bluuebunny/crossref_metadata_2025 huggingface dataset:
Loyalty Versus Variety: Insights from Hotel Selection Patterns in Australia
Authors: Udunuwara Maduka , Wilkins Hugh
Published: August 2021

This study explores the hotel selection patterns of leisure travellers to understand their loyalty or variety seeking intentions and profile them through their key characteristics, factors that influence their hotel consumption patterns. While data were collected via focus groups, twenty-two participants were purposively sampled based on the criteria-Australian travellers who have been to the same international destination three times or more for leisure. Data analysis used the thematic approach, which commenced with coding by identifying themes. The findings reveal that leisure travellers do seek variety in their hotel selection. It also identified three types of international leisure travellers based on their hotel selection within the same destination. Firstly, the same location within the destination and the same hotel as previous visits. Secondly, the same location within the destination and a different hotel to previous visits and finally, different location within the destination and a different hotel (rather than sticking to a hotel chain).The findings of this study further enrich the understanding of loyalty and variety-seeking behaviour in the accommodation sector. This paper extends the concept of variety seeking behaviour to micro level consumption choices—hotel selection at a destination.
Assessing Green Resorts Attributes Performance on Tourists’ Emotional Intelligence and Future Behavioural Responses: Evidence from Malaysia
Authors: NorAzam Nor RabiatulAdawiyah , Rashid Basri , AziminZainol Noor
Published: August 2021

Tourists will gain pleasurable experiences when engaging with the surrounding environments of their destinations as determined by the ability of resorts to provide and maintain quality products or services to satisfy the needs of travelers as well as create added value to their stay. Therefore, this study aimed to appraise how tourists perceived green resort attributes performance and how personal emotional intelligence could influence their future behavioural response. One hundred and fifty guests were randomly selected who had stayed in three green resorts in Langkawi and Penang to participate in this study. Applying regression analysis revealed a positive relationship between the green resort attributes performance and future behavioural response through emotional intelligence. This study also discovered that international tourists recorded a higher mean score for positive emotions compared to their domestic counterparts. Theoretically, this study enriches the existing literature by providing a deeper understanding of how tourists’ emotions affect their subsequent responses based on the green resort attributes performance. Practically, the findings of this study will be applicable to green resorts in Malaysia as their performance will induce positive emotions that impact the behaviours of tourists towards these resorts in the future, for example, recommending green resorts to their families or friends.
Factors Influence on the Development of Corporate Entrepreneurship on the Large Organizations in Sri Lanka: A Narrative-Based Model
Authors: Divakara Sanath
Published: August 2021

Corporate entrepreneurship is defined as entrepreneurs within the organization, thus corporate entrepreneurs play an imperative role in the growth of organizations. A booming trend in researching the concept of corporate entrepreneurship stimulated the performance of the business lexicon during the past two to three decades. This research focused on the exploration of influencing factors for the development of corporate entrepreneurs in large organizations in the context of Sri Lankan. The study focused on a qualitative approach and conducted in-depth interviews in order to explore first-hand contemporary knowledge in relation to their businesses. Corporate entrepreneurs are identified as the driving arms with business knowledge of the organizations and initiate required implementation aligned to the prevailing market trends. Hence influencing factors imperatively contribute to the development of corporate entrepreneurship in the process of decision making, creativity, innovation and strategic renewal. The study revealed answers to the question of how corporate entrepreneurship develop within the organization and how that effect on organizational growth. The study conducted in-depth interviews selecting ten most prominent corporate entrepreneurs in the large scale industries of the context using purposive sampling and analyzed the transcripts followed to narrative inquiry associating the software NVivo 12. The literature enabled to converge the findings into three areas of individual, organizational and environmental. Derived important themes related to the study scope and context that would enable to enhance to practice as the betterment of the relevant industry.
Plasmacytoid Dendritic Cells Facilitate Th Cell Cytokine Responses throughout Schistosoma mansoni Infection
Authors: Webb Lauren M , Phythian-Adams Alexander T , Costain Alice H , Brown Sheila L , Lundie Rachel J , Forde-Thomas Josephine , Cook Peter C , Jackson-Jones Lucy H , Marley Angela K , Smits Hermelijn H , Hoffmann Karl F , Tait Wojno Elia D , MacDonald Andrew S
Published: August 2021

Plasmacytoid dendritic cells (pDCs) are potent producers of type I IFN (IFN-I) during viral infection and respond to IFN-I in a positive feedback loop that promotes their function. IFN-I shapes dendritic cell responses during helminth infection, impacting their ability to support Th2 responses. However, the role of pDCs in type 2 inflammation is unclear. Previous studies have shown that pDCs are dispensable for hepatic or splenic Th2 responses during the early stages of murine infection with the trematode Schistosoma mansoni at the onset of parasite egg laying. However, during S. mansoni infection, an ongoing Th2 response against mature parasite eggs is required to protect the liver and intestine from acute damage and how pDCs participate in immune responses to eggs and adult worms in various tissues beyond acute infection remains unclear. We now show that pDCs are required for optimal Th2 cytokine production in response to S. mansoni eggs in the intestinal-draining mesenteric lymph nodes throughout infection and for egg-specific IFN-γ at later time points of infection. Further, pDC depletion at chronic stages of infection led to increased hepatic and splenic pathology as well as abrogated Th2 cell cytokine production and activation in the liver. In vitro, mesenteric lymph node pDCs supported Th2 cell responses from infection-experienced CD4+ T cells, a process dependent on pDC IFN-I responsiveness, yet independent of Ag. Together, these data highlight a previously unappreciated role for pDCs and IFN-I in maintaining and reinforcing type 2 immunity in the lymph nodes and inflamed tissue during helminth infection.
High sensitivity C reactive protein level is associated with prognosis in patients with severe coronavirus disease 19 pneumonia
Authors: Zhang Lei , Yu Bilian , Yang Lizhen , Zhang Hong , Huang Guxiang , Tang Liang , Xu Min , Zhou Jienan , Xiao Le , Tang Jianjun , Liu Xianling , Shu Chang , Li* Xin
Published: August 2021

OBJECTIVES:

The objective of the study is to describe the association of high-sensitivity C-reactive protein (hsCRP) in patients with severe coronavirus disease-19 (COVID-19) pneumonia and determine the relationship between hsCRP, prognosis, and other factors.

METHODS:

The hsCRP level and other clinical data of patients with severe COVID-19 pneumonia in Tongji Hospital were retrospectively reviewed. Unpaired t-test and Mann–Whitney test were used to compare difference in data between groups. Spearman analysis was used to analyze the correlation.

RESULTS:

Fifty-seven patients (25 male [43.9%] and 32 female [56.1%]) were included, and their condition was monitored for 28 days. The baseline hsCRP level was 35.5 ± 81.9 mg/L, and the hsCRP level of 49 patients increased (86.0%). Moreover, 45 (78.9%) patients recovered to ordinary/mild COVID-19 pneumonia and 12 (21.1%) progressed to critical COVID-19 pneumonia or continued having severe pneumonia. In the recovered group, the hsCRP level decreased significantly (P = 0.0023). The hsCRP level in the deteriorated group was significantly higher than that of the recovered group (P = 0.0019 and P = 0.0004). ΔhsCRP was significantly correlated with time from onset (P = 0.0151), prognosis (P = 0.0151), ΔD-dimer level (P = 0.0320), Δwhite blood cell count (P = 0.0018), and Δneutrophil count (P = 0.0061).

CONCLUSIONS:

Severe COVID-19 pneumonia is crucial to patient prognosis and manifests high hsCRP levels; decreased hsCRP level is associated with improved patient prognosis, but hsCRP level may not increase in patients with deteriorating conditions. Simultaneous increase in hsCRP and D-dimer levels may indicate risk for venous thromboembolism in COVID-19 patients.
Treatment of posttraumatic infrapopliteal pseudoaneurysm with a physician-modified covered stent
Authors: Zhou Xiang , Qiu Chen-Yang , Li Dong-Lin , Zhang Hong-Kun
Published: August 2021

Infrapopliteal pseudoaneurysms can occur after trauma. In recent years, endovascular repair has been increasingly used to treat infrapopliteal pseudoaneurysms. Nevertheless, there has been no covered stent specifically for small peripheral vessels. Here, we report a case of a 65-year-old male with a pseudoaneurysm of the anterior tibial artery which was managed with a physician-modified covered stent. 6 months after the procedure, the mass had completely disappeared and the vascular anatomy of the calf is well preserved.
Evaluation of Addition of Sodium Bicarbonate to Dexamethasone and Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Orthopedic Procedures
Authors: Kour Loveleen , Sharma Gourav , Tantray Saima Hassan
Published: August 2021

Background:

Peripheral nerve blocks have taken over as the principle technique for upper limb surgeries. A number of adjuvants have been tried individually, but very few studies have investigated the cumulative effect of two or more adjuvants given together along with local anesthetic.

Aim:

This study aimed to evaluate the effect of addition of sodium bicarbonate to dexamethasone and ropivacaine in supraclavicular brachial plexus block.

Settings and Design:

This was a prospective, randomized, double-blind study that comprised 90 American Society of Anaesthesiologist (ASA) 1 and 2 patients posted upper limb orthopedic procedures.

Materials and Methods:

Ninety ASA 1 and 2 patients were selected and divided into three groups of 30 each: Group R received 30 mL of 0.75% ropivacaine plus 4 mL normal saline; Group RD 30 mL of 0.75% ropivacaine, 2 mL normal saline and 2 mL of dexamethasone were given; Group RB 30 mL of 0.75% ropivacaine plus 2 mL of dexamethasone and 2 mL of sodium bicarbonate. Onset and duration of sensory and motor block and postoperative pain scores were studied in each group.

Statistical Analysis:

Student's independent t-test was employed for comparing the continuous variables and Chi-square test for the categorical variables. Kruskal–Wallis test was used for postoperative pain score data.

Results:

Addition of sodium bicarbonate to dexamethasone and ropivacaine quickens onset and prolongs duration of sensory and motor block.

Conclusion:

Sodium bicarbonate produces a synergistic and potentiating effect with dexamethasone as adjuvant in supraclavicular brachial plexus block.
Comparison of Ultrasound-Guided Direct versus Ultrasound-Guided Dart Technique of Radial Artery Cannulation
Authors: Varnitha M. S. , Kumar Ajay , Gupta Priyanka , Yadav Vikas , Agarwal Ankit , Darbari Anshuman
Published: August 2021

Background:

Three different types of cannulation method for radial artery are Direct technique, Seldinger technique, and modified Seldinger technique (Dart). Their comparative efficacy has been studied using palpatory method but not with ultrasound guidance.

Aims:

We compared the efficacy of ultrasound-guided Direct and ultrasound-guided Dart technique of arterial cannulation.

Settings and Design:

One hundred and sixty patients posted for elective surgeries were included in prospective randomized control, single-blind study in a tertiary care center.

Materials and Methods:

The study comprised of two groups: Direct method (n = 80) and Dart method (n = 80), which were compared for the rate of successful cannulation within 5 min. The secondary objectives were time for successful cannulation, number of attempts, and rate of complications (hematoma, posterior wall puncture, and needle reinsertion) between two groups.

Statistical Analysis:

The group comparison for continuously distributed data was compared using the independent sample t-test. The Chi-square test was used for the group comparison of categorical data. Binary logistic regression was conducted to ascertain significant predictors for successful cannulation in 5 min.

Results:

Cannulation success rate was similar in both Direct (57.5%) and Dart (55%) groups. There was no significant difference in time for successful cannulation, number of attempts, number of needle redirection, and posterior wall puncture. However, the incidence of hematoma (Direct 22.5% [18]; Dart 8% [10]) was significant. There was better success rate of cannulation (n = 90) in patients with normal pulse and bigger radial artery lumen.

Conclusion:

There was no significant difference between Dart and Direct technique with the use of ultrasound guidance.
Examination of Spinal Canal Anatomy with MRI Measurements in Lomber Disc Herniation Patients
Authors: Kaydu Ayhan , Andan İbrahim , Deniz Muhammed Akif , Bilge Hüseyin , Başol Ömer
Published: August 2021

Background and Aim:

The aim of this study is to investigate the magnetic resonance imaging (MRI) of patients with lumbar disc herniation (LDH) to identify the challenges associated with neuraxial anesthesia.

Materials and Methods:

The MRI images in the supine position of 203 patients admitted to hospital with complaints of lower back pain were studied. Medial sagittal slices of the lumbar spine were imaged from L1 to S1. LDH is classified as either bulging, extrusion, or protrusion.

Results:

For this study, 83 males and 120 females with a mean age of 43.18 ± 14.68 years were recruited. The highest herniation level was observed at L4–L5 in 145 (71.4%) patients: 76 instances of disc bulging (37.4%), 56 instances of extrusion (27.6%), and 13 instances of protrusion (6.4%). The longest distance between the skin and spinal cord was 60.06 ± 1.61 mm at L5–S1; the longest distance at width of the epidural space was 6.09 ± 1.95 mm at L3–L4. According to the disc herniation groups, no significant differences were found between the skin-to-dura distance, width of the epidural space, and depth of skin level to spinous process (P > 0.05). Moreover, the anterior dura to cord distances was significantly different from normal patients (P < 0.05). Indeed, there was a statistically weak and negative correlation between both the length and age of the lumbar spinal canal (P < 0.05, r = −0.295).

Conclusions:

Lumbar disc pathologies can cause anatomical derangements in the spinal canal, which may cause neurologic deficits by neuraxial blockade.
A Simple Modification of Sphenopalatine Ganglion Block for Treatment of Postdural Puncture Headache
Authors: Bhargava Tanvi , Kumar Abhishek , Rastogi Amit , Srivastava Divya , Singh Tapas Kumar
Published: August 2021

To evaluate the efficacy of modified sphenopalatine ganglion block (MSPGB) to reduce the severity of post-dural puncture headache (PDPH). Five adult patients of both genders with age >18 years having PDPH intractable to conservative management were given modified sphenopalatine block in the postoperative period, and numeric rating scale (NRS) was recorded at regular intervals till the hospital discharge. MSPGB is a simple, noninvasive technique that provides instantaneous symptomatic relief in PDPH.
Sequential Combined Spinal-epidural Anesthesia in a Multiple Comorbidity Patient
Authors: Singh Vishwadeep , Mowar Ashita , Pahade Akhilesh , Karki Geeta
Published: August 2021

Primary total knee joint arthroplasty (TKA) is a frequently performed procedure as part of osteoarthritis treatment. Optimal perioperative analgesia will augment functional recovery, improve knee mobility, and reduce postoperative morbidity. Octa- and nonagenarians undergoing TKA are often considered particularly difficult to manage and involve high levels of competence due to associated comorbidities these patients present with. We report a case of a geriatric patient with coronary artery disease and low ejection fraction with pulmonary fibrosis who underwent successful total knee arthroplasty under sequential combined spinal-epidural anesthesia.
A Comparative Study in Airway Novices Using King Vision Videolaryngoscope and Conventional Macintosh Direct Laryngoscope for Endotracheal Intubation
Authors: Pujari Vinayak Seenappa , Thiyagarajan Balaji , Annamalai Alagu , Bevinaguddaiah Yatish , Manjunath A. C. , Parate Leena Harshad
Published: August 2021

Background and Objectives:

Tracheal intubation using laryngoscopy is a fundamental skill, for an anesthesiologist. However, teaching this skill is difficult since Macintosh direct laryngoscope (DL) allows only one individual to view the larynx during the procedure. Hence, this study aimed to determine whether King Vision® videolaryngoscope (KVL) provides any advantage over direct laryngoscopy in teaching this skill to airway novices.

Materials and Methods:

In this prospective randomized crossover study, Ethical Committee clearance was obtained from the institutional review board (MSRMC/EC/2017) and the study was registered with Clinical Trial Registry. After informed consent, 53 medical students were allotted to perform laryngoscopy and endotracheal intubation on a manikin by using either KVL or Macintosh DL. The participants first performed laryngoscopy with either KVL or Macintosh DL following a brief instruction and then crossed over to the second arm of the study to perform laryngoscopy using the other scope. The primary outcome measure was the time for successful endotracheal intubation. The secondary outcome measures were incidence of esophageal intubation (EI), excess application of pressure on maxillary teeth excess maxillary pressure, and success rate.

Results:

Mean time for endotracheal intubation was significantly faster using KVL than in DL (44.64 vs. 87.72 s; P < 0.001). No significant difference was found in the incidence of esophageal intubation 15.1% in KVL group versus 24.5% in DL group (P = 0.223). In the KVL group, 81.1% did not apply pressure on maxillary teeth versus 26.4% in the DL group (P < 0.001). The success rate of intubation was 100% in the KVL group versus 86.8% in the DL group (P = 0.006).

Conclusion:

The KVL is a more effective tool to teach endotracheal intubation in comparison to Macintosh laryngoscope in airway novice medical students. Clinical trial registry India registration number: CTRI/2017/11/010491.
Clinical Features and Outcome of Stroke with COVID-19. COVID-19 Stroke Study Group (CSSG), India
Authors: Bhatia Rohit , Padma Srivastava M. V. , Sylaja P. N. , Komakula Snigdha , Upadhyay Ashish , Pardasani Vibhor , Iype Thomas , Parthasarathy Rajsrinivas , Reddy Rajshekhar , Kushwaha Suman , Roy Jayanta , Satish P , Trikha Anjan , Wig Naveet , Dhar Lalit , Vibha Deepti , Vishnu Venugopalan Y. , Pandit Awadh Kishore , Gupta Anu , Elavarasi A , Agarwal Ayush , Gupta Vipul , Singh Rakesh K. , Oza Harsh , Halani Hiral , Ramachandran Dileep , George Githin B. , Panicker Praveen , Suresh MK , Kumaravelu S , Khurana Dheeraj , Rajendran Srijithesh P. , Pamidimukkala Vijaya , Gupta Salil , Pandian Jeyaraj D. , Chowdhury Debashish , Rai Nirendra K. , Sharma Arvind , Nambiar Vivek K.
Published: August 2021

Background and Purpose:

Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19.

Methods:

The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019. The present study reports patients of stroke with and without COVID-19 (CoVS and non-CoVS, respectively) seen between February 2020 and July 2020. Demographic, clinical, treatment, and outcome details of patients were collected.

Results:

The mean age and gender were comparable between the two groups. CoVS patients had higher stroke severity and extent of cerebral involvement on imaging. In-hospital complications and death were higher among CoVS patients (53.06% vs. 17.51%; P < 0.001) and (42.31% vs. 7.6%; P < 0.001), respectively. At 3 months, higher mortality was observed among CoVS patients (67.65% vs. 13.43%; P < 0.001) and good outcome (modified Rankin score [mRS]: 0–2) was seen more often in non-CoVS patients (68.86% vs. 33.33%; P < 0.001). The presence of COVID-19 and baseline stroke severity were independent predictors of mortality.

Conclusions:

CoVS is associated with higher severity, poor outcome, and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and baseline stroke severity are independent predictors of mortality.
Delayed Thrombectomy Firing the Last Shoot
Authors: Shahat Mohammed , Elayoon Hesham Abo
Published: August 2021

Cervical carotid artery not common entity trauma, especially the blunt one. here, we are presenting a case of animal bite in the neck which caused internal carotid artery (ICA) thrombosis ICA. The patient showed rapid deterioration in the first 24 h that make us obliged to do thrombectomy patient show partial improvement after the surgery. ICA delayed thrombectomy may play role in the management of late ICA thrombosis.
A Rare Neck Mass
Authors: Singh Devender , Anurshetru Basavarajendra , Aryala Shalini
Published: August 2021

Intraluminal primary tumors of the body veins are rare clinical entities with few cases have been reported in the literature. Hemangiomas as a primary tumor, arising in the jugular vein are extremely rare. We present a case of right neck mass, was initially treated as venous thrombosis and finally diagnosed with hemangioma of external jugular vein on histopathological examination. Although rare, this case highlights the need of suspicion of a vascular tumor in cases of neck swelling for proper investigation and treatment.
Iliac Vein Stenosis and Venous Hypertension after Polytetrafluoroethylene Arteriovenous Loop Graft in the Thigh for Hemodialysis Access
Authors: Sekar Natarajan , Kanagasabai Kamala Sekar
Published: August 2021

Central venous stenosis occurs commonly as a complication of central venous catheterization. It is most often seen after arteriovenous (AV) graft or proximal AV fistula in the ipsilateral upper limb. Iliac vein stenosis after thigh AV graft has not been reported in the literature. Successful endovascular management of an iliac vein stenosis after AV loop graft in the thigh is presented here.
Use and Adherence to Oral Anticoagulants in a Tertiary Care Hospital
Authors: Pradhyumna M , Faruqui Atiya Rehman , Joshi Sunil S
Published: August 2021

Background:

In patients at risk of thromboembolism, oral anticoagulants (OAC) are effective, but there are limited data from India on OAC use and adherence. This study in a tertiary care hospital aims to record the pattern of prescription of OAC and medication adherence over 6 months.

Materials and Methods:

Medications prescribed were recorded, and a follow-up at 3 and 6 months was done to record outcomes and adherence to medication. Modified Morisky medication adherence scale (MMAS-8) was used and compliance to monthly International Normalized Ratio (INR) monitoring was recorded.

Results:

Of the 140 patients included, mean age was 55.32 (±18.04 years), and 84 (60.0%) were males. Indications for OAC were deep vein thrombosis 64 (45.7%) and atrial fibrillation 42 (30.0%). After initial injectable anticoagulants, majority of patients were shifted to Vitamin K antagonists. Most common OAC was nicoumarol 73 (52.1%), followed by warfarin 43 (30.2%), dabigatran 12 (9.2%), and apixaban 12 (9.2%). Over 6 months, 12 patients were lost to follow-up and 16 (11.4%) deaths were recorded. Monthly INR was done by 23 patients till the 3rd month but only by five patients between 3rd and 6th month. By the 3rd month, 19 (86.3%) and between 3rd and 6th month 4 (13.7%) patients were nonadherent. At 6th month, 78 (86.6%) had a MMAS-8 score of 8 (high adherence). The presence of a caretaker in 37 (41.2%) emerged as the most important factor contributing to adherence.

Conclusion:

Early identification of patient-specific barriers for INR monitoring and adherence to medications should be sought in patients with thromboembolism.
Lower Limb Vascular Anomalies and Malformations with Contrast-Enhanced Magnetic Resonance Angiography
Authors: Kiran S Krishna , Shaji PC , Rajendran Sunil , Gopinath TN , Jagdish J
Published: August 2021

Contrast-enhanced magnetic resonance angiography is a valuable technique in the assessment of vascular anomalies of the lower limb. This is an ideal investigation in children and young adults as it is non-invasive and poses no radiation risk. We present a series of cases to highlight this.
Premedication with intravenous midazolam for neonatal endotracheal intubation
Authors: Badiee Zohreh , Zandi Hamed , Armanian Amirmohammad , Sadeghnia Alireza , Barekatain Behzad
Published: August 2021

Background:

Pain during the neonatal period has been associated with immediate and long-term adverse effects. One of the most frequent painful procedures that neonates face in neonatal intensive care unit is the endotracheal intubation. Midazolam has been a candidate for premedication before neonatal intubation. Our aim was to evaluate the effects of midazolam as the premedication on endotracheal intubation of premature infants during surfactant administration.

Materials and Methods:

In a double-blind clinical trial, 80 preterm infants were undertaken for tracheal intubation following the use of atropine associated to either midazolam or placebo. Patient's vital signs and general conditions were constantly monitored, and pain was assessed using premature infant pain profile (PIPP) score.

Results:

The mean ± standard deviation for postnatal age was 95.38 ± 50.04 and 111.63 ± 49.4 min in control and midazolam groups, respectively. The patients in the midazolam group had significantly better outcomes across several intubation outcome measures such as duration of endotracheal intubation (23.5 ± 6.7 vs. 18.8 ± 4.8 s, P = 0.001), oxygen saturation level (88.05% ±13.7 vs. 95.1 ± 1.8%, P = 0.002), intubation failure (34.2% vs. 2.5%, P = 0.0001), awake and resistance during intubation (95% vs. 20%, P = 0.0001), and excellent patient condition during intubation (0% vs. 82.5%, P = 0.0001). In addition, PIPP score was significantly lower in the midazolam group (5.2 ± 2.06 vs. 12.9 ± 2.9, P = 0.0001).

Conclusion:

Premedication with midazolam in newborns before intubation, can hold promising effects that manifests as better overall outcomes, less complications, better vital signs, more comfortable situation, and lesser pain for these patients.
Trends of human brucellosis in Central Iran (2010–2018)
Authors: Khalilian Mohammad-Sadegh , Ramazanpour Javad , Hosseini Sayed Mohsen , Narrei Sina , Zeinalian Mehrdad
Published: August 2021

Background:

Brucellosis is one of the most common infectious diseases worldwide which is caused by direct contact with affected animals or their products. It puts a huge impact on the economy, society, and the environment. Iran is the fourth endemic country for brucellosis in the world. It has been described a new epidemiological feature of the disease and its trends in Isfahan province, as one of the endemic areas of brucellosis in Central Iran.

Materials and Methods:

This is a cross-sectional, population-based study. Data collection was performed using epidemiological questionnaires through Epi-2006 software from the private and public sectors in 22 districts of Isfahan province over 9 years (2010–2018). The results were obtained by the description statistics using the SPSS Statistics software version 20 (SPSS Inc., Chicago, IL, USA).

Results:

Altogether, 5751 new brucellosis patients were recorded over 9 years. About 70% of these cases were male. The majority of cases had occurred in the age group of 21–30 years. The average incidence of brucellosis over the 9 years was 14.1 cases/100,000 population including 8.8 in the urban versus 45.2 cases in the rural areas. During the 9-year study period, the incidence of brucellosis was increased between 2010 and 2014. From 2014 to 2017, the trend has been decreasing, but in the last year of the study, the trend has been increasing again. Seasonally, the incidence rate was variable between the lowest from October to January and the highest from June to July.

Conclusion:

According to the fluctuation of incidence trend of brucellosis during the 9-year study period in Central Iran, it seems some policy changes regarding to the control and prevention of brucellosis have a role, changes that should be fixed and corrected.
Translation and linguistic validation of the Persian version of the International consultation on Incontinence Questionnaire Vaginal Symptoms
Authors: Pourmomeny Abbas Ali , Foolad Farnaz , Sedighmehr Njmeh , Zargham Mahtab , Sharifiaghdas Farzaneh
Published: August 2021

Background:

There is no validated measurement tool to assess vaginal symptoms (VS), sexual matter (SS), and quality of life (QOL) among Persian-speaking women. This study aimed at translating and assessing the validity and reliability of the Persian version of the International Consultation on Incontinence Questionnaire for Vaginal Symptoms (PICIQ-VS).

Materials and Methods:

In this cross-sectional study, after obtaining permission from the International Consultation on Incontinence Questionnaire (ICIQ) Advisory Board, the English version of ICIQ-VS was translated into Persian per a standard translate and back translate process, and the validity and reliability were studied. Two hundred women with and without pelvic organ prolapse were asked to complete the PICIQ-VS (mean age: 52.1, range: 22–84 years). A panel of 10 experts evaluated the content and face validity of the questionnaire. Cronbach's alpha examined the internal consistency reliability of the measure. To evaluate the test–retest reliability, we redistributed the questionnaire among 30 patients 2 weeks after their initial visit using intra-class correlation coefficient (ICC).

Results:

Content and face validity of the questionnaire was confirmed after some light modification (content validity ratio ranged from 0.69 to 1.00, and content validity index ranged from 0.79 to 1.00). PICIQ-VS showed an acceptable internal consistency and stability reliability (VS: α = 0.64, ICC = 0.84; SM: α = 0.69, ICC = 0.88; and total scale: α = 0.72, ICC = 0.91, respectively). Significant differences were observed between the asymptomatic and symptomatic groups for VS and the total score (P < 0.05).

Conclusion:

In the light of the results, interestingly, PICIQ-VS could be utilized as a valid and reliable tool to assess the VS among Persian-speaking women, both in research and clinical practice.
A Rare Case of Melkersson–Rosenthal Syndrome
Authors: Verma Rajesh , Anand Rohit
Published: August 2021

Melkersson–Rosenthal syndrome (MRS) is a rare clinical syndrome. The onset of illness usually occurs in the second decade of life. It is characterized by idiopathic facial paralysis and/or fissured tongue with oro-facial swelling, mainly lip edema. The diagnosis is mainly clinical as the biochemical marker is not ascertained. The isolated facial palsy can mimic various other clinical entities including Bell palsy. The treatment guidelines for MRS are not mentioned in the literature, due to the paucity of randomized clinical trials, which could not happen because of its rarity. However, steroids are effective in this condition. This case report highlights the case of MRS with the typical triad of features, which is quite rare.
Project CommUnity
Authors: Camps-Romero Eduardo , Brown David R. , Castellanos Daniel
Published: August 2021

The COVID-19 (coronavirus) pandemic and its consequences have seriously affected Americans' physical and mental health. We developed Project CommUnity, an integrated individual and population health response to the COVID-19 pandemic based on the preexisting foundational principles of the Florida International University Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP). NeighborhoodHELP identifies and addresses the social determinants of health (SDOH) that can improve the health outcomes for household members by emphasizing social accountability and interprofessional education while providing patient and household-centered care. A lack of pandemic related mental health literature led us to build on a disaster mental health framework that is informed by our community resulting in the elaboration of specific concerns and our program's responses to them. Integrating the systematic assessment of SDOH and addressing these factors as a routine component of clinical care has the potential to improve the health of our underserved patients. We discuss how NeighborhoodHELP has mobilized to address the psychosocial needs of our households by expanding upon our existing programming and providing a range of tailored services in response to the current crisis. It is our aim to present how a social understanding of the current disaster can guide the development of an integrated health care response, focusing on the needs of low-income minority households who are disproportionately affected and least equipped to respond to the burdens suddenly imposed on them.
Could Our Species Usefully Become Social Psychiatry's 21st Century Scientific Concern?
Authors: Becker Robert E.
Published: August 2021

General Purpose:

To identify evolved human social traits that undermine effective interventions against social, environmental, and other threats to health, wellbeing, and survival of individuals and our species.

Methods:

To identify destructive individual and group social behaviors, the author surveyed 21st century interpretations of behavioral issues raised in primatologists studies of chimpanzees and bonobos. Drawing from a wide range of physical and social sciences, he then selected specific issues regarding health, wellbeing, and survival for study in humans. To test functionality, concepts were challenged for implications. To explore practicality, applications were identified and models for possible clinical and policy use were developed.

Results:

Analyses identified specific impediments to effective human responses to threatening or otherwise challenging circumstances and their implications. Using two models for psychiatric interventions, the author explored potentials for intervention against the involved dysfunctional behavioral traits.

Conclusions:

An evolutionary biological phylogenetic focus clarifies why humans experience dysfunctional traits as a result of evolution. This provides a broader, important grounding for further psychiatric research and development of interventions.
Beliefs Related to COVID-19 Infection
Authors: Sahoo Swapnajeet , Pattnaik Jigyansa Ipsita , Padhy Susanta Kumar , Mehra Aseem , Panigrahi Mahima , Nehra Ritu , Grover Sandeep
Published: August 2021

Aim:

To evaluate the prevalence of specific beliefs held by people with respect to SARS-2-CoV (COVID-19) infection.

Study Design:

Web-based cross-sectional survey by using nonprobability snow-balling sampling technique.

Methodology:

The survey-specific questionnaire designed based on the review of literature on the prevailing myths/beliefs was circulated by an online cross-sectional survey through the SurveyMonkey® platform using the WhatsApp®, both individually and through the WhatsApp groups, by using a nonprobability snow-balling sampling technique.

Results:

1695 people participated in the survey, of which 1636 responses were found to be complete and were analyzed. The mean age of the participants was 34.55 years, and two-thirds of the participants were males (n = 1092). About one-third of the participants were educated up to graduation (32.1%), and about one-fifth were healthcare workers. Incorrect beliefs related to various preventive aspects, modes of spread of infection, and treatments were present in a significant proportion of people, with a wide variation for specific issues. When the number of participants with at least one incorrect belief related to any of the aspects of COVID-19 infection was evaluated, except for four participants, all the participants reported at least one incorrect belief. Male and female participants differed significantly in few beliefs.

Conclusions:

This survey highlights a widespread prevalence of myths/misconceptions in society regarding various aspects of COVID-19 infection, which warrants more focus on awareness programs.
52 Years of Lassa Fever Outbreaks in Nigeria, 1969–2020: An Epidemiologic Analysis of the Temporal and Spatial Trends
Authors: Agbonlahor Dennis E. , Akpede George O. , Happi Christian T. , Tomori Oyewale
Published: August 2021

The year 2020 made 52 years since the first report of Lassa fever (LF) outbreaks from Nigeria, but what progress has been made in its control? We sought to answer this through an epidemiologic analysis of the temporal and spatial trends of the outbreaks from 1969 to 2020. The analysis showed an overall strengthening of the outbreaks, hallmarked by the change from irregular to regular annual and from limited local to nationwide outbreaks, while there was a sharp contrast between the upward trend in case numbers and downward trend in case fatality. Pending the availability of effective vaccines, greater effort is required to reverse the upward trend in case numbers and sustain the downward trend in case fatality. We discuss the factors associated with the observed trends as well as the prerequisites for further improvements.
Evaluasi Penerapan Konsep Ekowisata di Kampung Wisata Arborek, Raja Ampat
Authors: Tampubolon Novelina , Marampa Maria Mardia , Bato Marjan
Published: August 2021

Evaluasi penerapan konsep ekowisata pada sebuah destinasi wisata dinilai penting dalam menjaga keberlanjutan pengelolaan wisata. Kampung wisata Arborek tmerupakan salah satu kampung wisata terbaik di Raja Ampat sehingga pemilihan sebagai lokasi penelitian dirasa tepat untuk mengevaluasi penerapan konsep ekowisata pada setiap kegiatan wisata sehingga eksistensi Kampung W isata Arborek tetap terjaga. adapun tujuan penelitian ini adalah mengevaluasi penerapan konsep ekowisata di kampung wisata Arborek. Data diambil menggunakan kuisioner closed ended selanjutnya dianalisis dengan menggunakan metode One Score One Criteria Scoring System. Hasil penelitian menunjukkan bahwa pengelola wisata di Kampung Wisata Arborek telah memahami konsep ekowisata; memiliki keunikan dan ciri khas, adanya daya dukung masyarakat, pemerintah dan memiliki nilai jual. Sama halnya dengan persepsi masyarakat yang menyatakan bahwa dari sisi keadaan kampung, dampak kegiatan wisata bagi masyarakat dan fasilitas wisata rata-rata memiliki skor 6 yang artinya adalah baik. Persepsi yang sama diutarakan oleh wisatawan dari sisi fasilitas dan aksesbilitas yaitu skor 6 (baik) sedangkan untuk aspek atraksi wisata wisatawan menyatakan skor 7 yang artinya sangat baik. Secara umum, Kampung Wisata Arborek telah menerapkan konsep ekowisata dengan baik, Namun untuk menjaga keberlanjutan kegiatan wisata diperlukan kerjasama antar stakeholder yang terlibat (masyarakat, pemerintah dan NGO) sehingga keberlanjutan Kampung Wisata Arborek tetap terjaga.
Diversity of Fish Species in Several Sites Along the Brantas River East Java Indonesia
Authors: Ahmad Nuril , Hakim Luchman , Retnaningdyah Catur , Yanuwiadi Bagyo
Published: August 2021

The purpose of this study is to describe the presence of species diversity and composition in Bratas River. Fish sampling was conducted in dry and rainy seasons in five locations, namely Batu City, Blitar City, Tulungagung regency, Jombang Regency, and Mojokerto Regency, East Java. This study collected 295 individual fishes belonging to 12 species. The 162 individuals were obtained in the dry season, while 133 individuals were captured in rainy season. The most dominant species was mujahir (Oreochromis mosambica) followed by keting (Mystus paniceps) and kutuk (Channa striata). The fish abundance significantly varied among study sites, while that of species richness and diversity did not differ significantly. Fish diversity in high elevation was the lowest, while that in relatively middle elevation was the highest. Compared to the previous report, fish species diversity in Brantas was decreasing, some species were not found. Three species were considered as exotic include Oreochromis mosambica, Clarias batracus, Oreochromis niloticus.
Učinkovitost sljedeće generacije sekvenciranja u dijagnostici bakterijskih zoonoza
Authors: Duvnjak Sanja , Vaser Robert , Spičić Silvio , Reil Irena , Zdelar-Tuk Maja , Šikić Mile , Križanović Krešimir , Pavlinec Željko
Published: August 2021

Brucella , an extremely diverse but yet genetically highly homogenous genus of bacteria, has been a puzzle for scientists for many decades. These bacteria remain a prominent public health issue, particularly in the Balkan region. Correctly identifying and understanding the pathogen is a vital step in the epidemiology and epizootiology of any bacteria. Identification can be challenging, especially in the case of zoonotic species. This study aimed to implement fourth-generation sequencing in the typing of 11 Brucella suis strains kept in our archive and to compare this method to the classical and non-sequencing based molecular methods used to date. Classical biotyping is highly subjective and gave inconclusive results for 3 strains. Molecular methods used were multiplex PCR and RFLP methods since no one method can identify both species and biovar which is vital in the case of Brucella suis infections. Species and biovars of all the strains were successfully confirmed and in concordance with biotyping results. Oxford Nanopore long-read sequencing was used on a MinION device for next-generation sequencing (NGS). Various algorithms were implemented for genome assembly and BioNumerics 8.0 software was used for MLST identification and analysis. MLST 21 was used for biovar identification and epidemiological comparison of tested strains. The assembled genomes were 3,2 Mb in size and assembled into two chromosomes. MLST 21 analysis placed our strains into species and biovar clusters in concordance with other molecular tests used. To the extent of our knowledge, this is the first documented use of long-read sequencing in Brucella suis identification in this region. We conclude that bacteriological biotyping is outdated and host-specific identification in this genus is incorrect and that molecular characterisation is always the safer, faster and more suitable option. MinION sequencing proved to be a strong, accessible solution for species determination. Future study is required to determine how detailed genome information it can give, considering the error rate.
Relation Between Payer Source and Functional Outcomes, Visits and Treatment Duration in Patients with Lumbar Dysfunction
Authors: Nof Leah , Rone-Adams Shari , Hart Dennis
Published: August 2021

Background: The differences in the utilization of healthcare services and resultant charges for symptoms like back pain has necessitated those payers of healthcare services in the United States (US) make efficient decisions relative to resource utilization. Studies involving both public and private payers of healthcare services in the United States have shown that payer source makes a difference in utilization of resources and patient outcomes. With the current focus on efficient and effective treatment, further research is needed on the relationship between payer source and patient outcomes. Purpose:To examine the association between payer source and number of visits, duration of treatment, and discharge functional status (FS) for patients with lumbar dysfunction who received physical therapy (PT) services. Methods: This retrospective study used secondary analyses of the Focus On Therapeutic Outcomes, Inc. (Knoxville, TN, USA), database that contained FS measures, number of visits, and treatment duration. Data were analyzed from 16,977 patients who received PT for lumbar dysfunction. Patient self-report surveys were used to estimate risk-adjusted FS at discharge. Therapists reported number of treatment visits and calendar days of treatment duration. Results: Patients receiving benefits from indemnity insurance and managed care plans (private funding) reported the highest risk-adjusted discharge FS measures. Patients receiving benefits from Medicaid (public funding) reported the lowest discharge FS measures and least number of visits. Patients receiving benefits from Workers’ Compensation and patients involved in litigation had the longest treatment duration and highest number of visits. Conclusion: Results suggest that patients receiving benefits from different payers of healthcare services may differ in utilization of resources and outcomes. Further study is needed across a variety of diagnoses and payer sources to investigate the effect of payer source on utilization of physical therapy services and patient outcomes.
Can Human Patient Simulators be used in Physiotherapy Education?
Authors: Jones Annette , Sheppard Lorraine
Published: August 2021

Purpose: The purpose of this study was to review the evidence for the use of human patient simulators in physiotherapy education. Method: A review of the physiotherapy literature was undertaken. Due to the lack of studies found the search was expanded to include health professional education. Exclusion criteria were then applied to the identified literature and critical appraisal undertaken. Results: Due to the differences in methodology employed in the studies identified a meta-analysis could not be performed. The studies identified repeat practice and the ability to control the learning environment as positive aspects for learning using human patient simulators. In medical education psychomotor skills improved when simulators where used. Conclusions: Conclusions were not able to be drawn regarding whether the use of human patient simulators leads to improved patient management in a clinical environment especially in the field of physiotherapy. A controlled study investigating cardiorespiratory physiotherapy clinical performance is recommended to determine whether human patient simulators should be used in physiotherapy education