11th century and until now is considered an important part of the identity of the community. In the current conditions, the tradition of making traditional woven fabrics has persisted without improvements in terms of design, technique, function and products. However, the modern context has brought about a new lifestyle in Tuban that is no longer entirely traditional. Therefore, traditional woven fabrics also need a new identity that is compatible with the current conditions while still being connected to the original identity. This was done in the current research by developing visual novelty for the traditional woven fabrics of Tuban using an experimental method. Alternative processes and techniques of weaving were used to produce weavings with a variety of textures. In the development process, keeping elements that are traditionally valued by the local community was a major concern in order to retain the original character of the fabrics while adding novel elements.
A INOVAÇÃO NA AGROINDÚSTRIA DE CARNES: UM ESTUDO DE CASO EM UM FRIGORÍFICO DE AVES LOCALIZADO EM IPUAÇU – SC
Authors: Deon Daiane , Zanella Cleunice , Franceski Cleberton , Castagna Maiara
Published: April 2021

Este estudo teve como objetivo principal analisar a percepção do gestor de uma pequena agroindústria de aves a respeito da inovação. Identificar quais inovações são geradas nesta empresa, bem como verificar a visão do gestor acerca do processo inovativo, compreendendo desde a concepção do termo inovação, seus benefícios e principais dificuldades para a gestão e implementação de inovações. Trata-se de um estudo de caso com abordagem qualitativa. Para a coleta de dados, foi realizada entrevista com o gestor responsável pela agroindústria. Pode-se observar que a agroindústria objeto deste estudo, desenvolve inovações incrementais que são, em grande parte, baseadas em fornecedores, tanto de insumos, como máquinas e equipamentos, também através da introdução e/ou aprimoramento de processos na produção de bens ou serviços.
VIDA, ESTUDO E TRABALHO: DISCUTINDO AS TRAJETÓRIAS DOS JOVENS BRASILEIROS A PARTIR DA TEORIA DE INSERÇÃO PROFISSIONAL FRANCESA
Authors: Moraes Jhony pereira , Rocha-de-oliveira Sidinei , Andrade Arthur gehrke martins
Published: April 2021

Este estudo objetiva realizar uma aproximação entre a teoria de inserção profissional francesa e a juventude brasileira. Os pontos centrais de análise são a vida, o estudo e o trabalho, uma vez que a inserção profissional francesa considera os aspectos individuais, institucionais e sócio-históricos de um grupo social, sendo extensiva a diferentes contextos sociais. O estreitamento dessa teoria com a juventude brasileira é evidenciado pelo cenário formado por jovens franceses com elevada qualificação e grandes dificuldades de inserção no mercado - com atenção aos casos de desemprego e disposição de relações de trabalho precarizadas - algo semelhante ao que vem acontecendo com os jovens brasileiros nos últimos anos, apesar da expansão do ensino superior (considerando a influência de políticas públicas de acesso e programas de financiamento da educação superior).
Análise de Dados e Serviços Inteligentes Aplicados na Educação à Distância: um mapeamento sistemático
Authors: Silva Lidia Martins , Barbosa Jorge L. V. , Rigo Sandro José
Published: April 2021

A utilização de ambientes virtuais contribui na geração de dados educacionais e a aplicação de métodos e técnicas de análise nesses dados gera informações valiosas aos gestores educacionais. Estas informações possibilitam tomadas de decisões direcionadas e personalizadas, de forma a melhorar o aprendizado do aluno. A oferta de serviços inteligentes ajuda as instituições a minimizarem as reprovações escolares e as evasões nos cursos online. Este artigo apresenta os resultados de um mapeamento sistemático da literatura que visa identificar como a Learning Analytics (LA) e os serviços inteligentes vêm sendo aplicados em ambientes de educação à distância (EAD). Foram realizadas buscas de 2010 até junho de 2020 nas bases IEEE Xplore Digital Library, ACM Digital Library, Scopus, Springer e Sciencedirect. A busca inicial resultou em 55.832 artigos e após aplicação dos critérios de inclusão e exclusão foram selecionados 51 artigos para leitura completa com o intuito de responder as questões de pesquisa. Os principais resultados obtidos são: dos 51 artigos selecionados foi constatado que 39% aplicaram métodos e técnicas de análise em ambientes de EAD; 39% ofereceram serviços inteligentes no âmbito da EAD e 18% aplicaram métodos e técnicas de análise focados nos históricos de registros de logs deixados pelos alunos quando interagiram em ambientes virtuais de aprendizagem.
Safety and Potential Risks with Fecal Microbiota Transplantation
Authors: Gaonkar Pratyusha
Published: April 2021

The therapeutic potential of Fecal Microbiota Transplantation (FMT) is greatly proved worldwide in the recent years. The use of FMT is now an accepted treatment modality and effective standard of care for some patients owing to its success in treating recurrent Clostridium Difficile Infection (rCDI). However, it is still evolving and longer term follow-up data regarding safety are required. Post-FMT serious adverse events (SAEs) have been varied between studies, however have included significant morbidity necessitating hospital admission and mortality in the follow-up period. The follow-up of FMT recipients should be long enough to completely establish efficacy/adverse events. Furthermore, it is recommended that FMT should be offered with caution to immunosuppressed patients, in whom FMT appears efficacious without significant additional adverse effects. In the wake of COVID-19 situation, stringent policies in screening the FMT donors have to be put forth to ensure patient safety. There is a need for high-quality, large, prospective, randomized controlled trials and long-term follow-up investigating screened donors and recipients to evaluate the long term safety and the risk–benefit profile of this promising therapy.
Robotic Laparoscopic Single-Site Surgery
Authors: I. Luna Rene
Published: April 2021

Minimally invasive surgery has changed the landscape of women’s surgical healthcare. Conventional and robotic laparoscopy are the preferred approach for many major minimally invasive gynecological procedures. However, the philosophy of minimally invasive surgery has been pushed to reduce the size and minimize the number of ports placed. Many conventional minimally invasive surgical procedures use 3–5 ports through multiple small incisions. Laparoscopic single site surgery tries to perform on that philosophy but has its limitations. Enters robotic surgery already a major force in minimally invasive surgery and now sets to remove the limitations of single site surgery. However it requires proper understanding of the instruments and the techniques for successful robotic single site surgery. It starts with patient selection. Knowing the instruments needed and the proper set up of those instruments. Then knowing how to use the instruments in operating and suturing and closing. And finish with special considerations.
Arabian Sea Tropical Cyclones: A Spatio-Temporal Analysis in Support of Natural Hazard Risk Appraisal in Oman
Authors: Al-Manji Suad , Mitchell Gordon , Al Ruheili Amna
Published: April 2021

Tropical cyclones [TCs] are a common natural hazard that have significantly impacted Oman. Over the period 1881–2019, 41 TC systems made landfall in Oman, each associated with extreme winds, storm surges and significant flash floods, often resulting in loss of life and substantial damage to infrastructure. TCs affect Omani coastal areas from Muscat in the north to Salalah in the south. However, developing a better understanding of the high-risk regions is needed, and is of particular interest in disaster risk reduction institutions in Oman. This study aims to find and map TC tracks and their spatio-temporal distribution to landfall in Oman to identify the high-risk areas. The analysis uses Kernel Density Estimation [KDE] and Linear Direction Mean [LDM] methods to better identify the spatio-temporal distribution of TC tracks and their landfall in Oman. The study reveals clear seasonal and monthly patterns. This knowledge will help to improve disaster planning for the high-risk areas.
Cereal Grains of Bangladesh – Present Status, Constraints and Prospects
Authors: Khayer Mohammad Golam Sarwar Abul , Krishna Biswas Jiban
Published: April 2021

The edible seeds or grains of the grass family Poaceae (conserved name Gramineae) is commonly known as cereals and are cultivated for the edible component, grain consisting of the germ (or an embryo), endosperm and bran. Bangladesh, predominantly an agrarian country, has a long tradition of cereal grains cultivation, consumption and conservation. Rice is the staple food for millions (of people) across the globe including Bangladesh. It occupies more than 96% of the land area under “Cereal Agriculture” in Bangladesh. Maize occupies the 2nd position both in acreage and production followed by wheat and other minor cereals viz. barley, sorghum and millets. In this chapter, the historical development and production scenario of different cereal crops and their present status, constraints, challenges and opportunities has been described and discussed. The information presented here would provide a clear inside of the “Cereal Agriculture of Bangladesh” to students, researchers, administrators, policymakers, and the common people as well.
Role of Vitamin E in Pregnancy
Authors: Aftab Siddiqui Mohd , Ahmad Usama , Ali Asad , Ahsan Farogh , Faheem Haider Md.
Published: April 2021

Vitamins play important roles in female health. They are essential for many functions, including menstruation and ovulation, oocyte (egg) quality and maturation. Vitamin E was first discovered in 1922 as a substance necessary for reproduction. It has become widely known as a powerful lipid-soluble antioxidant. There are various reports on the benefits of vitamin E on health in general. Vitamin E helps your body create and maintain red blood cells, healthy skin, eyes and strengthens your natural immune system. However, despite it being initially discovered as a vitamin necessary for reproduction, to date studies relating to its effects in this area are lacking. Vitamin E supplementation may help reduce the risk of pregnancy complications involving oxidative stress, such as pre-eclampsia. This chapter is written to provide a review of the known roles of vitamin E in pregnancy.
In Vitro and In Silico Evaluation of Biological Activity of a New Series of Oxadiazole Compounds Against Esp Gene Expression in Enterococcus faecalis Biofilm
Authors: Ghameshlouei Sepideh , Zarrabi Ahrabi Nakisa , SarveAhrabi Yasin
Published: April 2021

Background: The enterococcal surface protein (Esp) is a high-molecular-weight surface protein of biofilm creating agent in Enterococcus faecalis. Oxadiazoles have a wide range of biological activities. Objective: This research aimed to examine the impact of new oxadiazole derivatives on the expression of Esp, playing an important role in promoting the biofilm formation ability of drug-resistant E. faecalis strains. Method: 1, 3, 4-oxadiazole derivatives were synthesized through a one-step synthesis. E. faecalis strains were collected and isolated from hospitals in Tehran. The antimicrobial properties of the synthesized materials against the isolated strains were investigated. RNA, DNA, and cDNA were extracted, and the relative expression of Esp in E. faecalis isolates was evaluated by real-time PCR. Docking study was performed by AutoDock vina software, and the resulting docking poses were analyzed using Discovery Studio 4.5 Client software. Results: The use of synthesized derivatives changed the Esp expression level in different isolates compared to the control sample. The two compounds containing naphthalene (4f) and methoxyphenyl (4g) caused respectively a 2-fold and a 3-fold decrease in Esp expression compared to the control sample. The compound 4f with the best binding energy among the compounds (-9.2) had the most hydrogen and hydrophobic bonds with the receptor-binding site. Conclusions: 1, 3, 4-oxadiazole derivatives, especially naphthalene and methoxyphenyl, act as inhibitors of bacterial biofilm formation and can be used in the pharmaceutical and biological industries.
COVID-19 in Cancer and Non-cancer Patients
Authors: Taghizadeh-Hesary Farzad , Porouhan Pejman , Soroosh Davood , PeyroShabany Babak , Shahidsales Soodabeh , Keykhosravi Batol , Rahimi Faeze , Houshyari Mohammad , Forouzanfar Mohammad Mehdi , Javadinia Seyed Alireza
Published: April 2021

Background: There is a global concern for the susceptibility of patients with cancer to the adverse effects of novel coronavirus disease (COVID-19). Nevertheless, there is a signal of potentially increased vulnerability of patients with cancer to more COVID-19-induced mortality, this notion needs to be further evaluated in various societies with different cancer epidemiology and practice. Objectives: To investigate the outcomes of cancer patients admitted due to COVID‐19 and compare them with data of COVID‐19 infected patients without a history of cancer. Methods: In this case-control study, the medical records of patients with cancer (Ca+ patients) who infected with COVID-19 were evaluated and compared with patients without a medical history of cancer (Ca- patients). Clinical data were collected from 19 February 2020 to 17 May 2020. The extracted data were classified into demographics, underlying medical conditions, clinical manifestations, imaging and laboratory findings, and clinical outcomes. Results: A total of 24 Ca+ patients were compared with 44 Ca- patients in terms of clinical manifestations and outcomes of COVID-19. The Ca- patients significantly developed more dry cough (75.0% vs 29.2%, P = 0.01) and fever (72.7% vs 45.8%, P = 0.02). Findings of the chest CT scan was comparable between groups, except for pleural effusion and lymphadenopathy that exclusively reported in Ca+ patients. (3% and 4%, respectively). At the end of observation, 13 (19.1%) patients died from COVID-19. This rate was significantly higher in Ca+ patients (41.7 vs 6.8%, P = 001). Likewise, Ca+ patients experienced more mechanical ventilation (25.0 vs 4.7%, P = 0.01). However, the rate of ICU admission was comparable between groups (P = 0.29). Conclusions: The patients with cancer had a higher rate of mechanical ventilation and COVID-19-induced mortality.
Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study
Authors: Mohta Alpana , Kumar Jain Suresh , Agrawal Aditi , Kushwaha Ramesh Kumar , Sharma Pritee , Sethia Khusbhoo , Jain Manish
Published: April 2021

Background: Leprosy, an insidious infectious granulomatous disease, is diagnosed traditionally through clinical examination coupled with skin smears and histopathology. It has myriad clinical presentations that pose diagnostic challenges. Lately, dermoscopy has emerged as a rapid, noninvasive diagnostic modality for many dermatoses.

Objectives: We evaluated the dermoscopic findings of various manifestations of leprosy and correlated them with clinical and histopathological features.

Methods: This prospective, cross-sectional study was conducted in our skin outpatient department for a period of 1 year. Patients newly diagnosed as having leprosy or those undergoing leprosy treatment for less than 6 months were included. The most representative lesion was dermoscopically evaluated and later biopsied.

Results: We included 73 patients in the study. Results indicated an obvious correlation between dermoscopic findings and histopathology. We noted orangish yellow and white structureless areas, steadily throughout the spectrum, depicting dermal granuloma. Additionally, we observed focal vascular structures such as branching, linear, and crown vessels that result from the pressure of granuloma pushing the dilated vessels upwards. The relative absence of skin appendages aided in differentiating leprosy from other granulomatous disorders. Novel findings of our study were the detection of a branch-like pattern of clofazimine-induced pigmentation on dermoscopy and orange globules on onychoscopy. Other unique findings included violaceous structureless areas, characteristic large telangiectatic vessels, follicular plugging, star-shaped silvery-white scaling, and white globules in type 1 reaction; white shiny steaks were observed in patients with borderline lepromatous leprosy, and central white dots and keratotic plugs were observed in patients with histoid leprosy.

Conclusions: Dermoscopy, as a noninvasive modality, could aid in the quick diagnosis of leprosy and should be used as a handy tool to complement other investigative tools for this disease.
Decreased Serum Levels of Interleukin-4 and Interleukin-21 in New Pemphigus Vulgaris Patients, but Not Chronic Patients With Inactive Disease Compared to Healthy Controls
Authors: Shahbazian Pegah , Izad Maryam , Daneshpazhooh Maryam , Mortazavi Hossein , Salehi Zahra , Behruzifar Shirin , Tavakolpour Soheil , Azizpour Arghavan
Published: April 2021

Background: Pemphigus is a rare group of autoimmune blistering diseases with unknown etiology and unclear pathogenesis. Pemphigus vulgaris (PV) is the most common subtype, and is characterized by ulcerations or flaccid blisters on mucous membranes and on the skin. It is accepted that cytokines have a critical role in the pathogenesis of PV, while their exact roles remain to be elucidated.

Objectives: This study assessed serum levels of interleukin (IL)-4 and IL-21 in different phases of the disease in comparison with healthy controls.

Methods: In a case-control cohort design, serum levels of IL-4 and IL-21 were determined by ELISA in three groups: patients with newly diagnosed PV, patients with chronic, inactive PV (PV in remission), and healthy controls.

Results: The study included 88 individuals (58 women and 30 men), including 26 with newly diagnosed PV, 33 with PV in remission, and 29 healthy controls. A significant difference was found among the groups for IL-21 (P = .044), but not for IL-4 (P = .374). Serum levels of IL-4 and IL-21 in newly diagnosed patients were significantly lower than in healthy controls (P = .005 for both), but these cytokine levels in patients with PV in remission were not different from those of controls (P = .343 and P = .221, respectively). Also, no differences in cytokine levels were detected between the newly diagnosed patients and patients with PV in remission. Regardless of disease phase, we detected significantly lower levels of IL-21 in patients than controls (P = .027), but no differences for IL-4 (P = .374).

Conclusions: IL-4 and IL-21 are involved in PV pathogenesis and disease severity. More studies are required to clarify the role of IL-4 and IL-21 in immunopathogenesis and immune response during PV.
Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision
Authors: Fougelberg Julia , Ek Hampus , Claeson Magdalena , Paoli John
Published: April 2021

Background: One common treatment for Bowen’s disease (BD) is surgical excision, but there is no international consensus on the appropriate surgical margins.

Objectives: This study examined what factors affect the rate of incomplete excision of BD.

Methods: Clinicopathological data potentially linked to surgical outcome (complete or incomplete excision) were retrospectively collected from medical and histopathological records on all surgically excised BD lesions diagnosed at Sahlgrenska University Hospital in Gothenburg, Sweden during 2014-2015. Data were analyzed with two definitions of incomplete excision: less strict (ie, BD present at the surgical margin) and strict (ie, dysplasia present at the surgical margin).

Results: In total, 463 BD lesions among 408 patients were included. With the less strict definition, 3 factors were associated with significantly higher rates of incomplete excision: surgical margins <3 mm, a less experienced surgeon, and use of punch biopsy excision. The same factors plus a tumor location on the head and neck area or upper extremities were associated with significantly higher rates of incomplete excision using the strict definition. After adjustment for confounders, less experience was independently associated with incomplete excision using the less strict definition, whereas less experience and location on the head and neck area or upper extremities were independently associated with incomplete excision using the strict definition. Surgeon specialty was not associated with incomplete excision regardless of the definition.

Conclusions: When removing BD surgically, an elliptical excision with surgical margins ≥3 mm carried out by an experienced surgeon should be recommended. Surgical margins may need to be adjusted depending on body site.
Launching the Hydrapolemic
Authors: Faucher Kane X. ,   Philosophy Documentation Center
Published: April 2021

It may be considered a rather oblique move to convene a discussion of the Hydra and Heracles in relation to our larger initiative to ground a conceptual typology of polemics, but it serves as perhaps the most effective analogy in the spirit of poststructuralist and deconstructive critique. That is, we invoke these two “styles” of critique with their preoccupation with language and the Other: two key components to elucidate upon the notion of polemics, and more specifically, take our cues from Derrida’s idea of hydratext and Deleuze’s clarion call for concept creation. If the polemicist is considered monstrous, then it behooves us to commit considerable study to the polemicist’s monstrosity.
Fetishism and Bad Faith
Authors: Gemerchak Christopher M. ,   Philosophy Documentation Center
Published: April 2021

Jean-Paul Sartre, in Being and Nothingness, develops the concept of “bad faith” in order to account for the paradoxical fact that knowledge can be ignorant of itself, and thus that a self-conscious subject can deceive itself while being aware of its own deception. Sartre claims that Freudian psychoanalysis would account for self-deception by positing an unconsciousness that guides consciousness without consciousness being aware of it. There­fore, Freudian psychoanalysis is an insufficient model with which to address bad faith. I disagree. There is a specific psychic mechanism in Freud that answers Sartre’s criteria for bad faith, and it is called “disavowal” (Verleugnung). Disavowal is the mechanism responsible for fetishism. And thus, fetishism is the Freudian account of bad faith.
Other-Regarding Preferences
Authors: Khalil Elias L. , Marciano Alain ,   Department of Philosophy, Florida State University
Published: April 2021

The category “other-regarding preferences” is a catch-all phrase based on a self/other dichotomy. While the self/other might be useful when the motive is self-interest or altruism, it fails when the motive involves bonding. This article identifies three motives that involve bonding: i) the preferences regarding friendship and community; ii) the preferences that amalgamate communal bonding with self-interest; and iii) the preferences for distinction and status. These three types of preferences unify the self and other—usually aided by ceremonies of gift exchange and celebratory prizes. This article offers a more complete taxonomy of preferences and, corollary, structures of exchange.
Suis-je aimée ?
Authors: Forest Martyne-Isabel
Published: April 2021

Je suis Alicia, un genre de Belle au bois dormant, qui s’éveille après quelques années de coma, délivrée à la suite d’une grossesse non désirée. Que dire maintenant que je retrouve l’usage de la parole ? Je veux critiquer le récit de Pedro Almodovar, dans Parle avec elle, concernant les conditions d’un accompagnement de qualité. Je m’interroge sur les questions importantes du respect, de l’identité, de l’altérité, de la charité, de l’autonomie, de l’amour et de ses dérives. Toutes des questions qui me sont venues avec force lorsque j’étais endormie et que j’étais l’objet de tant de gestes de la part de Benigno, mon principal infirmier. Je cherche aussi, inlassablement, le sens de ces gestes à travers mon questionnement sur le don et la dette. Quel est l’esprit du don ? Ce que je fais au fond en racontant « mon » histoire ? Je déplace mes regards, candide ou noir, sur la fragilité de l’amour.
Les aidants et leurs proches à l’aube d’une reconnaissance de leurs droits
Authors: Demers Dominique , Legault Lucie
Published: April 2021

Bien que le phénomène de l’aide aux proches ait toujours fait partie de la réalité de la société canadienne, il prend aujourd’hui des proportions plus importantes que jamais. Le vieillissement de la population et la mutation des soins du milieu institutionnel vers le milieu de vie naturel contribuent à l’accroissement du nombre de proches aidants et des responsabilités qu’ils assument. Sous les pressions du milieu, les gouvernements ont amorcé une réflexion sur la reconnaissance du rôle des aidants et le soutien à leur apporter. Cette réflexion a mené à l’adoption de quelques mesures d’aide financière, dont la prestation de compassion mise en place par le gouvernement fédéral en janvier 2004. Quoique nettement insuffisantes, les mesures actuelles visant à soutenir financièrement les aidants et à protéger leurs emplois constituent un début d’action prometteur dans le champ de l’aide aux proches.
« Nous devons un coq à Asclèpios »
Authors: Volant Éric
Published: April 2021

La toute dernière supplique, que, avant de mourir, Socrate adresse à Criton, est étonnante : « nous devons un coq à Asclèpios ». D’où notre intérêt de creuser cette énigme, à l’aide de Platon et de Nietzsche. Grâce au Phédon, Platon nous offre le loisir d’assister à la toute dernière journée de la vie de Socrate et de participer en esprit à son dialogue avec ses disciples. En cours de route, nous apprendrons les vertus thérapeutiques et les effets toxiques de la ciguë, qui causera la mort de Socrate. Le culte d’Asclèpios, dieu de la médecine, vénéré à Epidaure, nous donne la clé de la symbolique du coq. Après avoir présenté l’interprétation de la mort de Socrate par Nietzsche, nous confronterons deux manières d’affronter la mort, celle de Socrate selon les justifications de la raison et celle de Nietzsche selon la vérité du corps.
Le jury
Authors: Hébert Jean-C.
Published: April 2021

Le jury fait partie des institutions que nous nous sommes données au Canada pour assurer notre sécurité collective. Ce texte examine les trois fonctions du jury : le juge des faits, le promoteur d’équité et le garant de la démocratie. Il aborde également les caractéristiques du système de procès par jury : l’impartialité, la représentativité et la compétence.
Faire sens grâce à nos opérations conscientes et à nos communications
Authors: Laflamme Diane
Published: April 2021

La notion de sens joue un rôle d’importance majeure dans la théorie des systèmes sociaux développée par Niklas Luhmann. Cette courte présentation aborde quelques aspects du sens : la distinction entre les systèmes psychiques et les systèmes sociaux, tous deux étant considérés comme constitutifs du sens, les trois dimensions du sens et le processus de généralisation du sens dans des attentes et des structures. La phénoménologie et l’herméneutique sont interrogées en parallèle pour éclairer le vocabulaire que choisit Luhmann pour aborder la notion de sens et pour décrire une forme originale de constitution du sens dans la mouvance de ces théories.